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The development of babies whose families are homeless can easily be affected by their uncertain living arrangements. The PACT Therapeutic Nursery's attachment-based, trauma-informed, mindfully focused family interventions help these children and families move beyond the trauma of shelter living. In the past year, Nursery clinicians have infused Fussy Baby Network concepts into their daily interactions with families and into a parent and child regulation activity, the mindful awareness play session. The result has been more productive levels of parental self-reflection, calm, and joy in parent-child interactions.

Sensitive parenting and secure attachment can serve as protective factors against developmental risks associated with high-risk environments such as homelessness and shelter living. This article describes a program for mothers with children from birth to 3 years old whose families are living in shelters and who are enrolled in PACT: Helping Children With Special Needs' Therapeutic Nursery program. The authors describe the interventions designed to increase positive parenting behaviors to foster healthy parent-child interaction, and then present a research study that examines how maternal participation in these interventions is related to improved parent-child interaction.

PACT: Helping Children with Special Needs, an affiliate of the Kennedy Krieger Institute in Baltimore, Maryland, operates a therapeutic nursery that serves families who have at least one child from birth to 3 years of age, and who are living in a Baltimore City homeless shelter. In partnership with the Martin Luther King Early Head Start Program and the University of Maryland Medical System, PACT Therapeutic Nursery provides high-quality child care while parents look for housing and employment. The Therapeutic Nursery also offers mental health, nursing, speech and language therapy, occupational therapy, and physical therapy evaluations and interventions for the children. The homeless children in the nursery demonstrate language delays, delay in the development of imaginative play, and difficulty in their attachment relationships. The nursery's Wee Cuddle and Grow program uses the Nursing Child Assessment Satellite Training (NCAST) tool to strengthen parent-child relationships with interventions that are designed to decrease separation anxiety, improve parent-child communication, and help children express their feelings constructively through play. A retrospective study of 99 mothers and their children found that NCAST scores increased over the course of time spent in the therapeutic nursery.