Early developmental intervention

  • 文章类型: Journal Article
    早期认识到幼儿的发育困难可以加强预防和治疗方法。尽管它们是可行的,与高收入国家相比,中低收入(LAMI)国家的早期干预服务有限.这项研究的目的是通过系统评价和荟萃分析,研究LAMI国家五岁以下儿童发育困难的早期儿童干预计划的证据。在这样的背景下,2010年至2019年在同行评审期刊上发表的原始研究,重点是发展困难,包括延误和偏差;随机研究设计,明确描述干预和可衡量的结果,并在LAMI国家进行了系统评价。电子数据库,包括ProQuest,PubMed,奥维德,EBSCOhost,和谷歌学者,使用特定关键字的组合进行搜索。遵循PRISMA指南以包括这些研究。在应用适当的统计数据综合数据之前,对每项选定的研究进行质量评估。从2697份出版物中确定了14份出版物用于系统审查,其中四个被发现与荟萃分析兼容。审查的研究是在孟加拉国进行的,印度,巴基斯坦,乌干达,越南,赞比亚。对四项研究的荟萃分析为早期发育干预的效果提供了大量证据。本系统综述为LAMI国家的早期儿童干预计划提供了证据。本文讨论了这些发现对幼儿计划的影响。
    Early acknowledgment of developmental difficulties in young children strengthens both preventive and therapeutic approaches. Despite their feasibility, early intervention services are limited in Low-and-Middle-Income (LAMI) countries compared to high income countries. The aim of this study was to examine the evidence for early childhood intervention programs for developmental difficulties in children below five years in LAMI countries through a systematic review and meta-analysis. In this background, original studies published in peer-reviewed journals from 2010 to 2019 with a focus on developmental difficulties including delays and deviances; randomized research design with a clear description of the intervention and measurable outcomes, and conducted in LAMI countries were considered for the systematic review. Electronic databases, including ProQuest, PubMed, Ovid, EBSCOhost, and Google Scholar, were searched using a combination of specific keywords. PRISMA guidelines were followed to include the studies. Each of the selected study was assessed for quality before applying appropriate statistics to synthesize the data. Fourteen publications were identified from 2697 publications for the systematic review, out of which four were found compatible for a meta-analysis. The studies reviewed were conducted in Bangladesh, India, Pakistan, Uganda, Vietnam, and Zambia. A meta-analysis of four studies provided considerable evidence for the effects of early developmental intervention. This systematic review provides an evidence for early childhood intervention programs in LAMI countries. Implications of these findings for the early childhood programs are discussed in this article.
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  • 文章类型: Journal Article
    UNASSIGNED: Birth before term is a stressful experience for parents because of the unexpected delivery or admission to the neonatal intensive care unit.
    UNASSIGNED: This research aimed to evaluate the impact of the early PT intervention on preterm infants\' parents\' experiences, and also to obtain knowledge about parents\' experiences and perceived difficulties during preterm infants\' care.
    UNASSIGNED: This qualitative study is based on the methods of phenomenology. In the first phase, open interviews were developed to allow researchers to immerse themselves in the context of the study and refine the questions for the semi-structured interviews. Data collected from the semi-structured interviews were analyzed through content analysis.
    UNASSIGNED: The results were summarized around three themes: 1) parental competence; 2) difficulties during preterm infants\' care; and 3) coping strategies. Each theme was divided into two sub-themes.
    UNASSIGNED: Mothers and fathers of preterm infants experienced difficulties when caring for their babies. Parents that received the early physiotherapy intervention felt empowered to take care of their babies and to enhance infants\' development. These parents were more capable of developing coping strategies after the intervention. Parents that did not receive the early physiotherapy intervention expressed difficulties when caring for their preterm babies.
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  • 文章类型: Journal Article
    目标:确定父母-治疗师的领域,以家庭为中心,第三级早期发育干预(EDI)计划。报告在设定目标干预前后的绩效评分和绩效满意度的变化。
    方法:这项研究包括所有患有复杂发育障碍的儿童(年龄为30±3个月,61%的男孩)从2009年至2012年在高等教育EDI计划中注册,其父母完成了加拿大职业绩效评估(COPM)以评估目标设定。国际功能分类,残疾与健康:记录每个目标的儿童和青年版本(ICF-CY)域。计算了每个孩子的个人干预前后评分和平均目标。通过增加≤2来确定评级的积极变化,并以比例和平均值(标准偏差)表示。学生t检验,Fisher精确检验和卡方检验比较各组。
    结果:在为168名儿童设定的483个个人目标中,65.4%位于ICF-CY活性域,16.4%的参与率,身体机能10.3%,7.4%的环境和0.4%的车身结构。绩效评级发生了70%的积极变化;对于满意度,68%,与域无关。每个孩子的平均评分的积极变化显示:表现,67%;满意度,66%。
    结论:第三级EDI中残疾儿童的干预目标主要是活动目标,不像ICF-CY建议的那样参与;三分之二的目标显示出积极的变化。这些结果表明,需要进一步评估EDI计划中的目标设置,以期提高参与目标并提高绩效和满意度。
    OBJECTIVE: To determine the domains of parent-therapist collaboratively set goals for intervention within a family-centered, tertiary-level early developmental intervention (EDI) program. To report changes in ratings for performance and satisfaction of performance pre- and postintervention for the set goals.
