Department of Psychology, College of the Liberal Arts (Bierman, Heinrichs), and Prevention Research Center, College of Health and Human Development, Pennsylvania State University, University Park (Welsh); Department of Human Development and Family Studies, School of Human Ecology, University of Wisconsin-Madison (Nix).
Am J Psychiatry. 2021 Apr 1;178(4):305-312. doi: 10.1176/appi.ajp.2020.20030343. Epub 2020 Dec 10.
Living in poverty increases exposure to adversities that undermine healthy development, impeding growth in the social-emotional and language skills that support adaptive coping and promote mental health. Evidence-based programs have the potential to improve current preschool practice and strengthen these early skills, potentially reducing risk for later psychopathology. The authors tested the hypothesis that an enrichment program in preschool would be associated with reduced levels of psychopathology symptoms at the transition from middle to secondary school.
The Head Start REDI (Research-Based, Developmentally Informed) intervention was used to enrich preschool classrooms serving children from low-income families with an evidence-based social-emotional learning (SEL) program and a coordinated interactive reading program. Centers were randomly assigned to the intervention or usual practice, and 356 4-year-olds (58% White, 25% Black, 17% Latino; 54% female) were followed into early adolescence. Hierarchical linear models were used to evaluate intervention effects on teacher-rated psychopathology symptoms using the Strengths and Difficulties Questionnaire in grade 7 (ages 12-13) and grade 9 (ages 14-15), 8-10 years after the end of the intervention.
Statistically significant intervention-related reductions were observed in conduct problems and emotional symptoms in the intervention group. In addition, the proportion of youths with clinically significant levels of conduct problems, emotional symptoms, and peer problems was reduced in the intervention group, with rates one-third of those in the control group.
The study findings indicate that enriching preschool programs serving at-risk children with a relatively inexpensive evidence-based SEL program with interactive reading substantially improved the later benefits for adolescent emotional and behavioral health. This kind of SEL enrichment represents an approach that can leverage public investments in preschool programs to enhance public health.
生活贫困会增加遭受逆境的风险,而逆境会破坏健康发展,阻碍支持适应性应对和促进心理健康的社会情感和语言技能的发展。循证项目有可能改善当前的学前教育实践,并加强这些早期技能,从而降低日后出现精神病理学的风险。作者检验了这样一个假设,即学前教育强化项目与从中小学过渡到中学时精神病理学症状水平的降低有关。
使用“学前教育增强计划”(Head Start REDI)干预措施,为服务低收入家庭儿童的教室增添以循证为基础的社会情感学习(SEL)计划和协调互动阅读计划,从而丰富学前教育。中心被随机分配到干预组或常规实践组,对 356 名 4 岁儿童(58%为白人,25%为黑人,17%为拉丁裔;54%为女性)进行了随访,直到他们进入青春期早期。采用层次线性模型,使用 7 年级(12-13 岁)和 9 年级(14-15 岁)教师评定的《长处和困难问卷》(Strengths and Difficulties Questionnaire)评估干预对精神病理学症状的影响,该问卷在干预结束后 8-10 年进行。
干预组在行为问题和情绪症状方面观察到与干预相关的显著减少。此外,干预组中具有临床显著程度的行为问题、情绪症状和同伴问题的青少年比例降低,比率为对照组的三分之一。
研究结果表明,为面临风险的儿童提供的相对廉价的循证 SEL 计划与互动阅读相结合的学前教育强化计划,大大改善了青少年情绪和行为健康的后续益处。这种 SEL 强化代表了一种可以利用公共投资于学前教育计划来增强公共卫生的方法。