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Objective To determine the effectiveness of an intervention designed to improve outcomes for infants and toddlers in foster care. Method Records were reviewed for all children who were adjudicated as in need of care in a specific parish in Louisiana between 1991 and 1998. This period included 4 years before and 4 years after a comprehensive intervention was implemented. Children adjudicated between 1991 and 1994 were the comparison group, and those adjudicated between 1995 and 1998 were the intervention group. Results After the intervention, more children were freed for adoption and fewer children were returned to their birth families than before the intervention. There was no difference in length of time in care before and after the intervention. With regard to the same child returning in a subsequent incident of maltreatment, relative risk reduction for the intervention group ranged from 53% to 68%. With regard to the same mother maltreating another child subsequently, relative risk reduction for the intervention group ranged from 63% to 75%. Conclusions A comprehensive preventive intervention for maltreated infants and toddlers in foster care substantially reduced rates of recidivism but had no effect on length of time in care.

Les relations bebe-mode de soin constituent le contexte crucial pour le developpement et la psychopathologie du bebe. De nombreuses preuves suggerent que les bebes pourraient construire des relations qualitativement differentes avec des modes de soin differents. Pour ces raisons, les relations bebe-mode de soin devraient etre la piece centrale dans l'evaluation en sante mentale infantile. Nous preconisons l'evaluation des relations du bebe avec tous les modes de soin importants a la fois dans des contextes naturels et cliniques. Dans cet article, nous decrivons notre approche, qui est attentive a la fois a la composante externe de la relation, a l'interaction comportementale, ainsi qu'a la composante interne de la relation, l'experience subjective. En integrant les resultats d'evaluations de ces deux composantes, nous determinons les deux niveaux d'adaptation de la relation et les domaines specifiques de forces et faiblesses.