The impact of a mother–infant intervention on parenting and infant response to challenge: A pilot randomized controlled trial with adolescent mothers in El Salvador

ABSTRACT A pilot randomized controlled trial (RCT) was conducted in El Salvador of an intervention (‘Thula Sana’) previously shown to enhance maternal sensitivity and infant security of attachment in a South African sample. In El Salvador, trained community workers delivered the intervention from late pregnancy to 6 months postpartum as part of a home‐visiting programme. The sample comprised 64 pregnant adolescent women, aged 14–19 years, living in predominantly rural settings. They were randomised to receive either the intervention or normal care. Demographic information was collected at baseline and, immediately post‐intervention, blind assessments were made of parental sensitivity and infant emotion regulation. The intervention was found to have a substantial positive impact on maternal sensitivity. Further, compared to control group, infants in the intervention group showed more regulated behaviour: in a social challenge task they showed more attempts to restore communication, and in a non‐social challenge task they showed more social and goal‐directed behaviour. This replication and extension of the South African findings in a small El Salvador sample shows promise and justifies the conduct of a large‐scale RCT in a Central or South American context.