早期语言暴露对儿童语言发育的中长期影响

早期语言暴露的数量和质量对儿童语言发育的影响是至关重要的。根据儿童的发育年龄,家庭语言输入的质和量应该及时调整。18个月前父母语言输入的总词汇数量最为重要;30个月时输入词汇的多样性与复杂程度尤为重要,其中成人-儿童的对话轮换数同样重要;42个月时叙述、解释等语言输入最为重要。屏幕暴露和电子(发声)玩具对婴幼儿语言发育和亲子交流是弊大于利,在低受教育家庭中的儿童特别容易受到早期屏幕暴露的不利影响。     

婴幼儿认知发育的相关影响因素

目的 探讨婴幼儿认知发育的相关影响因素。方法 于2012年11月-2013年3月随机抽取日照市城区和乡镇医院各一个点作为项目点, 共抽取2~30个月婴幼儿118名。以问卷形式对家长进行家庭社会经济状况调查;同时采用贝莉婴幼儿发育量表婴幼儿进行认知发育评估。结果 婴幼儿平均年龄(12.52±7.94)个月, 男婴占55.9%, 城市比例为47.5%。智力发育商数(Mental Developmental Index, MDI)为109.97±16.88, 运动发育商数(Psychomotor Development Index, PDI)为108.18±13.76。婴幼儿年龄、城乡、家庭其他成员和婴幼儿交流时间, 母亲受教育程度对MDI有显著预测作用;对PDI有显著预测作用的有城乡、出生体重、母亲受教育程度。结论 家庭环境因素诸如母亲受教育程度、城乡、亲子交流时间尤其是家庭其他成员与儿童交流时间对婴幼儿认知发育起着重要作用, 加强对母亲低学历家庭、农村婴幼儿的关注和监测十分必要。     

语言发育迟缓儿童家庭语言干预效果的探讨

目的:探讨在语言治疗师指导下家庭语言干预对语言发育迟缓儿童的恢复情况。方法:每位儿童首次就诊时由儿童保健专家进行发育评估和语言水平的评价,制定干预计划。然后由语言治疗师对儿童家长进行培训,从而开展家庭干预指导,由家长对其进行语言干预。结果:经6个月的干预后,儿童发育诊断量表的语言发育商(DQ)显著提高(P<0.01),适应能力和社会行为发育商(DQ)也有显著提高(P<0.05)。语言发育商的提高显示出明显的追赶效应。结论:对语言发育迟缓儿童采用以家庭语言干预为中心,医疗指导相结合的干预模式是有效的,同时可降低治疗费用,方便灵活。     

舟曲县6～24月龄婴幼儿营养干预前后家庭喂养行为的变化

目的分析舟曲6～24个月婴幼儿营养干预后家长喂养方式的变化。方法按婴幼儿人口比例随机抽样开展基线和终期调查。基线和终期分别抽取了252名和239名婴幼儿及家长,采用问卷的形式了解在干预前后家长喂养行为变化情况。结果通过一年的干预,被调查婴幼儿的纯母乳喂养率由26.98%上升至39.33%,出生后一小时开奶率由17.06%上升至38.09%。配方奶粉的添加率由27.28%上升至61.51%,蔬菜类、肉类、豆类等辅食添加状况均有所改善。部分辅食的早添加率有少量下降。结论通过一年营养知识的干预,舟曲县婴幼儿家长的喂养行为有所改善,但仍存在喂养问题。需要加大干预力度,制定与实施切实可行的干预措施,实现婴幼儿家长的科学喂养。     

健康教育对基层婴幼儿行为发育的影响

目的探讨在儿童保健工作中实施健康教育干预对基层婴幼儿行为发育的影响。方法选取杭州市儿童医院2016年6-12月期间接受基层儿童保健的0~12个月的婴幼儿320例,随机分为两组,每组各160例。对照组给予常规家庭护理保健指导,观察组给予健康教育干预,为期6个月,在干预前及干预6个月后采用盖泽尔发育商检测法对婴幼儿发育商进行检测,对比两组干预后发育商、身高、体重、视力和牙齿各项指标达标情况。结果两组婴幼儿干预前各项能力的发育商相比差异无统计学意义(P0.05);干预6个月后,对照组各项能力的发育商提高不明显,观察组各项能力的发育商明显提高,观察组显著高于对照组(P0.05),观察组身高、体重、视力和牙齿各项指标达标率显著高于对照组(P0.05)。结论在儿童保健工作中实施健康教育干预对基层婴幼儿行为发育可显著提高婴幼儿行为发育,促进婴幼儿健康成长。     

