郑州市金水区入园体检儿童早期发展落后及影响因素研究

目的 探讨郑州市金水区入园体检儿童早期发展落后情况及相关影响因素,为促进儿童早期发展水平提升提供参考依据.方法 以2021年4-6月在郑州市某医院进行入园体检的金水区学龄前儿童作为研究对象,通过婴幼儿智能发育量表(CDCC)测试及问卷调查儿童的智力发育指数(MDI)、运动发育指数(PDI)及相关资料,采用描述性流行病学...     

3105例婴幼儿智能发育及影响因素的研究

目的:了解婴幼儿智能发育状况、结构均衡性及影响二者的因素,早期发现和干预智能发育障碍。方法:将儿童智能检查纳入系统管理,采用DST法,定期对儿童进行发育筛查,纵向追踪,并对影响智能发育的围产、环境、教养、疾病、家族等因素进行了调查与研究。结果:5年共调查3105例儿童。母亲高龄、多胎次生育、早产、低体重、吸头吸引器助产、人工喂养、未胎教、阳性家族史等儿童的智能发育与其他儿童相比,差异均有统计学意义(P<0.05或P<0.01)。结论:母亲高龄、多胎次生育、早产、低体重、胎头吸引器助产、人工喂养、未胎教、阳性家族史等是影响儿童智能发育的重要因素。     

山西农村婴幼儿智能发育状况分析

目的:了解山西农村婴幼儿的智能发育状况及其影响因素。方法:采用首都儿科研究所研制的"0~6岁儿童神经心理发育量表"对503名1~36个月农村儿童进行智力测验,同时调查其营养状况和父母受教育程度。结果:调查人群整体智能发育水平偏低,其中大运动相对较好,而语言、精细运动和适应能力较差,并且随着年龄增长发育商逐渐下降。智力水平偏低及落后的发生率分别为24.3%和1.8%,其中24~36月龄组适应能力、语言发育落后分别占13.9%和15.3%。智力水平与营养状况相关,智力偏低的发生率随着营养及体格发育水平的降低而增高,营养不良儿童的智力落后发生率明显高于营养正常儿童。父亲、母亲在小学及以下文化程度的婴幼儿智力发育低下的发生率分别为42.9%、52.7%。结论:山西农村婴幼儿智力发育水平比常模低10个分值,智力发育与营养、父母文化程度密切相关。     

佛山市0~2岁婴幼儿神经精神发育筛查

目的:尽早发现儿童发育异常,以便施行早期干预。方法:从2000年开始,对我院儿童系统管理的婴幼儿从1月龄开始,1岁内3个月一次,1岁后半年一次,定期进行智能发育筛查。对发育落后的儿童根据不同情况进行早期干预,并对家长进行早期育儿及发育指导。选择其中健康儿童进行纵向分析。结果:我院系统管理的儿童智能发育合格率逐年提高,而发育落后率逐年下降(P<0.01)。结论:对0-2岁儿童开展神经精神发育筛查,能更全面地了解儿童的生长发育情况,通过多种形式广泛开展早期教育对提高儿童综合素质有较好的促进作用。     

剖宫产对母儿近远期影响及干预的研究

目的:认识并了解剖宫产的利弊,对降低剖宫产率起到积极的指导作用。方法:以整群抽样的方法采用调查问卷和体格检查相结合方式,调查在哈市住院分娩的产后42 d、产后5年、产后10年及产后15年内的4个年段妇女;采用DDST小儿智能发育筛查工具测查生后42 d和1岁身体健康新生儿;采用学习能力评估测查工具测查学龄期儿童。结果:剖宫产对母亲近期显著性影响是刀口感染、延期愈合,纯母乳喂养率低,恶露持续时间延迟;远期显著性影响是宫外孕,肌体抵抗力下降,子宫内膜异位症,腹部不适消化不良,盆腔炎,性生活不适。剖宫产对学龄期儿童感觉运动和听知觉障碍有显著性影响。剖宫产对新生儿智能发育无显著性影响。结论:剖宫产对母儿近远期可产生不同程度影响,应采取有力措施降低剖宫产率,维护妇女儿童身心健康。     

