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会在行为和生理上适应对他们的照顾者具有挑战性的方式。儿童的应对策略使本已脆弱的父母尤其难以提供充分的支持。他们的父母需要帮助发展技能，以便他们能够提供适当的照顾。此外，他们往往需要帮助管理一系列其他挑战，包括心理健康问题，药物滥用和其他基本需求。这项研究将测试在支持性社区服务的背景下对受虐待儿童的亲生父母进行干预的有效性。这一干预措施针对被确定为至关重要的几个关键需求。首先，帮助父母重新解释孩子的行为信号。第二，父母被教导要“控制”自己的倾向，以不一致或拒绝的方式回应孩子。第三，父母的行为方式不会让孩子感到害怕。最后，帮助父母提供一个人际反应的环境，这有助于儿童发展监管能力。父母将被随机分配接受实验干预或接受替代治疗。这两个群体的父母将获得支持服务，帮助他们获得心理健康和药物滥用治疗，以及其他所需的服务。结果将包括评估父母的行为，以及儿童的行为，情绪和神经内分泌功能的评估。在干预后的评估中，接受实验干预的父母比对照组的父母更有教养，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.