0~3岁儿童心理行为发育预警征与Gesell发育评估一致性分析

目的 了解近三年北京市顺义区0~3岁儿童心理行为发育状况,评估预警征应用效果。方法 选取2018年9月—2021年9月在北京市顺义区妇幼保健院接受Gesell发育评估的儿童1 360例,检索相应儿童在社区体检中预警征的结果,对两种评估结果进行统计分析。结果 Gesell发育评估儿童1 360例中男童约占69.9%,女童约占30.1%,男童比例显著高于女童(χ² =214.412,P<0.05),男童语言及个人-社交能区显著低于女童(t＝4.201、2.186,P<0.05)。预警征筛查中12月龄以内的儿童阳性项目以大运动和精细动作发育落后为主,而12~36月龄儿童阳性项目以语言发育落后为主,各年龄段预警征阳性项目构成比差异有统计学意义(χ² ＝36.750、5.762、9.966、8.895、57.731、231.749、105.385、56.919,P<0.05)。经Kappa一致性检验,预警征与Gesell发育评估结果一致性为中等(Kappa=0.559,P<0.05)。预警征2项及以上阳性的儿童其适应性DQ值低于1项预警征阳性的儿童,差异有统计学意义(t=5.718,P<0.05)。结论 需关注男童心理行为发育,注重儿童早期发育促进,尤其重点关注婴儿的大运动及精细动作、幼儿的语言发育。

Consistency between early warning signs of psychological and behavioral development and Gesell Developmental Scale of children aged 0 to 3 years

Objectives To know about the psychological and behavioral development of children aged 0 to 3 years in Shunyi District of Beijing over the past three years, and to evaluate the application effects of early warning signs. Methods From September, 2018 to September, 2021, a total of 1 360 children who received assessment by Gesell Developmental Scale(GDS) in Maternal and Child Health Care Hospital of Beijing Shunyi District were selected, and the results of early warning signs of these children in community physical examination were retrieved. Then the results of two assessment methods were statistically analyzed. Results Among 1 360 children assessed by GDS,the proportion of boys(69.9%) was significantly higher than that of girls(30.1%) (χ² =214.412,P<0.05). The development quotients (DQ) of language and personal-social ability area of boys were significantly lower than those of girls (t＝4.201,2.186, P<0.05). In terms of early warning signs, children under 12 months old were mainly backward in the development of gross and fine movements, while children aged 12 to 36 months were mainly backward in language development.There was statistical difference in the composition ratio of early warning positive items among children in different age groups (χ²=36.750, 5.762, 9.966, 8.895, 57.731, 231.749, 105.385, 56.919, P<0.05). The result of early warning signs was moderately consistent with that of GDS (Kappa=0.559, P<0.05).The DQ value of adaptability in children with two or more positive early warning signs was significantly lower than that of children with one positive warning sign (t=5.718,P<0.05). Conclusion More attention should be paid to the development of boys' psychological and behavioral development, as well as the promotion of early childhood development, especially for the gross and fine movements development of infants, and the language development of young children.