Susan Woodhouse: ‘Good Enough’ Parenting is Good Enough


Staff member
New research finds that caregivers need only 'get it right' half the time when responding to babies’ need for attachment to have a positive impact on a baby.

Amy White
May 09, 2019
Susan Woodhouse
What really matters in caring for babies may be different than commonly thought, says Lehigh researcher Susan S. Woodhouse, an expert on infant attachment. In new research, she finds that caregivers need only “get it right” 50 percent of the time when responding to babies’ need for attachment to have a positive impact on a baby. Securely attached infants are more likely to have better outcomes in childhood and adulthood, and based on Woodhouse’s potentially paradigm-shifting work, there is more than one way to get there, particularly for low socioeconomic-status families.

Woodhouse, an associate professor of counseling psychology, studied 83 low socioeconomic-status mothers and infants at ages 4.5 months, 7 months, 9 months and 12 months to observe and assess attachment. Infants and mothers in the study were racially and ethnically diverse, and infants were selected for high levels of temperamental irritability.
Her findings are detailed in “Secure Base Provision: A New Approach to Examining Links Between Maternal Caregiving and Infant Attachment,” which appears in the journal Child Development, co-authored with Julie R. Scott of Pennsylvania State University, Allison D. Hepsworth of the University of Maryland School of Social Work, and Jude Cassidy of the University of Maryland.
The study scored mother-baby pairs based on a mother’s responses to the infant while the baby was crying and not crying to assess the qualities of “secure base provision.” This framework focuses on aspects of caregiving that tell an infant about the caregiver’s availability to serve as a secure base, such as soothing to cessation of crying and providing a present and safe base from which to explore.
Researchers found that this framework significantly predicted infant attachment, and that babies learned their mothers were providing a secure base when mothers responded properly at least 50 percent of the time.
“The findings provide evidence for the validity of a new way of conceptualizing the maternal caregiving quality that actually works for low-income families,” Woodhouse said.
What is Infant Attachment and Secure Base Provision?
Infant attachment is the bond infants form with their primary caregiver. A secure attachment allows babies to feel safe, which gives them both comfort in times of distress and the ability to explore, knowing they can return to their secure base when needed. Attachment is an infant’s first bond with important caregivers and a critical phase in development, with a major impact on emotional and social development.
Numerous studies have shown the importance of secure infant attachment to developmental outcomes. But, for the past 30 years, the actual building blocks leading to attachment have been unresolved. Caregiver “sensitivity”—the ability to accurately interpret infant needs and to respond promptly and appropriately—was shown to be a key predictor of attachment. But studies showed sensitivity accounts for a surprisingly low percentage of variation in attachment, and has an even lower impact among families with low socioeconomic status.
“That’s a real problem, because low-income babies face the most amount of risk, toxic stress and other factors that go along with being low income,” Woodhouse said. Data suggest secure attachment may serve a protective function in children’s socio-emotional development when in a context of high risk. Secure attachment is associated with better mental health outcomes in both childhood and adulthood—including less incidence of externalizing behaviors such as acting out and internalizing behaviors such as depression and anxiety—as well as greater school readiness.
“If we want to give advice to parents about what they can do to give their baby the best start in life, it would be really good to know what helps a baby to be secure,” Woodhouse said.
Woodhouse’s study seeks to address this critical gap in understanding what leads to secure attachment, through examining whether a new conceptualization of caregiving behavior, “secure base provision”—the degree to which a caregiver is able to meet an infant’s needs on both sides of the attachment-exploration continuum—predicts attachment security in infants. It is the first time this conceptualization has been tested separately from sensitivity and as a predictor of infant attachment. The new way of conceptualizing caregiving focuses on the aspects of caregiving that theoretically should be most important to building infant attachment because of what an infant can learn from them about a caregiver’s availability to serve as a secure base for the infant—both when the infant needs comforting and when the infant is focused on exploring.
Differences Between Secure Base Provision and Sensitivity
As frameworks, both sensitivity and secure base provision look at how caregivers perceive, interpret and appropriately respond to infant signals; and, in both, important infant signals occur at each end of the attachment-exploration continuum. But secure base provision looks only at certain key infant signals and more specific caregiver responses. It also focuses much less on prompt response and more on crying resolution (the ratio of infant crying episodes that end in chest-to-chest soothing until the infant is fully calmed, regardless of promptness).
Secure base provision also does not consider attunement to a baby’s state and mood in a moment-by-moment manner, as the sensitivity framework does. “Attunement is not key because the focus is on what the infant learns about his or her ability to, in the end, recruit the caregiver when needed—even in the context of a fair degree of insensitive behavior,” such as not picking up the baby right away, or saying, “Come on, don’t cry,” to the baby, the researchers said. “It is this infant learning about the availability of the caregiver to be recruited to provide a secure base (more often than not) that is central to the construct.”
Specifically, secure base provision looks at the degree to which a parent, on average, soothes a crying infant to a fully calm and regulated state while in chest-to-chest contact. “It is at the end of each crying episode that the infant learns about whether, on average, the caregiver can be counted on to be available as the infant achieves a calm state or whether the infant typically must stop crying alone,” the researchers said.
During infant exploration and other times when the infant is not distressed, the secure base provision approach focuses on whether the caregiver allows exploration to occur without terminating or interrupting it—for example, by making the baby cry through play that is too sudden or rough—and on “calm connectedness,” which communicates the mother’s ongoing availability if needed for regulation or protection: “I am here if you need me, and you can count on me.”
In addition, there are behaviors that caregivers must not do, either when the baby needs comfort or during exploration, in order for secure base provision to occur. Specifically, caregivers must not frighten the baby or fail to protect the baby when real hazards are present, such as another child who is too rough.
Secure Base Provision 8 Times More Effective at Predicting Attachment
The study scored mother-baby pairs based on maternal responses to the infant during episodes of infant crying and maternal responses outside of infant crying episodes. A separate group in another lab also scored for the commonly used sensitivity framework.

The researchers found the new maternal caregiving concept of secure base provision correlated significantly with infant attachment security: Mothers who had higher scores on secure base provision were more likely to have more securely attached infants, with an effect eight times larger than that of sensitivity, based on a meta-analysis of findings for low socioeconomic-status families. This was true, even after controlling for maternal sensitivity. They also found that “maternal sensitivity” did not significantly predict infant attachment security.

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