改善3岁及以下儿童执行功能的干预措施:系统性审查
Andrea F Duncan1,2, Gwyn J Gerner3,4, Mary Lauren Neel5
1Department of Pediatrics, Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Child: care, health and development
|July 3, 2024
概括
早期执行功能 (EF) 干预显示出多种方法,缺乏有效性的证据. 针对幼儿的有针对性的干预措施,需要更系统的方法来提高基础技能.
科学领域:
- 发展心理学 发展心理学
- 儿科干预科学 儿科干预科学
背景情况:
- 早期的执行功能 (EF) 技能对于学校准备,学术成功和精神病风险至关重要.
- 确定特定年龄的EF技能对于开发有效的早期干预至关重要.
- 这项研究检查了针对EF在3岁以下儿童中的干预措施.
研究的目的:
- 检查针对从婴儿期到3岁儿童执行功能 (EF) 技能的干预措施的特点和有效性.
- 在早期发育中识别特定的EF技能,这些技能在儿童年龄的变化中表现出变化.
- 综合目前关于EF早期干预的证据,以告知未来的研究和实践.
主要方法:
- 在主要数据库 (PubMed,Embase,CINAHL,APA PsycINFO) 进行了系统的文献搜索,寻找在2022年12月之前发表的研究.
- 包括针对3岁及以下儿童改善特定EF技能 (如注意力控制,自我调节,工作记忆) 的干预措施的随机和非随机研究.
- 通过使用修订的Cochrane风险偏见工具评估研究质量,并根据GRADE原则使用没有元分析的合成 (SWiM) 进行证据综合.
主要成果:
- 35项研究符合纳入标准,显示了针对EF技能,干预设计和结果评估的显著变化.
- 大多数干预措施的重点是加强冲动控制和自我调节,总体证据质量被评为低至中等.
- 虽然六项研究具有低偏差风险,但它们对干预疗效的发现是混合的,表明结果不一致.
结论:
- 目前的EF早期干预研究缺乏方法一致性,防止具体干预建议的证据趋同.
- 为了设计和实施有效的EF早期干预措施,需要采用更系统,更有针对性的方法.
- 需要进一步的研究,以建立基于证据的实践,以加强早期的执行职能.
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