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1.
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   

2.
A treatment program for families at-risk of abusive or neglectful parenting was described and evaluated. The program combined intervention strategies and concepts based on research on abuse, early intervention, education and social service. Treatment and education for the parent and child were provided in the three services of the program: Home-Based, Family School, and Neighborhood Peer Support Groups. At-risk families were identified by a high-risk stress index. Program evaluation was based on 46 families and their 74 preschool-age children. Data collected were: incidence of child abuse or neglect, family stresses, observations of parent-child interactions, family goal measurement, and developmental testing of the children. A significant reduction occurred in the number of children abused or neglected as compared to a similar high-risk, nonintervention sample. The family stresses were reduced, parent-child interactions improved, and the intellectual decline of the children was prevented. Families who participated in all three services gained the most from the program.  相似文献   

3.
Meeting Needs of Young Children at Risk for or Having a Disability   总被引:1,自引:0,他引:1  
Poverty-related factors place children at higher risk for disabilities and also serve as barriers to families accessing services for their children and themselves. Early childhood practitioners can play a critical role in supporting families by providing services to overcome these obstacles and by working in partnership with specialized early intervention programs to assure the families and children receive those services. Families (N = 3,001) enrolled in the Early Head Start (EHS) Research and Evaluation Project were randomly assigned to the program group (who received EHS services) or the control group in a rigorous, experimental design study in order to evaluate program impacts. All participating families were living in poverty, included a pregnant woman or a child below age 1, and were eligible for EHS. The majority of children enrolled in the EHS Research and Evaluation Project was identified as having at least one of a great variety of disability indicators (e.g., family received Part C services, child has been diagnosed as having asthma). There was a very small number of families, however, actually enrolled in Part C services. Enrollment in EHS was associated with children being less likely to have cognitive or language delays and their families being more likely to receive early intervention (Part C) services and have Individualized Family Service Plans (IFSPs) when they needed them.  相似文献   

4.
Seven hundred thirty-one income-eligible families in 3 geographical regions who were enrolled in a national food supplement program were screened and randomized to a brief family intervention. At child ages 2 and 3, the intervention group caregivers were offered the Family Check-Up and linked parenting support services. Latent growth models on caregiver reports at child ages 2, 3, and 4 revealed decreased behavior problems when compared with the control group. Intervention effects occurred predominantly among families reporting high levels of problem behavior at child age 2. Families in the intervention condition improved on direct observation measures of caregivers' positive behavior support at child ages 2 and 3; improvements in positive behavior support mediated improvements in children's early problem behavior.  相似文献   

5.
Following is a project sketch of a day program for adjudicated, abusive* and high risk families with babies 8–18 months of age.In order to broaden understanding and treatment of the battered child, four major agencies coordinated efforts to design a network of services under one administration, titled the Parental Stress Center, which houses a residential treatment center for babies 0–12 months. The FACT program is a very recent addition to the Parental Stress Center. This day program may be a transitional placement for families leaving the residential program but in need of continued support and further training, or an initial placement by court mandate.The goals of the program are to insure growth and development of the child and the parent; to assist in establishing more scientific and legally acceptable criteria for court determination and disposition, and to research the effectiveness of the program plan.The FACT program is both diagnostic and therapeutic in nature. The modality simulates a home environment — living, dining, play, nursery, kitchen and bathroom — with an interdisciplinary approach to parent and child, alleviating frustration and stress. By use of materials and affective behavior, a creative learning environment is established. In the church converted apartment parents and children experience a “typical” day's routine alongside teachers who are surrogate, model mothers. Each set of parents are given one day off per week. This “normalizing” factor aids the family in developing a routine which can easily be transferred to their own homes and lives. Simultaneously judicious use of social services helps remove environmental frustrations. In addition case conferences allow other ancillary services to assist in evaluation, diagnosis, prognosis and implementation. Joint conclusions are submitted to the courts quarterly or biannually for further jurisdiction. Although the program is relatively new, emotional and behavioral changes are quite evident in the initial program participants.Pre-service and in-service staff training, based on the program plan and program evaluation, are an integral part of the program.Areas are being explored for further in-depth study. “Effective ways to care for and educate stressful toddlers” or “Methods of transferring modes of parenting from institution to the home” could be areas proposed to the Parental Research team for exploration.  相似文献   

