Royal Free Hospital, London, UK.
Institute of Child Health, University College London, London, UK.
Dev Med Child Neurol. 2019 Dec;61(12):1362-1367. doi: 10.1111/dmcn.14187. Epub 2019 Mar 4.
The purpose of this review is to present a new framework, EI SMART (early intervention: sensorimotor development, attention and regulation, relationships, and therapist support) for identifying key components that could contribute to more effective interventions for infants at high risk of atypical neurodevelopmental outcome. We present a clinical consensus of current challenges and themes in early intervention, based on multidisciplinary group discussions, including parents of high-risk infants, supported by a literature review. Components to include in early intervention programmes are: (1) promotion of self-initiated, developmentally appropriate motor activity; (2) supporting infant self-regulation and the development of positive parent-infant relationships; and (3) promotion of early communication skills, parent coaching, responsive parenting, and supporting parental mental well-being. Such multimodal programmes may need to be evaluated as a package. WHAT THIS PAPER ADDS: Early intervention programmes should address sensorimotor development, attention, self-regulation, and early communication skills. Therapist input to the programme should include parent coaching and support for parental mental well-being.
本综述旨在提出一个新的框架 EI SMART(早期干预:感觉运动发育、注意力和调节、关系和治疗师支持),以确定可能有助于更有效地干预有非典型神经发育结局风险的婴儿的关键组成部分。我们基于多学科小组讨论,包括高危婴儿的父母,提出了当前早期干预中的临床共识和主题,同时结合文献回顾。早期干预方案中应包括:(1)促进自我发起的、发展适当的运动活动;(2)支持婴儿自我调节和积极的母婴关系发展;(3)促进早期沟通技巧、家长指导、反应性育儿以及支持父母的心理健康。这种多模式的方案可能需要作为一个整体进行评估。本文的添加内容:早期干预方案应针对感觉运动发育、注意力、自我调节和早期沟通技巧。治疗师在方案中的投入应包括对父母的指导和对父母心理健康的支持。