Specialized services for high-risk birth parents

描述(由申请人提供)：经历早期虐待的幼儿通常在行为和生理上以对照顾者具有挑战性的方式进行适应。儿童的应对策略使本已脆弱的父母尤其难以提供足够的照料。他们的父母需要帮助发展技能，这样他们才能提供足够的照顾。此外，他们经常需要帮助应对一系列其他挑战，包括精神健康问题、药物滥用和其他基本需求。这项研究将在支持性社区服务的背景下测试对受虐待儿童的亲生父母进行干预的有效性。这种干预针对的是几个被确定为关键需求的关键需求。首先，帮助父母重新解释孩子的行为信号。其次，父母被教导要“超越”他们自己的倾向，以不一致或拒绝的方式回应孩子。第三，帮助父母以不让孩子害怕的方式行事。最后，帮助父母提供一个人与人之间反应的环境，帮助孩子发展监管能力。父母将被随机分配接受实验干预或接受替代治疗。这两个群体的父母都将得到支持服务，帮助他们获得心理健康和药物滥用治疗，以及需要的其他服务。结果将包括对育儿行为的评估，以及对儿童行为、情绪和神经内分泌功能的评估。在干预后评估中，接受实验干预的父母预计会比对照组父母更有教养，更敏感，对孩子的恐惧更少。实验组父母的孩子比对照组父母的孩子表现出更好的行为和生物行为调节。

DESCRIPTION (provided by applicant): Young children who experience early maltreatment often adapt behaviorally and physiologically in ways that are challenging to their caregivers. Children's coping strategies make it especially difficult for already vulnerable parents to provide adequate caregiving. Their parents need help in developing skills such that they can provide adequate care. In addition, they often need help managing a host of other challenges, including mental health problems, substance abuse, and other basic needs. This study will test the effectiveness of an intervention for birth parents of maltreated children in the context of supportive community services. This intervention targets several key needs identified as critical. First, parents are helped to re-interpret children's behavioral signals. Second, parents are taught to "over-ride" their own propensities to respond in inconsistent or rejecting ways to children. Third, parents are helped to behave in ways that are not frightening to their children. Finally, parents are helped to provide an interpersonally responsive environment, which helps children develop regulatory capabilities. Parents will be randomly assigned to receive the experimental intervention or receive an alternative treatment. Parents in both groups will receive support services that help them access mental health and substance abuse treatment, and other services as needed. Outcomes will include assessments of parenting behaviors, as well as assessments of child behavioral, emotional, and neuroendocrine functioning. In post-intervention assessments, parents receiving the experimental intervention are expected to be more nurturing, sensitive, and less frightening to children than control group parents. Children of experimental group parents are expected to show better behavioral and biobehavioral regulation than children of control group parents.