婴儿运动发育迟缓社区筛查方法研究

目的研究编制适宜社区使用的0~1岁婴儿运动发育迟缓筛查方法,为儿童脑瘫早期筛查与监测提供方法。方法 1)筛查方法设计:设计1~12个月龄的每月筛查内容,通过专家论证。2)信度、效度及应用研究:整群抽样1~12月龄婴幼儿2 711名,设计筛查阳性(n=59)与阴性病例(n=177)对照,进行重测信度研究;对阳性组和阴性组均进行DDST筛查,研究校标关联效度,对转诊的阳性儿童(n=32)评估发育情况及肌张力情况,进行应用研究。3)使用SPSS17.0进行统计学分析。结果 1)信度:具有专家信度;重测信度100%。2)效度:具有校标关联效度。运动筛查阳性与DDST结果及大运动迟缓阳性显著相关(r=0.77,P=0.000)。3)应用:筛查阳性率为2.18%。筛查阳性确诊运动发育迟缓65.63%,确诊运动发育迟缓和运动边缘状态率为100%,伴有肌张力异常43.75%。重症病例确诊脑瘫、中枢协调障碍、肌张功能不全各1例。结论本筛查方法适合社区儿童保健医生在系统体检时对0~1岁婴幼儿进行运动发育迟缓筛查,具有较好的信度和效度,具有应用价值。

Research of community screening method of infant motor developmental delay.

Objective To research and design suitable development delay screeningMethods for monitoring 0~1 year old infants within the community,and to provideMethods for early screening and monitoring of children with cerebral palsy.Methods 1)ScreeningMethods design:monthly screening content was designed to cover ages from 1~12 months,and passed through the expert argumentation.2)Study of the reliability,validity and application:Cluster sampling (n=2 711) was performed in infants aged 1~12 months from 6 community health service centers of three city districts.A positive group with positive cases (n=59) and a negative control group with negative cases (n=177) were all performed the test-retest reliability study,and two groups all carried out Denver Developmental Screening Test (DDST) to research criterion-related validity.Developmental condition and muscular tension of the positive referral cases evaluated for application study.3)Statistical analysis was performed by SPSS17.0. Results 1)Reliability:the method provided 100% professional reliability and test-retest reliability.2)Validity:the method possessed criterion-related validity and the positive testing of motor screening were significantly correlated with DDST Results and gross motor developmental delay (r=0.77,P=0.000 respectively).3)Application:screening positive rate was 2.18%.Gross Motor developmental delay was diagnosed in 65.63% of the positive referral cases,but total rates of gross motor developmental delay and edge state was 100%,including 43.75% with abnormal tension of muscle.The diagnosis of cerebral palsy,central coordination disorder and muscular tension dysfunction each included 1 case.Conclusion The screening method is suitable to child health care doctors for motor developmental delay screening among 0~1 year old infants within the community,and with good reliability and validity has value in its application.