广西贫困地区197名5岁以下儿童营养与智力发育水平分析

目的了解广西贫困地区农村学龄前儿童智力发育水平,为提高贫困地区农村儿童身体素质和智力水平提供参考依据。方法运用首都儿科研究所研制的《0～6岁儿童神经心理发育量表》及配套测查用具,对广西国家级贫困县平果县、融水县197名5岁以下儿童进行神经心理发育测查。结果 197名儿童智力测试结果评分等级中,优秀者占0.51%,聪明者占6.60%,正常者占82.74%,偏低者占10.15%;儿童智力偏低与儿童营养状况、看护人及母亲文化程度有一定相关关系。结论广西贫困地区5岁以下儿童智力发育偏低。应加强儿童的营养改善和早期智力教育,对于提高贫困地区儿童生长和智力发育有主要作用。     

早期教育对婴幼儿智能发育的影响

目的:了解早期教育对婴幼儿智能发育的影响,为早期开发婴幼儿智能发育提供参考依据。方法:按照鲍秀兰编写的《挖掘儿童潜能始于0岁》中的0～3岁教学大纲要求对早教组进行干预训练,定期随访,用0～6岁小儿神经心理发育测查(首都儿研所研制)的方法,定期对早教儿童进行发育商测试。结果:参加早期教育儿童的发育商高于对照组,差异有统计学意义(P<0.01)。结论:早期教育对婴幼儿智能发育有积极作用。     

佛山市0～2岁婴幼儿神经精神发育筛查

目的尽早发现儿童发育异常,以便施行早期干预.方法从2000年开始,对我院儿童系统管理的婴幼儿从1月龄开始,1岁内3个月一次,1岁后半年一次,定期进行智能发育筛查.对发育落后的儿童根据不同情况进行早期干预,并对家长进行早期育儿及发育指导.选择其中健康儿童进行纵向分析.结果我院系统管理的儿童智能发育合格率逐年提高,而发育落后率逐年下降(P＜0.01).结论对0～2岁儿童开展神经精神发育筛查,能更全面地了解儿童的生长发育情况,通过多种形式广泛开展早期教育对提高儿童综合素质有较好的促进作用.     

0—6岁小儿神经心理发育测验结果分析

目的：了解0—6岁小儿神经心理发育状况．并探讨其影响因素。方法：采用首都儿科研究所编制的0—6岁小儿神经心理发育量表时600例小儿进行测试,用发育商评估。对测查结果进行分析。结果：各能区原始得分随年龄的增长而增加．DQ值呈正态分布；DQ与孕周、母亲文化程度、围产期高危因素有相关性．与性别、生产方式、孕胎次、父亲文化程度无相关性。结论：小儿神经心理发育测试可以早期发现发育落后、智力低下儿童，并为小儿儿早期于预或治疗提供依据。     

上海城乡儿童智力发育调查

为探索着力低下早期发现的途径和方法，对上海城乡4546名0～12岁）儿童进行了智力发育测查。首先用DDST或绘人测验进行智力筛查，筛查阳性者按不同年龄用儿——心量表、WPPSI或WISC—R进行测试。DQ或IQ低于70者以婴幼儿一初中生社会生活量表进行社会适应能力评估。测查结果共发现智力低下42例，占调查儿童总数的9．24％。城乡相比，农村智力低下现患率（16．13‰）明显高于城市（4．19‰），P＜0．01。从性别来分，男孩现患率（11．36‰）高于女孩（6．91‰）。智力低下患病率有随年龄增加而上升的趋势。因素分析与配对研究显示智力低下与父母文化素质有密切关系，父母文化程度小学以下者其子女智力低下患病率高。智力低下的发生还与高危因素有关。     

Mild mental retardation in black and white children in metropolitan Atlanta: a case-control study.

OBJECTIVES. This study assessed differences in the prevalence of mild mental retardation, defined as an intelligence quotient (IQ) from 50 to 70, between Black and White children. METHODS. A case-control study design was used. Ten-year-old children with mental retardation were identified from multiple sources. Information on race, sex, maternal age, birth order, economic status, and maternal education was abstracted from birth certificates of 330 case children and 563 control children (public school students). RESULTS. The crude Black-White odds ratio (OR) was 2.6, but it was reduced to 1.8 after the other five covariates were controlled. The disparity was largest among children whose mental retardation was first diagnosed when they were 8 to 10 years old (adjusted OR = 2.5). We found no significant difference in the occurrence of mild mental retardation between Black and White children diagnosed before the age of 6 years (adjusted OR = 1.2). Black children had a higher prevalence of mild mental retardation within all strata of the other five covariates. CONCLUSIONS. Five sociodemographic factors accounted for approximately half of the excess prevalence of mild mental retardation among Black children. Possible reasons for the residual difference are discussed.     

