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通过神经发育知情临床干预对患有胎儿酒精谱系障碍的领养儿童进行临床改善:一项试点研究。

Clinical improvements in adopted children with fetal alcohol spectrum disorders through neurodevelopmentally informed clinical intervention: A pilot study.

作者信息

Zarnegar Zohreh, Hambrick Erin P, Perry Bruce D, Azen Stanley P, Peterson Cassandra

机构信息

Los Angeles County Department of Mental Health, USA

Children's Health International, USA.

出版信息

Clin Child Psychol Psychiatry. 2016 Oct;21(4):551-567. doi: 10.1177/1359104516636438. Epub 2016 Mar 16.

Abstract

Research on early intervention for young children (infants and toddlers) with fetal alcohol spectrum disorders (FASD), particularly children with comorbid maltreatment experiences, is limited. Existing research has primarily focused on structuring environments to be responsive to the needs experienced by children with FASD rather than improving their functioning. The purpose of this study is to present outcomes from an early psychosocial intervention with 10 adopted, maltreated young children diagnosed with FASD, aged 10-53 months (M = 35 months), and their adoptive parents. The potential for early, targeted interventions to improve developmental outcomes for children with prenatal alcohol exposure was examined, as well as improving the skills of and reducing stress experienced by their adoptive parents. Based on the outcomes of a neurodevelopmentally informed assessment protocol, the 10 children whose data are presented were recommended to receive a range of regulatory, somatosensory, relational, and cognitive enrichments. As part of their treatment, children and caregivers received Child-Parent Psychotherapy (CPP), and caregivers (here, adoptive parents) also received Mindful Parenting Education (MPE). Related-samples Wilcoxon signed-rank tests indicated that scores of several measures of child developmental functioning improved from pre- to post-intervention and that parents' caregiving skills improved while their caregiving stress decreased. Reliable change analyses indicated that change observed from pre- to post-intervention was reliable. The promise of using neurodevelopmentally informed assessment strategies to sequence interventions for young children with diverse neurodevelopmental insults is discussed.

摘要

针对患有胎儿酒精谱系障碍(FASD)的幼儿(婴儿和学步儿童),尤其是伴有虐待经历的儿童的早期干预研究有限。现有研究主要集中在构建能够响应FASD儿童需求的环境,而非改善他们的机能。本研究的目的是呈现一项针对10名被收养的、受虐待的FASD幼儿及其养父母的早期心理社会干预的结果。这些幼儿年龄在10至53个月(平均年龄35个月)。研究考察了早期针对性干预改善产前酒精暴露儿童发育结果的潜力,以及提高其养父母的技能并减轻他们所经历的压力的效果。基于神经发育知情评估方案的结果,推荐了10名呈现数据的儿童接受一系列调节、体感、关系和认知强化训练。作为治疗的一部分,儿童和照顾者接受亲子心理治疗(CPP),照顾者(此处为养父母)还接受正念养育教育(MPE)。相关样本Wilcoxon符号秩检验表明,儿童发育机能的多项测量得分在干预前后有所改善,父母的养育技能提高,养育压力降低。可靠变化分析表明,干预前后观察到的变化是可靠的。本文还讨论了使用神经发育知情评估策略为遭受不同神经发育损伤的幼儿安排干预顺序的前景。

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