疑诊发育迟缓儿童1 979例的Gesell量表结果分析

目的 了解疑诊发育迟缓儿童智能发育概况,为指导早期筛查及有效干预提供科学依据。方法 选取2014年1月1日-2017年1月1日在四川大学华西第二医院儿童保健门诊行Gesell发育评估的2 178例疑诊发育迟缓儿童作为研究对象,对发育商进行统计分析。结果 最终纳入数据完整者1 979例,其中男童约占76.5%(1 514/1 979),女童约占23.5%(465/1 979),且不同月龄段男、女童构成比差异有统计学意义(χ²=44.652,P＜0.05)。语言能区发育缺陷比例高达86.2%,适应性行为、个人-社交行为、精细动作及大运动能区发育缺陷比例分别为68.6%、68.0%、57.3%及52.8%。男童语言能区发育缺陷比例高于女童(P＜0.05)。相关性分析结果显示语言能区发育缺陷程度与适应行为、个人-社交行为、大运动及精细动作能区发育缺陷程度均呈显著正相关(r=0.731、0.795、0.676、0.690,P＜0.001)。结论 疑诊发育迟缓儿童中语言发育缺陷问题突出,且伴其余能区不同程度发育缺陷,尤其应重点关注男童语言发育,早期对儿童进行以语言发育为主的全面智能发育干预应作为临床工作重点。

Analysis of the results of Gesell Developmental Scale of 1 979 children with suspected developmental retardation

Objective To understand the general situation of mental development of children with suspected mental retardation,in order to provide scientific evidence for early screening and timely intervention.Methods A total of 2 178 children with suspected mental retardation who completed the Gesell Developmental Scale were enrolled at West China Second Hospital in this study from 1st January,2014 to 1st January,2017. The mental development was assessed by Gesell Development Scale,and the developmental quotient was analyzed. Results Totally 1 979 children with completed data were analyzed,of which 1 514(76.5%) were boys and 465(23.5%) were girls. The proportion of boys was significantly higher than that of girls at different month groups(χ²=44.652,P＜0.05). The proportion of developmental defects in language area was 86.2%,and it was 68.6%,68.0%,57.3% and 52.8% in adaptive behavior,personal-social behavior,fine motor and gross motor area,respectively. The proportion of developmental defects in language area of boys was higher than that of girls(P＜0.05). Correlation analysis indicated that there were significant positive correlations between the degree of developmental defects in language area and the degree of developmental defects in adaptive behavior,personal social behavior,gross motor and fine motor area(r=0.731,0.795,0.676,0.690,P＜0.001). Conclusions Language developmental defects are prominent in children with suspected developmental retardation,which are comorbid with different degrees of developmental defects in other functional areas. In particular,attention should be paid to the language development of boys. Therefore,the early intervention of comprehensive mental development based on the language development should be the focus of clinical work right now.