孤独症儿童心理理论特征及临床干预的研究进展

心理理论发展的缺损或滞后是导致孤独症谱系障碍(ASD)患儿社交障碍的重要原因之一,这使得ASD患儿缺乏恰当的社会交往技能,无法正常地与人交流,更难以融入家庭、学校、社区等。通过ASD患儿的心理理论能力进行干预训练可以促进他们的社会交往能力的发展。现有的干预训练内容大致包括以下几项:对错误信念理解的干预训练,以正常儿童心理理论发展顺序为参照的多心理理论成分训练,将心理理论能力与社会交往能力相结合的干预训练。已有研究分析,对未来的干预训练更应注重心理理论技能干预的泛化和针对不同层次的ASD儿童设置差异化的干预方案。     

孤独症儿童与正常发展儿童愿望-信念推理能力的对比研究

目的 研究孤独症儿童的愿望-信念推理能力发展,及与正常儿童的差异,为进一步干预提供依据。方法 测试智龄为3~5岁的孤独症谱系障碍儿童(n=18)愿望与信念理解能力,并与正常发展儿童(n=18)做比较。两组儿童在智龄和性别上一一匹配。结果 结果显示孤独症儿童和正常儿童在区分愿望任务中的表现差异无统计学意义;但孤独症儿童在理解区分信念和错误信念任务的成绩显著低于正常儿童(P<0.05)。 结论 孤独症儿童能够理解愿望,但在理解信念方面却存在困难。     

Fertility Limitation and Child Schooling in Ouagadougou: Selective Fertility or Resource Dilution?

Using original data collected in Ouagadougou, Burkina Faso, this study investigates evidence for the competing theories that fertility reductions increase children's education through either the quantity–quality tradeoff (intentionally choosing smaller families to make greater investments in education and other indicators of child quality) or resource dilution (having more children reduces resources available per child, regardless of intentionality of family size). The results provide evidence for both hypotheses: children having four or fewer siblings were significantly more likely to be enrolled in school if their mothers had intentionally stopped childbearing relative to those whose mothers wanted more children but whose childbearing was limited by subfecundity. The difference between intentional and unintentional family limitation was not significant for parities greater than five. In addition, the relationship between number of siblings and their schooling is negative, regardless of the intentionality of family‐size limitation, but the strength of this negative relationship is approximately twice as high among children whose mothers intentionally limited fertility (reflecting both selection and dilution effects) than among children whose mothers were subfecund (reflecting the pure dilution effect).     

Responses to Children's Media Use in Families With and Without Siblings: A Family Development Perspective

Drawing on family development theory, this study provides insight into how family stages with and without siblings are related to media habits and effects. Two national samples (N = 527 and N = 1,257) present a cross‐sectional snapshot of media uses in families across three stages of family life: families with preschoolers (2–6 years), with elementary school‐age children (7–12 years), and with adolescents (13–17 years). We observed differences between family stages in five domains of media use: alternative activities to screen media, media use, parental monitoring, consistency in applying media rules, and resistance to media effects. Generally, more positive media habits were associated with families in earlier stages, families with siblings, and families with larger age gaps in sibling spacing. But greater vulnerability to media effects was associated with those families with multiple children and gaps in sibling spacing that spanned more than one stage.     

宁波市多胎家庭3~6岁儿童忽视状况及影响因素分析

  目的  了解宁波市多胎家庭3~6岁儿童忽视状况及影响因素,提出提升多胎家庭养育质量的意见。  方法  采用随机整群抽样方法,抽取宁波市12所幼儿园中2 200名多胎家庭和1 200名单胎家庭的儿童,采用“中国3~6岁城区儿童忽视评价量表”对其家长进行问卷调查。  结果  宁波市多胎家庭3~6岁儿童总忽视率为21.5%,总忽视度为(37.98±5.49)。忽视率在不同兄弟姐妹年龄差和儿童数量组间差异均有统计学意义(P值均 < 0.05),其中年龄差为3~ < 6岁组在各个层面忽视率上均最高。不同儿童数量组在总忽视率、身体忽视率、情感忽视率和教育忽视率方面差异均有统计学意义(χ2值分别为31.42,4.65, 28.12, 0.75,P值均 < 0.05),在情感忽视度和教育忽视度方面差异均有统计学意义(t值分别为19.57,2.67,P值均 < 0.05),其中家庭儿童数量>2个的在各项忽视率上均高于二胎家庭。多胎家庭在总忽视率、情感忽视率、教育忽视率以及总忽视度、情感忽视度、教育忽视度均高于单胎家庭,差异均有统计学意义(P值均 < 0.05)。影响多胎家庭3~6岁儿童受忽视的主要因素有儿童气质类型、兄弟姐妹年龄差、家庭儿童数量、家庭月收入和母亲文化水平(OR值分别为1.55,1.59,1.92,0.74,0.58,P值均 < 0.05)。  结论  宁波市多胎家庭3~6岁儿童忽视状况高于单胎家庭,其中情感忽视和教育忽视尤为明显。平等对待每位儿童,加强政策扶持,提高家庭收入水平和母亲文化水平能有效改善多胎家庭儿童忽视状况。     