大庆市城区婴幼儿营养与喂养状况调查及干预研究

目的掌握大庆市城区2岁以内婴幼儿营养与喂养现状、存在的主要问题;探索城市婴幼儿营养与喂养健康教育的有效方法。方法按照随机抽样原则,从儿童保健门诊抽取常规体检的0～18个月健康儿童400人为研究对象,进行基线调查,对儿童主要看护人实施为期半年的干预后再次进行终末调查。所有数据资料应用SPSS10.0软件进行统计分析。结果 6月龄内婴儿母乳喂养率86.0%。家长在儿童营养与喂养知识方面存在误区,家长对此方面的知识有广泛需求。结论经对家长举办培训,家长喂养行为与喂养方法得到改善,项目开发的宣传资料及宣教方式干预效果良好,基本满足家长和医生的需求,可广泛推广应用。     

母子交流时间对婴幼儿认知发育影响的研究

目的 探讨母子交流时间对婴幼儿认知发育影响,为科学育儿提供科学依据。方法 选择江苏省淮安市城区和乡镇医院各一个点作为项目点,随机抽取2~30个月婴幼儿共140名。家长填写儿童个人及家庭社会环境问卷,专业人员采用《贝莉婴幼儿发育量表》对儿童进行认知发育评估。结果 入组儿童平均年龄(12.52±7.78)月龄;男童占52.9%;城区婴幼儿占74.6%;智力发育指数(mental development index,MDI)为104.16±13.036,运动发育指数(psychomotor development index,PDI)为 103.34±11.431。城市与乡镇婴幼儿的MDI无统计学差异(103.27±13.81 vs 106.20±9.95,F=3.36,P=0.250),城市婴幼儿PDI为101.92±12.01,显著低于乡镇婴幼儿PDI 106.51±8.09(F=7.31,P=0.013)。父亲文化程度不同,儿童的MDI存在差异(F=2.71,P=0.047)。城乡差异、父母文化程度和家庭结构等因素对母子交流的影响无统计学差异。母子交流时间越多,婴幼儿智力发育指数越高(F=3.28,P=0.023),且多元线性回归显示控制儿童年龄、性别、父亲文化程度等相关因素后,母子交流仍是婴幼儿MDI的独立影响因素。结论 母子交流时间对婴幼儿认知发育尤其是智力发育指数有显著的促进作用。     

儿童听力障碍的早期干预

目的:探讨听力障碍婴幼儿语言、言语早期干预的效果及早期干预的临床模式.方法:将56例10月龄～2岁听力障碍婴幼儿分为干预组与未干预组,采用Gesell发育量表对各组儿童进行语言认知评估,比较干预组、未干预组和正常儿童语言、言语认知发育水平.结果:干预组患儿与正常儿童语言能力无统计学差异,未干预组与正常儿童语言能力差异有统计学意义.结论:早期干预能显著改善听力障碍患儿的语言、言语水平.     

佛山市南海区流动儿童免疫规划干预模式效果评价

目的 评价佛山市南海区流动儿童免疫规划促进干预效果,探索提高流动儿童疫苗接种率的长效机制。方法 在南海区开展4年免疫规划促进干预项目,采用政策支持、优化服务、人员培训、健康教育和同伴干预等措施,评价指标为流动儿童家长对疫苗接种的认知和态度（接受度）及儿童疫苗接种的行为。结果 干预前、中、后分别调查814、252、376名流动儿童家长,家长认知水平从干预前54.13％增加到干预后73.38％,增幅为19.25％;接受度从干预前71.00％增加到干预后85.40％,增幅为14.40％;流动儿童疫苗接种行为从干预前71.20％增加到干预后99.40％,增幅为28.20％。控制混杂因素后,家长认知得分和态度得分、流动儿童疫苗接种行为得分在干预不同阶段不同（均P<0.01）。结论 干预项目的实施有助于提高流动儿童家长对疫苗接种的认知度和接受度,促进流动儿童完成免疫规划疫苗接种。     

