目的 研究发育性语言障碍(DLD)儿童亲子互动的特征以及影响因素,为临床早期发现、早期干预提供依据。方法 选取2018年1月-2020年3月在山东大学齐鲁医院儿童保健门诊就医,经专业医师确诊的DLD儿童30例,另选取同时期在山东大学齐鲁医院儿童保健门诊及山东大学中心校区校医院儿童保健门诊进行健康查体的正常儿童30例为对照组。利用中文版亲子互动评估量表,采用录像分析的方式对纳入研究的儿童和其养育者的互动行为进行分析。结果 DLD组亲子互动得分低于对照组,差异有统计学意义(t=4.548,P<0.05)。多因素回归分析结果显示:亲子互动的自主性和社会情感得分越高,DLD的发生风险越高(OR=5.935、8.833,P＜0.05);亲子互动的共情、对自主性的尊重、认知能力的培养维度得分越高,DLD的发生风险越低(OR=0.165、0.417、0.202,P＜0.05);母亲受教育程度高(OR=0.159,95%CI:0.031~0.805)、家庭养育环境好(OR=0.051、0.140)、家庭年收入>10万(OR=0.113,95%CI:0.033~0.380)是DLD的保护性因素;每日视屏时间>1 h(OR=21.605,95%CI:3.214~145.225)是DLD的危险性因素。结论 社区基层医疗机构儿童保健工作中,可借助亲子互动早期识别有DLD倾向的儿童,为早期筛查和干预赢得时间。日常生活中,改善家庭养育环境、减少儿童视屏时间可降低儿童语言障碍的发生。
Abstract
Objective To study the characteristics of parent-child interaction in children with developmental language disorder (DLD), and to analyze the influencing factors of DLD, so as to provide basis for early clinical detection and early intervention. Methods Thirty children with DLD diagnosed in the Child Health Care Clinic of Cheeloo Hospital of Shandong University were selected into this study from January 2018 to March 2020. Meanwhile, 30 normal children who took physical examination in the Child Healthcare Clinic of Cheeloo Hospital of Shandong University and the Child Healthcare Clinic of Shandong University Central Campus Hospital were selected as control. The Chinese version of the Parent-Child Interaction Assessment Scale and video analysis were used to assess the interactive behaviors of the children and their caregivers. Results There was significant difference in the scores of parent-child interaction between the DLD group and the control group (t=4.548, P<0.05). Multivariate regression analysis showed that the higher the scores of autonomy and social emotion of parent-child interaction, the higher the risk of DLD (OR=5.935, 8.833,P<0.05); While the higher the scores of empathy, respect for autonomy and the cultivation of cognitive ability in parent-child interaction, the lower the risk of DLD (OR=0.165, 0.417, 0.202, P<0.05). Higher education level of mothers (OR=0.159, 95%CI: 0.031 - 0.805), better family rearing environment (OR=0.051, 0.140) and family annual income>105 yuan (OR=0.013, 95%CI: 0.033 - 0.380) were protective factors for DLD, while the daily video time＞1 h/d (OR=21.605, 95% CI: 3.214 - 145.225) was a risk factor for DLD in children. Conclusions In community primary medical institutions, children with DLD can be identified early with the help of parent-child interaction, so as to get chance for early screening and intervention. Improving family rearing environment and reducing screen time may reduce the occurrence of children's language disorder.
关键词
发育性语言障碍 /
亲子互动 /
家庭养育环境 /
视屏时间 /
儿童
Key words
developmental language disorder (DLD) /
parent child interaction /
family rearing environment /
screen time /
children
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参考文献
[1] 张尧. 亲子互动对12~24个月幼儿情绪社会性影响的研究 [D]. 哈尔滨:哈尔滨师范大学, 2016.
[2] 徐亚琴,胡小沙,梁沂,等. 发育性语言障碍儿童的Gesell测评分析[J]. 中国儿童保健杂志, 2013, 21(1): 71-73.
