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1.
The outcome of an early intervention program for low-birthweight (LBW) infants was examined in this study. The intervention consisted of 11 sessions, beginning during the final week of hospitalization and extending into the home over a 3-month period. The program aimed to facilitate maternal adjustment to the care of a LBW infant, and, indirectly, to enhance the child's development. Neonates weighing less than 2,200 grams and under 37 weeks gestational age were randomly assigned to experimental or control conditions. A full-term, normal birthweight (NBW) group served as a second control. 6-month analyses of dyads who completed all assessments over a 4-year period (N's = 25 LBW experimental, 29 LBW control, and 28 NBW infant-mother dyads) showed that the experimental group mothers reported significantly greater self-confidence and satisfaction with mothering, as well as more favorable perception of infant temperament than LBW control group mothers. A progressive divergence between the LBW experimental and LBW control children on cognitive scores culminated in significant group differences on the McCarthy GCI at ages 36 and 48 months, when the LBW experimental group caught up to the NBW group. Possible explanations for the observed delay in the emergence of intervention effects on cognitive development and the mediating role of favorable mother-infant transactional patterns are discussed in light of recent evidence from the literature.  相似文献   

2.
Objective: To evaluate intermittent Kangaroo Mother Care (KMC) with additional opportunities to breastfeed on weight gain of low birth weight (LBW) neonates with delayed weight gain. Methods: 40 LBW neonates were followed to see whether KMC with additional opportunities to breastfeed improved weight gain. Results: In the KMC group, the mean age of regaining birth weight was significantly less (15.68 vs. 24.56 days) and the average daily weight gain was significantly higher (22.09 vs. 10.39 g, p < .001) than controls. Conclusion: KMC with additional opportunities to breastfeed was found to be an effective intervention for LBWs with delayed weight gain and should be considered to be an effective strategy.  相似文献   

3.
The Infant Health and Development Program is a randomized clinical trial to test the efficacy of educational and family support services and pediatric follow-up offered in the first 3 years of life on reducing the incidence of developmental delay in low-birthweight (LBW), preterm infants in 8 clinical sites ( N = 985). Effects of the intervention on cognitive and behavior problem scores over the 3 years are examined. Significant intervention effects were seen on cognitive scores at 24 and 36 but not 12 months of age; effect sizes were similar at both ages. These effects persist when controlling for earlier cognitive scores. At 24 and 36 months, behavior problem scores for the intervention group were significantly lower than for the follow-up group; the intervention was more efficacious for children with higher initial behavior problem scores. Results are discussed in terms of timing and targeting of services for LBW and disadvantaged children.  相似文献   

4.
Epidemiologic variations in childhood sexual abuse   总被引：3，自引：0，他引：3  
We retrospectively reviewed records of 566 children ranging from 6 months to 16 years of age who presented to a sexual assault crisis center. They represented 33.2% of all alleged sexual assault victims seen over a 36 month period. There were 103 males (18.2%) and 463 females (81.8%). Significant differences in presentation were demonstrated with respect to the victim's age, sex, and race, but the major factor influencing the variation is the victim/assailant relationship. Younger children were more likely than older children to present with histories of multiple assaults (p less than .0005), by known assailants (p less than .0005), occurring in the child's or assailant's home (p less than .001) and to report less violence (p less than .05). More risk of violence (p less than .0005) or evidence of trauma (p less than .0005) and less reporting of home assaults (p less than .0005) or multiple assault episodes (p less than .0005) were found in assaults by strangers when compared with non-stranger assaults. A lower frequency of reporting was found in females between 7 and 11 years of age. The dynamics of childhood sexual abuse are discussed in relationship to these findings. A number of victim and assailant related factors determine reporting patterns of childhood sexual abuse.  相似文献   

5.
A tobacco use prevention curriculum tailored for deaf/hard of hearing youth was tested using a quasi-experimental design. Two schools for the deaf received the curriculum; two served as noncurriculum controls. Surveys assessed changes in tobacco use, tobacco education exposure, and tobacco-related attitudes and knowledge among students in grades 7-12 over 3 school years (n = 511-616). Current (past month) smoking decreased significantly at one intervention school (23% to 8%,p = .007), and current smokeless tobacco use at the other (7.5% to 2.5%, p = .03). Tobacco education exposure and antitobacco attitudes and knowledge increased significantly at one or both intervention schools. At one control school, reported tobacco education exposure decreased (p < .001) and antitobacco attitudes increased (p = .01). The results indicate that the curriculum increased perceived tobacco education exposure and significantly affected tobacco-related practices, attitudes, and knowledge.  相似文献   

