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。

Objective To understand the influence of different intervention modes on early integrated development of children aged 0 to 3 years, in order to provide scientific basis for the work on early childhood development. Methods Totally 295 infants and toddlers were enrolled in this study in September 2018, and were divided in to control group (n=97), family intervention group (n=100) and community intervention group (n=98) according to the different interventions.Early integrated development was evaluated by specialized persons using Early Learning Accommodation Profile (E-LAP) and Learning Accommodation Profile Diagnostic (LAP-D).The rate of the assessed developmental month age older than or equal to the actual month age was defined as better development and an evaluation index to evaluate the intervention effect. Results After family intervention, there were significant differences on better gross motor, fine motor, cognitive, language development and social skills (χ²=39.111,27.604,30.083,12.562,13.657,P＜0.05).While significant difference existed only on gross motor and language in the community intervention group (χ²=4.015,5.227,P＜0.05).In control group, there was significant difference on gross motor (χ²=7.009,P＜0.05).After adjusting children′s age, maternal age, and parental education, the generalized estimation equation model showed that compared with the control group, the family intervention group has a significantly higher ratio of better development in gross motor, fine motor and cognitive dimension(OR _gross=1.859,OR _fine=2.942,OR _cognitive=1.813, P＜0.05).Community intervention group only had significant difference in better gross motor development(OR_gross=1.751, P＜0.05).There was no significant difference on language and social skills among different intervention groups (P>0.05). Conclusion Early intervention programmes for infants and toddlers aged 0-3 years, especially the family interventions, could effectively promote integrated early development.