Early intervention for children adopted internationally

描述（由申请人提供）：在过去的二十年里，国际上被收养到美国的儿童数量急剧增加，其中许多儿童在收养前都经历过机构照顾。与早期机构护理相关的问题包括注意力不集中，抑制控制缺陷和不安全的附件。尽管一些领域取得了快速进展，但许多问题仍然存在。至关重要的是，必须制定干预措施，解决这些儿童及其父母面临的具体问题。国际收养儿童依恋和生物行为追赶（ABC-I）是一个为期10天的父母培训计划，旨在提高儿童调节注意力，行为和生理的能力，并发展安全，有组织的依恋父母。拟议的研究将通过随机对照设计检查这种干预措施的有效性。最初将有220名在收养前生活在机构照顾中的幼儿参加这项研究。他们将被随机分配到ABC-I干预或对照干预。每年至少有180名儿童将在各种情况下接受评估，直到他们4岁。在整个研究期间，将评估儿童调节注意力、行为和生理的能力。与对照组相比，ABC-I干预组的儿童注意力不集中的问题更少，抑制性控制更好，依恋更安全，激素产生模式更规范，诊断出的行为障碍发生率更低。公共卫生相关性：在机构护理后被收养的幼儿患一系列精神和行为障碍的风险增加，但很少有基于证据的治疗方案来解决这些问题。本研究评估的预防性干预措施针对的是已被确定为对这些儿童特别有问题的问题。

DESCRIPTION (provided by applicant): The number of children adopted into the United States internationally has increased dramatically over the last two decades, with many of these children experiencing institutional care prior to adoption. Problems associated with early institutional care include inattention, deficits in inhibitory control, and insecure attachments. Although rapid gains are seen in some areas, many problems persist. It is critical that interventions be developed that address the specific issues faced by these children and their parents. Attachment and Biobehavioral Catch-up for Children Adopted Internationally (ABC-I) is a 10 session parent training program designed to enhance children's ability to regulate attention, behavior, and physiology, and develop secure, organized attachments to their parents. The proposed study will examine the effectiveness of this intervention through a randomized control design. Initially 220 young children who have lived in institutional care prior to adoption will be enrolled in the study. They will be randomly assigned to the ABC-I intervention or to a control intervention. At least 180 children will be assessed in various contexts annually until they are 4-years- old. Children's ability to regulate attention, behavior, and physiology will be assessed throughout the study period. Children in the ABC-I intervention are expected to show fewer problems with inattention, better inhibitory control, more secure attachments, more normative patterns of hormone production, and lower incidence of diagnosed behavior disorders, than children in the control intervention. PUBLIC HEALTH RELEVANCE: Young children who are adopted after living in institutional care are at increased risk for a range of psychiatric and behavioral disorders, but there are few evidence-based treatment programs that address such problems. The preventive intervention assessed in this study targets issues that have been identified as particularly problematic for these children.