首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 31 毫秒
1.
Failure to thrive: Parental indicators, types, and outcomes   总被引:2,自引:0,他引:2  
The present study clinically evaluated and followed 42 parents and their infants with environmental failure to thrive (FTT) to determine if the type of FTT is related to assessments of parental awareness/cooperation, subsequent FTT outcome, and later neglect. The relationships between the parent's Child Abuse Potential (CAP) Inventory scores and the clinical measures were determined. As expected, the type of FTT was related to the degree of parental awareness/cooperation and to FTT outcome. The degree of parental awareness/cooperation was predictive of FTT outcome. However, no relationships were found between FTT type, parental awareness/cooperation, FTT outcome and later neglect. In contrast, while the CAP scores were not related to FTT type, parental awareness/cooperation, and FTT outcome, they were predictive of later neglect.  相似文献   

2.
Developmental psychophysiologists have long been interested in a means for evaluating infants at risk for cognitive disabilities. The current research addressed the utility of a noninvasive measure of cardiac vagal tone in predicting developmental outcome. At 40 weeks conceptional age, 3 min of resting EKG were recorded from 80 infants. Four groups of infants were evaluated: prematures who had no medical complications in the postnatal period; prematures who experienced respiratory distress syndrome during the postnatal period; term infants who experienced birth asphyxia during labor and/or postdelivery; and healthy term infants. The mental scale of the Bayley Scales of Mental Development was administered at 8 and 12 months conceptional age. Heart period data were analyzed to derive mean heart period, heart period variability, and estimates of vagal tone for each subject. Analyses of the relationship between the heart period variables and 8- and 12-month outcome (i.e., Bayley Scales) indicated that infants with high vagal tone at 40 weeks conceptional age always had positive developmental outcome at both eight and 12 months of age. Infants with low vagal tone had varied outcomes. Measures of medical complications and other measures of heart period variability were not related to developmental outcome. The results suggest that measurement of cardiac vagal tone may provide an important means for assessing risk in birth stressed populations.  相似文献   

3.
This paper describes the characteristics of thriving and failure to thrive (FTT) children and their mothers and examines the effect of short-term lay health visitor intervention in cases of nonorganic failure to thrive (NO FTT). Twenty-five FTT children and mothers received lay health visitor (LHV) intervention in addition to other community and medical treatment; 25 other FTT children and mothers did not receive the LHV intervention but did receive all other medical and community treatment. Twenty-five thriving children and mothers were matched with the FTT children and mothers in the LHV group on the child's age at intake, sex, birth weight, and the mother's age, ethnicity, and number of living children. At initial assessment, the FTT and thriving groups were found to be comparable on demographic factors, infant birth weight percentiles, apgar scores, complications of pregnancy or delivery, and separations in the newborn period. There were more premature births in the LHV group although the proportion of premature births for the FTT and thriving groups overall were similar. A majority of mothers in the FTT groups had negative memories of childhood in contrast to more positive memories in the thriving group. At initial assessment, the majority of thriving children were developmentally normal and had increased from their birth weight percentiles whereas all of the FTT children had decreased from their birthweight percentiles and over half were developmentally delayed. There were clear differences in mother-child interaction patterns in the thriving and FTT groups. Three patterns of interaction were identified in the FTT group: benign neglect, incoordination, and overt hostility. Intervention had no measurable effect on the child's weight, development, or interaction patterns. Only 8 of 37 FTT children reevaluated 6 months later showed "catch up" growth and only 7 had improved in developmental score category. Patterns of interaction were found to persist over the 6 months in all cases. One to three year follow-up of 44 families emphasized the severity of the condition and the need for differentiation of the severity of the disturbance in the mother-child relationship and for more intensive intervention than was available in this study. Of these 44 cases, 2 children had died, 5 had been physically abused or further neglected, and 10 were in alternative care arrangements.  相似文献   

4.
This paper presents 6-month follow-up on a group of 16 infants hospitalized during the first months of life for non-organic failure to thrive (N-O FTT) and their mothers. Eight of these infants were placed in foster care and eight were returned home with their parents following hospitalization. The effects of placement on infant outcomes were examined through comparison of developmental scores and weight percentile changes, and the implications of foster care placements for mother-infant interactions were examined through analysis of patterns of interaction in videotaped sessions of feeding and play six months after hospital discharge. This analysis snowed that (1) mothers in both groups failed to make significant progress in resolving their own emotional or psychological conficts through treatment available; (2) weight and developmental status of the infants did not improve as expected in either group, and finally that (3) the patterns of interaction between mother and infant showed little change over time, and, regardless of placement at home or in foster care, remained concerning.  相似文献   