6.
OBJECTIVE: The aim of this study was to examine associations between childhood adversity, parental bonding, gender, depressive symptoms, and quality of life in non-treatment-seeking adults from the community. METHOD: Effects of differential parental rearing were compared in adults who reported a high degree of childhood maltreatment (n=72) and those who reported no significant adverse events in childhood (n=69). Subjects completed retrospective measures of childhood maltreatment and perceived parenting style, as well as measures of current depressive symptoms and quality of life. RESULTS: The subjects without childhood maltreatment were younger and endorsed less current depressive symptomatology than did subjects with childhood maltreatment. While the subjects without a history of maltreatment reported more "optimal" bonding experiences with their parents, the maltreatment group members were more likely to characterize their early parental bonding experiences in terms of "affectionless control" (p<.001 for both maternal and paternal parenting), "affectionate constraint" (p=.025 for maternal parenting and p=.004 for paternal parenting), or "weak or absent" bonding (p<.001 for both maternal and paternal parenting). Results of a multiple regression analysis revealed that overall quality of paternal care (p=.015) and current level of depressive symptoms (p<.001) were significant independent predictors of adult quality of life. Gender effects between subjects providing parental bonding data were limited to the group with childhood maltreatment. CONCLUSION: These findings extend previous work documenting a relationship between early life maltreatment and suboptimal parental bonding, suggesting gender-specific effects of maternal and paternal care. Effects of childhood maltreatment on quality of life in adulthood appear to be linked with the quality of childhood paternal care and the occurrence of depressive symptomatology in adulthood, suggesting possible targets for primary or secondary prevention.  相似文献   

7.
Although kinship guardianship is an increasingly important foster care exit pathway for children in the United States, research on the factors leading to kinship guardianship breakdown is lacking. This study examines the factors associated with guardianship breakdown for children who exited foster care to kinship guardianship in California between 2003 and 2010 (N = 18,831). Specifying time-dependent Cox relative risk models, children’s age trajectories are directly accounted for in the analysis. This allows differentiation between duration dependence (i.e., time spent in guardianship) and children’s development (expressed as age). Overall, 17.3% of children reentered care by 2017. Early adolescents, age 13–15 years (HR = 1.63, p < .001), and late adolescents, age 16–17 years (HR = 1.93, p < .001), had an increased hazard of reentry compared with children under the age of six. Children with a history of mental health concerns had more than twice the hazard of reentering than children without such a history (HR = 2.18, p < .001). Our findings indicate that transition to adolescence was associated with increased risk of reentry into care, highlighting the need for guardianship support services leading up to, and during, this child developmental stage.  相似文献   

8.
This study compared the effects on reading outcomes of delivering supplemental, small-group intervention to first-grade students at risk for reading difficulties randomly assigned to one of three different treatment schedules: extended (4 sessions per week, 16 weeks; n = 66), concentrated (4 sessions per week, 8 weeks; n = 64), or distributed (2 sessions per week, 16 weeks; n = 62) schedules. All at-risk readers, identified through screening followed by 8 weeks of oral reading fluency (ORF) progress monitoring, received the same Tier 2 reading intervention in groups of 2 to 4 beginning in January of Grade 1. Group means were higher in word reading and ORF at the final time point relative to pretest; however, the groups did not differ significantly on any reading outcome or on rates of adequate intervention response. Of potential covariates, site, age, free lunch status, program coverage rate, and tutor were significantly related to student outcomes; however, the addition of these variables in multivariate models did not substantially change results. Rates of adequate intervention response were lower than have been reported for some first-grade interventions of longer duration.  相似文献   