基于以家庭为中心的护理模式对婴幼儿健康促进效果的研究

目的：探讨基于以家庭为中心的婴幼儿护理（FCC）模式的健康促进效果。方法：将240名6～18个月婴幼儿随机分成两组,对照组采用常规的儿童保健措施,观察组采用基于FCC模式的健康促进措施;6个月后观察婴幼儿生理发育指标的变化,以及健康状况指标和管理效果指标。结果：干预前两组的认知能力、体格发育和精细运动评分指标比较,差异无统计学意义（P>0.05）。干预6个月后两组指标均较前升高,观察组升高幅度高于对照组;干预6个月后,观察组的反复呼吸道感染、胃肠功能紊乱、维生素营养障碍和缺铁性贫血等慢性病的患病率低于对照组;观察组的监护人认知度、工作质量评分和护理满意度高于对照组,差异均有统计学意义（均P<0.05）。结论：对婴幼儿实施基于FCC模式的健康促进措施,能有效促进婴幼儿的体智发育和改善健康状况,提高儿童保健的工作质量。     

Effectiveness of a parenting program in Bangladesh to address early childhood health,growth and development

A stratified cluster design was used to evaluate a 10-month parenting program delivered to mothers of children in rural Bangladesh. Intervention mothers through a combination of group meetings and home visits received messages along with an illustrative card concerning hygiene, responsive feeding, play, communication, gentle discipline, and nutritious foods. Control mothers received the standard government care. Three months prior, 463 children between 4 and 14 months in a subdistrict of western Bangladesh were administered the cognitive, receptive language and expressive language Bayley III subtests, their length was taken and past week illness recorded. Gross motor milestones were reported by the mother and verified through observation. Mothers were interviewed concerning their practices: preventive health practices, dietary diversity, home stimulation, and knowledge about development milestones. Maternal depressive symptoms were assessed as a measure of emotional availability. Family sociodemographic variables included maternal education, family assets, decision-making and mobility autonomy. One month after the end of the program, mothers and their children were again assessed. Comparisons were made between intervention and control children who were under-12 months vs. 12 months and older at the start of the program. This may be a critical age, when children begin to be upright and mobile enough to explore on their own and be less dependent on parenting stimulation. Analyses yielded strong intervention effects on the three Bayley subtests and on parenting practices related to stimulation and knowledge of development milestones. Age effects were found only for dietary diversity in that younger children in the program benefited more than older ones. However, all children became more stunted. Findings are discussed in terms of theories of behaviour change and parenting, critical ages for parenting programs, and implications for program delivery.     

Accelerating early language development with multi-sensory training

This paper reports the outcome of a multi-sensory intervention on infant language skills. A programme titled ‘Rhyming Game and Exercise Club’, which included kinaesthetic–tactile mother–child rhyming games performed in natural joint attention situations, was intended to accelerate Finnish six- to eight-month-old infants’ language development. The participants were 20 infants (10 training group children and 10 control children). Their cognitive skills and both receptive and expressive language skills (Bayley Scales III) were tested three times (pre-, post- and follow-up assessments). The groups differed significantly in receptive language skills at the baseline, in favour of the controls. The results showed that the performance of the training group children in cognition and receptive language increased after the intervention. The training group girls showed more acceleration in receptive language skills than the boys. The results suggested that training consisting of rhyming games and kinaesthetic-tactile stimulation is a useful tool for accelerating early language development and for enriching mother–child interaction.     

