目的 调查和分析语言发育迟缓儿童的临床特征及其影响因素,为临床早期发现及干预提供科学依据。方法 以2019 年11月—2020年7月在复旦大学附属儿科医院儿保科语言专科门诊就诊的126例语言发育迟缓儿童为病例组,2020 年5—7月在闵行社区卫生服务中心儿保科就诊的18～48月龄的100例正常儿童为对照组。采用Gesell发育量表对病例组儿童进行发育评估。采用自制问卷调查两组儿童一般情况和家庭环境因素,包括儿童出生胎龄、生育间隔、生产方式、出生体重、开始独走月龄、主要照顾者、电子屏幕暴露时间、母亲文化程度等。结果 病例组儿童初诊年龄为(29.2±4.5)月,男童∶女童为2.7∶1。Gesell评估中语言、大运动、精细运动、适应性和个人社交的DQ值分别为49.9±16.3、73.5±15.4、72.4±18.1、70.2±16.2和60.4±16.4。病例组儿童中,早产儿占比明显高于对照组(χ²=4.873,P<0.05);开始独走月龄为(14.7±2.4)月,明显晚于对照组的(12.6±2.0)月(t=5.766, P<0.05);其电子屏幕暴露时间为(3.6±1.9) h/d,明显高于对照组的(1.2±1.0) h/d(t=10.587, P<0.05)。对照组儿童母亲受教育年限长于病例组患儿母亲,差异有统计学意义(t=7.973,P<0.05);两组间分娩方式、主要照顾者和生育间隔等,差异均无统计学意义(P>0.05)。结论 因语言发育迟缓就诊的儿童不仅语言问题突出,还可能同时伴有其它能区的发育落后。早产、电子屏幕暴露时间长、母亲文化程度低是儿童语言发育障碍可能的影响因素。

Objective To investigate the clinical features and high influencing factors of language delay in children, in order to provide reference for the early detection and intervention. Methods From November 2019 to July 2020, a total of 126 children with language delay in the Department of Child Health Care, Children's Hospital of Fudan University were enrolled in case group. While 100 normally developed children who visited the hospital from May to July 2020 were selected as control group. Children in case group were assessed by Gesell test. For both groups, a self-designed questionnaire about individual information and family environment was used to collected related information, including gestational age, pregnancy interval, delivery mode, birth weight, initial walking age, main caregivers, screen time and maternal education level. Results The first visit age for 126 children with language delay was (29.2±4.5) months. The ratio of boys and girls was 2.7∶1. Developmental quotients (DQs) of language, gross motor, fine motor, adaptive and social in Gesell Development Scale were 49.9±16.3, 73.5±15.4, 72.4±18.1, 70.2±16.2 and 60.4±16.4, respectively. The ratio of the preterm birth in the case group was higher than that in the control group(χ²=4.873, P<0.05). For children in the case group, the initial walking age was later than that in the control group [(14.7±2.4) months vs. (12.6±2.0) months, t=5.766, P<0.05]. The screen time of children in case group was longer than that of the control group [(3.6±1.9) h vs. (1.20±1.0) h, t=10.587, P<0.05]. The level of maternal education of case group was lower than that of control group (t=7.973, P<0.05). There were no significant differences in the main caregiver, pregnancy interval and delivery mode between the two groups (P>0.05). Conclusions Children with language delay may suffer from problems in other developmental areas as well. The longer screen time, lower maternal education and preterm birth may be the influencing factors for language delay in childhood.