Educational outcome at 8 years for children who were born extremely prematurely: a controlled study

OBJECTIVE: To assess the educational outcome and utilization of special education resources at age 8 years in children who were born extremely prematurely, and to compare this outcome with a matched cohort of children born full-term. METHODS: All children with gestational age less than 28 weeks or birthweight of less than 1000 g, born at Royal North Shore Hospital from July 1985 through June 1990 were enrolled in a study of long-term outcome. A cohort of full-term children matched for age, sex and school with non-disabled extremely premature children was enrolled at age 8 years. Children were assessed using standardized measures of cognitive and academic achievement. Information was obtained from teachers regarding educational support and academic progress. RESULTS: Of 82 extremely premature children assessed at age 8 years, 8 (10%) had a severe disability, 13 (16%) had a mild or moderate disability and 61 (74%) were non-disabled (IQ > or = 85, no neurosensory disability). Thirty-five (43%) required special education support, 22 (27%) were below grade level in reading or mathematics and 25 (30%) were performing at grade level without support. Compared with controls, non-disabled extremely premature children had lower scores on standardized measures of academic achievement and were more likely to be reported by teachers as falling below grade level in reading (48% vs 13%; P < 0.001), mathematics (48% vs 10%; P < 0.001) and spelling (48% vs 17%; P < 0.002), and to require special education support (25% vs 4%; P = 0.004). CONCLUSION: Parents and professionals caring for extremely premature children need to be alert to the additional support that these children may require at school.     

An Exploratory Study of Group-as-a-Whole Dynamics in Children's Group Therapy

In this study, dynamics of group-as-a-whole (GAW) moments within children's group therapy were investigated. The children's groups, called Play Activity Groups (PAGs), were a part of the elective activities within an afterschool program. This study included the participation of 17 children and six facilitators from five school age groups. Kinetic drawings from the children, process notes from the facilitators, and semi-structured interviews from both children and facilitators were analyzed as indirect, retrospective, and qualitative data. The study showed that the sequence of events in GAW was related to the ability of the group, and particularly of the adult members, to sustain the role of other, and to withstand the destructive forces of GAW activity. If this task was accomplished, a sense of play, fluidity, and safety were noted by both children and adults. The study was exploratory, and has limited generalizability. The need for research with different groups and methods is presented. The implications for therapists' techniques are discussed.     

Psychoeducational outcome at school age of preterm infants with bronchopulmonary dysplasia

OBJECTIVE: To investigate the cognitive performance and educational attainment at school-age of children with bronchopulmonary dysplasia (BPD), compared with a preterm control group of children. METHODS: Seventy preterm infants with BPD and 61 birth weight matched controls were prospectively followed-up to school-age. The Weschler Intelligence Scale for Children - III (WISC), the Wide Range Achievement Test (WRAT) and the Developmental Test of Visual Motor Integration (VMI) were administered. The results were compared between the two groups and multiple regression analyses were performed to determine the effect of confounding variables. RESULTS: The children in the BPD group performed less well on the Full Scale IQ (mean 86.7 vs 93.5; 95% CI, 1.9-11.7), Verbal IQ (mean 87.1 vs 94.1; 95% CI, 2.0-12.0) and the Performance IQ (mean 88.6 vs 95.2; 95% CI, 2.0-11.2) of the WISC, the reading component of the WRAT (mean 93.8 vs 98.9; 95% CI, 0.3-9.8) and the VMI (mean 88.9 vs 93.3; 95%, CI 1.1-7.8). Despite controlling for social and biological variables, statistical differences persisted for Full Scale and Verbal IQ and reading. A Verbal IQ >1 SD below the mean was found in 41% of BPD children compared to 21% of controls, while on the reading component of the WRAT a greater proportion of BPD children also had scores>1 SD below the mean. CONCLUSION: Impaired psychoeducational performance was found in preterm children with BPD compared to controls, especially in the areas of language abilities and reading skills. This supports a greater need for special educational services and counseling for parents for these children.     

中国学龄儿童青少年1985～2000年超重、肥胖流行趋势动态分析

目的 分析中国不同群体儿童青少年1985～2000年期间超重、肥胖流行动态。方法 资料来自1985、1991、1995和2000年全国学生体质健康调查,7～18岁汉族儿童青少年共计98万余人,分大城市、中小城市、富裕乡村、中下水平乡村4个群体,统一使用中国肥胖工作组(WGOC)新制定的中国学龄儿童青少年超重、肥胖体重指数筛查分类标准,筛查超重、肥胖,分析不同群体在不同年代的检出率。结果 1985年,中国即使大城市男女儿童青少年肥胖检出率也仅为0．2％和0．1％,超重率1％～2％,无实质性肥胖流行。90年代开始超重率大幅上升,增幅城市高于乡村,男生高于女生。北京等发达大城市男性7～9岁、10～12岁和女性7～9岁年龄组肥胖率分别为4．7％、3．8％和3．2％,肥胖高发人群初步形成。学生人群中营养不良和超重增加趋势并存,两极分化明显。1995年前后,城乡均出现超重检出率大幅增长．发达大城市男女超重率分别比10年前增长3倍和2倍;肥胖检出率男性6％～8％,女性4％～6％。2000年前后,大城市进入肥胖全面增长期,北京等发达大城市男性7～9岁、10～12岁和女性7～9岁、10～12岁年龄组超重 肥胖检出率分别达到254％、25．5％和17．0％、14．3％,男性小学生肥胖率分别为12．9％和9．1％,接近中等发达国家水平。其他群体超重率都增长迅猛,但肥胖率还较低,中小城市为4．8％(男)和2．6％(女),富裕乡村为1．2％(男)和0．9％(女),经济中下水平乡村为0．9％(男)和1．2％(女)。结论 中国儿童青少年总体上处于肥胖流行早期,但增势迅猛。提出加强监测、营养教育、科学膳食、有氧锻炼、培养健康饮食行为等肥胖综合防治策略,并针对大城市、中小城市和乡村人群不同特点分别提出有针对性的措施,以达到早期预防超重发生、控制超重向肥胖发展的目标。     