不同干预方案对0~3岁婴幼儿早期综合发展能力的影响

目的 了解不同干预模式对0~3岁婴幼儿早期综合发展能力的影响,为开展儿童早期综合发展工作提供科学依据。方法 2018年9月选取295名婴幼儿为研究对象,根据干预模式的不同分为对照组(n=97),家庭干预组(n=100)和社区干预组(n=98)。由专业人员借助早期教育测评系统(E-LAP)和教育测评诊断系统(LAP-D)两种测评工具分别对干预前后婴幼儿综合发展能力进行测评,并以“测评发育月龄≥实际月龄的比例”作为主要评估指标,评估干预效果。结果 婴幼儿接受家庭干预前后,大运动、精细动作、认知、语言和社交情绪方面“测评发育月龄大于或等于实际月龄的比例”差异有统计学意义(χ²=39.111,27.604,30.083,12.562,13.657,P＜0.05);社区干预组仅在大运动和语言两个方面差异有统计学意义(χ²=4.015,5.227,P＜0.05);对照组在大运动方面差异有统计学意义(χ²=7.009,P＜0.05)。调整婴幼儿年龄、母亲年龄、母亲文化程度和父亲文化程度后的广义估计分析显示,与对照组相比,家庭干预组在大运动、精细动作和认知方面,大于或等于实际月龄的比例较高,且差异有统计学意义(OR_大动作=1.859,OR_精细=2.942,OR_认知=1.813,P＜0.05);社区干预组仅在大运动方面与对照组差异有统计学意义(OR_大运动=1.751,P＜0.05);不同干预方案在语言和社交情绪方面差异均无统计学意义(P＞0.05)。结论 针对0~3岁婴幼儿的早期干预方案,尤其是家庭干预能有效提升早期综合发展能力。     

不同干预方案对0~3岁婴幼儿早期综合发展能力的影响

目的 了解不同干预模式对0~3岁婴幼儿早期综合发展能力的影响,为开展儿童早期综合发展工作提供科学依据。方法 2018年9月选取295名婴幼儿为研究对象,根据干预模式的不同分为对照组(n=97),家庭干预组(n=100)和社区干预组(n=98)。由专业人员借助早期教育测评系统(E-LAP)和教育测评诊断系统(LAP-D)两种测评工具分别对干预前后婴幼儿综合发展能力进行测评,并以“测评发育月龄≥实际月龄的比例”作为主要评估指标,评估干预效果。结果 婴幼儿接受家庭干预前后,大运动、精细动作、认知、语言和社交情绪方面“测评发育月龄大于或等于实际月龄的比例”差异有统计学意义(χ²=39.111,27.604,30.083,12.562,13.657,P＜0.05);社区干预组仅在大运动和语言两个方面差异有统计学意义(χ²=4.015,5.227,P＜0.05);对照组在大运动方面差异有统计学意义(χ²=7.009,P＜0.05)。调整婴幼儿年龄、母亲年龄、母亲文化程度和父亲文化程度后的广义估计分析显示,与对照组相比,家庭干预组在大运动、精细动作和认知方面,大于或等于实际月龄的比例较高,且差异有统计学意义(OR_大动作=1.859,OR_精细=2.942,OR_认知=1.813,P＜0.05);社区干预组仅在大运动方面与对照组差异有统计学意义(OR_大运动=1.751,P＜0.05);不同干预方案在语言和社交情绪方面差异均无统计学意义(P＞0.05)。结论 针对0~3岁婴幼儿的早期干预方案,尤其是家庭干预能有效提升早期综合发展能力。     

Breastfeeding and cognitive development in the first 2 years of life

The relationship between breastfeeding and cognitive development in the first 2 years of life was examined in a cohort of children being followed in a study of risk factors in development. A significant difference between bottlefed children, children breastfed less than or equal to 4 months and those breastfed greater than 4 months was found on the Mental Development Index of the Bayley Scales at ages 1 and 2 years, favoring the breastfed children. At age 6 months, the direction of the relationship was the same but did not reach significance. Supplementary regression analyses examining the strength of the relationship between duration of breastfeeding and cognitive development similarly showed a small but significant relationship between duration of breastfeeding and scores on the Bayley at 1 and 2 years. Alternative explanations for the results are discussed.     

The covariation between parental and expert evaluations of early language skills

This study investigated the potential interrelationship between parental (maternal) and expert assessments of the expressive and receptive language skills of 12- to 18-month-old children. The language activities of 27 children were monitored by their mothers (MCDI scale: Lyytinen, 2000. Varhaisen kommunikaation ja kielen kehityksen arviointimenetelmä. Jyväskylän yliopiston lapsitutkimuskeskus ja Niilo Mäki Instituutti. Jyväskylä: Yliopistopaino. [An assessment tool for early communication and language development] Jyväskylä: University Press) and trained researchers (Bayley Scales III: Bayley, 2006. Bayley III Scales of Infant Development. Administration Manual. San Antonio, TX: Psychological Corporation). First and foremost, the results showed that parental and expert assessments of different aspects of child development were in accord, even after controlling for the child's age. Covariance modelling confirmed the strong concordance between maternal and expert assessment of both aspects of early language development. Furthermore, maternal age did have an effect on the child's receptive language, according to experts' assessments. Gender or maternal education level did not have an impact on language skills as measured by Bayley assessment. Parent-reported dyslexia in a close relative was also taken into account.     