6.
This study examined child maltreatment as a function of cumulative family risk in a sample of at-risk families (N = 837) who were referred to an intensive family preservation program because of child behavior problems or suspected child abuse and neglect. The goal of this intensive family preservation program is to improve parenting skills and reduce immediate family stressors that may lead to an increased risk of child abuse and neglect. The findings indicate that the most prominent family risks comprising the cumulative risk scale in our sample were socio-economic disadvantage (e.g., income, unemployment, housing instability) and parental characteristics (e.g., mental/physical health, parental use of alcohol, domestic violence). Further, the results demonstrated a strong quadratic trend in the relationship between cumulative family risk and child maltreatment, and identified a risk threshold effect at three cumulative family risks after which the child risk for maltreatment increased exponentially. These findings are interpreted in the light of the current research on differentiative interventions, supporting differentiated services to the families with low vs. higher risk for child maltreatment.  相似文献   

7.
The At Risk Parent Child Program is a multidisciplinary network agency designed for the secondary prevention of poor parenting and the extremes of child abuse and neglect. This model system of service delivery emphasizes (1) the coordination of existing community resources to access a target population of families at risk of parenting problems, (2) the provision of multiple special services in a neutral location (ambulatory pediatric clinic), and (3) the importance of intensive individual contact with a clinical professional who serves as primary therapist, social advocate and service coordinator for client families. Identification and assessment of families is best done during prenatal and perinatal periods. Both formal and informal procedures for screening for risk factors are described, and a simple set of at risk criteria for use by hospital nursing staff is provided. Preventive intervention strategies include special medical, psychological, social and developmental services, offered in an inpatient; outpatient, or in-home setting. Matching family needs to modality and setting of treatment is a major program concern. All direct services to at risk families are supplied by professionals employed within existing local agencies (hospital, public health department, state guidance center, and medical school pediatric clinic). Multiple agency involvement allows a broad-based screening capacity which allows thousands of families routine access to program services. The administrative center of the network stands as an independent, community-funded core which coordinates and monitors direct clinical services, and provides local political advocacy for families at risk of parenting problems.  相似文献   

8.
A family developmental framework was applied to data from families of children with intellectual disabilities to understand the role of parenting in the path from early adversity to problem behaviors in mid-childhood. Data from 9 months to 11 years tested the Family Stress Model in families of 555 children. Adversarial parenting between 3 and 5 years mediated the path from early adversity (family poverty and maternal psychological distress at nine months) to problem behaviors at 7 and 11 years. Positive parent–child relationship only mediated the path to conduct problems. Multiple mediation was not present. Early adversity impacts both positive parent–child relationship and adversarial parenting between three and five, but the latter is crucial for problem behaviors in mid-childhood.  相似文献   

9.
Much is known about how to provide safe environments for preschool children (3–5 years-of-age); however, many preschool children still experience preventable injuries—particularly children living in poverty. This study examined the use of an assessment tool used to identify children at risk for unintended injury in two large, federally funded Head Start programs during home visits. Families of preschool children in two multi-center Head Start programs (N = 499 and N = 228) were screened by teachers for risks related to safety in their home and parenting environment during mandatory Head Start home visits in the fall and spring. The safety screening tool was part of an established, broader interview assessment called the Family Map, which was designed to help Head Start programs meet mandatory performance standards related to the identification of risk and strengths in the family. Study results indicated that a large number of preschool children from low-income backgrounds were at risk for a variety of risks related to unintentional injury. Further, in some areas Head Start families increased their safety related parenting behaviors by the second assessment with different areas noted in the two programs. This study demonstrated that, beyond the use of the tool to identify families in need of intervention services, it can be used by childcare providers to effectively monitor family need and for program self-assessment.  相似文献   

10.
The relationship between risk factors and Child Protective Services (CPS) outcomes in families who participate in home visiting programs to prevent abuse and neglect and who are reported to CPS is largely unknown. We examined the relationship between parental risk factors and the substantiation status and number of CPS reports in families in a statewide prevention program. We reviewed CPS reports from 2006 to 2008 for families in Connecticut's child abuse prevention program. Six risk factors (histories of CPS, domestic violence [DV], mental health, sexual abuse, substance abuse, and criminal involvement) and the number of caregivers were abstracted to create risk scores for each family member. Maltreatment type, substantiation, and number of reports were recorded. Odds ratios were calculated. Of 1,125 families, 171 (15.6%) had at least one CPS report, and reports of 131 families were available for review. Families with a substantiated (25.2%) versus unsubstantiated (74.8%) first report had a high number of paternal risk factors (OR = 6.13, 95% CI [1.89, 20.00]) and were more likely to have a history of maternal DV (OR = 8.47, 95% CI [2.96, 24.39]), paternal DV (OR = 11.23, 95% CI [3.33, 38.46]), and maternal criminal history (OR = 4.55; 95% CI [1.32, 15.60]). Families with >1 report (34.4%) versus 1 report (65.6%) were more likely to have >3 caregivers, but this was not statistically significant (OR = 2.53, 95% CI [0.98, 6.54]). In a prevention program for first-time families, DV, paternal risk, maternal criminal history, and an increased number of caregivers were associated with maltreatment outcomes. Targeting parental violence may impact child abuse prevention.  相似文献   