9.
OBJECTIVE: No published studies have examined childhood abuse and neglect in body dysmorphic disorder (BDD). This study examined the prevalence and clinical correlates of abuse and neglect in individuals with this disorder. METHODS: Seventy-five subjects (69.3% female, mean age=35.4+/-12.0) with DSM-IV BDD completed the Childhood Trauma Questionnaire and were interviewed with other reliable and valid measures. RESULTS: Of these subjects, 78.7% reported a history of childhood maltreatment: emotional neglect (68.0%), emotional abuse (56.0%), physical abuse (34.7%), physical neglect (33.3%), and sexual abuse (28.0%). Forty percent of subjects reported severe maltreatment. Among females (n=52), severity of reported abuse and neglect were .32-.57 standard deviation units higher than norms for a health maintenance organization (HMO) sample of women. Severity of sexual abuse was the only type of maltreatment significantly associated with current BDD severity (r=.23, p=.047). However, severity of sexual abuse did not predict current BDD severity in a simultaneous multiple regression analysis with age and current treatment status. There were other significant associations with childhood maltreatment: history of attempted suicide was related to emotional (p=.004), physical (p=.014), and sexual abuse (p=.038). Childhood emotional abuse was associated with a lifetime substance use disorder (r=.26, p=.02), and physical abuse was negatively associated with a lifetime mood disorder (r=-.37, p=.001). CONCLUSIONS: A high proportion of individuals with BDD reported childhood abuse and neglect. Certain types of abuse and neglect appear modestly associated with BDD symptom severity and with gender, suicidality, and certain disorders.  相似文献   

10.
Nine years after child sexual abuse   总被引：7，自引：0，他引：7  
OBJECTIVE: During 1988-1990, 103 children presented to Child Protection Units (CPU) at two children's hospitals in Sydney, Australia. Nine years later, the psychological adjustment of these young people (mean age=19.1 years, SD=3.4 years; range=14-25 years) was compared with that of non-abused young people of similar age and gender to assess group differences and examine potential risk factors. METHOD: At intake, data on the nature of the index sexual abuse, demographics and the family environment were collected by clinicians. A comparison group, of similar age and gender, was selected from schools in the catchment area of the CPUs. Six years after presentation for the abuse, records of the statutory child protection authority were checked to determine any further notifications for abuse and/or neglect. Nine years after intake, 49 of the abused young people and 68 of the non-abused young people and/or their parents were interviewed and assessed. RESULTS: The sexually abused young people performed more poorly than non-abused young people on psychometric tests of depression (p=.001), self-esteem (p<.001), anxiety (p<.001), behavior (Child Behavior Checklist: p=.01; Youth Self Report: p=.01; Young Adult Self Report: p<.001), and despair (p=.001). They were also more likely to have a history of bingeing (p=.002), self-inducing vomiting (p=.02), smoking cigarettes (p=.01), and using amphetamines (p=.002), ecstasy (p=.002) and cocaine (p=.004). Potential risk factors were in two groups, family and child. Family factors: family functioning, parental drug/alcohol problems, mother's sexual abuse history, mother's depression and socio-economic status. Child factors: despair and hopefulness, number of negative life events, ratings of their father's care, previous notifications for child sexual abuse and placements in out-of-home care by the statutory child protection authority. In the presence of other risk factors, child sexual abuse was a significant predictor of self-esteem, behavior and bingeing. CONCLUSIONS: Rather than focusing only on the individual's child sexual abuse, treatment may also need to address the family's functioning and the individual's feelings of despair.  相似文献   

11.
OBJECTIVE: To describe the presenting characteristics, hospital course, and hospital charges associated with hospital admissions for head trauma in young children at a regional pediatric trauma center, and to examine whether these factors differ among abused and non-abused subjects. METHOD: Comparative case series study involving a retrospective medical record review of children less than 3 years of age admitted to Children's Hospital of Pittsburgh from January 1, 1995 to December 31, 1999. Subjects (n=377) were identified on the basis of ICD-9-CM codes for head injury. Subjects were classified as abused or non-abused based on standard criteria using information about the type of injuries, the history provided by the caretaker, and physical and radiographic findings. RESULTS: Eighty nine (23.6%) subjects were classified as abused and 288 (76.4%) were classified as non-abused. Abused subjects were more likely then non-abused subjects to be <1 year of age (vs. >1 year of age) (OR: 9.8; 95% CI: 5.0, 19.2), covered by Medicaid (vs. commercial insurance) (OR: 2.8; 95% CI: 1.7, 4.8), and admitted to the ICU (OR: 3.5; 95% CI: 2.1, 5.8; p<.001). The caretakers of abused subjects were more likely to give a history of no trauma or minor trauma compared to the caretakers of non-abused subjects (97% vs. 54%, p<.001). Length of stay was significantly greater for abused subjects versus non-abused subjects (mean: 9.25 days vs. 3.03 days, p<.001). Hospital charges (1999 dollars) were significantly higher for abused (mean+/-SD: 40,082 dollars +/- 58,004 dollars) versus non-abused (mean +/- SD: 15,671 dollars +/- 41,777 dollars) subjects. CONCLUSIONS: These results highlight the differences in the demographics, presenting characteristics and economic impact of abusive head injuries compared to non-abusive head injuries.  相似文献   

