Preventing Child Neglect in High-Risk Mothers

描述（由申请人提供）：拟议的项目旨在通过帮助高风险母亲建立新的育儿思维模式和新的育儿方式和做法，减少在忽视和虐待方面虐待儿童的发生率；400名母亲将参加4个研究地点。将招募15-18岁的高危孕母、怀孕少女母亲和没有高中学历的成年母亲（22 - 35岁），并将其随机分配到两组之一：治疗组1 （T1）将获得若干加强服务，例如转到精神卫生服务机构或工作培训机会，称为“有利条件”；T1作为评估T2对养育和忽视的影响的“最小干预控制”。此外，T2将接受直接干预，包括两个育儿模块：由Melanie Brown开发和测试的My Baby U计划，以及由Susan Landry开发的0-session PALS计划。My Baby U已被证明可以改变产妇的态度和保健行为；我们将以家长按摩疗法培训作为本单元的补充。第二个模块是PALS，旨在向来自低社会经济地位背景的家庭教授响应式育儿；它利用大量的“培训脚本”和家庭录像带，帮助孩子在6到12个月之间形成反应灵敏的育儿做法。

DESCRIPTION (provided by applicant): The proposed project is designed to reduce the incidence of child maltreatment, in terms of neglect and abuse, in high-risk mothers by helping them to create new mental models of parenting and new parenting styles and practices; 400 mothers will participate at 4 research sites. High-risk primaparous, pregnant teenage mothers, ages 15-18, and adult mothers without a high school degree (ages 22 to 35), will be recruited and randomly assigned to one of two groups: Treatment Group 1 (T1) will receive several enhanced services, such as referrals to mental health services or job training opportunities, referred to as "enabling conditions"; T1 serves as a "minimal intervention control" for assessing the effects of T2 on parenting and neglect. In addition, T2 will receive the Direct Intervention, which consists of 2 parenting modules: The My Baby U program, developed and tested by Melanie Brown, and the I 0-session PALS program, developed by Susan Landry. My Baby U has been shown to change maternal attitudes and health care behaviors; we will supplement this module with parent training in massage therapy. The second module, PALS, is designed to teach responsive parenting with families from low SES backgrounds; it makes use of extensive "training scripts" and in-home videotapes that help shape responsive and sensitive parenting practices between 6 and 12 months. A companion module, PALS lI (the Toddler Program), will be introduced at 18 months and continue to 24 months; this module will focus on language stimulation, play activities, and appropriate methods of discipline. Modules on decision making, health and safety, and strengthening social support networks will also be presented. The effects of the intervention will be measured at 1, 2, and 3 years across several domains of maternal and child development, especially parenting attributable to the intervention styles and practices, neglectful-abuse behaviors, maternal socioemotional adjustment, and substance abuse. In the child, the focus will be on attachment, language, and mental development. A unique feature of this intervention program is the measurement of "low levels" of psycho-social neglect, using a newly constructed phone interview technique as well as more standard measures of child maltreatment, including each mother's own personal history of maltreatment. Cross-sectional and longitudinal analyses will be used to demonstrate treatment effectiveness (including a reduction in neglectful-abusive parenting) and to show that changes in maternal behaviors are strongly linked to children's developmental trajectories. In short, our goals are to develop more sensitive and responsive parents (the antithesis of neglect and abuse), who are aware of the importance of stimulating in-home enrichments and the roles they can play in helping children achieve important developmental milestones.