Bassuk E L, Weinreb L F, Dawson R, Perloff J N, Buckner J C
Better Homes Fund, Newton, Massachusetts 02159, USA.
Pediatrics. 1997 Jul;100(1):92-100. doi: 10.1542/peds.100.1.92.
To describe the characteristics of homeless and low-income preschool-aged children, and to identify family and environmental determinants of their behavior.
An unmatched case-control design was used to recruit a sample of sheltered homeless families and a comparison group of low-income housed families who were never homeless in Worcester, Massachusetts. Seventy-seven sheltered homeless and 90 low-income housed mothers with preschool-age children were assessed using a comprehensive interview protocol. Information about mothers' housing, income, service use, par-enting practices, and children's father was obtained. Data about children's background, health, and life events were included. Standardized instruments were administered to assess mothers' mental health and their children's behavior. Comparisons of homeless and low-income housed families were used to describe the sample of 167 preschoolers. Multiple linear regression was used to examine the association of various stressors, such as homelessness, and family factors with their behavior.
Although homeless preschoolers were significantly more likely to have experienced stressful life events, undergone a care and protection investigation, and been placed in foster care when compared with low income preschoolers, differences in adverse behaviors were minimal. Although homeless children scored higher than housed children on the internalizing, externalizing, and total problem score on the Child Behavior Checklist (CBCL) (52.5 vs 49.9, 54.8 vs 51.2, and 54.4 vs 51.1, respectively), approximately equal numbers of children from both groups scored in the clinical range. With regard to determinants of behavior, mothers' emotional status was one of the strongest independent predictors of negative behavioral outcomes on both subscales. Foster care placement and death of a child's friend were predictors of adverse internalizing behavioral outcomes on the CBCL. After controlling for housing status, parenting practices, child's age, child's history of physical abuse, and specific life stressors predicted adverse externalizing behavioral outcomes. For both subscales, housing status and behavior were only marginally associated in the multivariate model.
Both homeless and low-income children experienced significant adversity in their lives, with homeless preschool children facing more stress. However, differences in behavior as measured by the CBCL were minimal. Mothers' emotional status, in addition to various stressors, strongly predict children's negative outcomes for both CBCL subscales. These findings emphasize the importance of preventive family-oriented interventions that address the needs of preschoolers and their mothers.
描述无家可归和低收入学龄前儿童的特征，并确定其行为的家庭和环境决定因素。
采用非匹配病例对照设计，在马萨诸塞州伍斯特招募了一个受庇护的无家可归家庭样本以及一个从未无家可归的低收入有住房家庭的对照组。使用综合访谈方案对77名受庇护的无家可归母亲和90名有学龄前儿童的低收入有住房母亲进行评估。获取了有关母亲住房、收入、服务使用、育儿方式以及孩子父亲的信息。纳入了有关孩子背景、健康和生活事件的数据。使用标准化工具评估母亲的心理健康及其孩子的行为。通过比较无家可归家庭和低收入有住房家庭来描述这167名学龄前儿童的样本。使用多元线性回归来检验各种压力源（如无家可归）和家庭因素与其行为之间的关联。
与低收入学龄前儿童相比，无家可归的学龄前儿童经历压力性生活事件、接受照料和保护调查以及被安置在寄养家庭的可能性显著更高，但不良行为方面的差异很小。尽管在儿童行为清单（CBCL）的内化、外化和总问题得分上，无家可归儿童的得分高于有住房儿童（分别为52.5对49.9、54.8对51.2和54.4对51.1），但两组中得分处于临床范围的儿童数量大致相等。关于行为的决定因素，母亲的情绪状态是两个分量表上负面行为结果最强的独立预测因素之一。寄养安置和孩子朋友的死亡是CBCL上内化行为不良结果的预测因素。在控制了住房状况、育儿方式、孩子年龄、孩子身体虐待史和特定生活压力源后，预测了外化行为不良结果。在多变量模型中，住房状况与行为仅存在微弱关联。
无家可归儿童和低收入儿童在生活中都经历了重大逆境，无家可归的学龄前儿童面临更多压力。然而，用CBCL衡量的行为差异很小。母亲的情绪状态以及各种压力源强烈预测了CBCL两个分量表上孩子的负面结果。这些发现强调了针对学龄前儿童及其母亲需求的预防性家庭干预措施的重要性。