5.
A majority of cases of failure to thrive (FTT) do not have a known organic etiology. Social and psychological determinants are sought for these "non-organic failure to thrive" (N-O FTT) cases. Social and psychological differences between non-organic and organic cases are also explored here. With the introduction of the term, "maternal deprivation," medical practitioners have implicated mothers' deficiencies as instrumental in the etiology of N-O FTT. However, these mothers are themselves usually deprived. Lack of cooperation in childcare by both parents is noted when classic clinical cases are reviewed. We suggest that the concept, "parental deprivation," provides a more accurate model. Preliminary research findings support our hypothesis that mothers of FTT infants do not have good social support networks. Teen motherhood and socioeconomic status also appear to be important, but not necessary as determinants. An unexpected finding is that there are few differences in the social deficiencies of families of N-O FTT infants as compared to those failing for organic reasons. Two unanticipated findings appear noteworthy. First, infants failing for organic reasons are significantly smaller and thinner at birth, independent of pregnancy complications or prematurity. Second, infants failing for non-organic reasons are more likely to present during the period of infant-caretaker role development and less likely in the later toddler stage. Additional research into the feasibility of strengthening family supports as a basis of intervention is recommended.  相似文献   

6.
This article reviews our experience, as well as the medical literature, regarding the treatment of failure to thrive (FTT) on an outpatient basis. Nonorganic FTT can be accidental, neglectful, or deliberate. Accidental FTT occurs with errors in formula preparation, diet selection, or feeding technique. These errors can usually be corrected by education and demonstration. Deliberate underfeeding is rare, and these children usually require placement in foster care. Neglectful FTT usually occurs because the mother is overwhelmed or psychologically disturbed. Children with neglectful FTT do not automatically require hospitalization. If the degree of FTT is mild to moderate, the mother-child interaction is positive, the mother is not severely disturbed, and the baby has no inflicted injuries or deprivational behavior, the baby can be safely and more economically managed as an outpatient. Management includes new feeding instructions, a stimulation program, social work intervention, home visits by a public health nurse, and weekly weight checks. Most infants respond to this one-month therapeutic trial with an appropriate weight gain. Even after normal weight is attained, many of these families require long-term follow-up to help them deal with multiple psychosocial issues.  相似文献   

7.
Failure to thrive (FTT) is a frequent cause for the admission of infants to the hospital. Such hospitalizations are often lengthy and expensive, and usually do not contribute to an understanding of the etiology of FTT. Generally, organic causes of FTT can be ruled out by a thorough history and physical examination. In this study two groups were examined: 17 infants who were admitted to foster medical placement homes (MPH), private homes with specially trained parents; and a comparison group of 18 infants who were treated in a more traditional way with diagnostic hospitalization. The groups were similar in all regards prior to admission. All infants were less than a year of age. Family disruption was a prominent feature in both groups, but socio-demographic analysis showed them to be similar in all areas studied. The comparison group gained an average of 276 grams in the hospital over 8.6 days. The MPH group gained 362 grams in the hospital over 8.7 days, with an additional 1270 grams in the medical placement home over 31.1 days. Five children were admitted to the medical placement home without hospitalization. After correcting for an expected weight gain of 15 grams per day (normal growth), the comparison group showed a catch-up growth of 16 gms/day, while the MPH group gained 29 gms/day in excess of expectation, almost twice the comparison group. A 100-gram weight gain cost +308 in the MPH program and +1,635 in the traditional approach. This five-fold difference was felt to be a significant deterrent to the continuing approach of admitting children to the hospital for for the workup of FTT.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

8.
9.
Parents seldom seek help directly for infant mental health problems. Parents enter the health care system seeking advice for identified or presumed biological problems in their infants. Many of these biological problems, however, have major psychosocial components of importance to infant mental health. It is important that physicians deal directly with the psychosocial issues and avoid converting them into biological medical problems unintentionally. Three common types of problems and appropriate methods of management are discussed to ensure special recognition and effective handling by the physician of psychosocial problems and the promotion of mental health. The problems discussed are the following: Infants seen with defined medical conditions that generally have associated psychosocial problems including child abuse. Infants seen who have fully recovered from critical illnesses but are considered "at risk" for later developmental disability. Infants seen with normal variations of behavior that are misinterpreted by their parents or physicians as due to a medical problem. In infancy medical and psychosocial issues are so closely interwoven that it is critical that physicians learn to recognize the major psychosocial consequences of primary medical problems and the medical manifestations of primary psychosocial problems and their management.  相似文献   

