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早期療育介入架構

早期療育介入架構. 李儒卿 台北市萬芳醫學中心精神科兼任主治醫師 台北醫學大學附設醫院精神科兼任主治醫師 台北醫學大學醫學系兼任講師 天主教輔仁大學醫學院臨床心理系兼任講師 Reference book: S honkoff P. Jack, & Meisels J. Samuel(2000): Handbook of Early Childhood Intervention(2nd. Ed.), Cambridge University Press. Problem: SIRSE. Symptoms Impact: distress or impairment

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早期療育介入架構

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  1. 早期療育介入架構 李儒卿 台北市萬芳醫學中心精神科兼任主治醫師台北醫學大學附設醫院精神科兼任主治醫師 台北醫學大學醫學系兼任講師 天主教輔仁大學醫學院臨床心理系兼任講師 Reference book:Shonkoff P. Jack, & Meisels J. Samuel(2000): Handbook of Early Childhood Intervention(2nd. Ed.), Cambridge University Press.

  2. Problem: SIRSE • Symptoms • Impact: distress or impairment • Risks: factors initiate and maintain? • Strengths: assets to work with？ • Explanatory model: beliefs family bring with?

  3. Transactional model of intervention: 3 R • Child Remediate Parent • Parent Redefine parent: LBW infant • Parent Reeducate child

  4. Transactional intervention: environtype

  5. Development :cognition; speech/language; motor; social-emotional; disorder; elimination • Emotion: worries, fears, misery, stomach-aches etc. • Disruptive behavior: defiant, aggressive, antisocial behaviors • Other: school refusal? • Not a formal psychiatric disorders: dysfunctional families; juvenile offenders; victim of abuse

  6. Guiding principles:developmental-psychoanalytic perspective • Diagnosis ongoing: a changing orientation • Preventing developmental compromises:1. learning2. emotional regulation3. behavioral conduct4. risk-taking behavior and exposure to physical illness

  7. Guiding principles:developmental-psychoanalytic perspective • Strengthening individual pathways:1. motivation for learning and positive experience with exploration2. motivation for reciprocity in relationships3. confidence in using emotions for self and others4. safety and health

  8. Protective Factors within Individuals before Age of Six • low distress/low emotionalityactive, alert, high vigor, drivesociabilityeasy engaging temperamentadvanced self-help skillsaverage-above average IQability to distance oneself, impulse controlstrong achievement motivationspecial talent, hobbiespositive self-conceptsplanning foresightstrong religious orientation, faith

  9. Protective Factors within Family and Community before Age of Six • Small family size • Mother’s education • Maternal competence • Close bound with primary caregiver • Supportive grandparents, siblings • Girls: autonomy with emotional support from primary caregiver; Boys: structure and rules in household; For both: assigned chores ”required helpfulness” • Close competent peer • Supportive teacher, Successful school experience, Mentors

  10. Parenting to parenting: Intervention(0-3yrs)

  11. Parenting to parenting:Beginning of head start(3-7 yrs)

  12. Parenting to parenting:Primary school(7-10 yrs)

  13. Parenting to parenting: Middle schoolhood(10-17yrs)

  14. Parenting to parenting:adolescence(17-25 yrs)

  15. 社會心理取向的介入模式 早期療育方案的成分 壓力源 資源支持 社會支持 訊息與直接服務 正式療育方案（如家庭為中心的服務） 家長團體家庭諮商 覺察並能找到第一線協調性服務 家長、專業者的關係（健康、安全、參與式指導、問題解決） 建立家庭/友伴/社會支持網路 補助性支持 （經濟、臨托等） 個別治療 表一取自Guralnick（2000）

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