ABSTRACT:The clinical and practical experiences of a multidisciplinary infant mental health team using the DC: 0-3 Diagnostic Classification system are presented. Using data obtained from clinical in-depth evaluations of 167 consecutive referred infants, the characteristics and clinical features of this sample of children and parents are examined. The principal issues are children and families' socioeconomic status, number and types of stressors, as well as the symptoms or difficulties exhibited by the infants themselves. A significant proportion of infants come from a deprived socioeconomic background, and many are exposed to violence in the home. The diagnoses given to infants and to the kind of relationship they have with the primary caregiver (Axes I and II) are presented, as well as data as to their physical status (Axis III) and stressors (Axis IV). Many children are diagnosed as having regulatory disturbances, predomiDirect correspondence to: Martín Maldonado, Family Service and Guidance Center, 325 SW Frazier, Topeka, KS 66604; phone; 785-232-5005; fax: 785-232-0160; e-mail: Maldo2000mor@aol.com. DC: 0-3 and Infant Clinic • 379nantly of the hypersensitive and motorically disorganized type. A significant proportion of mothers exhibited depression. About a third of the babies and primary caregivers had a relationship disorder, the predominant category being the underinvolved type. The implications of these findings are discussed, emphasizing the usefulness and frequency of some categories, while questioning the usefulness of other diagnostic categories. The experience of the group contributes to a dialogue and database regarding the clinical usefulness and applicability of this diagnostic classification system. RESUMEN: Se presentan en este estudio las experiencias clínicas y prácticas de un equipo de salud mental infantil multidisciplinario que utilizó la clasificación de diagnóstico DC: 0-3. Usando la información obtenida de una evaluación clínica profunda de 167 infantes que consecutivamente nos fueron enviados, este estudio examina las características y rasgos clínicos de dicho grupo muestra compuesto de infantes y sus padres. Los asuntos principales son: la condición socioeconómica de los niños y sus familias, el número y el tipo de las causas de estrés, así como los síntomas o dificultades presentadas por los mismos infantes. Una proporción significativa de los niños procede de niveles socioeconómicos bajos, y muchos están expuestos a violencia en sus hogares. Se presentan los diagnósticos que se les dieron a los infantes y a los tipos de relación que tales infantes tienen con quien les prestan el cuidado inmediato (Ejes I y II). También se presenta la información sobre la condición física de los infantes (Eje III) y de estrés (Eje IV). Muchos niños reciben el diagnóstico que los describe con trastornos regulatorios, predominantemente del tipo de hipersensibilidad y de desorganización motora. Una proporción significativa de madres presentó de depresión. Cerca de un tercio de los bebés y quienes les cu...
Feeding problems tend to have patterns according to the age of the baby in a nonreferred sample. They are not associated with an altered parent-infant relationship nor poor feeding technique. Parents often adapt successfully to the uniqueness of the baby to maintain weight gain.
Over the course of several years, a protocol for psychoeducational intervention has been implemented, evaluated, and continually refined. The protocol aims to increase adolescents' awareness of the impact of trauma on their functioning, thereby setting the stage for helping them cope more effectively with stress; all in the service of diminishing the likelihood of re-enactment and risk-taking behaviors. This chapter describes the current status of the protocol, its evolution through the process of evaluation, and its potential for wider applications in the community. First, it presents the latest version of the protocol. Second, it traces the course of its evaluation, from a quantitative to a qualitative approach, the latter developed to better validate clinical impressions. Third, it presents a framework to conceptualize the role of this intervention in violence prevention. Finally, some of the implications for future community applications are discussed.
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