Number of siblings, birth order, and childhood overweight: a population-based cross-sectional study in Japan

ABSTRACT: BACKGROUND: Although several studies have investigated the relationship between the number of siblings or birth order and childhood overweight, the results are inconsistent. In addition, little is known about the impact of having older or younger siblings on overweight among elementary schoolchildren. The present population-based study investigated the relationship of the number of siblings and birth order with childhood overweight and evaluated the impact of having younger or older siblings on childhood overweight among elementary schoolchildren in Japan. METHODS: Subjects comprised fourth-grade schoolchildren (age, 9--10 years) in Ina Town during 1999--2009. Information about subjects' sex, age, birth weight, birth order, number of siblings, lifestyle, and parents' age, height, and weight was collected by a self-administered questionnaire, while measurements of subjects' height and weight were done at school. Childhood overweight was defined according to age- and sex-specific cut-off points proposed by the International Obesity Task Force. A logistic regression model was used to calculate the odds ratio (OR) and 95% confidence intervals (95% CI) of "number of siblings" or "birth order" for overweight. RESULTS: Data from 4026 children were analyzed. Only children (OR: 2.13, 95% CI: 1.45-3.14) and youngest children (1.56, 1.13-2.16) significantly increased ORs for overweight compared with middle children. A larger number of siblings decreased the OR for overweight (P for trend < 0.001). Although there was no statistically significant relationship between a larger number of older siblings and overweight, a larger number of younger siblings resulted in a lower OR for overweight (P for trend < 0.001). CONCLUSIONS: Being an only or youngest child was associated with childhood overweight, and having a larger number of younger siblings was negatively associated with overweight. The present study suggests that public health interventions to prevent childhood overweight need to focus on children from these family backgrounds.     

The relationship of family size and spacing to the growth of preschool Mayan children in Guatemala.

The height of preschool Mayan children is analyzed with respect to family size and the spacing of their siblings, controlling for parental heights and weights. Data on 643 cases were abstracted from the records of two previous longitudinal studies on the health of children under age five years living in the highlands of Guatemala. Height at age three years is estimated from the linear regression equations fitted for each child to measurements of height repeated at three-month intervals from ages one to four years. Family size is expressed in terms of birth rank, live siblings, and the number of dependent and independent family members. Family spacing is measured as birth intervals, i.e., the number of months between the birth of the index child and his previous and subsequent siblings. Most previous studies have reported that height decreases as family size increases. This study shows that Mayan children from both small and large families are taller than those from middle-sized families. Evidence is presented to support the hypothesis that children in large families are relatively tall because their early-born siblings contribute to the family fortunes. Birth intervals are positively correlated with height. The findings are discussed in terms of their implications for family planning.     

The home environment of the malnourished-deprived child

The extent of childhood malnutrition-deprivation throughout the world is indicated and its nature and the forms it takes are described. An account is given of several studies carried out by the author and his colleagues in Lebanon. An investigation of failure to thrive in young children revealed that in an apparently homogenous low socioeconomic group there was a wide spectrum of physical growth which correlated closely with a number of home environment variables. Another study of the mental development of some of these children carried out over several years showed that children with even mild growth failure had a statistically significant impairment of mental development as compared with their apparently healthy siblings, also living in a home environment characterized by deprivation. The far reaching consequences are emphasized. In a third study which investigated the formal education of mothers, their nutritional knowledge and practices and the growth of their children, the indices were found to be interrelated to some extent. Finally, a small study gave some indication, perhaps contrary to general belief, that the rapid social change undergone by families who migrate from the country to an urban slum may be associated with an improvement in nutrition of the children.     