智力低下儿童的病因及相关致病因素分析

目的:了解2005~2009年温州市6~11岁智力低下(mental retardation,MR)儿童的病因构成特点及相关致病因素。方法:对就诊患儿采用儿童韦氏智力量表进行诊断,并进行病例对照研究及COX回归分析。结果:诊断MR儿童268例,病因明确者202例,占75.30%。其中生物医学因素所致164例,占61.10%;社会心理因素38例,占14.17%。农村MR儿童染色体病的人数高于城市,城市MR儿童受社会心理因素影响致病的人数高于农村(P均<0.01)。产前、产时和产后各种病因在农村和城市间差异无统计学意义(P均>0.05);病例对照生物危险因素分析及COX回归分析结果显示,早产、出生时窒息、母孕期接触化学物质和近亲结婚可使MR发生的风险增高。结论:加强孕期保健和产前诊断,提高产科质量,积极防治后天获得性疾病是预防MR的关键。     

Epidemiological survey of psychiatric disorders of Japanese school children. Part 2. Prevalence of psychiatric disorders in school children

An epidemiological survey of mental health of Japanese regular public school children was performed using both Rutter's teacher's and parent's questionnaires as a screening instrument and a diagnostic interview as a definitive method. A total of 592 junior high and elementary school children, average age 13.2 years old and ranging from 10 to 15 years old, were examined in the preliminary survey. Purposes were to study survey methodology and to determine the prevalence of psychiatric disorders. In part 1, the Japanese version of Rutter's questionnaire was found to be satisfactory for screening, and the diagnostic interview by pediatricians in this survey was shown to be a reliable tool for the diagnosis of psychiatric disorders of the adolescent. In the present study, psychiatric disorder prevalence and characteristics were studied. The 592 school children were divided into 3 groups by the Rutter's questionnaires: 1) 55 positive children by Rutter's method, 2) 424 negative children having no risk factors by Rutter's method, 3) 112 negative children by Rutter's method having some risk factors such as "school problems", "visits to school nurse", and "not being liked by peers". All of the 55 positive children and 144 children randomly selected from the negative group were interviewed and diagnosed by pediatricians, and estimates of prevalence rates for mental disorder were determined for the 3 children groups. It was 51% in the positive group, 11% in the negative group having no risk factors, and 25% in the negative group having some risk factors. Thus, the prevalence rate for the total group of 591 children was 17%, with one case of mental retardation being excluded.(ABSTRACT TRUNCATED AT 250 WORDS)     

404例智力低下儿童智力测试结果及病因探讨

目的:分析智力低下儿童智力测试结果及病因,为智力低下儿童的诊治提供依据。方法:2010年1月～2011年12月期间对1 332例儿童进行智力测试,其中4～6岁儿童采用中国修订的韦氏学龄前儿童智力量表(C-WYCSI)进行智商测定,7～17岁儿童采取韦氏学龄儿童智力量表(C-WISC)进行智商测定。结果:①确定为智力低下儿童404例,检出率为30.33%。其中轻度智力低下患儿155例(38.37%),中度智力低下患儿119例(29.46%),重度智力低下患儿76例(18.81%),极重度智力低下患儿54例(13.37%)。4～6岁238例,7～17岁166例。男性215例,女性189例。学龄前智力低下儿童与学龄儿童智力低下各级别分布构成、不同性别智力低下儿童智力各级别分布构成之间均无统计学差异(P>0.05)。②智力低下病因明确者288例(71.29%),病因不明者116例(28.71%);病因明确的智力低下患儿,导致智力低下的病因主要为先天性智力发育迟缓(17.08%)、染色体异常(10.64%)、脑积水(6.93%)为前三位原因。结论:4～17岁智力低下儿童以轻度智力低下为主,导致智力低下的病因较多,但以先天性智力发育迟缓、染色体异常及脑积水为最常见原因。     

Influences on neuromotor development of 5 to 10-year-old children in Basel

In a longitudinal study concerning somatic, psychic, and social development of children in Basle, the neuromotor development at the age of 5 and 10 years was examined. Motor retardation shows significant correlations with psychic and social development. The way 5 year old children of working mothers have been taken care of showed a significant influence on motor development. A retardation in motor development of kindergarten children indicates an increased probability for further retardations in school age, too.     

