AJ Pappanikou Center for Excellence in Developmental Disabilities Education, Research, and Service, University of Connecticut Health Center, Farmington, CT, USA.
University of Florida, Gainesville, FL, USA.
Dev Med Child Neurol. 2024 Jun;66(6):713-724. doi: 10.1111/dmcn.15764. Epub 2023 Oct 2.
To systematically review the effectiveness of caregiver and parent skills training programs, including caregiver-mediated interventions, for caregivers of individuals with neurodevelopmental disorders.
We conducted a systematic review with a random-effects meta-analysis. We searched 11 electronic databases through July 2021 and used a snowball methodology to locate relevant articles of randomized controlled trials. Effect size estimates were pooled using Hedges' g from data extracted from study reports and through author requests using random-effects meta-analyses for three child outcome categories (child development, adaptive behavior, and problem behavior) and three caregiver outcome categories (parenting skills and knowledge, psychological well-being, and interpersonal family relations).
We located 44 910 records, from which 75 randomized controlled trials involving 4746 individuals with neurodevelopmental disorders and their caregivers were included. Random-effects meta-analyses showed improvements in child development (g = 0.30; 99% confidence interval [CI] = 0.07-0.53) and reduction in reported problem behaviors (g = 0.41; 99% CI = 0.24-0.59), but not a statistically significant improvement in adaptive behavior (g = 0.28; 99% CI = -0.42 to 0.98). Caregivers showed improvements in parenting skills and knowledge (g = 0.72; 99% CI = 0.53-0.90), psychological well-being (g = 0.52; 99% CI = 0.34-0.71), and interpersonal family relations (g = 0.76; 99% CI = 0.32-1.20).
Caregiver skills training programs benefit both caregivers and children with neurodevelopmental disorders. Skills training programs improve child development and behavior, improve parenting skills, reduce caregiver mental health issues, and improve family functioning. Programs using culturally appropriate training material to improve the development, functioning, and participation of children within families and communities should be considered when caring for children with neurodevelopmental disorders.
Caregiver skills training programs are effective interventions for both caregivers and children. Children with neurodevelopmental disorders benefit from improvements in development and reduction of problematic behaviors. Caregivers benefit from enhanced skills and psychological well-being. Improvements in interpersonal family relationships have also been documented.
系统评价针对神经发育障碍个体的照料者技能训练计划（包括照料者介导干预）的有效性，包括照料者技能训练计划。
我们进行了系统评价和随机效应荟萃分析。我们通过 2021 年 7 月前的 11 个电子数据库进行了搜索，并使用滚雪球方法定位了相关的随机对照试验文章。使用来自研究报告的数据提取和通过作者请求获得的 Hedges'g 值，对三个儿童结局类别（儿童发育、适应行为和问题行为）和三个照料者结局类别（育儿技能和知识、心理幸福感和家庭人际关系）进行了随机效应荟萃分析。
我们共定位到 44910 条记录，其中纳入了 75 项随机对照试验，涉及 4746 名神经发育障碍个体及其照料者。随机效应荟萃分析显示，儿童发育（g=0.30；99%置信区间[CI]：0.07-0.53）和报告的问题行为减少（g=0.41；99%CI：0.24-0.59）有显著改善，但适应行为无统计学意义上的改善（g=0.28；99%CI：-0.42 至 0.98）。照料者在育儿技能和知识（g=0.72；99%CI：0.53-0.90）、心理幸福感（g=0.52；99%CI：0.34-0.71）和家庭人际关系（g=0.76；99%CI：0.32-1.20）方面均有显著改善。
照料者技能训练计划使神经发育障碍儿童及其照料者均受益。技能训练计划可改善儿童发育和行为，提高育儿技能，减少照料者心理健康问题，并改善家庭功能。在照顾神经发育障碍儿童时，应考虑使用文化适宜的训练材料来改善儿童在家庭和社区中的发育、功能和参与度。
照料者技能训练计划对照料者和儿童均为有效的干预措施。神经发育障碍儿童从发育改善和问题行为减少中获益。照料者在技能和心理幸福感方面也得到了提高。家庭人际关系的改善也有记录。