The home environment of the malnourished-deprived child

The extent of childhood malnutrition-deprivation throughout the world is indicated and its nature and the forms it takes are described. An account is given of several studies carried out by the author and his colleagues in Lebanon. An investigation of failure to thrive in young children revealed that in an apparently homogeneous low socioeconomic group there was a wide spectrum of physical growth which correlated closely with a number of home environment variables. Another study of the mental development of some of these children carried out over several years showed that children with even mild growth failure had a statistically significant impairment of mental development as compared with their apparently healthy siblings, also living in a home environment characterized by deprivation. The far reaching consequences are emphasized. In a third study which investigated the formal education of mothers, their nutritional knowledge and practices and the growth of their children, the indices were found to be interrelated to some extent. Finally, a small study gave some indication, perhaps contrary to general belief, that the rapid social change undergone by families who migrate from the country to an urban slum may be associated with an improvement in nutrition of the children.     

Sibling empathy and behavioural adjustment of children with chronic illness

This study Investigated the relationship of healthy siblings’empathy to the psychosocial adjustment of children with a congenital heart disease (CHD) in 28 sibling dyads aged 3.5-11 years, as well as the perceived quality of sibling Interactions, reported by mothers and children with illness. As in previous studies, children with CHD were reported to have more behaviour problems in the clinical range than either siblings or normative populations. On the basis of a task unconnected with illness issues, siblings were assigned to a high or low empathy group. Children with illness, but not their mothers, saw the siblings with high empathy more positively than those with low empathy. However, the adjustment of the children with illness did not differ between high and low empathy groups. Findings suggest the need to seek children's points of view when studying psychosocial effects of paediatric conditions.     

Association between asthma and family size between 1977 and 1994.

STUDY OBJECTIVES: Several recent reports show a negative association between asthma and family size or birth order, but this association was not detected in data collected between 10 and 30 years ago. This study compared the association between sibship size and asthma in three surveys using the same methodology in 1977, 1985/86, and 1993/94. DESIGN: Cross sectional comparison of the 1977, 1985/86, and 1993/94 surveys. SETTINGS: Study areas in England and Scotland. PARTICIPANTS: Parents of children between 5 to 11 years in England and Scotland were asked about asthma and bronchitis attacks in the last 12 months, and wheeze in their child. Approximately 9000 children participated in each of the surveys. RESULTS: The overall association between asthma, defined as asthma attacks or wheeze, and total number of siblings was not significant (p = 0.22), but an only child had a higher prevalence of asthma than children with siblings (OR 0.87 95% CI 0.76 to 0.98). The interaction between year of survey and sibship size on asthma was not significant (p = 0.36). There was no association between asthma and birth order. A significant interaction between social class and year of survey on asthma was detected (p = 0.004). In the 1993/94 survey children whose fathers had a semi or unskilled manual occupation had a higher prevalence of asthma (16%) than children whose fathers belonged to other social classes (13%). CONCLUSIONS: This study provides only marginal support for a change over time of the association between sibship size and asthma. Based on recent reports the nature of the exposure agent that may explain the association remains controversial. This study suggests a disproportionate increase of asthma in lower social classes.     

Impact of a family‐oriented rehabilitation programme on behavioural and emotional problems in healthy siblings of chronically ill children

Objective To evaluate the impact of a family‐oriented inpatient rehabilitation programme on behavioural and emotional problems in healthy siblings of chronically ill children and to assess the association between these problems and quality of life. Methods A total of 259 healthy children (4–16 years, M = 8.6 years, SD = 3.3) with a chronically ill sibling were enrolled in the study. Parents filled in the Strengths and Difficulties Questionnaire, while the children answered a self‐report quality of life instrument (LQ‐KID) at the time of admission and discharge from the clinic and at a 6‐month follow‐up. Comparisons were performed with a matched control group from the German general population (n= 777). Results Significant behavioural or emotional symptoms were found in 30.5% of the healthy siblings, the relative risk of having elevated scores being 2.2 compared with the control group. Symptoms were inversely correlated with quality of life (r=?0.42). During the inpatient rehabilitation, symptoms decreased significantly to a normal level. Similarly, quality of life significantly improved, except in the dimension family relations. Conclusions Family‐oriented inpatient rehabilitation is a promising approach to improve the mental health of children with a chronically ill sibling.     

