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

描述（由申请人提供）：拟议的项目旨在建立一个由社区提供者、有人际关系和沟通障碍儿童的家庭、资助机构和研究人员组成的联盟，以确定一种基于证据的干预措施，以满足这些婴儿/幼儿及其家庭的需求。沟通困难、行为调节困难、感觉敏感困难以及早期依恋关系的发展问题使婴幼儿面临未来精神健康障碍的风险，包括自闭症和发育迟缓、社会情感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期精神和发育障碍的规划。疾病控制与预防中心的合作报告强调，有必要利用综合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受到限制，主要关注技能缺陷，而没有充分考虑儿童与环境互动、与照顾者互动或自我调节的能力。此外，它们可能无法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措施，提供者可以同时治疗现有的缺陷并防止进一步的困难出现。鉴于针对婴幼儿社交问题的干预研究有限，公共和私人机构都在努力实施适当和有效的计划。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要，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)建立社区和研究合作联盟；(2)在社区背景下，考察两种行为发展性父母实施的婴幼儿关联沟通障碍及其家庭综合干预措施的“契合度”，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进行培训模式和选择干预措施的可行性测试，并制定协作R01。这些活动将得到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的支持。拟议的项目由临床医生发起，并由伙伴关系或家庭、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。决策公平、资源共享、共同学习和能力建设的CBPR原则以及研究和社区价值的平衡也推动了拟议的活动。

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.