Preventing Child Neglect in High-Risk Mothers

说明(申请人提供)：拟议的项目旨在通过帮助高危母亲建立新的育儿心理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名母亲将在4个研究地点参与。15-18岁的高危怀孕少女母亲和没有高中学历(22-35岁)的成年母亲将被招募并随机分配到两组中的一组：治疗1组(T1)将接受几项增强的服务，例如转介到精神健康服务或工作培训机会，称为“使能条件”；T1作为评估T2对育儿和忽视的影响的“最小干预对照”。此外，T2将接受直接干预，该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I 0-Session Pals计划。我的宝宝U已经被证明改变了母亲的态度和保健行为；我们将用按摩疗法的父母培训来补充这个模块。第二个模块，PALS，旨在教授来自低SES背景的家庭的响应性育儿；它利用广泛的“培训脚本”和家庭录像带，帮助在6至12个月期间形成响应性和敏感度的育儿实践。 同伴模块PALS Li(幼儿计划)将在18个月至24个月时推出；该模块将侧重于语言刺激、游戏活动和适当的训练方法。还将介绍有关决策、健康和安全以及加强社会支持网络的模块。干预的效果将在1年、2年和3年在母婴发展的几个领域进行测量，特别是归因于干预方式和做法、疏忽虐待行为、母亲社会情绪适应和药物滥用的育儿。在孩子身上，重点将放在依恋、语言和智力发展上。这一干预计划的一个独特之处是，使用新构建的电话采访技术以及更标准的虐待儿童措施，包括每位母亲自己的虐待个人史，来衡量心理-社会忽视的“低水平”。将使用横断面和纵向分析来证明治疗效果(包括减少疏忽-虐待父母)，并表明母亲行为的变化与儿童的发展轨迹密切相关。简而言之，我们的目标是培养更敏感、更积极响应的父母(与忽视和虐待相反)，他们意识到刺激家庭丰富的重要性，以及他们在帮助孩子实现重要发展里程碑方面可以发挥的作用。

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.