Six homosexual siblings

A family consisting of several homosexual siblings is reported. All ten of the siblings in this family were to some degree homosexually experienced. Six were homosexual or predominantly homosexual, and five had a homosexual identity. The sex composition of the family was three females and seven males. Of the three females, one was homosexual, one was bisexual, and one had had some homosexual experience. There was one set of male dizygotic twins concordant for homosexuality in the family. All ten siblings were exposed to relatively similar family dynamics. The father's behavior toward the children and his wife was characterized by hostility, violence, and alcoholism. He was eventually murdered when the youngest child was 6 years old. The mother demonstrated qualities that were essentially opposite those of the father. She was described as affectionate and loving toward all the children, and she did not display violent behavior. The male homosexual sibling who was interviewed displayed a strong identification with his mother via a feminine self-identification, the adoption of the housewife role in a homosexual marriage, and the adoption of the passive role in anal intercourse. Only one other multiple homosexual sibling family has been reported in the scientific literature. This family consisted of 14 siblings, 11 male and three female. The four homosexual siblings in this family were all male and consisted of two sets of dizygotic twins. The behavior of the parents of this family was quite similar to the behavior of the parents in this study—a hostile and violent father and an affectionate and loving mother. These two multiple homosexual sibling families provide support for theories that emphasize the importance of early family relationships in the development of a homosexual adaptation. It is held that multiple homosexual sibling families can be employed as strategic data in testing various etiological theories of homosexuality.     

Predictors of Sibling Relationship Characteristics in Youth With Juvenile Chronic Arthritis

Relationships between 20 children with juvenile chronic arthritis (JCA) and their siblings were compared with relationships among 20 comparison sibling pairs. Participants ranging in age from 7 to 21 years were interviewed using the Sibling Relationships Questionnaire-Revised. Parents completed ratings of their families' and children's behavior and an illness activity rating scale. Siblings in the JCA and comparison groups did not differ in perceptions of their relationships or in their family structure. Age, sex, birth order, and age difference between siblings were associated with sibling relationship variables, whereas adaptive behavior was not a significant factor. Among JCA patients, severity of illness was positively associated with perceived conflict with siblings.     

Health insurance coverage within sibships: Prevalence of mixed coverage and associations with health care utilization

An increasing proportion of children in the United States lives in families with complicated family structures and a mix of immigrant and US-born family members. Eligibility rules for health insurance coverage, however, were not designed with these families in mind. The result can be complicated insurance patterns among siblings within families, with some “sibships” only being partially-insured, and other sibships having both private and public coverage. We hypothesize that mixed coverage among siblings causes confusion and logistical difficulties for parents and may lead to less access to appropriate health care for their children. In this article, we use data from the 2009–2011 National Health Interview Survey (n = 51,418 children in 20,478 sibships) to present estimates of the prevalence of mixed health insurance coverage among siblings and describe the predictors of such coverage. We also use linked data from the 2001–2005 National Health Interview Survey and 2002–2007 Medical Expenditure Panel Survey (n = 17,871) to show how mixed coverage is related to health care utilization. We find that although few sibships are characterized by different health insurance coverage types, mixed coverage among siblings is far more common among families with mixed nativity status, and blended families with step- and half-siblings. In terms of outcomes, children living in sibships with mixed coverage have significantly lower odds of having a usual source of health care. We also consider whether the association between mixed insurance coverage and health care outcomes differs across particular combinations of insurance coverage. We find that both publicly-insured children who have uninsured siblings and privately-insured children with publicly-insured siblings are less likely to have a usual source of care than similar children with uniformly-insured siblings. Because a usual source of care is associated with better health care outcomes, we argue that policymakers should consider ways to reduce mixed coverage among children and families.     