高危儿2岁时语言发育迟缓情况临床分析

目的 探讨高危儿2岁时语言发育迟缓情况,为早期诊断、早期干预,改善其预后提供科学依据。方法 选择2014年6月-2015年7月在上海长海医院儿科住院治疗并随访至24月龄的64例高危儿为研究对象,以同期在儿保门诊体检的52例正常小儿为对照组,采用0~6岁儿童发育筛查测验(DST)分别在高危儿12、18、24月龄时和对照组24月龄时进行发育筛查评估。结果 高危儿在24月龄时语言发育迟缓的检出率约34.4%,对照组为8.0%,差异有统计学意义(P<0.05),其中足月小样儿检出率63%最高,其次为早产儿40%,男女比例为3.4∶1。12月龄时高危儿运动发育落后和语言发育落后的检出率相差异无统计学意义(P=0.191),但18、24月龄时两者间检出率差异有统计学意义(P<0.05)。结论 高危儿仍然是语言发育迟缓的高危人群,不同高危因素所致语言发育迟缓检出率不同。对高危儿需定期随访、监测和筛查语言发育,争取早发现、早干预,改善预后。     

Low birthweight and the risk for mental retardation later in childhood

Summary. Data from the population-based Metropolitan Atlanta Developmental Disabilities Study were used in a case-control study to assess the association between low birthweight and mental retardation (intelligence quotient ≤70) among 10-year-old children who were born in 1975 or 1976. Children with mental retardation were identified from existing records at multiple sources and control children were selected from public school rosters. Data on birthweight and other covariates (sex, birth order, maternal age, maternal race, maternal education and gestational age) came from birth certificates. We used multiple logistic regression modelling to obtain adjusted odds ratios for mental retardation, with normal birthweight children (those weighing ≥2500g) as the referent group. For low birthweight children as a whole, the odds ratio for mental retardation was 2.8 (95% CI 1.9-4.2). The risk was higher for very low birthweight (<1500 g) children than for moderately low birthweight (1500–2499 g) children, and higher for severe mental retardation (intelligence quotient <50) than for mild mental retardation (intelligence quotient 50–70). Adding gestational age to the models revealed that normal birthweight children who were born preterm also were at increased risk of having mental retardation at age 10 years.     

安徽省某农村地区儿童精神发育迟滞危险因素病例对照研究

目的 探讨农村地区儿童精神发育迟滞(Mental Retardation，MR)的危险因素。方法 对安徽省某乡镇的24个行政村所有常住家庭中4～17岁儿童进行人户调查，确诊75名无明确病因精神发育迟滞儿童作为病例组，按年龄、性别进行1：2的配比，在同一村选择智力正常且无其它缺陷的150名儿童作为对照组，对上述儿童进行智力测验、社会适应性能力评价及自制问卷调查。结果 单因素分析儿童MR的危险因素有：家庭贫困、母亲文化程度低、父母亲智力低下或癫痫家族史、母亲妊娠前月经周期异常、母孕期发热、母孕期出血、母孕期患有慢性病、早产、出生后第一声啼哭是否需辅助、新生儿发热、惊厥、窒息。COX比例风险模型分析儿童精神发育迟滞危险因素的结果显示，父母亲智力低下或癫痫家族史、母孕期是否患慢性病、是否早产、出生后第一声啼哭是否需辅助5个因素进入最终方程。结论 社会文化因素、遗传因素及围生期因素与儿童MR的发生相关，应采取综合的干预措施，减少儿童精神发育迟滞的发生。     

中国八省市城乡婴幼儿早期发展现状研究

目的 评估我国婴幼儿认知和运动发展水平,了解我国儿童早期发展现状。方法 于2012年10月-2013年3月抽取全国8个省市1 026名2~30月龄足月、健康婴幼儿作为研究对象。通过问卷调查获得人口学及社会经济水平等因素,采用贝利婴幼儿发展量表第1版对婴幼儿进行发育评估。使用多元回归分析,探索婴幼儿认知发育及运动发育的影响因素。结果 我国2~30月龄婴幼儿平均认知发展指数102.38±17.58,平均运动发展指数为101.39±16.38。认知发育迟缓发生率为7.70%,运动发育迟缓发生率8.28%。控制混杂因素后,发现相较于母亲教育程度为大专及以上的人群,母亲受教育程度为初中及以下学历人群的认知发展指数和运动发展指数降低显著(β=-8.51,95%CI:-11.23~-5.78;β=-4.17,95%,CI:-6.79~-1.55)。结论 我国城乡地区婴幼儿早期发展水平较20年前有上升,母亲受教育程度对婴幼儿认知、运动发育有重要影响。