Maulik P K, Darmstadt G L
Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
J Perinatol. 2009 Aug;29(8):531-42. doi: 10.1038/jp.2009.42. Epub 2009 Apr 30.
Interventions targeting the early childhood period (0 to 3 years) help to improve neuro-cognitive functioning throughout life. Some of the more low cost, low resource-intensive community practices for this age-group are play, reading, music and tactile stimulation. This research was conducted to summarize the evidence regarding the effectiveness of such strategies on child development, with particular focus on techniques that may be transferable to developing countries and to children at risk of developing secondary impairments.
PubMed, PsycInfo, Embase, ERIC, CINAHL and Cochrane were searched for studies involving the above strategies for early intervention. Reference lists of these studies were scanned and other studies were incorporated based on snow-balling.
Overall, 76 articles corresponding to 53 studies, 24 of which were randomized controlled trials, were identified. Sixteen of those studies were from low- and middle-income countries. Play and reading were the two commonest interventions and showed positive impact on intellectual development of the child. Music was evaluated primarily in intensive care settings. Kangaroo Mother Care, and to a lesser extent massage, also showed beneficial effects. Improvement in parent-child interaction was common to all the interventions.
Play and reading were effective interventions for early childhood interventions in low- and middle-income countries. More research is needed to judge the effectiveness of music. Kangaroo Mother Care is effective for low birth weight babies in resource poor settings, but further research is needed in community settings. Massage is useful, but needs more rigorous research prior to being advocated for community-level interventions.
针对幼儿期（0至3岁）的干预措施有助于改善一生的神经认知功能。针对这个年龄组的一些成本较低、资源密集度较低的社区实践活动包括玩耍、阅读、音乐和触觉刺激。开展这项研究是为了总结关于此类策略对儿童发育有效性的证据，特别关注可能适用于发展中国家以及有发展继发性损伤风险的儿童的技术。
在PubMed、PsycInfo、Embase、ERIC、CINAHL和Cochrane数据库中检索涉及上述早期干预策略的研究。对这些研究的参考文献列表进行了筛选，并基于滚雪球法纳入了其他研究。
总共识别出76篇文章，对应53项研究，其中24项为随机对照试验。这些研究中有16项来自低收入和中等收入国家。玩耍和阅读是最常见的两种干预措施，对儿童智力发育有积极影响。音乐主要在重症监护环境中进行评估。袋鼠式护理以及程度较轻的按摩也显示出有益效果。所有干预措施都普遍改善了亲子互动。
玩耍和阅读是低收入和中等收入国家幼儿期干预的有效措施。需要更多研究来判断音乐的有效性。袋鼠式护理对资源匮乏环境中的低出生体重婴儿有效，但在社区环境中还需要进一步研究。按摩是有用的，但在倡导用于社区层面的干预之前需要更严格的研究。
