Research on Infant/Toddler Mental Health: Building a Community Partnership

说明(由申请人提供)：拟议的项目旨在发展一个由社区提供者、患有关联和沟通障碍的儿童的家庭、资助机构和研究人员组成的联盟，以确定一种循证干预措施，以满足这些婴儿/幼儿及其家庭的需求。沟通困难、行为调节、感官敏感度，以及发展早期依恋关系的问题，都会使婴儿和蹒跚学步的孩子面临未来精神健康障碍的风险，包括自闭症和发育迟缓、社交情绪问题和严重的行为困难。疾病控制中心(CDC)最近将这些问题确定为重大的公共卫生挑战，呼吁制定旨在预防后来的精神和发育障碍的规划。疾控中心的合作报告强调，需要利用全面的社区模式制定预防性干预措施，以促进适当的发展和促进健康的环境。目前的早期干预模式可能会受到限制，主要集中在技能缺陷上，而没有充分考虑儿童与环境接触、与照顾者互动或自我调节的能力。此外，它们可能没有解决感知到的社区需求或符合社区价值观。通过确定针对这些儿童和家庭的一系列需求并适合社区的早期预防性干预，提供者可以同时治疗存在的缺陷，并防止出现进一步的困难。鉴于对解决婴幼儿社会交往问题的干预措施的研究有限，公共和私营机构正在努力实施适当和有效的方案。我们认为，发展社区伙伴关系可以同时满足已确定的社区需求，并促进对这一年轻儿童群体的干预科学。拟议项目的具体目标是：(1)建立一个社区和研究合作联盟；(2)审查在社区范围内对患有关系和沟通障碍的婴幼儿及其家庭实施的两种综合行为发育家长干预措施的“适合性”，并选择具体的干预措施和相应的培训模式在社区实施；(3)与社区提供者和家长一起对培训模式和选定的干预措施进行可行性测试，并制定协作R01。这些活动将在儿童和青少年服务研究中心丰富的跨学科研究和培训环境中得到支持。拟议的项目是由临床医生发起的，该提议是由合作伙伴或家庭、社区提供者、资助机构和研究人员达成共识的优先事项推动的。CBPR在决策、资源共享、共同学习和能力建设方面的公平原则以及研究和社区价值观的平衡也推动了拟议的活动。 公共卫生相关性：拟议的项目寻求建立一个由社区提供者、患有关联和沟通障碍的儿童的家庭、资助机构和研究人员组成的联盟，以确定一种循证干预措施，以满足这些婴幼儿及其家庭日益增长的需求。该项目使用社区利益攸关方和研究人员参与的协作方法和经验证的框架来衡量协作过程。确定和测试在大型社区中使用的特定模式将同时促进早期干预/预防的科学，并满足社区提供者、资助机构和家庭确定的关键需求。

DESCRIPTION (provided by applicant): The proposed project seeks to develop a consortium of community providers, families of children presenting with disorders of relating and communicating, funding agencies and researchers to identify an evidence-based intervention to meet the needs of these infants /toddlers and their families. Difficulty with communication, behavioral regulation, sensory sensitivity, and problems developing early attachment relationships place infants and toddlers at-risk for future mental health disorders, including autism and developmental delays, social-emotional problems, and serious behavior difficulties. The Centers for Disease Control (CDC) recently identified these issues as significant public health challenges, calling for programming directed toward preventing later mental and developmental disorders. The CDC collaborative report emphasized the need to develop preventative interventions using comprehensive community models to facilitate appropriate development and promote healthy environments. Current early intervention models may be limited by focusing primarily on skill deficits without adequate regard for the child's ability to engage with the environment, interact with caregivers, or self-regulate. Further, they may not address the perceived community needs or fit with community values. By identifying an early preventative intervention that targets a range of needs in these children and families and fits the community, providers can simultaneously treat presenting deficits and prevent further difficulties from emerging. Given the limited research on interventions addressing social-communicative issues in infants and toddlers, public and private agencies are struggling to implement appropriate and effective programs. We believe that developing a community partnership can concurrently meet the identified community need and advance the science of interventions for this young group of children. The specific aims of the proposed project are to: (1) Develop a coalition for community and research collaboration; (2) Examine the "fit" of two integrated behavioral- developmental parent-implemented interventions for infants and toddlers with disorders of relating and communicating and their families within the context of the community, and select a specific intervention and corresponding training model for implementation in the community; and (3) Conduct feasibility testing of the training model and selected intervention with community providers and parents and develop a collaborative R01. The activities will be supported within the rich, interdisciplinary research and training environment of the Child and Adolescent Services Research Center. The proposed project was initiated by clinicians and the proposal was driven by consensual priorities across a partnership or families, community providers, funding agencies and researchers. CBPR principles of equity in decision-making, resource sharing, co-learning and capacity-building, and a balance of research and community values also drive the proposed activities. PUBLIC HEALTH RELEVANCE: The proposed project seeks to develop a consortium of community providers, families of children presenting with disorders of relating and communicating, funding agencies and researchers to identify an evidence-based intervention to meet the growing needs of these infants and toddlers and their families. The project uses a collaborative approach involving community stakeholders and researchers and an empirically validated framework to measure the collaborative process. Identifying and testing a specific model for use in a large community will simultaneously advance the science in early intervention/prevention and serve a critical need identified by community providers, funding agencies and families.