12.
OBJECTIVE: To determine which areas of family functioning lay therapy intervention can improve in a home visitation program for first time mothers at high risk for parenting difficulties, including the potential for child abuse and neglect. METHODS: Families were assessed for risk of parenting difficulties using the Parent Readiness and Risk Assessment Checklists. Lay therapists completed the Scale of Family Functioning pre- and postintervention with 108 high risk families for whom they provided support, education, and referrals. RESULTS: Paired t tests were done to determine whether the eight categories of the Scale of Family Functioning improved from baseline to termination of the service. Four categories showed statistically significant improvement: social support (p = .001), self-esteem (p < .001), confidence as a parent (p < .001), and affective relationships (p = .003). CONCLUSIONS: Statistically significant improvement occurred in four of the eight categories on the Scale of Family Functioning indicating that home intervention programs can improve some categories of family functioning. Longer intervention and an increased focus on improving parent/infant interactions may be able to increase parental sensitivity and expectations. In this study, the categories of family conflict and stability/meeting basic needs were not amenable to change with lay therapy intervention.  相似文献   

13.
Prematurity and low birth weight (LBW) are two major biological factors that put infants and young children at high risk for developmental delays or disabilities. While survival rates for premature and LBW children have improved, incidence figures have changed little over the past 20 years; in fact, the incidence of LBW has increased. Although the vast majority of LBW children have normal outcomes, as a group, they have higher risk for subnormal growth, illnesses, and neurodevelopmental problems. The purpose of this article is to examine the factors that influence the effectiveness of early intervention for premature, LBW children and to describe a strategy for linking assessment and early intervention. Linking assessment and intervention involves comprehensive assessment; a team approach to both assessment and intervention; empowering and enabling families; and the development of functional goals and objectives.  相似文献   

14.
Abstract

This study compared the effects on reading outcomes of delivering supplemental, small-group intervention to first-grade students at risk for reading difficulties randomly assigned to one of three different treatment schedules: extended (4 sessions per week, 16 weeks; n = 66), concentrated (4 sessions per week, 8 weeks; n = 64), or distributed (2 sessions per week, 16 weeks; n = 62) schedules. All at-risk readers, identified through screening followed by 8 weeks of oral reading fluency (ORF) progress monitoring, received the same Tier 2 reading intervention in groups of 2 to 4 beginning in January of Grade 1. Group means were higher in word reading and ORF at the final time point relative to pretest; however, the groups did not differ significantly on any reading outcome or on rates of adequate intervention response. Of potential covariates, site, age, free lunch status, program coverage rate, and tutor were significantly related to student outcomes; however, the addition of these variables in multivariate models did not substantially change results. Rates of adequate intervention response were lower than have been reported for some first-grade interventions of longer duration.  相似文献   

15.
In order to determine if Ureaplasma urealyticum (Uu) or large colony mycoplasma (LCM) colonization was related to a history of sexual abuse, the type of sexual contact, an enlarged vaginal introitus transverse diameter (greater than 4 mm), age or race, 452 female children, ages 1-12 years, were evaluated by the Child Sexual Abuse Team at Wake Medical Center in Raleigh, NC. Thirty-six girls were deleted because of inadequate cultures. When controlled for race and age, Uu throat (T), vaginal (V), and rectal (R) colonization and LCM vaginal and rectal colonization were not related to any of the other variables listed above. The enlarged vaginal introital diameter was related to a history of sexual abuse (p less than .001). Uu and LCM vaginal colonization rates were increased in black girls as compared to white girls (p less than .05). Uu V, Uu R, LCM V, and LCM R colonization increased with age. In our study population, Uu and LCM colonization was not a useful marker of sexual contact.  相似文献   

