Fostering Self-Regulation in Infants and Toddlers with FASDs

培养患有 FASD 的婴幼儿的自我调节能力

基本信息

批准号：
8138505
负责人：
Blair Paley
金额：
$ 34.3万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-30 至 2013-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8138505
关键词：
Address Advocacy Advocate Affect Alcohols Attitude Behavior Brain Caregivers Caring Child Child Development Clinical Communities Control Groups Data Development Diagnosis Early treatment Education Educational process of instructing Effectiveness Emotions Ensure Environment Evaluation Evidence based intervention Evidence based treatment Exposure to Failure Family Feedback Fetal Alcohol Exposure Fetal Alcohol Spectrum Disorder Focus Groups Fostering Goals Health Knowledge, Attitudes, Practice Hour Human Hydrocortisone Impairment Individual Infant Informal Social Control Intervention Knowledge Learning Life Manuals Measures Mental Health Modification Music Neurodevelopmental Disorder Outcome Parent-Child Relations Parenting Education Parenting behavior Parents Patient Self-Report Phase Play Population Problem behavior Provider Randomized Recording of previous events Regulation Reporting Research Research Personnel Resources Risk Role Schools Services Severities Social Work Stress System Testing Toddler Training Work adverse outcome alcohol exposure base caregiving cohort design effective therapy emotional experience experience foster child high risk high risk infant improved innovation multi-component intervention programs public health relevance satisfaction skills therapy design

项目摘要

DESCRIPTION (provided by applicant): Researchers have demonstrated that in human infants, prenatal alcohol exposure (PAE) is associated with problems with state and autonomic regulation, increased post-stress cortisol levels, higher levels of irritability, increased negative affect, and increased level of activity. These findings suggest that PAE can profoundly compromise an infant's capacity for self-regulation, which in turn may place them well on course for a negative developmental trajectory. Deficits in self-regulation can confer further vulnerability on the alcohol- exposed infant by compromising early parent-child relationships, impairing a child's ability to manage stressful situations, interfering with learning and mastery of developmentally appropriate tasks, and potentially impacting early brain development. Strikingly, there are currently no evidence-based interventions designed for infants and toddlers with PAE or who have been diagnosed with a Fetal Alcohol Spectrum Disorder (FASD). Given the persistence and severity of many alcohol-induced deficits, and the extremely poor long-term outcomes of individuals affected by PAE, especially for those whom do not receive the benefit or early intervention or a stable, nurturing caregiving environment, the need to develop effective treatments for infants and toddlers in this high-risk population is urgent. Early intervention aimed at enhancing these children's capacity to regulate their emotions and behavior would potentially represent a major advance in efforts to reduce the long-term adverse outcomes for these children. Moreover, as the consequences of prenatal alcohol exposure are likely to reverberate well beyond those experienced directly by the alcohol-exposed individual, interventions that operate at multiple levels of the family system are likely to be the most effective. Thus the proposed study entails an innovative multi-component intervention to foster self-regulation in infants and toddlers in foster or adoptive care with a history of PAE or a diagnosis of an FASD. Two components, a parent education and advocacy module and an attachment-based parent group, will focus on improving parents' knowledge and skills that will enhance their ability to respond to their children in ways that support the development of self- regulation. A third component, a music-based parent-child play group, will serve to promote positive parent- child interactions and is based on findings that exposure to singing and music can enhance self-regulation in young children. Improving parental sensitivity, increasing parental commitment, decreasing parental stress, enhancing the quality of the parent-child relationship, and ultimately, fostering the child's capacity for self- regulation may all play a critical role in circumventing a cascade of negative developmental outcomes associated with PAE. Furthermore, the aim of this multi-component to address a core deficit-impairment in self-regulation--would likely have relevant applications for other high-risk infants and toddlers presenting with other neurodevelopmental disorders. PUBLIC HEALTH RELEVANCE: Children with prenatal alcohol exposure often experience emotional and behavioral problems throughout life. The goal of this study is to test an intervention designed to help infants and toddlers learn skills that will help them manage their emotions and behaviors and teach parents how to support their children's development of those skills. Teaching children with prenatal alcohol exposure these skills may help reduce their risk for negative long-term outcomes, such as delinquency, school failure, and mental health problems.

描述（由申请人提供）：研究人员已经证明，在人类婴儿中，产前酒精暴露（PAE）与州和自主性调节问题有关，施加后压力性皮质醇水平增加，更高的烦躁水平，负面影响增加以及水平增加水平活动。这些发现表明，PAE可以严重损害婴儿的自我调节能力，这反过来又可能使他们在负面的发展轨迹方面很好地使他们成为良好的过程。自我调节的缺陷可以通过损害早期的亲子关系，损害孩子管理压力状况的能力，干扰学习和掌握适当的发展任务并潜在影响早期大脑发展的能力，从而赋予对酒精暴露婴儿的进一步脆弱性。令人惊讶的是，目前尚无针对患有PAE的婴儿和幼儿设计的基于证据的干预措施，或者被诊断出患有胎儿酒精谱系障碍（FASD）。鉴于许多酒精引起的赤字的持久性和严重性，以及受PAE影响的个体的极差的长期结果，特别是对于那些未接受福利或早期干预或稳定，养育的护理环境的人，需要发展在这种高风险人群中对婴儿和幼儿的有效治疗是紧迫的。旨在增强这些儿童调节情绪和行为的能力的早期干预措施可能代表减少这些孩子的长期不良后果的努力。此外，由于产前酒精暴露的后果可能会远远超出直接受酒精曝光个人而经历的后果，因此在多个家庭系统中运行的干预措施可能是最有效的。因此，拟议的研究需要进行创新的多组分干预措施，以促进婴儿和幼儿的自我调节，并具有PAE史或FASD的诊断。父母教育和倡导模块和一个基于依恋的父母组的两个组成部分将着重于提高父母的知识和技能，以增强他们以支持自我调节发展的方式对孩子做出反应的能力。第三个组成部分是一个基于音乐的亲子游戏小组，将有助于促进积极的父母互动，并基于发现唱歌和音乐可以增强幼儿自我调节的发现。提高父母的敏感性，提高父母的承诺，减轻父母的压力，提高亲子关系的质量，并最终培养孩子的自我调节能力都可能在规避与PAE相关的负面发展结果的级联方面起关键作用。此外，该多组分的目的是解决自我调节中核心赤字障碍的目标 - 可能会在其他神经发育障碍的其他高风险婴儿和幼儿中有相关的应用。公共卫生相关性：产前酒精暴露的儿童经常在一生中遇到情绪和行为问题。这项研究的目的是测试旨在帮助婴儿和幼儿学习技能的干预措施，以帮助他们管理情绪和行为，并教父母如何支持孩子的这些技能的发展。教授产前酒精暴露的儿童这些技能可能有助于降低其长期结果负面结果的风险，例如犯罪，学校失败和心理健康问题。