11.
OBJECTIVE: To evaluate the effects of a home visiting program modeled after Healthy Families America on parenting behaviors in the first 2 years of life. METHODS: A sample of 1173 families at risk for child abuse and neglect who met the criteria for Healthy Families New York (HFNY) was randomly assigned to either an intervention group that was offered HFNY or a control group that was given information and referrals to other services. Data were collected through a review of CPS records, and maternal interviews at baseline and the child's first birthday (90% re-interviewed) and second birthday (85% re-interviewed). RESULTS: HFNY mothers reported committing one-quarter as many acts of serious abuse at age 2 as control mothers (.01 versus .04, p<.05). Two sets of interactions were tested and found to have significant effects (p<.05). At age 2, young, first-time mothers in the HFNY group who were randomly assigned at 30 weeks of pregnancy or less were less likely than counterparts in the control group to engage in minor physical aggression in the past year (51% versus 70%) and harsh parenting in the past week (41% versus 62%). Among women who were "psychologically vulnerable," HFNY mothers were one-quarter as likely to report engaging in serious abuse and neglect as control mothers (5% versus 19%) at age 2. CONCLUSIONS: These findings suggest that who is offered home visitation may be an important factor in explaining the differential effectiveness of home visitation programs. Improved effects may be realized by prioritizing the populations served or by enhancing the model to meet program objectives for hard-to-serve families.  相似文献   

12.
OBJECTIVES: To assess the impact of a voluntary, paraprofessional home visiting program on promoting child health and development and maternal parenting knowledge, attitudes, and behaviors. METHODS: This collaborative, experimental study of 6 Healthy Families Alaska (HFAK) programs enrolled 325 families from 1/00 to 7/01, randomly assigned them to HFAK and control groups, interviewed mothers at baseline, and followed families until children were 2 years old (85% follow-up). Child outcomes included health care use, development and behavior. Parent outcomes included knowledge of infant development, parenting attitudes, quality of the home environment, and parent-child interaction. HFAK records were reviewed to measure home visiting services. Home visitors were surveyed to measure knowledge, perceived effectiveness and perceived training adequacy. RESULTS: There was no overall impact on child health, but HFAK group children had more favorable developmental and behavioral outcomes. HFAK and control mothers had similar parenting outcomes except that HFAK mothers had greater parenting self-efficacy (35.1 vs. 34.6 based on the Teti Self-Efficacy Scale, p<.05). Fewer HFAK families had a poor home environment for learning (20% vs. 31%, p<.001). HFAK families were more likely to use center-based parenting services (48% vs. 39%, p<.05). The impact was greater for families with lower baseline risk (Family Stress Checklist scores<45). There was little evidence of efficacy for families with a higher dose of service. CONCLUSIONS: The program promoted child development and reduced problem behaviors at 2 years. Impact could be strengthened by improving home visitor effectiveness in promoting effective parenting. Future research is needed to determine whether short-term benefits are sustained.  相似文献   

13.
In summary, the Circle House Residential Treatment Program for abusive families did meet its goals of protection of the child without separation from the family. The program was also effective in making and executing permanent plans for children in a relatively short period of time, but at huge financial cost.Residential care tor abusive families may be feasible if planned for 12–18 families at a time, thus utilizing staff fully. Also, in the Circle House program the single-parent families were clearly able to utilize the program to deal with their child-care techniques. Because the program was primarily geared to improving child-rearing patterns, some fathers in two-parent families, who viewed themselves as only occasional disciplinarians, never really participated in the program. Some were successful in learning new techniques, others were not.Residential care may also be more feasible if utilized as a diagnostic and prognostic facility with enhanced opportunity for long-term relationships to be formed, rather than as a primarily treatment facility, with the expectation of improvement and “cure.” Treatment of abusive families then becomes long-term supportive care no matter how intense the initial intervention. Even with the multitude of services of Circle House at the beginning phase of diagnosis and treatment of a family, this does not reduce or remove the need for ongoing long-term services. The true results of present intervention will be measured in future generations.  相似文献   

