背景：儘管台灣近年出生率下降，早期療育（早療）服務需求仍持續增加。過去研究多聚焦於已確診兒童之家庭，對於處於需求察覺階段的早療家庭的了解仍相當有限。接受早療的兒童常伴隨行為問題，進而增加照顧者的親職壓力。雖然兒童行為問題與親職壓力具有密切關聯，但僅針對兒童行為問題的介入可能不足以改善家庭整體適應。家庭韌性被視為潛在的調節因子，且可能隨早療而提升；然而，其在兒童行為問題與親職壓力關係中的調節角色仍缺乏實證支持。因此，本研究以台南某醫學中心之早療評估資料為基礎，探討需求察覺階段的早療家庭之兒童行為問題、親職壓力與家庭韌性。
方法：本研究採橫斷式次級資料分析，納入兒童年紀18至71個月、首次接受早療評估之兒童及其主要照顧者。研究工具包括學齡前兒童行為檢核表（Child Behavior Checklist for Ages 1½–5, CBCL）、親職壓力量表第四版短版（Parenting Stress Index–Fourth Edition Short Form, PSI-4-SF）及Walsh家庭韌性量表臺灣版（Walsh Family Resilience Questionnaire-Taiwan version, WFRQ-T）。資料分析採用描述性統計、相關分析及SPSS 30.0之PROCESS巨集進行調節效果分析。
結果：共納入165個家庭的資料。照顧者平均年齡為37.0歲（SD = 5.8），多數為母親（81.8%）；兒童平均年齡為40.0個月（SD = 13.3），70.9%為男性。兒童行為問題平均T分數為57.8（SD = 10.1），其中32.1%達臨床顯著範圍。親職壓力平均分數為93.4（SD = 19.0），80.0%的照顧者親職壓力落於正常範圍。家庭韌性平均分數為89.2（SD = 17.2），高於量表中點。兒童行為問題與親職壓力呈顯著正相關（r = .42, p < .01），家庭韌性與親職壓力呈顯著負相關（r = −.44, p < .01）。調節分析結果顯示，兒童行為問題可正向預測親職壓力（p < .001），家庭韌性則可負向預測親職壓力（p < .001）；然而，家庭韌性之調節效果未達顯著（p = .41）。控制共變數後，最終模型共可解釋33%的親職壓力變異量（p < .001）。
討論：相較於已獲確切診斷之早療家庭普遍呈現較高的親職壓力，本研究之需求察覺階段之早療家庭展現相對較低的親職壓力與中度家庭韌性。然而，其家庭韌性分數略低於一般社區樣本，顯示兒童發展不確定性可能對家庭適應能力造成影響。過往研究指出家庭韌性可能透過促進性過程或保護性過程來影響家庭面對困境時的適應能力，而在本研究中家庭韌性未呈現調節效果，表示其在此需求察覺階段之早療家庭主要作為促進性資源，而非保護性因子。
結論：在台灣需求察覺階段之早療家庭中，兒童行為問題與親職壓力呈正相關，而家庭韌性與親職壓力呈負相關。然而，家庭韌性未能調節兒童行為問題與親職壓力之間的關係，顯示其在需求察覺階段之早療家庭可能較偏向穩定的促進性資源。因此，在此時期導入合適衛教與提供家庭導向策略，可能有助於提升早療需求察覺階段家庭之家庭韌性並進而避免照顧者之親職壓力惡化。

Background: Despite declining birth rates, the demand for early intervention (EI) services in Taiwan continues to increase. Previous studies have primarily focused on families of children with confirmed diagnoses, while little is known about families during the recognition stage of EI. Children receiving EI services often present behavior problems that may increase caregivers' parenting stress. Although child behavior problems and parenting stress are closely associated, interventions targeting child behaviors alone may be insufficient. Family resilience has been identified as a potential moderator and may improve following EI services; however, its moderating role in the relationship between child behavior problems and parenting stress remains unclear. Therefore, this study aimed to analyze EI assessment data from a medical center in Tainan, Taiwan, to examine child behavior problems, parenting stress, and family resilience among families in the recognition stage of EI services.
Methods: This cross-sectional secondary data analysis included children aged 18–71 months receiving their first EI evaluation and their primary caregivers. Child behavior problems, parenting stress, and family resilience were assessed using the Child Behavior Checklist for Ages 1½–5 (CBCL), Parenting Stress Index-Fourth Edition Short Form (PSI-4-SF), and Walsh Family Resilience Questionnaire-Taiwan version (WFRQ-T), respectively. Descriptive statistics, association analyses, and moderation analysis using the PROCESS macro were conducted in SPSS 30.0.
Results: Secondary data from 165 families were included in the analysis. Caregivers had a mean age of 37.0 years (SD = 5.8), and most were mothers (81.8%). Children had a mean age of 40.0 months (SD = 13.3), and 70.9% were male. The mean T-score for child behavior problems was 57.8 (SD = 10.1), with 32.1% in the clinically significant range. The mean parenting stress score was 93.4 (SD = 19.0), and 80.0% of caregivers reported stress within the normal range. The mean family resilience score was 89.2 (SD = 17.2), which was above the scale midpoint. Child behavior problems were positively associated with parenting stress (r = .42, p < .01), whereas family resilience was negatively associated with parenting stress (r = −.44, p < .01). Moderation analysis showed that child behavior problems positively predicted parenting stress (p < .001), while family resilience negatively predicted parenting stress (p < .001). However, the moderating effect of family resilience was not significant (p = .41). After accounting for the covariates, the final model explained 33% of the variance in parenting stress (p < .001).
Discussion: Different from higher parenting stress observed in post-diagnosis samples, families at the recognition stage demonstrate relatively low parenting stress and relatively moderate levels of family resilience. However, their family resilience scores were slightly lower than those reported in general community samples, suggesting that concerns about children’s developmental conditions may already challenge families' ability to adapt during the recognition stage. Previous research has suggested that family resilience may influence families’ adaptation to adversity through either promotive or protective processes. In the present study, however, family resilience did not demonstrate a moderating effect, suggesting that during the recognition stage of EI, family resilience primarily functions as a promotive resource rather than a protective factor.
Conclusion: Child behavior problems were positively associated with parenting stress, whereas family resilience was negatively associated with parenting stress among families in the recognition stage of EI in Taiwan. However, family resilience did not moderate the relationship between child behavior problems and parenting stress, suggesting that it may function as a stable promotive resource during the recognition stage of EI. Therefore, implementing appropriate education and providing family-based strategies during this critical period can enhance family resilience and prevent parenting stress from worsening in families among families in the recognition stage of EI.

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