Families of Youth with Developmental Disabilities: A Theory-Based Intervention

项目摘要/摘要 尽管有智力和发育障碍(IDD)儿童的家庭经历增加 家庭冲突、压力和适应问题的风险，几乎没有循证方案来支持它们。 项目很少适应这些家庭的特定需求，可用的干预措施也不是经验性的。 基于Cally的或经过严格评估的。现有的方案未能解决家庭制度问题，往往忽视了 父母和通常发育中的(TD)兄弟姐妹的幸福。迫切需要一种以证据为基础的亲 改善家庭压力和冲突对父母和TD兄弟姐妹整体福祉的影响， 以及患有IDD的个人。我们在这项建议中的目标是测试对父母、TD兄弟姐妹和 IDD儿童适应心理教育和沟通训练的方法 先前验证的社区家庭预防/干预计划，并检查其机制 与作为为期4周计划的结果而发生的变化过程相关联。我们的长期目标是- 提高经验支持的家庭系统方法的可用性和可负担性，以减少家庭 碘缺乏病患者家庭的压力和冲突。我们的中心假设是，参与该计划 将支持有IDD儿童的家庭确定的需求，改善福祉和调整PAR- Ents，增加TD兄弟姐妹的情绪安全和调整，并与改善 IDD患者的适应性功能。这一中心假设得到了有希望的定性证据的支持。 Dence和来自正在进行的试点研究的初步分析，该研究使用的是 已发送建议书。我们的理由是提供一个家庭系统的方法来改善家庭环境 将支持每个家庭成员的福祉，包括患有IDD的儿童。具体目标是：(1)消除贫困 确定该计划对父母的有效性，(2a)确定该计划的有效性，以典型地确定 发展兄弟姐妹，(2b)测试过程模型，在情绪安全理论(EST；Davies&Cum- Mings，1994)，解释了作为该计划的结果而发生变化的方式和原因以及对谁和何时发生的变化，以及 (3)检查该计划对IDD患者的影响。包括一名缺碘儿童的家庭(n=150) 年龄在11到17岁之间的TD兄弟姐妹将被随机分配到两组中的一组：(1)父母 并典型地发展兄弟姐妹干预，或(2)仅资源控制。对所有家庭进行多方法评估- LY成员将在干预前和干预后访问，以及6个月和1年的跟踪调查中获得。美联社- Proach是创新的，因为它解决了多个家庭成员的需求，测试了关于解释性的理论 项目影响的模型，并利用简短的心理教育形式和RCT设计来评估其 功效。这项研究具有重要意义，因为它将为家庭系统创建一个廉价的模式程序- 对患有IDD儿童的家庭进行干预，使父母、兄弟姐妹和IDD儿童受益，包括 对常备社区中心的项目有效性进行评估。

Project Summary/Abstract Although families with children with intellectual and developmental disabilities (IDD) experience heightened family conflict, stress and risk for adjustment problems, few evidence-based programs exist to support them. Programs are rarely adapted to these families’ specific needs, and the available interventions are not empiri- cally-based or rigorously evaluated. Existing programs fail to address the family system, often ignoring the well-being of parents and typically developing (TD) siblings. A critical need exists for an evidence-based pro- gram to ameliorate the impact of family stress and conflict on the overall well-being of parents and TD siblings, as well as individuals with IDD. Our objective in this proposal is to test the efficacy for parents, TD siblings, and children with IDD of an adaptation of the psycho-educational and communication training approach used in a previously validated prevention/intervention program for community families, and to examine the mechanisms associated with change processes that occur as a result of the 4-week program. Our long-term goal is to in- crease the availability and affordability of empirically-supported family-systems approaches to reduce family stress and conflict in families of individuals with IDD. Our central hypothesis is that participation in the program will support the identified needs of families with a child with IDD, improve the well-being and adjustment of par- ents, increase emotional security and adjustment for TD siblings, and be associated with improvements in adaptive functioning for individuals with IDD. This central hypothesis is supported by promising qualitative evi- dence and preliminary analyses from an ongoing pilot study using the adapted curriculum included in the pre- sent proposal. Our rationale is that providing a family-systems approach to improving the family environment will support the well-being of each family member, including the child with IDD. The specific aims are: (1) de- termining the efficacy of the program for parents, (2a) determining the efficacy of the program for typically de- veloping siblings, (2b) testing process models, guided by the Emotional Security Theory (EST; Davies & Cum- mings, 1994), to explain how and why and for whom and when changes occur as a result of the program, and (3) examining the impact of the program on individuals with IDD. Families (n=150) that include a child with IDD and a TD sibling between 11 and 17 years of age, will be randomly assigned to one of two groups: (1) parent and typically developing sibling intervention, or (2) resource only control. Multi-method assessments of all fami- ly members will be obtained at pre- and post-intervention visits, and 6-month and 1-year follow-ups. The ap- proach is innovative because it addresses multiple family members’ needs, tests theory about explanatory models for program impact, and utilizes a brief, psycho-educational format and a RCT design to evaluate its efficacy. This research is significant because it will create an inexpensive model program for family-system- level interventions for families of children with IDD, benefiting parents, siblings and the child with IDD, including evaluations of program effectiveness in standing community centers.