Supporting language and cognitive development of infants and young children living in children's homes in Turkey

Aim The purpose of the present study was to improve language and cognitive development of infant and young children residing in institutional settings in Turkey. Method In Study I, there were 12 children with a mean age of 35 months in the intervention group and 12 children with a mean age of 36 months in the control group. Results When both groups' pre‐test post‐test general development t scores and cognitive and language sub‐domain developmental gaps were compared, neither the time nor the time by group interactions were significant. Nevertheless, both groups' developmental gap appeared to decline. In Study II, children were recruited from the same institution and randomly assigned to the intervention and control groups. Results indicated that infants and children who were in the intervention group showed a decline in the language and cognitive development gaps, whereas the control group children's developmental gaps were increased. Conclusions It can be concluded that by increasing the quality of care in children's homes infants' and young children's development can be enhanced.     

School readiness among low-income black children: family characteristics,parenting, and social support

This study focuses on the associations between family variables and academic and social school readiness in low-income Black children. Analyses drew from the National Institute for Child Development (NICHD) Study of Early Child Care and Youth Development dataset. The participants included 122 children and their mothers. Data collection occurred when the children were 1, 6, 15, 24, 36, and 54 months old. Findings indicated that maternal sensitivity and the quality of the home environment predicted cognitive and language outcomes, whereas maternal depression and social support predicted social–behavioural outcomes. In addition, the impact of family resources on cognitive and language outcomes was fully mediated by parenting behaviours and the impact of social support on behaviour problems was fully mediated through maternal depression. Implications for family intervention are discussed.     

小儿智力糖浆在脑瘫患儿中的治疗作用

目的:探讨中成药小儿智力糖浆对脑性瘫痪(cerebral palsy,CP)患儿运动、语言与认知行为发展的影响。方法:90例CP患儿随机分为对照组45例,采用常规神经生理学疗法,疗程3个月;治疗组45例,采用常规神经生理学疗法加小儿智力糖浆口服,疗程3个月。比较两组患儿治疗前后的Gesell儿童发育量表、Bayley婴幼儿发展量表的评分结果。结果:治疗3个月后治疗组患儿Gesell儿童发育量表的应物能、应人能、语言能和Bayley婴幼儿发展量表的智力指数与对照组比较,差异显著或非常显著(P<0.05或P<0.01)。结论:小儿智力糖浆可能对CP患儿的认知行为和语言有一定程度的改善作用。     

One-year follow-up of the outcome of a randomized controlled trial of a home-based intervention programme for children with autism and developmental delay and their families

Introduction There is debate about the type and intensity of early childhood intervention that is most helpful for children with developmental problems. The aim of the study was to determine whether a home‐based programme provided over 12 months resulted in sustained improvement in development and behaviour 12 months after the intervention ceased. The characteristics of the children and families who benefited most from the intervention were also studied. Method Randomized controlled trial. Participants A total of 59 children, aged 3–5 years, attending two early childhood intervention centres in Melbourne, Australia. Intervention Half of the subjects received an additional home‐based programme consisting of 40 weekly visits. Main outcome measures Bayley Scales of Infant Development and Wechsler Preschool and Primary Scale of Intelligence Revised, Preschool Behaviour Checklist, Bayley Behaviour Rating Scale and Behaviour Screening Questionnaire. All tests administered pre‐intervention, following the intervention and 12 months later. Secondary outcome measures Family stress, support and empowerment. Results Fifty‐four children completed the assessments 12 months after conclusion of the intervention. Compared with the control group, improvement in aspects of cognitive development in the children who received the extra intervention was sustained 1 year later (P= 0.007) while significant behavioural differences post intervention were not. Analyses of the data by the Reliable Change Index indicated improvement of clinical significance occurred in non‐verbal areas. In contrast to the control group who deteriorated, language skills in the intervention group remained stable. Improvements were significantly associated with higher stress in the families. Conclusion Improvements following the provision of a home‐based programme to preschool children with developmental disabilities were sustained 1 year later. Children from highly stressed families appeared to benefit most, reinforcing the importance of involving families in early childhood intervention programmes.