婴幼儿先天性及后天性脑损伤的跨学科评估与治疗效果

Stephen J. Bagnato, John T. Neisworth
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引用次数: 19

摘要

评估和治疗脑损伤青少年的复杂性需要跨学科的努力。一个多专业的方法可以提供不同的和一致的信息来指导治疗。虽然团队合作的方法受到了赞扬,但很少有研究试图证明它的效率或功效。本研究采用跨学科模型评估脑损伤儿童在治疗过程中的进展。具体而言,该研究试图记录团队方法在3.5个月期间对两组病因不同的儿童(获得性损伤,n = 7;先天性损伤,n = 10)。对团队干预期间(-x = 3.5个月)的发育和行为进展的分析显示,先天性和后天性脑损伤儿童在干预前后都有显著的进步。在Bayley婴儿发展量表、早期干预发展档案和Carolina个体行为记录中,团队治疗在四个发展领域(即认知、社会情感、自我照顾、知觉/精细运动)和五个行为过程(即社会取向、注意力、接受性沟通、对象取向和自我调节)中都有显著的效果,超出了预期的成熟收益。尽管在这些领域进行了干预,但在各种神经运动、自我调节和神经生理领域(即大运动、表达性交流、活动、反应性、挫折和安慰性)的进展不太明显。建议的指导方针团队诊断,干预,和方案评估为年幼的脑损伤儿童详细。
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Efficacy of interdisciplinary assessment and treatment for infants and preschoolers with congenital and acquired brain injury

The complexities of assessment and treatment for brain-injured youngsters demand interdisciplinary effort. A multiprofessional approach can provide both varied and congruent information to guide treatment. While the team approach has been extolled, few research studies have attempted to document its efficiency or efficacy. The present study employed an interdisciplinary model to assess the progress of brain-injured children during their course of treatment. Specifically, the study attempted to document the effectiveness of a team approach over a 3.5 month period of intensive treatment for two etiologically distinct groups of children (acquired injury, n = 7; congenital injury, n = 10). Analysis of developmental and behavioral progress over the period of team intervention (-x = 3.5 months) revealed significant pre-post gains for the congenital as well as the acquired groups of brain-injured children. Significant team therapy effects beyond gains expected due to maturation were evident across four developmental domains (i.e., cognitive, socio-emotional, self-care, perceptual/fine motor) and five behavioral processes (i.e., social orientation, attention, receptive communication, object orientation, and self-regulation) on the Bayley Scales of Infant Development, Early Intervention Developmental Profile, and Carolina Record of Individual Behavior. Progress was less evident in various neuromotor, self-regulatory, and neurophysiological areas (i.e., gross motor, expressive communication, activity, reactivity, frustration, and consolability) despite intervention in these areas. Suggested guidelines for team diagnosis, intervention, and program evaluation for young brain-injured children are detailed.

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