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[针对有风险的新生儿的预防方法、早期干预:其目的是什么?2]

[Preventive approach to newborn infants, at risk, early intervention: what is its purpose? 2].

作者信息

Brazelton T B

机构信息

Child Development Unit, Children's Hospital Medical Center, Boston, Massachusetts.

出版信息

Pediatrie. 1990;45(7-8):491-503.

PMID:2170927
Abstract

In this study, the bases of the principle of early intervention have been examined. At-risk neonates should be assessed as early as possible via a preventive and therapeutic approach. Before the situation aggravates to such an extent that treatment administered has no effect, early intervention can in fact prevent a number of difficulties from taking place, which arise when the environment cannot be adapted to the at-risk neonates. During early childhood, the association of the child's developmental processes and the parent's available energy, resulting in development of the child's optimum potential, has in fact exceeded our expectations. The assessment of the infant's capacity to organize positive interaction experiences with a nurturing adult has led us to better understand the plasticity process which permits the neonate's recuperation form damage to the central nervous system (CNS). Informing the parents in question of our observations and approach in order to improve the child's behaviour has resulted in gained confidence and cooperation, and therefore optimum recuperation. Our assessments of normal and premature neonates have both for ourselves and the parents led to a better understanding of organization and ongoing development, which in early childhood may also include the direct interview procedure. In other words, assessment by observation of a neonate's state of health consists not only of evaluating organizational capacities connected with his or her present state, but also how the infant will affect parental attitudes, and in turn what the parents will have to do to organize the child. By sharing our assessment with the parents, and with close cooperation, we aid them in identifying the positive elements as well as the defects in the child's potential. Thus the parents can utilize their nurturing capacities in their relationship with the child to bring about the best recuperation possible. Repeated observations enable an evaluation to be made of the neonate's organizational capabilities during the recuperative period following birth, and adaptation to the new environment. Adopting the same procedure throughout the child's first year of life has permitted us to share with the parents observation of the child's progress, and to point out to them the effect that they have in this area. The above system has aided the parents by showing them that the child can be organized and that its health is recuperable, even after damage to the CNS or premature birth.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

在本研究中,对早期干预原则的基础进行了考察。高危新生儿应通过预防和治疗方法尽早进行评估。在情况恶化到治疗无效之前,早期干预实际上可以预防许多因环境无法适应高危新生儿而产生的困难。在幼儿期,儿童发育过程与父母可用精力的结合,使儿童的最佳潜能得以发展,这一情况实际上超出了我们的预期。对婴儿与养育成人组织积极互动体验能力的评估,使我们更好地理解了可塑性过程,该过程使新生儿能够从中枢神经系统(CNS)损伤中恢复。告知相关父母我们的观察结果和方法以改善孩子的行为,已带来了信心和合作,从而实现了最佳恢复。我们对正常和早产新生儿的评估,对我们自己和父母而言,都有助于更好地理解组织和持续发展,这在幼儿期可能还包括直接访谈程序。换句话说,通过观察新生儿的健康状况进行评估,不仅包括评估与其当前状态相关的组织能力,还包括婴儿将如何影响父母的态度,以及反过来父母为组织孩子需要做什么。通过与父母分享我们的评估并密切合作,我们帮助他们识别孩子潜能中的积极因素和缺陷。这样,父母就可以在与孩子的关系中利用他们的养育能力,以实现尽可能好的恢复。反复观察能够对新生儿出生后恢复期的组织能力以及对新环境的适应情况进行评估。在孩子生命的第一年采用相同的程序,使我们能够与父母分享对孩子进步的观察,并向他们指出他们在这方面的影响。上述系统通过向父母表明即使在中枢神经系统受损或早产之后,孩子也能够被组织起来且其健康可以恢复,从而帮助了父母。(摘要截选至400字)

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