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[Action-research on the prevention of abuse in the very young child. Methodology and initial results]
N Job-Spira1, M Lamour, M Gabel
1Unité de recherches INSERM U 292, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
Insights
This action-research identifies disrupted mother-infant interactions at 3 months as a key danger sign for infant abuse. It also highlights disrupted grandparental family structures and the father's role as significant risk factors.
Area of Science:
- Public Health
- Pediatrics
- Psychiatry
- Child Development
Background:
- Infants with medico-psychosocial risk factors are vulnerable to abuse and neglect.
- Existing surveillance methods may not adequately identify high-risk families.
- Understanding early mother-infant interactions is crucial for prevention.
Purpose of the Study:
- To develop and evaluate novel prevention strategies for infant abuse and neglect.
- To identify early indicators of risk in high-risk infants and families.
- To assess the impact of specific interventions on mother-infant interactions.
Main Methods:
- A longitudinal randomized controlled trial involving infants under one year.
- Two groups: intervention group receiving specific preventive care and control group receiving standard surveillance.
- Assessment of mother-infant interactions at 3 months, 1, 2, and 3 years of age.
Main Results:
- Dysharmonious mother-infant interactions at 3 months identified as a "danger" pointer.
- Disrupted grandparental family structures emerged as a novel risk factor.
- The father's role in mother-infant interactions was found to be significant.
Conclusions:
- Early identification of mother-infant interactional discord is vital for preventing abuse.
- Family structure, including grandparental involvement and paternal roles, influences infant well-being.
- Findings are refining intervention methods for the ongoing active phase of the research.
Abstract:
Teams of pediatricians and psychiatrists are leading a joint action-research in public health which intends to develop and evaluate original modes of prevention of abuse and grave neglect concerning infants with medico-psychosocial high risk factors. The framework of this study is a randomized controlled trial on the modes of prevention. The sample, consisting of infants under one year of age and selected from their health certificate of the 8th day and 9th month, is divided into two groups: the treated group who benefited from specific preventive interventions and the control group who benefited from classic surveillance. The research was longitudinal and was centered on the study of mother-infant interactions at 3 months, 1 year, 2 years and 3 years of age. The dynamics in the action-research is illustrated by the evolution of the tool for assessment of early interactions and the refocusing of the research. From the analysis of the data from the phase of feasibleness, which included 114 infants, three main results have come out: definition of a "danger" pointer: dysharmonious mother-infant interactions at 3 months; a new risk factor was brought to light: "disrupted grand-parental family"; father's role in mother-infant interactions. These first results have had a major impact on the method for the active phase which is now in progress and intends to evaluate the new modes of prevention.