Causal Effects of Enhanced Parenting on Resting-State Graph Properties of Adolescents at Risk for Maltreatment.

Background: In this study, we investigated the sustained causal effects of enhanced early caregiving quality on adolescent brain network properties approximately 11 years after families received an attachment-based parenting intervention. Methods: Participants included 60 adolescents whose parents were referred by Child Protective Services (CPS) because of risk for child maltreatment and 35 adolescents from families without a CPS history (total Results: Graph-theoretical analyses were completed with intervention status as the group-level predictor of interest. Adolescents who received the ABC intervention exhibited distinct global and local network properties compared with the DEF group. The ABC group demonstrated lower current-flow global efficiency and more hierarchical structure, indicating intervention-driven modulation of connectome-wide neurodevelopmental outcomes. Node-specific analyses also indicated intervention effects on clustering coefficients and communicability distances in frontal, limbic, and parietal cortices, suggesting nuanced effects of early interventions on local network properties. Exploratory moderation analyses revealed associations between brain network metrics and externalizing symptoms in the DEF group-indicative of neurobiological risk-that were absent in the ABC and low-risk groups. Conclusions: The results suggest that the ABC intervention causally shapes the development of the resting-state connectome and associated regulatory health, offering insights into the neural pathways through which early enhanced care may get under the skin of at-risk adolescents.