Findings from the Families on Track Intervention Pilot Trial for Children with Fetal Alcohol Spectrum Disorders and Their Families.
Findings from the Families on Track Intervention Pilot Trial for Children with Fetal Alcohol Spectrum Disorders and Their Families.
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DOI：
10.1111/acer.13408
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Robinson LK
中科院分区：
文献类型：
--
作者：
Petrenko CLM;Pandolfino ME;Robinson LK
胎儿酒精谱系障碍（FASD）患者出现代价高昂、使人衰弱的心理健康问题以及继发性疾病（如学业中断、违法问题和药物使用）的风险很高。本研究的目的是试行一种多成分干预措施，旨在预防FASD儿童的继发性疾病并改善家庭适应性。
30名患有FASD或产前酒精暴露（PAE）的儿童（年龄4至8岁）及其主要照顾者参与了研究。这些家庭被随机分配到“家庭步入正轨综合预防干预”组或神经心理学评估及个性化社区转诊的积极对照组。这项为期30周的干预措施整合了经科学验证的每两个月一次的上门家长行为咨询以及每周一次的儿童技能小组活动。在基线和干预后的随访中测量的结果包括干预满意度、儿童情绪和行为功能、儿童自尊、照顾者对FASD的了解及宣传、照顾者态度、有针对性的养育方式的使用、家庭需求得到满足的感知、社会支持以及自我照顾。数据分析强调效应量的计算，并辅以方差分析技术。
分析表明，参与干预的家庭对项目满意度较高。与对照组的结果相比，该干预措施对儿童的情绪调节、自尊和焦虑有中等到较大的影响。两组在破坏性行为方面都有中等程度的改善。在重要的照顾者结果方面也看到了中等到较大的影响：对FASD的了解及宣传、行为归因、先行策略的使用、养育效能、家庭需求得到满足、社会支持以及自我照顾。
这项试点研究从多成分的“家庭步入正轨综合预防干预”中得出了关于儿童和照顾者结果的有希望的发现。接下来重要的一步是用一个更能充分代表这一服务不足的临床人群的更大样本完成“家庭步入正轨”项目的随机对照试验，并对实施参数进行内置研究。
Individuals with fetal alcohol spectrum disorders (FASD) are at high risk for costly, debilitating mental health problems and secondary conditions, such as school disruption, trouble with the law, and substance use. The study objective was to pilot a multi-component intervention designed to prevent secondary conditions in children with FASD and improve family adaptation. Thirty children with FASD or prenatal alcohol exposure (PAE) (ages 4 to 8) and their primary caregivers were enrolled. Families were randomized to either the Families on Track Integrated Preventive Intervention or an active control of neuropsychological assessment and personalized community referrals. The 30-week intervention integrates scientifically validated bi-monthly, in-home parent behavioral consultation and weekly child skills groups. Outcomes measured at baseline and follow-up post-intervention included intervention satisfaction, child emotional and behavioral functioning, child self-esteem, caregiver knowledge of FASD and advocacy, caregiver attitudes, use of targeted parenting practices, perceived family needs met, social support, and self-care. Data analysis emphasized calculation of effect sizes and was supplemented with analysis of variance techniques. Analyses indicated that families participating in the intervention reported high program satisfaction. Relative to comparison group outcomes, the intervention was associated with medium to large effects for child emotion regulation, self-esteem, and anxiety. Medium-sized improvements in disruptive behavior were observed for both groups. Medium and large effects were seen for important caregiver outcomes: knowledge of FASD and advocacy, attributions of behavior, use of antecedent strategies, parenting efficacy, family needs met, social support, and self-care. This pilot study yielded promising findings from the multicomponent Families on Track Integrated Preventive Intervention for child and caregiver outcomes. An important next step is to complete a randomized control trial of the Families on Track program with a larger sample fully representative of this underserved clinical population with built-in study of implementation parameters.
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影响因子：
5.8
作者：
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通讯作者：
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DOI：
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期刊：
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