14.
Parenting differs in purpose and strategy according to cultural background (Brooks-Gunn & Markman, 2005; Iruka, LaForett, & Odom, 2012). The current study tests a unique latent factor score, Adaptive Parenting, that represents culturally-relevant, positive parenting behaviors: maternal coping with stress through reframing, maternal scaffolding of toddlers’ learning during a low-stress task, and maternal commands during a high-stress task. Participants were Black mothers (N = 119; Mage = 27.78) and their 24- to 30-month-old toddlers. Families were part of a broader study examining family resilience among urban, low-income young children and their families. Results demonstrate that the proposed variables align on a single factor and positively predict toddlers’ emotion regulation. Findings are discussed in the context of Black culturally-specific parenting processes.  相似文献   

15.
OBJECTIVES: This study evaluated client-level outcomes among an entire statewide group of Family Preservation and Family Support (FPFS) programs funded under PL 103-66. METHOD: A total of 1,601 clients (primarily low income, moderate to high risk with no current involvement in the child protection system) were assessed and followed over time for future child maltreatment events reported to Child Protective Services. The study compared program completers with program dropouts, compared recipients of more lengthy full-service programs with recipients of one-time services, and examined the effects of program duration, intensity, service site (center-based vs. home based) and service model/content. Effects were modeled using survival analysis and variable-exposure Poisson hierarchical models, controlling for initial client risk levels and removing failure events because of surveillance bias. Changes in lifestyle, economic and risk factors were also examined. RESULTS: A total of 198 (12.2%) participants had at least one defined failure event over a median follow-up period of 1.6 years. Controlling for risk and receipt of outside services, program completers did not differ from program dropouts or from recipients of one-time services, and there was no relationship between program intensity or duration and outcomes. Program types designed to help families meet basic concrete needs and programs using mentoring approaches were found to be more effective than parenting and child development oriented programming, and center-based services were found to be more effective than home-based services, especially among higher risk parents. CONCLUSIONS: The findings did not support the effectiveness of these services in preventing future maltreatment cases, and raised questions about a number of common family support assumptions regarding the superiority of home-visiting based and parent training services. A number of possible reasons for this are explored.  相似文献   

16.

Objective

A prevention form of the Incredible Years (IY) parenting program was offered to parents who had children enrolled in Head Start, regardless of whether they reported having a history of child maltreatment. This study compared whether parenting practices and child behavioral outcomes differed in families who self reported a history of child maltreatment relative to families who did not.

Methods

A site-randomized controlled trial of the IY parenting program was conducted in 64 classrooms in seven Head Start centers in Seattle, Washington. Families of 481 children took part in the study, with 335 in the IY condition and 146 in the control condition. Parenting practices and child behavior were measured by blinded raters through in-home observations and self-report questionnaires prior to the start of the IY program, in the spring after the IY program had concluded, and 12–18 months after study enrollment when children were in kindergarten. Analyses examine the impact of the IY program on parenting practices and children's behavior, exploring whether the program had differential impacts for parents with and without a self-reported history of child maltreatment.

Results

The IY program resulted in improvements along many parenting dimensions and on characteristics of observed child behavior. Program impacts were similar for parents who did and did not report a history of child maltreatment. However, parents with a reported history of prior maltreatment had greater initial room for improvement in areas such as harsh/critical parenting, nurturing/supportive parenting, and discipline competence than parents without such a history.

Conclusions

The IY parenting program has positive impacts for parents who self-reported a history of child maltreatment. While similar benefits were observed for both groups of parents in this study, results support delivering evidence-based parenting programs of longer duration and higher intensity than often used by agencies serving parents in contact with child welfare.

Practice

Agencies serving parents referred for child maltreatment should carefully examine the characteristics of the parenting programs they deliver. Use of a parenting program that has a sound base of empirical support, such as IY, and sufficient intensity and duration, is likely to make substantial changes in parents’ child-rearing practices.  相似文献   