[3] 邹园园,张素卿,黄师菊,等. 2～3岁儿童孤独症谱系障碍与发育性语言障碍的Gesell结果分析[J]. 中国儿童保健杂志, 2015, 23(3): 298-300.
[4] Woods JJ, Wetherby AM. Early identification of and intervention for infants and toddlers who are at risk for autism spectrum disorder[J]. Lang Speech Hear Serv Sch, 2003, 34(3): 180-193.
[5] 丁美琦,许梦雪,朱宗涵,等. 早期亲子互动常用观察法评估量表研究进展[J]. 中国儿童保健杂志, 2018, 26(6): 641-644.
[6] Anme T, Yuko Y, Shinohara R, et al. The validity and reliability of Interaction Rating Scale (IRS):Characteristics for children with behavioral or environmental difficulties[J]. Jpn J Hum Sci Health Soc Serv, 2007, 14(1): 23-31.
[7] Anme T, Sugisawa Y, Shinohara R, et al. Validity and reliability of the Interaction Rating Scale between Children (IRSC) by using motion capture analysis of head movement[J]. Public Health Res, 2012, 2(6): 208-212.
[8] 严琼,唐静芳,童连. 户籍与流动学龄前儿童焦虑症状的相关因素研究[J]. 中国儿童保健杂志, 2019, 27(5): 535-538.
[9] Mochizuki Y, Tokutake K, Anme T, et al. Validity and reliability of the Index of Child Care Environment (ICCE)[J]. Public Health Front, 2013, 2(3): 141-145.
[10] 童连. 0~6岁儿童心理行为发展评估[M]. 上海: 复旦大学出版社, 2017.
[11] 高越,张云婷,赵瑾,等. 养育环境与儿童早期发展的相关性[J]. 中华儿科杂志, 2021, 59(3): 175-180.
[12] 沈力,田园,冯金彩,等. 发育性语言障碍诊断及早期干预[J]. 国际儿科学杂志, 2018, 45(2): 145-148.
[13] 李廷玉,谭梅. 孤独症谱系障碍儿童微营养素缺乏的监测和干预原则[J]. 中国儿童保健杂志, 2021, 29(1): 1-4.
[14] 金星明,静进. 发育与行为儿科学[M]. 北京: 人民卫生出版社, 2020.
[15] 静进. 儿童孤独症的早期诊断和早期干预治疗[J]. 中国儿童保健杂志, 2007, 15(5): 453-454.
[16] 刘玉娟. 0~3岁儿童语言和言语障碍的早期诊断与干预[J]. 中国特殊教育, 2018,25(9): 53-57.
[17] 刘慧燕,陈蓁蓁,陈小霞,等. 儿童早期语言发育迟缓的影响因素分析[J]. 中国儿童保健杂志, 2019, 27(12): 1285-1287.
[18] 吴剑波,尹晓娜,吴传安,等. 儿童婴幼儿期视屏接触时间与孤独症样行为的关联[J]. 中国学校卫生, 2020, 41(1): 21-24.
[19] 国家卫生和计划生育委员会办公厅.关于印发儿童眼及视力保健等儿童保健相关技术规范的通知[J]. 中华人民共和国卫生部公报, 2013, 4: 39.
[20] 周珊珊,严双琴,曹慧,等. 婴幼儿视屏暴露对发育行为的影响[J]. 中国儿童保健杂志, 2020, 28(5): 587-590.
[21] 方红英,徐成恒,汤银霞,等. 视屏暴露和家庭养育环境对儿童行为问题的影响分析[J]. 中国妇幼保健, 2019, 34(15): 3498-3500.
[22] 胡梦杰,杨小云. 儿童语言发育迟缓的研究进展[J]. 齐齐哈尔医学院学报, 2020, 41(4): 467-469.
基金
山东省自然科学基金 (ZR2020MH162);山东省医学会脐带血科研专项基金项目(YXH2020ZX011)
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