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《胎儿酒精谱系障碍儿童及其家庭的轨道干预试验的六个月随访》。

Six-Month Follow-up of the Families on Track Intervention Pilot Trial for Children With Fetal Alcohol Spectrum Disorders and Their Families.

机构信息

Mt. Hope Family Center, University of Rochester, Rochester, New York.

出版信息

Alcohol Clin Exp Res. 2019 Oct;43(10):2242-2254. doi: 10.1111/acer.14180. Epub 2019 Sep 5.

Abstract

BACKGROUND

When the primary disabilities associated with fetal alcohol spectrum disorders (FASD) are not well supported, individuals are at higher risk for mental health problems and other secondary conditions. The Families on Track (FOT) intervention was designed to prevent secondary conditions and improve family functioning in children with FASD. Promising results from a pilot study demonstrated positive effects on child and caregiver outcomes immediately following the intervention. The objective of this study was to examine the sustainability of these effects 6 months postintervention.

METHODS

Thirty children (ages 4 to 8) with prenatal alcohol exposure and their caregivers were enrolled in the original study. Families were randomized to the FOT intervention or an active comparison group that provided comprehensive assessment and individualized feedback. The intervention integrated a positive parenting curriculum and a child skills group. Families were assessed at baseline, postintervention, and 6-month follow-up visits. Follow-up data were available for 24 families on child and caregiver outcomes. Data were analyzed using effect size calculations and analysis-of-variance techniques.

RESULTS

Relative to the comparison group, intervention families showed continued gains in parenting efficacy and maintained prior improvements in FASD knowledge over the follow-up period. Although intervention families reported a decrease in their needs being met over the follow-up period, they continued to report their needs being met to greater extent than those in the comparison group. Consistent with postintervention outcomes, children in both groups exhibited similar decreases in child disruptive behavior 6 months following the intervention. Unfortunately, positive gains seen at postintervention for child self-esteem and emotion regulation were attenuated at follow-up.

CONCLUSIONS

This pilot study yielded promising effects on important areas of caregiver functioning. However, the intervention's impact on child functioning waned over time, suggesting the need for sustained or alternate child intervention.

摘要

背景

当与胎儿酒精谱系障碍(FASD)相关的主要残疾得不到充分支持时,个体患心理健康问题和其他继发性疾病的风险会更高。“追踪家庭”(FOT)干预旨在预防 FASD 儿童的继发性疾病并改善家庭功能。一项试点研究取得了可喜的成果,表明干预后儿童和照顾者的结果立即产生了积极影响。本研究的目的是在干预后 6 个月时检查这些效果的可持续性。

方法

30 名(4 至 8 岁)有产前酒精暴露的儿童及其照顾者参加了原始研究。家庭被随机分配到 FOT 干预组或提供全面评估和个性化反馈的积极对照组。干预措施整合了积极的育儿课程和儿童技能小组。家庭在基线、干预后和 6 个月随访时接受评估。有 24 个家庭的儿童和照顾者结果可获得随访数据。使用效应量计算和方差分析技术对数据进行分析。

结果

与对照组相比,干预组在照顾者效能方面继续取得进展,并在随访期间保持了先前在 FASD 知识方面的改善。尽管干预组在随访期间报告其需求得到满足的程度有所下降,但他们继续报告其需求得到满足的程度比对照组更高。与干预后结果一致,两组儿童在干预后 6 个月时表现出类似的行为问题减少。不幸的是,在干预后观察到的儿童自尊和情绪调节的积极增益在随访时减弱了。

结论

这项试点研究在照顾者功能的重要领域取得了有希望的效果。然而,随着时间的推移,干预对儿童功能的影响减弱,这表明需要持续或替代儿童干预。

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