10.
The accuracy of a risk index based on reproductive and demographic factors to predict subsequent development was tested with 51 full-term and 53 preterm (birth weight less than 1,501 grams) infants. Stanford-Binet IQ and Reynell Language Expression and Comprehension at 3 years were significantly predicted by this risk index. Socioeconomic status, birth order, and, for the preterm group, severity of illness in the perinatal period were the most significant predictors of developmental outcome. The Home Observation for Measurement of the Environment (HOME) scores were significantly correlated, independently of SES and developmental level, with the 3-year Reynell and Stanford-Binet scores for the preterm, but not the full-term, group. Children who were classified as being at risk at 12 months but who had scores in the normal range at 3 years came from families with significantly higher scores on the HOME scale. Children not detected as being at risk in infancy but whose development was delayed at 3 years came from families with lower scores on the HOME scale. The combination system of perinatal, reproductive, and environmental variables allows the detection of infants at risk for subsequent developmental problems.  相似文献   

11.
Mother-infant attachment in adoptive families   总被引:3,自引:0,他引:3  
Data from 2 separate samples using the Strange Situation paradigm were combined to assess the quality of attachment relationships in adoptive and nonadoptive mother-infant pairs. Infants were between 13 and 18 months at the time of observation. Results indicated no differences in mother-infant attachment between nonadopted and intraracial adopted subjects or between intraracial and interracial adopted subjects. Interracial adoptive mother-infant pairs did show a higher incidence of insecure attachment in comparison to nonadoptive pairs. Mothers of interracial adopted infants also were less comfortable having others care for their babies and perceived less emotional support from extended family and friends for their decision to adopt a child prior to the actual adoption than did other mothers. No relation was found, however, between quality of mother-infant attachment and either perceived social support, infant developmental quotient, infant temperament, number of foster homes experienced by the infant, or infant's age at the time of adoption placement. It was suggested that the higher incidence of psychological problems found among adoptees in middle childhood and adolescence cannot be explained in terms of insecure attachment relationships during the infancy years.  相似文献   

12.
A conceptual model was tested in which the effects of mentoring relationships on adolescents' academic outcomes were hypothesized to be mediated partially through improvements in parental relationships. The parameters of the model were compared with those of an alternative, in which improved parental relationships were treated as an outcome variable rather than a mediator. The study included 959 young adolescents (M age = 12.25 years), all of whom applied to Big Brothers Big Sisters programs. The adolescents were randomly assigned to either the treatment or control group and administered questions at baseline and 18 months later. The hypothesized model provided a significantly better explanation of the data than the alternative. In addition to improvements in parental relationships, mentoring led to reductions in unexcused absences and improvements in perceived scholastic competence. Direct effects of mentoring on global self-worth, school value, and grades were not detected but were instead mediated through improved parental relationships and scholastic competence. Implications of the findings for theory and research are discussed.  相似文献   

13.
Using a sample of 42 Korean mothers whose infants are cared for by someone at non-maternal child care facilities, this study first examined both main effects and interaction effects between maternal knowledge of infant development and maternal self-efficacy on parenting behavior. Second, the combined effects of variables of interest in this study including maternal knowledge of infant development, maternal self-efficacy, and parenting behavior on the child developmental outcome were investigated. Significant relationships between maternal knowledge of infant development and parenting behavior and child development outcome were detected. Only main effects of maternal knowledge of infant development were detected. Furthermore, maternal knowledge of infant development was the only significant predictor of infant developmental outcome. Research implications were discussed both on the continuum of findings from previous studies with Western samples and in terms of provision of effective early intervention programs for this targeted population.  相似文献   

14.
OBJECTIVE: This study's aim was to examine variables associated with different short-term trajectories in multiply disadvantaged adolescent mothers by investigating antecedents and concomitants of parenting stress. METHOD: We followed 49 adolescent mothers (ages 14-18 at study outset) who were wards in Illinois foster care using a longitudinal correlational design. We examined whether parenting variables (childrearing beliefs, quality of parent-child interactions, and child abuse risk) and personal adjustment variables (emotional distress and social support) at initial assessment predicted parenting stress measured at follow-up (a mean of 22.5 months later). We also examined concurrent relationships between parenting stress and mothers' adaptive functioning in educational, social support, and childbirth areas at follow-up. RESULTS: We found that parenting variables, but not personal adjustment variables, predicted later parenting stress. Results also showed that current adaptive functioning was significantly related to parenting stress. Specifically, educational status and social support predicted concurrent parenting stress, whereas number of childbirths did not. CONCLUSIONS: These findings extend the small literature on the link between parenting difficulties and parenting stress to adolescent mothers in foster care. Parenting challenges, particularly as reflected in unrealistic childrearing expectations, appear to be markers for later parenting stress. Considering the longitudinal relationships observed, early and periodic assessment of adolescent mothers' parenting knowledge, skills, and interactions is recommended. Also, given that this study found concurrent social support and educational status to covary with current parental stress, these variables, and others for which they may serve as proxy, are implicated for careful monitoring.  相似文献   

