What are the most effective early response strategies and interventions to assess and address the immediate needs of children outside of family care?
What are the most effective early response strategies and interventions to assess and address the immediate needs of children outside of family care?
复制标题
评估和解决家庭护理之外儿童的迫切需求的最有效的早期应对策略和干预措施是什么？
DOI：
10.1016/j.chiabu.2012.09.004
复制
发表时间：
2012
影响因子：
4.8
通讯作者：
Walker,Vick
中科院分区：
文献类型：
--
作者：
Boothby,Neil;Wessells,Mike;Williamson,John;Huebner,Gillian;Canter,Kelly;Rolland,EduardoGarcia;Kutlesic,Vesna;Bader,Farah;Diaw,Lena;Levine,Maya;Malley,Anita;Michels,Kathleen;Patel,Sonali;Rasa,Tanya;Ssewamala,Fred;Walker,Vick
目的家庭以外的儿童面临着更高的幸福威胁风险，他们的教育成就较低，并经历不利的发展结果。虽然人们普遍认为，早期反应和干预对于减少与家人分离的儿童受到伤害的风险至关重要，但并不总是清楚评估和解决其迫切需要的最有效的早期反应战略是什么。这项审查的目的是确定循证早期反应战略和干预措施，以改善家庭照料以外儿童的结果，包括流浪儿童和流浪儿童、被贩卖儿童、受冲突和灾难影响的儿童以及被剥削从事劳动的儿童。方法对同行评议和灰色文献进行多阶段、系统的证据审查，共产生101份符合纳入标准的文献并进行了审查。很少有研究包括仔细的结果测量或比较组。尽管几乎没有得到证实的干预措施出现，但审查确定了几种有希望的早期干预措施和方法。在紧急情况下，寻找家人和与家人团聚是对失散儿童的一种非常有效的应对措施，而将儿童送入机构看护是有问题的，以前招募的儿童可能会被安置在临时看护中心，但有时间限制的情况除外。在预防和应对生活在家庭照料之外的儿童方面，生计支助是有希望的。其他有希望的干预措施包括心理社会支助，包括酌情使用传统的清洁仪式、儿童友好空间等教育支助、为街头或街头儿童保持家庭联系、使用有助于社会融合的基于社区的办法以及使儿童能够有意义地参与的办法。一个反复出现的主题是，为了有效，所有的评估和干预措施都必须符合环境。结论迫切需要加强证据基础，以证明对不在家庭照料之外的儿童进行早期评估和应对的有效性，并利用证据指导业务政策和实践。审查过程中提出了有关政策、实践和研究的建议。
OBJECTIVESChildren outside of family care face increased risk of threats to their well-being, have lower educational achievement, and experience adverse developmental outcomes. While it is generally accepted that early response and intervention is critical to reducing the risk of harm for children who have been separated from their families, it is not always clear what the most effective early response strategies are for assessing and addressing their immediate needs. The purpose of this review was to identify evidence-based early response strategies and interventions for improving the outcomes of children outside of family care, including children of and on the street, institutionalized children, trafficked children, children affected by conflict and disaster, and who are exploited for their labor.METHODSA multi-phased, systematic evidence review was conducted on peer-reviewed and gray literature, which yielded a total of 101 documents that met the inclusion criteria and were reviewed.RESULTSOverall there is a weak evidence base regarding assessment and early response interventions for children living outside of family care. Few studies included careful outcome measures or comparison groups. Although few proven interventions emerged, the review identified several promising early interventions and approaches. In emergency settings, family tracing and reunification is a highly effective response in regard to separated children, whereas placing children in institutional care is problematic, with the possible exception of time-limited placements of formerly recruited children in interim care centers. Livelihood supports are promising in regard to preventing and responding to children living outside family care. Other promising interventions include psychosocial support, including the use of traditional cleansing rituals as appropriate, educational supports such as Child Friendly Spaces, the maintenance of family connectedness for children of or on the streets, the use of community-based approaches that aid social integration, and approaches that enable meaningful child participation. A recurrent theme was that to be effective, all assessments and interventions must fit the context.CONCLUSIONA strong need exists for strengthening the evidence base regarding the effectiveness of early assessments and responses to children living outside family care and for using the evidence to guide operational policy and practice. Recommendations regarding policy, practices, and research emerged from the review process.