Trauma-Informed Parenting for Children with Developmental Delays

摘要 童年创伤和慢性压力与成年后和随后的后代的不良养育有关 发展问题。支持性的、有凝聚力的共同养育（即，父母支持/破坏的方式 并在养育子女方面相互协调）有可能减轻童年创伤的影响， 长期压力对父母的适应和养育质量的影响，从而促进后代的发育 结果。不幸的是，目前的共同养育干预措施并没有解决先前暴露于 童年创伤和共同养育关系的长期压力，限制了这些计划的效力 儿童时期受到创伤和长期压力影响的父母。此外，经历过 儿童时期的创伤和长期压力可能难以获得服务。因此，一个以儿科初级保健为基础的共同- 一个育儿计划，解决童年暴露于创伤和慢性压力的影响， 合作式的教育提供了一个独特的机会，可以打破童年创伤的代际影响。 和慢性压力，并改善高危儿童的发展成果。的总体目标 一个拟议的项目是修改家庭基金会（FF）计划，一个以证据为基础的初级预防 旨在加强同居/已婚孕妇之间共同养育关系的方案 父母，以初级保健为基础的干预，减轻童年创伤的负面影响， 对共同养育的长期压力，评估的可行性，可接受性，和对共同养育技能的影响， 采用试点测试的适应性共同养育方案。拟议的研究将采用定性，干预， 开发和实施科学方法，以适应FF计划成为一个创伤知情的养育 为受童年创伤和长期压力影响的照顾者提供的方案。收集的试点数据， 这项研究的一部分将支持未来的R 01赠款，重点是在初级保健中实施这种干预措施 设置和评估这种基于初级保健的创伤知情的共同养育干预的有效性， 改善由认可创伤暴露的照顾者抚养的儿童的发育结果 和慢性压力。拟议的应用程序属于NIMHD资助的ODEI的范围 研究（R 01 MD 011598），探讨共同养育对儿童发展的影响， 调整共同养育干预措施，用于受以下影响的照顾者的儿科初级保健环境 创伤和慢性压力我的长期研究兴趣集中在减少种族和 通过制定以初级保健为基础的干预措施， 解决儿童时期遭受创伤和长期压力对养育子女的影响。来进行这一系列的 研究我需要在定性方法、干预开发和实施方面的额外培训 科学NIH NIMHD多样性补充将使我能够发展成为一名 独立的学术研究者在这个领域。

ABSTRACT Childhood trauma and chronic stress are associated with poor parenting as an adult and subsequent offspring developmental problems. Supportive, cohesive co-parenting (i.e., ways in which parents support/undermine and coordinate with each other in parenting) has the potential to mitigate the impact of childhood trauma and chronic stress on parent adjustment and parenting quality and therefore improve offspring developmental outcomes. Unfortunately, current co-parenting interventions do not address the impact of prior exposure to childhood trauma and chronic stress on co-parenting relationships, limiting the efficacy of such programs among parents impacted by trauma and chronic stress as children. In addition, parents who have experienced trauma and chronic stress as a child may struggle to access services. Thus, a pediatric primary care-based co- parenting program that addresses the impact of childhood exposure to trauma and chronic stress on cooperative caregiving offers a unique opportunity to disrupt the intergenerational impact of childhood trauma and chronic stress and improve developmental outcomes for at risk children. The overall objective of the proposed project is to modify the Family Foundations (FF) Program, an evidence-based primary prevention program designed to enhance co-parenting relationships among cohabitating/married expecting first-time parents, to a primary care-based intervention that mitigates the negative impact of childhood trauma and chronic stress on co-parenting, assessing the feasibility, acceptability, and impact on co-parenting skills of the adapted co-parenting program using pilot tests. The proposed study will use qualitative, intervention development, and implementation science methods to adapt the FF program into a trauma-informed parenting program for caregivers impacted by childhood exposure to trauma and chronic stress. Pilot data collected as part of this study will support future R01 grants focused on implementation of this intervention in a primary care setting and evaluation of the efficacy of this primary care-based trauma informed co-parenting intervention in improving child developmental outcomes among children reared by caregivers endorsing exposure to trauma and chronic stress as children. The proposed application is within scope of the parent NIMHD funded ODEI study (R01MD011598) in addressing the effects of poor co-parenting on child development and innovative in adapting a co-parenting intervention for use in pediatric primary care settings among caregivers impacted by trauma and chronic stress as a child. My long-term research interests center around decreasing racial and ethnic disparities in child developmental problems by developing primary care-based interventions designed to address the impact of exposure to trauma and chronic stress as a child on parenting. To conduct this line of research I require additional training in qualitative methods, intervention development, and implementation science. The NIH NIMHD diversity supplement would enable me to develop the skills necessary to become an independent academic investigator in this field.