Kable Julie A, Coles Claire D, Taddeo Elles
Marcus Institute, an Affiliate of Kennedy Krieger Institute at Emory University, Atlanta, Georgia 30329, USA.
Alcohol Clin Exp Res. 2007 Aug;31(8):1425-34. doi: 10.1111/j.1530-0277.2007.00431.x. Epub 2007 Jun 5.
Fetal alcohol syndrome (FAS) has been recognized as a disabling condition with a significant impact on the neurobehavioral functioning of affected individuals, including cognition, behavior, and academic functioning, but little research has been performed on targeted interventions for these children.
A socio-cognitive habilitative program focused on improving behavior and math functioning in children 3 to 10 years of age (n=61) was developed and evaluated. The intervention provided parental instruction on FAS, advocacy, and behavioral regulation via workshops and interactive math tutoring with children. All families received parental instruction and were then randomly assigned to either the math instruction or standard psychoeducational care groups.
Satisfaction with workshops was very high, with over 90% agreeing that trainers were knowledgeable and materials easy to understand and helpful. Significant gains in knowledge were found for information provided in the instructional groups. At posttesting, caregivers reported fewer problem behaviors on the Achenbach Child Behavior Checklist, Internalizing Problem Behavior, Externalizing Problem Behavior, and Total Problem Behavior summary scales. After 5 months, both groups of children demonstrated gains in math knowledge but significantly higher gains were found in the group receiving direct math instruction. The math treatment group was also more likely to demonstrate a gain of over 1 standard deviation on any of the 4 math outcome measures used.
These findings suggest that parents of children with fetal alcohol spectrum disorders (FAS(D)) benefit from instruction in understanding their child's alcohol-related neurological damage and strategies to provide positive behavioral supports and that targeted psychoeducational programs may be able to remediate some of the math deficits associated with prenatal alcohol exposure.
胎儿酒精谱系障碍(FASD)已被确认为一种致残性疾病,对受影响个体的神经行为功能有重大影响,包括认知、行为和学业功能,但针对这些儿童的针对性干预措施的研究较少。
开发并评估了一项社会认知康复计划,该计划旨在改善3至10岁儿童(n = 61)的行为和数学功能。该干预通过研讨会和与儿童的互动数学辅导,为家长提供有关FASD的指导、宣传和行为调节方面的内容。所有家庭都接受了家长指导,然后被随机分配到数学指导组或标准心理教育护理组。
对研讨会的满意度非常高,超过90%的人认为培训师知识渊博,材料易于理解且有帮助。在教学组提供的信息方面,知识有显著增加。在测试后,照顾者在阿肯巴克儿童行为清单、内化问题行为、外化问题行为和总问题行为汇总量表上报告的问题行为减少。5个月后,两组儿童在数学知识方面都有进步,但接受直接数学指导的组进步明显更大。数学治疗组在使用的4项数学结果测量中的任何一项上,也更有可能表现出超过1个标准差的进步。
这些发现表明,胎儿酒精谱系障碍(FASD)儿童的家长从了解孩子与酒精相关的神经损伤以及提供积极行为支持的策略的指导中受益,并且有针对性的心理教育计划可能能够弥补一些与产前酒精暴露相关的数学缺陷。