15.
The relationships of Israeli mothers and fathers with their 38 preterm infants during hospitalization were traced in a short-term longitudinal study. Parent-infant interactions were observed and self-reports of parental feelings and perceptions were assessed twice: at the beginning and end of the nursery period. Mothers engaged in more caregiving, talking, and holding during initial contacts, but the disparity in maternal and paternal interactions decreased with time. Except for caregiving, in which mothers still surpassed fathers, fathers equaled mothers in all other activities at the time of the infants' discharge from the hospital. Fathers consistently surpassed mothers in playing and stimulating. Mothers perceived their infants to be more difficult than did fathers but reported enjoying them more. With time, parents were less disappointed and concerned over the infants' well-being but perceived them as more difficult. The data also demonstrated an association between infant behavioral states, parental feelings and perceptions, and parental behavior.  相似文献   

16.
This study compared the effectiveness of developmental education for parents with parent education in child management and with a no-education control condition in motivating parents to participate in home treatment programs for developmentally delayed infants. 39 delayed infants, matched for age and severity of delay, and their families were randomly assigned to the 3 treatment groups. The subsequent differential effectiveness of home treatment programs, in terms of the infants' developmental gains, was then examined. Results indicated that the children in the developmental education group gained a greater number of skills, and their parents participated more in the assigned home treatment programs than did parents in the other 2 groups. At follow-up approximately 1 year later, parents who received developmental education continued to participate more than the other parents in their child's treatment program. Developmental education appears to enable parents to discriminate small developmental gains, facilitating the intrinsic motivation involved in working with their children.  相似文献   

17.
Infants hospitalized for non-organic failure to thrive in the first six months of life are in a life-threatening situation and are already at risk for poor bonding with mother. In light of this, the meaning and use of foster care and how this separation affects the developing mother-child relationship are the issues addressed through examination of 16 cases in which 8 of the infants were placed in foster care and 8 discharged home after the failure to thrive hospitalization. This paper examines (1) maternal histories of pregnancy, labor and delivery and the neonatal status of placed and non-placed infants; (2) the developmental and weight status of placed children; (3) the nature of the decision criteria for after-hospital care; and (4) the mother-infant relationship at initial intake in terms of mother's report of events and observations of feeding and play interactions during a videotaped assessment process. The study found that the interactions between mother and infant in those situations which required foster care were clearly more dysfunctional when compared to those in which the baby was discharged home to mother. Babies in the two groups were comparable in weight status at the time of hospitalization although babies in foster placement had slightly lower scores on the Bayley Scales. Maternal histories of pregnancy, labor, and delivery were similar for the two groups as were the birth and neonatal histories of the infants.  相似文献   

18.
A precisely controlled automated procedure confirms a developmental decalage: Infants acquiring English link count nouns to object categories well before they link adjectives to properties. Fourteen- and 18-month-olds ( n = 48 at each age) extended novel words presented as count nouns based on category membership rather than shared properties. When the same words were presented as adjectives, infants revealed no preference for either category- or property-based extensions. The convergence between performance in this automated procedure and in more interactive tasks is striking. Perhaps more importantly, the automated task provides a methodological foundation for (a) exploring the development of form–meaning links in infants acquiring languages other than English and (b) investigating the time course underlying infants' mapping of novel words to meaning.  相似文献   

19.
To Investigate heart rate and respiratory sinus arrhythmia (RSA) as markers of developmental outcome, infant ECG and 3 year outcome were assessed in 41 very low birth weight (<1,500 g) infants. Measures of mean hart rate and RSA, and the maturational shifts in their values from 33 to 35 weeks gestational age, were recorded. RSA measures predicted 3 year outcome beyond the effects of birth weight, medical risk, and socio-economic status. Higher RSA was associated with better social skills, whereas greater RSA maturation was associated with better mental processing and gross motor skills. Lower heat rate was associated with better behavior regulation and social skills, whereas greater maturational decreases were associated with better gross motor skills. Dividing the sample into groups of infants with birth weight less than 1,000 g and these with birth weight over 1,000 g, RSE maturation emerged a strong predictor of mental processing, knowledge base and gross motor skills in the former. A measured of joint maturation of RSA and heart rate was associated with better behavior regulation at 3 years, as measured by Child Behavior Checklist and parenting Stress Index scores, for this group. The findings directly respond to the need for physiological variables in the prediction of outcome in high-risk infants.  相似文献   

20.
Social histories and demographic data were collected on 178 patients—101 in the United States and 77 in Australia—in treatment for drug/alcohol addiction. The purpose of the study was to determine the degree to which a correlation exists between child abuse/neglect and the later onset of drug/alcohol addiction patterns in the abuse victims. The questionnaire explored such issues as family intactness. parental violence/abuse/neglect, parental drug abuse, sibling relationships and personal physical/ sexual abuse histories, including incest and rape. The study determined that 84% of the sample reported a history of child abuse/neglect.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号