Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany.
Catholic University of Applied Sciences, Aachen, Germany.
Dev Psychopathol. 2021 Aug;33(3):992-1005. doi: 10.1017/S0954579420000280.
Children of adolescent mothers are a high-risk group for negative child development. Previous findings suggest that early interventions may enhance child development by improving mother-child interaction. The purpose of the current study was to evaluate a mother-child intervention (STEEP-b) program in high-risk adolescent mother-infant dyads (N = 56) within a randomized controlled trial (RCT). Mother-child interaction was assessed at baseline (T1), postintervention (T2), and follow-up (T3). The primary outcome was the change in maternal sensitivity and child responsiveness from T1 to T2 that was measured by blinded ratings of videotaped mother-child-interaction with the Emotional Availability Scales. A modified intention-to-treat analysis was performed to examine the data. No intervention effect was found for maternal sensitivity, 95% CI [-0.59-0.60], p = .99, and child responsiveness, 95% CI [-0.51-0.62], p = .84. Maternal sensitivity and child responsiveness did not change over time in both groups (all ps > .05). A statistically nonsignificant, but potentially clinically meaningful difference emerged between rates of serious adverse events, SC: 4 (14.8%), STEEP-b: 1 (3.4%), possibly driven by different intensity of surveillance of dyads in the treatment groups. The current findings question the effectiveness of STEEP-b for high-risk adolescent mothers and do not justify the broad implementation of this approach.
青少年母亲的孩子是儿童发展不良的高风险群体。先前的研究结果表明，早期干预措施可以通过改善母婴互动来促进儿童的发展。本研究的目的是在一项随机对照试验（RCT）中评估高危青少年母婴对子（N=56）的母子干预（STEEP-b）方案。在基线（T1）、干预后（T2）和随访（T3）时评估母婴互动。主要结果是通过对母婴互动录像的情绪可用性量表盲评来衡量从 T1 到 T2 的母婴敏感性和儿童反应性的变化。采用修改后的意向治疗分析来检验数据。敏感性和儿童反应性没有干预效果，95%CI[-0.59-0.60]，p=.99，95%CI[-0.51-0.62]，p=.84。两组的敏感性和儿童反应性均未随时间发生变化（所有 p 值均大于 0.05）。严重不良事件的发生率出现了统计学上无显著但可能临床上有意义的差异，SC：4（14.8%），STEEP-b：1（3.4%），这可能是由于治疗组对母婴对子的监测强度不同所致。目前的研究结果对 STEEP-b 对高危青少年母亲的有效性提出了质疑，并且没有证明这种方法的广泛实施是合理的。
