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早期干预的首次经验:全国视角

First experiences with early intervention: a national perspective.

作者信息

Bailey Donald B, Hebbeler Kathleen, Scarborough Anita, Spiker Donna, Mallik Sangeeta

机构信息

Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.

出版信息

Pediatrics. 2004 Apr;113(4):887-96. doi: 10.1542/peds.113.4.887.

Abstract

BACKGROUND

Families of young children with disabilities are eligible for early intervention services as mandated by Part C of the Individuals With Disabilities Education Act. Although prior research has shown that families are generally satisfied with early intervention, this research has not been based on a nationally representative sample of families, nor has it systematically examined perceptions of the initial experiences entering early intervention.

OBJECTIVE

This study was designed to determine families' initial experiences in determining their child's eligibility, interactions with medical professionals, effort required to obtain services, participation in planning for services, satisfaction with services, and interactions with professionals.

METHOD

We interviewed a nationally representative sample of 3338 parents of young children with or at risk for disability. All the children had recently entered an early intervention program operated under the auspices of Part C of the Individuals With Disabilities Education Act.

RESULTS

The average age at which families reported a concern about their child was 7.4 months. A diagnosis was made, on average, 1.4 months later, the child was referred for early intervention an average of 5.2 months after the diagnosis, and the individualized family service plan was developed 1.7 months later or at an average age of 15.7 months. Most families were very positive about their entry into early intervention programs. They reported discussing their concerns with a medical professional and finding that person helpful. Families reported relative ease in accessing services, felt that services were related to their perceived needs, rated positively the professionals working in early intervention, and felt that they had a role in making key decisions about child and family goals. A small percentage of families experienced significant delays in getting services, wanted more involvement in service planning, or felt that services were inadequate, and nearly 20% were unaware of the existence of a written plan for services. Minority families, families with limited income, and families with less-educated mothers were more likely to report negative experiences.

CONCLUSIONS

We conclude that the beginning of early intervention services generally is highly successful and responsive, a finding that should give pediatricians more confidence in referring families for early intervention services. However, research and local evaluation efforts are needed to develop strategies to assure that all families receive services in a timely and appropriate fashion.

摘要

背景

根据《残疾人教育法》C部分的规定,残疾幼儿家庭有资格获得早期干预服务。尽管先前的研究表明家庭通常对早期干预感到满意,但该研究并非基于全国代表性的家庭样本,也未系统地考察对进入早期干预初始体验的看法。

目的

本研究旨在确定家庭在确定孩子资格、与医疗专业人员互动、获取服务所需努力、参与服务规划、对服务的满意度以及与专业人员互动方面的初始体验。

方法

我们采访了全国代表性样本中的3338名残疾幼儿或有残疾风险幼儿的家长。所有孩子最近都进入了在《残疾人教育法》C部分主持下运作的早期干预项目。

结果

家庭报告对孩子感到担忧的平均年龄为7.4个月。平均在1.4个月后做出诊断,孩子在诊断后平均5.2个月被转介接受早期干预,个性化家庭服务计划在1.7个月后制定,即平均年龄为15.7个月时制定。大多数家庭对进入早期干预项目非常积极。他们报告说与医疗专业人员讨论了自己的担忧,并觉得那个人很有帮助。家庭报告获取服务相对容易,觉得服务与他们感知到的需求相关,对早期干预工作的专业人员评价积极,并觉得他们在就儿童和家庭目标做出关键决策方面发挥了作用。一小部分家庭在获得服务方面经历了显著延迟,希望更多地参与服务规划,或者觉得服务不足,近20%的家庭不知道有服务书面计划的存在。少数族裔家庭、收入有限的家庭以及母亲受教育程度较低的家庭更有可能报告负面经历。

结论

我们得出结论,早期干预服务的开端总体上非常成功且反应迅速,这一发现应使儿科医生在将家庭转介接受早期干预服务时更有信心。然而,需要开展研究和地方评估工作,以制定策略确保所有家庭及时、适当地获得服务。

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