杭州市区两所小学学龄儿童血铅水平与生长发育、学习能力相关性调查

【目的】了解当前杭州市区学龄儿童的铅暴露状况,分析当前低水平铅暴露情况下学龄儿童生长发育以及学习能力是否受到影响。【方法】采用石墨炉原子吸收法检测儿童血铅水平,测量儿童身高、体重、胸围等指标,通过教师评分与学校考试成绩相结合的方法评估儿童学习能力。【结果】297例儿童血铅水平中位数为52.1μg/L,血铅中毒仅6例占2%,其中男童血铅水平显著高于女童。各年级儿童生长发育状况良好,在控制了部分混杂因素后未发现当前儿童血铅水平与生长发育有关指标呈负相关,但本次调查表明接受调查的学龄早期儿童血铅水平与其学习能力呈负相关,以儿童阅读理解能力受到的影响最为显著。【结论】当前杭州市儿童铅负荷较前明显下降,在当前低水平铅暴露下,铅对学龄早期儿童学习能力的影响仍要引起高度重视。     

学龄儿童体质指数与生活作息状况分析

目的了解哈尔滨市学龄儿童的体质指数(BMI)和生活作息状况,发现存在的问题。方法在哈尔滨市有代表性的4所中小学校中,采用分层整群抽样的方法对小学四年级到初中三年级进行了调查,并测量身高及体重。数据采用SPSS13.0软件进行统计分析。结果用BMI指数判断学龄儿童的肥胖发生情况,在男生10～12岁和13～15岁2个年龄组的肥胖检出率显著高于2000年我国大城市的水平,而女生未表现出来。亲子间的BMI指数呈显著的相关性。男女生的BMI指数均与看电视时间呈显著正相关,而与睡眠时间呈显著负相关。在男生组,体育锻炼对超重和肥胖的发生有显著性影响,而在女生中未出现。结论调查结果提示:学龄儿童的肥胖检出率很高,且与生活作息方面有显著的相关性。     

Epidemiology and Course of Psychiatric Disorders in School-Age Children—Results of a Longitudinal Study

In an epidemiological longitudinal study, 356 out of 399 8-yr old children were re-examined at age 13. Prevalence rates for psychiatric disorders of about 16% remained constant during adolescence. The course of emotional disorders proved very promising, while that of conduct disorders was extremely unfavorable. Remission of psychiatric disorders was also influenced by an improved psychosocial environment within the family. Development of disorders in initially healthy children was related to prior learning disabilities and stressful life events. More effective approaches in the treatment of conduct disorders as well as early detection of detrimental familial conditions and learning disabilities are called for.     

257名学龄期儿童口腔健康教育防治龋病的效果研究

目的：探索学龄期儿童口腔健康教育防治龋病的效果。方法：将257名小学生随机分为两组,实验组128人接受口腔健康教育干预,对照组129人仅给予口腔卫生宣传。结果：干预后,儿童及其家长口腔卫生认知明显提高,实验组龋病患病率为43．75％,显著低于对照组的79．07％;实验组龋齿充填率（60．87％）也较对照组（50．73％）高。结论：口腔健康教育可以全面降低学龄儿童龋病患病率,改善学龄儿童口腔保健行为。     

临床护理路径在学龄期患儿手术一日住院中的运用

目的为了减少手术治疗对在校学龄期患儿学习的影响,尝试实行了手术一日住院制度,并将临床护理路径运用其中。方法对手术一日住院的患儿(实验组)实施临床护理路径,同期普通手术住院患儿(对照组)给予传统的手术治疗护理,对二者的治疗护理效果进行比较,并对家长发放问卷进行调查。结果实验组在缩短住院日,降低医疗费用,提高满意度,掌握健康教育知识方面均优于对照组。结论在小儿外科小手术一日住院制度实施过程中运用临床护理路径,能够得到预期治疗护理效果,满足了学龄期患儿的实际需求,值得推广,是与国际先进医疗护理水平接轨的体现。     

义乌市城区学龄儿童性发育现状分析

目的 了解义乌市城区学龄儿童性发育现状,比较义乌地区与全国水平的差异。方法 于2016年9-10月分层整群抽取义乌市城区2所小学学龄儿童共1 026名(男578名,女448名),按照统一标准测量其身高、体重、腰围和臀围等。青春期发育指标为女童乳房发育和男童睾丸发育Tanner分期。结果 1)女童9岁组乳房发育到达B2期占18%,B3期及以上达11.5%;男童10岁组睾丸开始发育达8.9%,G3期及以上达1.1%;2)男童超重及肥胖分别占16.1%和13.0%,女童超重及肥胖分别占7.2%和12.6%;3)男童睾丸容积与年龄、身高、体重、BMI、腰围均呈正相关,与年龄相关性最强;4)男童和女童各年龄段超重组及肥胖组开始青春发育比例均高于正常组。结论 义乌市城区学龄儿童性发育水平高于全国平均水平,应引起重视。