Parent training support for intellectually disabled parents

 

Abstract

Background

Intellectual disability may impact on an individual’s capacity to parent a child effectively. Research suggests that the number of intellectually disabled people with children is increasing. Children of parents with intellectual disabilities may be at increased risk of neglectful care which could lead to health, developmental and behavioural problems, or increased risk of intellectual disability.

However, there is some indication that some parents with intellectual disabilities are able to provide adequate child care if they are given appropriate training and support to do so.

Objectives

To assess the effectiveness of parent training interventions to support the parenting of parents with intellectual disabilities

Search methods

We searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, EMBASE, CINAHL, PsycINFO, ASSIA, Sociological Abstracts, Dissertation Abstracts International, MetaRegister of Controlled Trials, and ZETOC.

Selection criteria

Randomised controlled trials comparing parent training interventions for parents with intellectual disabilities with usual care or with a control group. Outcomes of interest were: the attainment of parenting skills specific to the intervention, safe home practices and the understanding of child health.

Data collection and analysis

Two review authors independently assessed risk of bias and undertook data extraction.

Main results

Three trials met the inclusion criteria for this review but no meta-analysis was possible. One study reported improved maternal-child interaction following group parent training compared with the control group. The second study reported some improvements in parents knowledge of life threatening emergencies, ability to recognise dangers and identify precautions and smaller improvements in their ability to implement precautions, use medicines safely and recognise child illness and symptoms. The third study reported improvement in child care and safety skills following the intervention.

Authors' conclusions

There is some risk of bias in the included studies, with limited information available to assess possible bias and to fully assess the findings of one included study. Whilst the evidence presented here does seem promising with regard to the ability of such interventions to improve parenting knowledge and skill in this population, there is a need for larger RCTs of interventions before conclusions can be drawn about the effectiveness of parent training for this group of parents.

 

Plain language summary

Parent training support for intellectually disabled parents

Parents with intellectual or learning disabilities may need support to provide adequate care for their children and prevent problems that can arise in children's welfare or development. Parent training programmes may help them to learn the parenting skills they need.This review found three randomised controlled trials that met the inclusion criteria. The quality of the evidence in the studies is moderate to low. One study found improvement in mother-child interaction compared with the control group, whilst the second found improvement in safe home practices, recognition of child illness and safe use of medicines. The third study found improvement in child care and safety. More research is needed to assess the effects of these interventions before conclusions can be drawn.

 

摘要

背景

智能不足家長訓練方面的支持

智能不足可能會影響一個人照顧孩童的能力。研究發現智能不足且擁有小孩的人越來越多。父母親智能不足的孩童，照顧不周的風險會較高，可能導致健康、發育及行為問題，智能不足的風險也會提升。然而，智能不足的家長在經過適當的訓練後，也能夠提供小孩適當的照顧。

目標

以家長訓練幫助智能不足的家長，評估訓練的成效。

搜尋策略

我們搜尋了以下的資料庫，包括Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library) 、MEDLINE, EMBASE、CINAHL、PsycINFO、ASSIA、Sociological Abstracts, Dissertation Abstracts International、MetaRegister of Controlled Trials及ZETOC。

選擇標準

針對智能不足的家長，以家長訓練和一般照護或其它對照組比較的隨機對照試驗。以介入措施中所訓練的撫育技巧、家庭安全實施及對孩童健康的了解作為結果。

資料收集與分析

2位文獻回顧者分別評估誤差的風險，並進行資料擷取。

主要結論

有3個試驗符合本篇回顧的收錄標準，但無法執行統合分析。一篇研究顯示，和控制組相比，經過團體的家長訓練後，母親和孩童間的互動有改善。第二篇研究顯示在對危急狀況的知識、辨識危險的能力及找出預防措施的能力有一些改善，而在執行預防措施、安全用藥，以及辨識孩童疾病與症狀的能力提升上則較少。第三篇研究顯示經過訓練後，在孩童照護及安全技能方面有改善。

作者結論

收錄的研究中有一些誤差風險，由於可得的資訊有限，評估可能風險及收錄研究的結果時有所限制。雖然目前的證據，都認為這些介入措施可以增強智能不足家長的知識及技能，仍然需要更大型的隨機對照試驗，才能判斷家長訓練的效果。

翻譯人

本摘要由朱奕蓁翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

智能不足家長訓練方面的支持智能不足或學習障礙的家長可能需要提供其孩童適當照護方面的支持，並且避免可能影響兒童福利或發展的問題產生，家長訓練課程可能可以幫助他們學習其所需的撫育技巧。本篇文獻回顧找到3篇符合文章選取條件的隨機控制試驗。文章中的證據品質介於中等至低的程度。一篇研究發現，與控制組相較，母親於孩童間的互動有所改善，而第二篇發現居家安全的維護、孩童疾病的辨識及安全用藥上有所改善。第三篇研究則發現在孩童照護及安全上有所改善。在下結論前，仍然需要更多的研究評估此類介入措施的效果。