Korteland C, Cornwell J R
Neumann College, Aston, PA 19014.
Child Health Care. 1991 Winter;20(1):56-61. doi: 10.1207/s15326888chc2001_9.
With the passage of P.L. 99-457 in October of 1986, the field of early intervention has been faced with the challenge of broadening its scope (Silber, 1989). This legislation expanded early intervention from a child-centered service to a service offered to families within a variety of contexts; from a service for children with special needs to a service available to families as soon as risks are identified. New programs are being designed and developed with an interagency focus which serve not only children with developmental disabilities but also their families in health, education and social services (Cornwell and Thurman, 1990). Current legislation suggests that services should be available to families as soon as their children are identified as being at-risk (Smith, 1987). In response to the legislation, states are developing definitions of "at-risk" based on criteria other than the child's test scores. Therefore, in many cases, early intervention services are being offered to families while their at-risk infants are still hospitalized and receiving intensive care. Evaluation of these innovative and complex service delivery programs is being addressed as these services are developed. With the broadening of the scope of early intervention comes the need to rethink the traditional methods of evaluating these programs. This paper will address some of the issues involved in evaluating family-centered programs which are based in neonatal intensive care units (NICU).
随着1986年10月第99 - 457号公法的通过，早期干预领域面临着扩大其范围的挑战（西尔伯，1989年）。这项立法将早期干预从以儿童为中心的服务扩展为在多种背景下向家庭提供的服务；从为有特殊需求的儿童提供的服务扩展为一旦确定风险就向家庭提供的服务。正在设计和开发以跨机构为重点的新方案，这些方案不仅为发育障碍儿童服务，还为他们的家庭提供健康、教育和社会服务（康韦尔和瑟曼，1990年）。现行立法表明，一旦家庭的孩子被确定为有风险，就应为其提供服务（史密斯，1987年）。为响应这项立法，各州正在根据除儿童考试成绩之外的标准制定“有风险”的定义。因此，在许多情况下，早期干预服务是在有风险的婴儿仍住院并接受重症监护时就提供给家庭的。随着这些服务的发展，对这些创新且复杂的服务提供方案的评估也在进行。随着早期干预范围的扩大，有必要重新思考评估这些方案的传统方法。本文将探讨评估以新生儿重症监护病房（NICU）为基础的以家庭为中心的方案所涉及的一些问题。
