Shonkoff J P, Hauser-Cram P, Krauss M W, Upshur C C
Monogr Soc Res Child Dev. 1992;57(6):v-vi, 1-153.
This Monograph presents the results of a nonexperimental, longitudinal investigation of developmental change in 190 infants and their families after 1 year of early intervention services. The Early Intervention Collaborative Study (EICS), conducted in association with 29 community-based programs in Massachusetts and New Hampshire, was designed to assess correlates of adaptation in young children with disabilities and their families over time, to inform social policy by analyzing the influences of family ecology and formal services on child and family outcomes, and to generate conceptual models to guide further investigation. The study sample (mean age at entry = 10.6 months) includes 54 children with Down syndrome, 77 with motor impairment, and 59 with developmental delays of uncertain etiology. Data were collected during two home visits (within 6 weeks of program entry and 12 months later) and included formal child assessments, observations of mother-child interaction, maternal interviews, and questionnaires completed independently by both parents as well as monthly service data collected from service providers. Child and family functioning varied considerably. Developmental change in the children (psychomotor abilities, adaptive behavior, spontaneous play, and child-mother interaction skills) was influenced to some extent by gestational age and health characteristics, but the strongest predictor of change was the relative severity of the child's psychomotor impairment at study entry. Families demonstrated generally positive and stable adaptation (in terms of the effect of rearing a child with disabilities on the family, parenting stress, and social support), despite persistent challenges with respect to mother-child interaction and differences in reported stress between mothers and fathers. Documentation of services revealed that early intervention is a complex and multidimensional experience that spans multiple public and private systems. Vulnerable and resilient subgroups within the sample were identified, and different correlates of adaptive change were demonstrated. Results of data analyses suggest new perspectives on the study of early childhood disability. The implications of the findings for developmental theory and social policy are discussed.
本专著呈现了一项非实验性纵向调查的结果，该调查针对190名婴儿及其家庭在接受1年早期干预服务后的发育变化。与马萨诸塞州和新罕布什尔州的29个社区项目联合开展的早期干预协作研究（EICS），旨在评估残疾幼儿及其家庭随时间推移的适应相关因素，通过分析家庭生态和正规服务对儿童及家庭结果的影响为社会政策提供信息，并生成概念模型以指导进一步研究。研究样本（入组时平均年龄 = 10.6个月）包括54名唐氏综合征患儿、77名有运动障碍的患儿以及59名病因不明的发育迟缓患儿。数据在两次家访期间收集（项目入组后6周内和12个月后），包括正式的儿童评估、母婴互动观察、母亲访谈，以及父母双方独立完成的问卷，还有从服务提供者处收集的月度服务数据。儿童和家庭功能差异很大。儿童的发育变化（心理运动能力、适应性行为、自发游戏以及母婴互动技能）在一定程度上受到胎龄和健康特征的影响，但变化的最强预测因素是研究入组时儿童心理运动障碍的相对严重程度。尽管在母婴互动方面持续存在挑战，且父母报告的压力存在差异，但家庭总体上表现出积极且稳定的适应（就抚养残疾儿童对家庭的影响、育儿压力和社会支持而言）。服务记录显示，早期干预是一种复杂且多维度的体验，跨越多个公共和私人系统。在样本中识别出了脆弱和有复原力的亚组，并展示了适应性变化的不同相关因素。数据分析结果为幼儿残疾研究提供了新视角。讨论了研究结果对发展理论和社会政策的影响。
