Gwynne Kerry, Blick Bijou A, Duffy Gabrielle M
Dalwood Spilstead Centre, Child and Family Health Service, New South Wales, Australia.
J Paediatr Child Health. 2009 Mar;45(3):118-24. doi: 10.1111/j.1440-1754.2008.01439.x. Epub 2009 Feb 2.
Children from vulnerable families, where there is social disadvantage, parental mental health problems, substance abuse or domestic violence, are at risk of attention, language, learning and behaviour problems because of poor attachment and lack of stimulation in the early years. Three primary modes of early intervention have been shown to produce sustained improvements in children's health, education and well-being despite these risk factors. This pilot aimed to evaluate the Spilstead Model (SM) of early intervention in Australia, which provides a uniquely integrated model of centre-based care, incorporating all three best-practice approaches.
The study targeted all new clients who attended the SM programme over a 12-month period. A battery of standardised clinician and parent-rated measures assessed parent, child and family functioning via pre-post test research design.
Results indicated large effect size changes (P < 0.01) in parent/child interaction; reduced parent stress; parental satisfaction; parent confidence; parental capacity; family interactions; child well-being; and total family functioning. A total of 71% of children who presented on initial developmental screening with delays in the clinical range were found to be within the normal range on post-testing; 41% moved from the below average range to scores within the normal range in language development. Parents noted improvements in externalising behaviours of large effect size (1.46).
(i) Results were highly positive for both children and parents; (ii) the synergistic nature of the SM may have the potential to maximise outcomes for families via a cumulative programme effect; and (iii) implications for further research were established.
来自弱势家庭的儿童,即存在社会劣势、父母有心理健康问题、药物滥用或家庭暴力的家庭中的儿童,由于早年缺乏依恋关系和刺激,有出现注意力、语言、学习和行为问题的风险。尽管存在这些风险因素,但三种早期干预的主要模式已被证明能持续改善儿童的健康、教育和幸福感。本试点研究旨在评估澳大利亚的斯皮尔斯泰德早期干预模式(SM),该模式提供了一种独特的综合中心式护理模式,融合了所有三种最佳实践方法。
该研究针对在12个月期间参加SM项目的所有新客户。通过前后测试研究设计,采用一系列标准化的临床医生和家长评定量表来评估家长、儿童和家庭功能。
结果表明,在亲子互动方面有较大的效应量变化(P < 0.01);家长压力减轻;家长满意度提高;家长信心增强;家长能力提升;家庭互动改善;儿童幸福感增强;家庭整体功能提升。在初始发育筛查中表现出临床范围内发育迟缓的儿童中,共有71%在测试后被发现处于正常范围内;41%的儿童在语言发展方面从低于平均水平提升到正常范围内的分数。家长们指出,外化行为有较大的效应量改善(1.46)。
(i)对儿童和家长的结果都非常积极;(ii)SM的协同性质可能有潜力通过累积项目效应使家庭成果最大化;(iii)确定了对进一步研究的启示。