Siblings and childhood mental health: Evidence for a later-born advantage

The social and health sciences have often emphasised the negative impacts of large sibship size and late birth order on childhood. For example, it is now well established that, other things being equal, children in large families and/or with many older siblings, receive lower allocations of care time from both parents, are more likely to grow up in conditions of economic hardship, and, as a likely consequence, exhibit relatively poor educational and physical health outcomes. Few researchers have, however, quantitatively assessed how siblings may influence indicators of mental health, where it is conceivable that social interactions with siblings may have a positive influence. Here, using data from a large British cohort survey (the Avon Longitudinal Study of Parents and Children), we explored the effects of sibling configuration on the Strengths and Difficulties Questionnaire, as a multidimensional index for mental health problems. We demonstrate a significant socio-economic gradient in mental health between the ages of three and nine years, but little evidence for negative effects of large sibship size. Rerunning this analysis to examine birth order, a much clearer pattern emerged; the presence of older siblings was associated with relatively good mental health, while the presence of younger siblings was associated with relatively poor mental health. This suggests that being born into a large family, providing the child is not joined by subsequent siblings, may carry important benefits unconsidered by past research. We discuss possible interpretations of this pattern and the wider implications for understanding the family context of child development.     

健康信念模式在学龄期支气管肺炎患儿中的应用效果

目的 探讨以健康信念模式为指导的健康教育在学龄期支气管肺炎患儿中的应用效果.方法 选择2017年5月-2019年5月某儿童医院收治的学龄期支气管肺炎患儿100例,按随机数字表法分为两组,各50例.对照组给予常规健康教育,观察组采用以健康信念模式为指导的健康教育,比较两组患儿家属健康知识掌握度和患儿生存质量.结果 观察组...     

The Family Environment in Bereaved Families and Its Relationship to Surviving Sibling Behavior

The purpose of this study was to describe the family environments (Family Environment Scale) of families in which a child had died from cancer to compare the family environments of these bereaved families with those of normal and distressed families, and to examine the relationship between the family environments and the behavioral responses (Achenbach Child Behavior Checklist) of the surviving siblings Subjects were 34 families in the Western United States and Canada who had experienced the death of a child from cancer and who had at least one surviving child, aged between 6 and 16 years Results indicate that bereaved families are more like normal than like distressed families Families with higher Cohesion, Active/Recreational Orientation, and Moral/ Religious Emphasis have children who demonstrate fewer behavioral problems up to 3 years after siblings death The higher the family emphasis on Active/Recreational Orientation and Intellectual/Cultural Orientation, the greater the social competence demonstrated by the children Findings suggest that support gamed by having a family emphasis on social involvement is associated with the children's behavior scores Implications for health care professionals are discussed.     

Risk of Haemophilus influenzae type b meningitis in Polish children varies directly with number of siblings: Possible implications for vaccination strategies

Background: In the absence of an effective vaccine, Haemophilus influenzae type b (Hib) meningitis has frequently been found to be the most common bacterial meningitis among children less than or equal to 5 years of age. This study was conducted prior to the introduction of Hib vaccine in Poland, and is the first case–control study of Hib meningitis in this country. Methods: A 1:3 matched case–control study was nested within a population-based surveillance study of Hib meningitis in children less than or equal to 5 years old in Poland. Controls were matched on the case's age at onset of disease and immunization center. Results: Having one or more siblings is a highly significant risk factor for Hib meningitis and, under the rare disease assumption, risk increases linearly with the increase in the number of siblings. The size of the living area of the home was not itself a significant risk factor for disease. Breast-feeding was not protective in contrast to previous studies. Childcare outside of the home was a significant risk factor for Hib meningitis especially among children greater than 16 months of age, whereas the effect of sibling number on Hib meningitis was much greater among the younger children. Conclusion: Risk of Hib meningitis approximately doubles for every unit increase in the number of siblings. Routine vaccination of Polish infants who have two or more siblings could potentially prevent half of the Hib meningitis cases.     

Physical and personality traits of preschool children in Fuzhou, China: only child vs sibling

Concern about the healthy growth and development of an only child has been voiced since the 1970s, when the Chinese government launched the only child policy. In this study, the physical and personality traits of rural Chinese preschool only-children (onlies) whose age ranged from 3 to 6 years old were evaluated. The sample included 197 onlies and 367 children with siblings who came from seven kindergartens in rural areas in Fuzhou, Fujian province. The results showed no statistically significant differences in height, mass or BMI between the onlies and siblings. Regarding the personality traits, the significant difference was that the onlies exhibited more somatic complaints, however, the data didn't indicate any other undesirable personality traits for the onlies. These results suggest that Chinese preschool children grow normally with or without siblings.