    METHODS: This study includes all children with complex developmental disabilities (30 ± 3 months of age, 61% boys) registered in a tertiary-level EDI program from 2009 to 2012 whose parents completed the Canadian Occupational Performance Measure (COPM) to evaluate goal setting. The International Classification of Functioning, Disability and Health: Children & Youth version (ICF-CY) domain for each goal was recorded. Pre- and postintervention ratings for individual and averaged goals per child were calculated. Positive changes in ratings were determined by an increase of ≤2 and presented as a proportion and as means (standard deviation). Student t test, Fisher Exact and chi-square tests compared groups.
    RESULTS: Of 483 individual goals set for 168 children, 65.4% were in the ICF-CY activity domain, 16.4% participation, 10.3% body function, 7.4% environment and 0.4% body structure. Positive changes in ratings for performance occurred in 70%; for satisfaction, 68%, with no difference in relation to domain. Positive changes in average ratings per child showed: performance, 67%; satisfaction, 66%.
    CONCLUSIONS: Intervention goals for disabled children within tertiary-level EDI are primarily those of activity, not participation as ICF-CY recommends; two-thirds of goals show positive change. These results suggest the need for further evaluation of goal setting within EDI programs with the expectation of increasing goals of participation and improving ratings for performance and satisfaction.
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  • 文章类型: Journal Article
    背景:先前的研究表明,早期发育干预(EDI)对发展中国家儿童发育的积极影响。很少有研究,然而,纵向研究了何时可以观察到不同的治疗效果,以及差异结果是否与暴露于不同的风险因素和实施国家相关。此外,出生窒息作为一种危险状况还没有得到很好的研究。为了解决这些限制,我们进行了一项随机对照试验,以检验以下假设:在印度农村地区的儿童中,将有不同的发育轨迹有利于接受EDI的儿童与健康教育干预的儿童。巴基斯坦,赞比亚。
    方法:有和没有出生窒息的儿童随机接受EDI或对照干预,这是由父母实施的,他们接受了在1个月儿童之前开始的双周家访培训,并持续到36个月。使用Bayley婴儿发育量表和年龄和阶段问卷对376名12、24和36个月的儿童进行了发育评估,评估人员对干预分配和风险状况视而不见。
    结果:纵向混合模型分析表明,EDI导致认知能力在36个月内得到更好的发展,无论风险状况如何,孕产妇资源,儿童性别,或国家。精神运动发育和父母报告的一般发育显示出与认知能力相似的趋势,但干预条件之间没有统计学差异。在36月龄时首先观察到发育差异。
    结论:早期发育干预有望改善发展中国家儿童在各种风险条件下的发育。EDI应该是开始解决长期成果和贫困代际传播的一种突出方法。
    BACKGROUND: Previous research has indicated positive effects of early developmental intervention (EDI) on the development of children in developing countries. Few studies, however, have examined longitudinally when differential treatment effects may be observed and whether differential outcomes are associated with exposure to different risk factors and country of implementation. Also, birth asphyxia as a risk condition has not been well studied. To address these limitations, we conducted a randomized controlled trial to test the hypothesis that there will be differential developmental trajectories favoring those who receive EDI versus a health education intervention in children in rural areas of India, Pakistan, and Zambia.
    METHODS: Children with and without birth asphyxia were randomized to EDI or control intervention, which was implemented by parents who received training in biweekly home visits initiated before child age 1 month and continuing until 36 months. Development was assessed in 376 children at ages 12, 24, and 36 months using the Bayley Scales of Infant Development and Ages & Stages Questionnaire administered by evaluators blind to intervention assignment and risk condition.
    RESULTS: Longitudinal mixed model analysis indicated that EDI resulted in better development over 36 months in cognitive abilities, regardless of risk condition, maternal resources, child gender, or country. Psychomotor development and parent-reported general development showed similar trends as for cognitive abilities, but were not statistically different between intervention conditions. Developmental differences were observed first at 36 months of age.
    CONCLUSIONS: Early developmental intervention has promise for improving development in children across developing countries when exposed to various risk conditions. EDI should be one prominent approach used to begin to address long-term outcomes and intergenerational transmission of poverty.
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