German Clinical Trials Register

Acronym/abbreviation of the study

EVA

URL of the study

http://www.sfi-frankfurt.de/de/forschung.html

Brief summary in lay language

As many studies in the fields of empirical infant research, relationship research and psychoanalysis demonstrate, the experience of stable emotional relationships in the first years of one's life is the best precondition for a successful psychical, cognitive and psychosocial development, including the acquisition of language. Numerous prevention programs follow these empirical findings and try to support children already at the kindergarten age; yet such offers do not reach all families, as families with a migration background are, for instance, unaware of such programs. The early prevention of violence, social learning and the support of the social integration of children from these societal groups were therefore the aims of the Frankfurt prevention study, which was conducted by the Sigmund-Freud-Institut in cooperation with the Institut für Analytische Kinder- und Jugendlichenpsychotherapie and the municipal education authority in 14 day-care centers in Frankfurt from 2003 to 2006. The study was based on clinical experiences and new findings in psychoanalytical developmental psychology, early education and brain science according to which the early years of life set the course for future psychical and psychosocial developments. Against this backdrop, the findings of the representative study were of great significance: the aggression and fearfulness of children as well as the hyperactivity of girls showed a statistically significant reduction in comparison to the control group. Conducted by the Sigmund-Freud-Institut in Frankfurt am Main, the follow-up project to the Frankfurt prevention study, EVA, is now meant to review the differential effects of two established prevention programs – „FISTLESS“ and „EARLY STEPS“. Both prevention projects run in seven day-care centers selected because of their interest in conducting these projects.

Brief summary in scientific language

Given that the experience of stable emotional relationships in the first years of one's life is the best precondition for a successful psychical, cognitive and psychosocial development numerous prevention programs try to intervene very early and support children already at the kindergarten age; yet such offers very often do not reach all families or they do not meet the specific needs of the families. In the EVA research project we intent to intervene very early in order to disrupt adverse developments in the very special population, namely children aged 3 to 5, who are strained by different risk factors such as migration background, poor socioeconomic status etc. We therefore installed two different prevention programs in problematic urban districts in Frankfurt/Main in order to compare their effecttiveness in preventing social-emotional or psychic disturbances in children. From a scientific point of view one of our major aims is to evaluate these two early prevention programs and their effectiveness. The hypothesis is, that a program like „EARLY STEPS“ which tries to individually address the specific needs of the child, that such a program is more effective given these risk populations than a more general curriculum like „FISTLESS“. On the other hand, in some day-care centers the more narrow approach of „FISTLESS“ might better meet the teachers‘ demand for structure – so what we are also interested in, is to investigate the effectiveness of the prevention program in relation to its actual „goodness of fit“ to the needs of the institution. One approach to tap the specific mother-child-interrelation and the child‘s inner object representations is the attachment approach. That is why we want to investigate the programs‘ influence on the attachment. We assume that by offering good and stable alternative relational experiences and by working on the parent-child relationship within the „EARLY STEPS“ program, we might manage to change the attachment type of some children from an unsecure or desorganized to a more secure attachment. Design of the EVA-study: In EVA we realize a longitudinal cluster randomized trial design with pre-, post- and follow-up measurement time points. The clusters, respectively the day care-centers were randomly chosen on basis of a representative baseline survey of all Frankfurt day-care centers carried out in 2003. In this baseline survey relevant characteristics of more than 5300 children, namely their levels of hyperactivity, aggression and anxiety were measured. Additionally, statistical socioeconomical indicators of the City of Frankfurt/Main were included. Regarding the institutional framework: The IDeA (Center for Research on Individual Development and Adaptive Education of Children at Risk) was founded by the German Institute for International Educational Research (DIPF) and Goethe Universität Frankfurt in cooperation with the Sigmund-Freud-Institute (SFI). IDeA is an interdisciplinary research center which is financed by the LOEWE iniative of the State Hessen, Germany, a huge promotional program fostering excellent research in Hessen.