17.
Identified spouse abuse as a risk factor for child abuse   总被引:4,自引:0,他引:4  
CONTEXT: There are limited data on the extent to which spouse abuse in a family is a risk factor for child abuse. OBJECTIVE: To estimate the subsequent relative risk of child abuse in families with a report of spouse abuse compared with other families. DESIGN: Cohort study. SETTING: Analysis of a centralized US Army database PARTICIPANTS: Married couples with children with at least one spouse on active duty in the US Army during 1989-95. MAIN OUTCOME MEASURES: The US Army Family Advocacy Program's Central Database was used to identify child and spouse abuse. The exposure was an episode of identified spouse abuse and the main outcome was a substantiated episode of subsequent child abuse.RESULTS: During the study period of an estimated 2,019,949 person years, 14,270 incident child abuse cases were substantiated. Families with an incident case of spouse abuse identified during the study period were twice as likely to have a substantiated report of child abuse compaired with other military families, rate ratio, 2.0, (95% confidence interval [CI] 1.9-2.1). Young parental age had the highest rate ratio, 4.9 (95% CI 4.5-5.3) in the subgroup analysis controlling for rank. Identified spouse abuse was associated with physical abuse of a child, rate ratio 2.4 (95% CI 2.2-2.5), and with sexual abuse of a child, rate ratio 1.5 (95% CI 1.3-1.7). Identified spouse abuse was not associated with child neglect or maltreatment, rate ratio, 1.0 95% CI 0.9-1.1) CONCLUSION: An identified episode of spouse abuse in a family appears to be associated with an increased risk of subsequent child abuse and serves as an independent risk factor. Therefore. care providers should consider the potential risk to children when dealing with spouse abuse.  相似文献   

18.
The relation of parenting style to adolescent school performance   总被引:21,自引:0,他引:21  
This article develops and tests a reformation of Baumrind's typology of authoritarian, permissive, and authoritative parenting styles in the context of adolescent school performance. Using a large and diverse sample of San Francisco Bay Area high school students (N = 7,836), we found that both authoritarian and permissive parenting styles were negatively associated with grades, and authoritative parenting was positively associated with grades. Parenting styles generally showed the expected relation to grades across gender, age, parental education, ethnic, and family structure categories. Authoritarian parenting tended to have a stronger association with grades than did the other 2 parenting styles, except among Hispanic males. The full typology best predicted grades among white students. Pure authoritative families (high on authoritative but not high on the other 2 indices) had the highest mean grades, while inconsistent families that combine authoritarian parenting with other parenting styles had the lowest grades.  相似文献   

19.
This study examined whether children attending Head Start for two years have better developmental outcomes than children attending for one year and whether their families enjoy a more positive family environment. Forty-five children were in the one-year duration group and 29 were in the two-years duration group. The Family Environment Scale (FES), the Child Development Inventory (CDI), and a demographic questionnaire were administered. Results indicated that children’s scores on the CDI did not differ as a function of the length of participation in Head Start. However, families who participated for two years reported an increased intellectual-cultural orientation, and increased active recreational orientation. These families placed greater emphasis on organization, and read more times to their child during the week than families who participated in the program for only one year.  相似文献   

20.
OBJECTIVE: This study aimed to: (1) Assess the community utility of a screening tool to identify families with child abuse or neglect risk factors in the immediate postnatal period (2) Determine the social validity and effectiveness of a home visiting program using community child health nurses and offering social work services for identified families, and (3) Identify factors in the immediate postnatal period associated with the child's environment that predict poor adjustment to the parenting role. METHOD: A randomized controlled trial using a cohort of 181 families was undertaken to evaluate the impact of a home visiting program. Mothers were recruited in the immediate postnatal period and allocated either into the home visiting program or into a comparison group. The research design required self-identification into the study by providing positive responses to a range of risk factors. A repeated measures design was used to test parenting stress and maternal depression from the immediate postnatal period to 12-month follow-up and physical child abuse potential to 18-month follow-up. To test whether measures taken in the immediate postnatal period were predictive for poor adjustment to the parenting role, a linear regression model was used. RESULTS: The screening procedure was shown to have utility in the context of recruitment to a research trial and mothers were willing to accept the home visiting program examined by this study from the immediate postnatal period. From as early as 6 weeks the program demonstrated ability to impact positively on maternal, infant, family, and home environment variables (testing 90 randomly allocated intervention vs. 91 comparison families). At follow-up, parental adjustment variables were not significantly different between groups (testing the remaining 68 (75.5%) intervention vs. 70 (76.9%) comparison families) and home environment assessment scores had converged. Predictive analysis of factors measured in the immediate postnatal period revealed an absence of any predictive value to demographic characteristics, which secondary prevention efforts typically target. CONCLUSIONS: Follow-up evaluation did not demonstrate a positive impact on parenting stress, parenting competence, or quality of the home environment confirming the need to test early program success on longer term outcomes. Further, thestudy not only demonstrated that there was a relationship between maternal, family and environmental factors identified in the immediate postnatal period. and adjustment to the parenting role, but also challenged demographic targeting for child abuse and neglect risk. At the same time, the immediate postnatal period presented an exciting window of opportunity to access high-risk families who may otherwise have become marginalized from traditional services.  相似文献   

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