目的 编制中国婴幼儿心理行为发育里程碑检查表,并进行该工具的心理测量学特性分析,为提高照养人婴幼儿心理健康与发展的认识,早期发现儿童发育问题、提升家庭养育技能提供依据。方法 在初步筛选发育里程碑评价指标、多中心横断面调查获取婴幼儿发育数据的基础上,在五个心理行为发育能区选取适合婴幼儿的心理行为发育指标,以75%儿童实现该指标为参照纳入相应月龄,组成“婴幼儿心理行为发育里程碑检查表”。采用内部一致性系数、重测信度、测试者信度评价其信度,以内容效度、效标效度、结构效度评价其效度。结果 基于2020年在15个省/自治区/直辖市的30个区/县8 010名正常婴幼儿的144个发育指标的调查数据,参照基本公共卫生健康检查月龄,形成“婴幼儿心理行为发育里程碑检查表”。该表包含大运动、精细动作、语言、认知和社交与自理5个维度,涉及0～3岁的8个月龄段,共40项条目。在信度方面,该表重测信度为0.990、测试者信度ICC值为0.941、内部一致性系数Cronbach′s α系数为0.977,表明该工具测量结果的稳定性及内部一致性均较好。在效度方面,内容效度指数I-CVI为0.820~1,S-CVI为0.929,具有良好的内容效度。以相符月龄段两项里程碑不达标为判别标准,与Gesell发育量表进行效标比较,该工具的敏感度为73.6%,特异度为80.7%。结论 本研究建立了适合婴幼儿的心理行为发育里程碑检查表,具有较好的心理测量学特性,可为家庭养育照护提供支持,与儿童保健服务相衔接,以促进儿童早期发展。
Abstract
Objective To raise caregivers′ awareness of young Children's mental health and childhood development and promote evidence-based parenting practice, we developed the Infant and Toddler Developmental Checklist, and tested the psychometric validity of the checklist to promote early identification of developmental difficulties. Methods By pooling and screening existing developmental milestones and analyzing the infant and toddler developmental data we collected from a multicenter cross-sectional survey, we selected 5 domains and formed the items for the Infant and Toddler Developmental Checklist. We set the passing age of each item as 75% of the children in this age could achieve a certain behavior. The internal consistency coefficient, retest reliability, and tester reliability were used to evaluate the reliability, and the content validity, criterion validity, and structural validity were used to evaluate the validity. Results We developed the Infant and Toddler Developmental Checklist based on the survey data of 144 developmental milestones of 8010 healthy infants and toddlers in 30 districts and counties of 15 provinces in 2020, and with reference to the schedule of primary public health examination. The checklist consists of 5 dimensions: gross motor, fine motor, language, cognition, and social and self-care, covering 8 times visiting from 0 to 3 years old, with a total of 40 items. In terms of reliability, the scale had a retest reliability of 0.990, a tester reliability ICC value of 0.941, and an internal consistency coefficient Cronbach′s α coefficient of 0.977, indicating that the stability and internal consistency of the checklist were good. In terms of validity, the content validity index I-CVI was 0.820-1 and S-CVI was 0.929, indicating good content validity. We tested the checklist against Gesell using the non-attainment of two milestones in the matched month age group as the discriminant criterion. The result showed the checklist had a sensitivity of 73.6% and a specificity of 80.7%. Conclusion Through this study we established a psycho-behavioral developmental checklist for infants and toddlers, which is aligned with the primary public health examination schedule for children, with good psychometric properties. Our findings and output provided support for evidence-based parenting and family care and early childhood development.
关键词
婴幼儿 /
心理行为发育 /
家庭 /
信度 /
效度
Key words
infants and toddlers /
mental and behavioral development /
family /
reliability /
validity
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基金
中国疾控中心妇幼中心科技创新与发展项目(2019KJ05)
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