16.
Growth at the age of 4 years subsequent to early failure to thrive   总被引：1，自引：0，他引：1  
Fifty-five children previously investigated for failure to thrive (a rate of weight gain below -2 SD) during at least 6 weeks at 4-18 months of age were followed up and reinvestigated at the age of 4 years. The children were studied in two groups: children with organic causes (OFTT) (n = 21); and children for whom no organic cause was found (nonorganic failure to thrive, NFTT) (n = 34). In children with OFTT, normalization of growth was found for both weight and height attained, as most of the diseases were either amenable to treatment or spontaneously subsided. The only exception was a child with severe encephalopathy. In children with NFTT, much lower values were found, particularly for weight, p less than .01 for both weight and height. Children with a low psychosocial score (less than or equal to 3 adverse factors) showed partial catch-up growth, although significantly lower than that of children with OFFT. Among 13 children with high psychosocial scores (greater than or equal to 4), 6 children had been subjected to strong social and/or psychological intervention. These children showed a more favorable growth pattern compared to children with comparable psychosocial scores where no intervention had been undertaken. The children with NFTT continued to grow slowly, remained meager and seemed to maintain a suboptimal growth pattern, particularly those with higher numbers of risk factors.  相似文献   

17.
ABSTRACT

This randomized control trial study evaluated the effectiveness of the solution-focused approach in addressing academic, motivational, and socioemotional needs of 14 children with reading difficulties. The intervention group received five 40-min solution-focused sessions. The control group received academic homework support. Results showed advantages for the intervention condition in 26 out of 38 measures. The mean eta-squared effect size for intervention was .20 (very) large. For the control group, there were only 10 effects favoring it and the mean was .09, a medium sized effect, both significantly greater than 0 (p < .01). Comparisons of the solution-focused brief therapy (SFBT) effect sizes to the mean of the control showed it was significantly larger (p < .001), confirming that SFBT was an efficacious intervention in this sample.  相似文献   

18.

Two levels of training (100 vs. 500 trials) and two ages of rats (young and adult) were used in a developmental analysis of the relationship between response strength and the effects of punishment. The apparatus was a Y maze with three discriminably different arms. After 100 or 500 reinforced trials, subjects were shocked each time they responded in one arm. The recovery sessions followed the punishment session. Results from the punishment day indicated that: (a) young rats received a greater amount of shock, and (b) additional training increased the amount of shock received by the young but decreased it in the adults. The recovery data showed that: (a) the suppressive effects of punishment were greater for the adults than for the young, and (b) the recovery scores were not influenced by degree of overtraining. The Age by Overtraining interaction suggested that the relationship between response strength and punishment is age dependent. The age differences found with the amount-of-shock and recovery measures provided additional support for the position that younger rats are less competent than adult rats in inhibiting responses.

  相似文献   

19.
The caregiving environment experienced by 243 premature, low birthweight (LBW) children living in poverty was examined to determine whether the quality of care such children receive affords them some measure of protection from the generally deleterious consequences of poverty and prematurity. Only 26 children were identified as functioning in the normal range for cognitive, social/adaptive, health, and growth parameters at age 3. These children, who showed early signs of resiliency, differed from nonresilient children in that they were receiving more responsive, accepting, stimulating, and organized care. They were also living in safer, less crowded homes. 6 "protective" aspects of caregiving were identified and used as part of a cumulative protection index. Children with less than 3 protective aspects of caregiving present at age 1 had only a 2% probability of being resilient, and only a 6% probability if fewer than 3 were present at age 3. Overall, premature LBW children born into conditions of poverty have a very poor prognosis of functioning within normal ranges across all the dimensions of health and development assessed. However, those raised in a setting with 3 or more protective factors were more likely to show early signs of resiliency.  相似文献   

20.
Abstract

The current study examined the effects of a silent rapid reading skills training intervention on the reading rate and reading achievement of primary school students in China in order to determine the efficacy of the intervention and explore potential gender differences. A total of 108 Chinese primary school students were randomly assigned by the classroom to either an experimental (n = 54) or control (n = 54) condition. Students in the experimental group completed 12 sessions of rapid reading skills training designed to increase their ability to rapidly read Chinese text in silence. Students in the control group engaged in regular Chinese language curriculum for the same time period. After the three-week intervention period, students in the experimental group displayed significantly greater silent reading speed of Chinese characters (M?=?1331.26 characters per minute) compared to students in the control group (M?=?617.48 characters per minute; p?<?.001). Children in the intervention group also displayed a significantly greater effective reading rate (F = 87.11, p?<?.001, partial η2?=?0.46) at post-test compared to the control. Male students displayed greater increases in reading speed than female students. Neither intervention effect nor gender difference was evident for reading comprehension. Implications for educational interventions designed to increase silent reading speed among Chinese students are discussed.  相似文献   

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