Dumaret A C
Inserm U 502, centre de recherche médecine, sciences, santé et société, 7, rue Guy-Môquet 94801 Villejuif cedex, France.
Arch Pediatr. 2003 May;10(5):448-61. doi: 10.1016/s0929-693x(03)00078-2.
While research on early-intervention programs remains rare in France, there are numerous scientific publications in the English-language literature. This article attempts to describe the contribution of such programs in terms of children subsequent development and changes in their families. Twenty-six programs incorporating home intervention, care, social support and early-childhood education, have been conducted for more than a year within local and hospital populations selected through various scales of risk. The large majority of the programs have randomized trials. Intervention and early education applied essentially to families from deprived environment, families with premature or low-birth-weight infants, and families exhibiting psychosocial or psychiatric risks. Programs of relatively long-term and addressing to families' needs and well-being, initiated in the prenatal period, resulted in variable degrees of positive influences on children cognitive, behavioural and social development, and on parent-child relationships. The most remarkable results with the most prolonged effects concerned school attendance and school performance. Positive effects were also recorded in specific populations (adolescent mothers, mentally retarded mothers.). Nevertheless the efficacy of such programs remained limited and mainly dependent upon parents' motivation and involvement and concurrent family risk factors. Although evaluation of intervention programs regarding multiple risk factors remains difficult, qualitative analyses complementing the available statistical data appear necessary.
虽然法国对早期干预项目的研究仍然很少,但英文文献中有大量的科学出版物。本文试图从儿童后续发展及其家庭变化的角度描述此类项目的贡献。通过各种风险量表在当地和医院人群中开展了26个包含家庭干预、护理、社会支持和幼儿教育的项目,为期一年多。绝大多数项目都有随机试验。干预和早期教育主要适用于来自贫困环境的家庭、有早产或低体重婴儿的家庭,以及存在心理社会或精神风险的家庭。这些相对长期的、针对家庭需求和幸福的项目在孕期启动,对儿童的认知、行为和社会发展以及亲子关系产生了不同程度的积极影响。在入学率和学业成绩方面取得了最显著且持续时间最长的效果。在特定人群(青少年母亲、智障母亲)中也记录到了积极影响。然而,此类项目的效果仍然有限,主要取决于父母的积极性和参与度以及并发的家庭风险因素。尽管对涉及多种风险因素的干预项目进行评估仍然困难,但补充现有统计数据的定性分析似乎是必要的。