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利用教练实践对发育障碍/迟缓高危儿童进行早期干预:系统评价。

Utilisation of coaching practices in early interventions in children at risk of developmental disability/delay: a systematic review.

机构信息

School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Bentley, Australia.

Perth Children's Hospital, Kids Rehab WA, Nedlands, Australia.

出版信息

Disabil Rehabil. 2020 Oct;42(20):2846-2867. doi: 10.1080/09638288.2019.1581846. Epub 2019 Apr 25.

Abstract

To conduct a systematic review of early intervention programs (0-5 years) utilising coaching practice characteristics, to identify (i) implementation fidelity; (ii) parent training processes, and (iii) outcome measures of capacity building in parents. The coaching practice characteristics of (1) joint planning, (2) observation, (3) action/practice, (4) reflection and (5) feedback identified by Rush and Shelden were utilised. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed. A comprehensive search of 6 electronic databases was undertaken in March 2016 and updated in February 2018. Of 2397 articles, 18 papers met full inclusion criteria. Of these, 5 were randomised controlled trials. Only one specifically evaluated the impact of parent coaching versus therapist only delivered interventions. Risk of bias and study quality using Downs and Black checklist for clinical trial quality yielded the following descriptive ratings: Seven studies: "Poor" (scores 1-13); Six studies: "Fair" (scores 15-17); and five "Good" (scores 20-24). Coaching in early intervention is well accepted. Nevertheless, this review identified a continued lack of operationalised definitions; inconsistency in the reporting of therapist training and adherence to active ingredients/coaching principles; and an absence of outcome measures focused on parent capacity.Implications for RehabilitationContemporary early intervention services recognise the importance of engaging parents as active participators in their child's development. This is evident by the increase in interventions that utilise parent coaching practices. The findings of this systematic review indicate the need for professionals to:•Describe and document fidelity of coaching practices in the delivery of intervention.•Objectively measure changes in parent capacity and self-efficacy as a result of the coaching based intervention.The reporting of parent capacity measures will allow us to truly examine the effectiveness of coaching practices in empowering families to support their child to realise their full potential.

摘要

对利用教练实践特征开展的 0-5 岁早期干预项目进行系统回顾,以确定:(i)实施一致性;(ii)父母培训过程;以及(iii)父母能力建设的结果衡量。利用 Rush 和 Shelden 确定的教练实践特征(1)联合规划、(2)观察、(3)行动/实践、(4)反思和(5)反馈进行了研究。本研究遵循了系统评价和荟萃分析的首选报告项目(PRISMA)声明。2016 年 3 月进行了全面的 6 个电子数据库检索,并于 2018 年 2 月进行了更新。在 2397 篇文章中,有 18 篇符合全文纳入标准。其中,5 篇为随机对照试验。只有一篇专门评估了父母教练与仅治疗师提供干预的影响。使用 Downs 和 Black 临床试验质量清单评估风险偏倚和研究质量,得出以下描述性评分:7 项研究:“差”(评分 1-13);6 项研究:“中等”(评分 15-17);5 项“好”(评分 20-24)。早期干预中的教练普遍得到认可。尽管如此,本综述仍发现缺乏可操作的定义;治疗师培训和对活跃成分/教练原则的一致性报告;以及缺乏专注于父母能力的结果衡量。康复意义当代早期干预服务认识到让父母作为其孩子发展的积极参与者的重要性。这体现在增加了利用父母教练实践的干预措施上。本系统回顾的结果表明,专业人员需要:•描述和记录在提供干预时教练实践的一致性。•客观衡量父母能力和自我效能感因基于教练的干预而发生的变化。父母能力衡量报告将使我们能够真正检验教练实践在赋予家庭权力以支持其孩子充分发挥潜力方面的有效性。

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