A descriptive Study of a Community-Based Home-Visiting Program with Preschool Children Prenatally Exposed to Alcohol.

Background Research suggests that prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorder (FASD) increases the risk of insecure caregiver-child attachment and related negative child emotional-behavioural outcomes. Research also shows positive effects of attachment-focused interventions in preventing disrupted caregiver-child attachment relationships; however, such interventions have not been specifically adapted for children with FASD. Objectives This paper describes the implementation, challenges, and results of a community home-based attachment intervention, Circle of Security (R) (COS), with preschool children affected by PAE/FASD in Manitoba, Canada. Methods Twelve caregiver-child dyads completed the FASD adapted COS intervention. Children's ages ranged from 2-5 years. Results Results support a positive influence of this individualized intervention on child behaviour and parent efficacy. There was a significant reduction in parent stress that was maintained at 3-month follow-up, and a clinically significant reduction in child behavioural issues was noted. Children showed increased ability to communicate their needs more effectively to their parent. Parents also showed an improvement in their ability to attend to their child's cues. Conclusions This study supports the use of community home-based attachment intervention for caregivers of children with PAE/FASD.