Chan Shi Hua, Oh Jean Yin, Ong Li Ming, Chow Wen Hann, Chay Oh Moh, Soliman Salam, Daniel Lourdes Mary, Agarwal Pratibha, Tan Charmain Samantha, Sai Jun Lin, Especkerman Joanne Ferriol, Sultana Rehena, Low Cong Jin Wilson, Yeleswarapu Sita Padmini
Department of Child Development, KK Women's and Children's Hospital, Singapore.
Division of Medicine, KK Women's and Children's Hospital, Singapore.
Ann Acad Med Singap. 2025 Apr 15;54(4):208-218. doi: 10.47102/annals-acadmedsg.2024281.
Adverse childhood experiences (ACEs) are associated with significant long-term impacts, yet few interventions specifically target ACE exposure, especially in Asian populations. Anchor, Singapore's first home visitation programme, addresses maltreat-ment among preschool children. This study evaluated Anchor's impact on children's developmental and behavioural outcomes.
We conducted a prospective evaluation of children under 4 years assessed for maltreatment from November 2019 to July 2023. Developmental and behavioural progress was measured every 6 months using the Ages and Stages Questionnaires (ASQ-3) and ASQ:Social-Emotional (ASQ:SE-2), and annually using the Child Behaviour Checklist (CBCL).
The results of 125 children (mean age 20.0 months, 48% female) were analysed. The mean length of stay in programme was 21.2 (7.3) months. At baseline, 92 (73.6%) children were at risk of develop-mental delay and 25 (31.7%) children aged ≥18 months had behavioural concerns. The programme was associated with significant improvements in gross motor (=0.002) and fine motor (=0.001) domains of the ASQ-3 and internalising problem scale (=0.001) of the CBCL.
Anchor effectively enhances develop-mental and behavioural outcomes for children exposed to maltreatment. Targeted early intervention through such programmes can mitigate adverse impacts, optimising developmental trajectories and potentially reducing the long-term clinical and economic burdens associated with ACEs.
童年不良经历（ACEs）会产生重大的长期影响，但专门针对ACE暴露的干预措施却很少，尤其是在亚洲人群中。新加坡首个家访项目“Anchor”旨在解决学龄前儿童遭受虐待的问题。本研究评估了“Anchor”对儿童发育和行为结果的影响。
我们对2019年11月至2023年7月期间接受虐待评估的4岁以下儿童进行了前瞻性评估。每6个月使用《年龄与发育阶段问卷》（ASQ - 3）和《ASQ：社会情感问卷》（ASQ：SE - 2）测量发育和行为进展，每年使用《儿童行为检查表》（CBCL）进行测量。
分析了125名儿童（平均年龄20.0个月，48%为女性）的结果。项目平均停留时间为21.2（7.3）个月。基线时，92名（73.6%）儿童有发育迟缓风险，25名（31.7%）18个月及以上儿童存在行为问题。该项目与ASQ - 3的大运动（=0.002）和精细运动（=0.001）领域以及CBCL的内化问题量表（=0.001）的显著改善相关。
“Anchor”有效地改善了遭受虐待儿童的发育和行为结果。通过此类项目进行有针对性的早期干预可以减轻不良影响，优化发育轨迹，并有可能减轻与ACEs相关的长期临床和经济负担。
