ABSTRACT Global developmental delay (GDD) is defined as significant delay in two or more developmental domains, including motor, speech and language, cognition, social/personal and activities of daily living. The prevalence of GDD is estimated to be 1–3% of children below 5 years of age, yet the child psychiatric and psychoanalytic literature is very limited as to effective treatment modalities for pre-school children with severe and/or multiple developmental delays. For these impacted children, the treatments are often highly fragmented with multiple providers typically prioritizing their own objectives with potential results, from the child’s and the parents’ point of view, of uncoordinated, confusing, challenging and anxiety-producing experiences. This case report, describing the first 2 ½ years of the psychoanalytic treatment of a 3 ½ year old girl with global developmental delay, proposes that, in the treatment of such pre-school children, a psychoanalytic play therapy model with multiple visits per week effectively can: (i) focus on and address the child’s developmental and emotional state as a whole; (ii) provide a safe, stable and containing developmental object relationship for the child to use effectively in their developmental process to build internal psychic structure; (iii) significantly decrease anxiety and oppositional or negative behaviors by verbally linking words and co-created meaning to difficult feelings, problems and memories and thereby provide the child with tools to understand and govern their own emotions and behaviors and finally (iv) help the larger system of parents and allied professionals organize the clinical data, prioritize goals and shift technique to consider the child’s mental states.

中文翻译：

---

通过游戏创造意义：对全球发育迟缓学龄前儿童的精神分析干预

摘要 全球发育迟缓（GDD）被定义为两个或多个发育领域的显着延迟，包括运动、言语和语言、认知、社交/个人和日常生活活动。GDD 的患病率估计为 1-3% 的 5 岁以下儿童，但儿童精神病学和精神分析文献对于严重和/或多发性发育迟缓的学龄前儿童的有效治疗方式非常有限。对于这些受影响的儿童，治疗通常高度分散，多个提供者通常优先考虑他们自己的目标，从孩子和父母的角度来看，可能会产生不协调、令人困惑、具有挑战性和产生焦虑的经历。这份病例报告，描述一个 3.5 岁全发育迟缓女孩的前 2.5 年精神分析治疗，建议在治疗此类学龄前儿童时，每周多次就诊的精神分析游戏治疗模型可以有效地：（i ) 关注并解决儿童的整体发育和情绪状态；(ii) 为儿童提供安全、稳定和包容的发展客体关系，以便在他们的发展过程中有效地使用，以建立内部心理结构；(iii) 通过口头将单词和共同创造的意义与困难的感觉联系起来，显着减少焦虑和对立或消极的行为，