目的 了解张家港市学龄前儿童发育性协调障碍(DCD)的现状及相关影响因素,为儿童DCD的早期识别干预提供依据。方法 2024年5—6月采用分层随机整群抽样,抽取张家港市13所幼儿园1 391例3~6岁学龄前儿童进行调查,通过小龄儿童发育性协调障碍问卷(little DCDQ)评估儿童运动协调能力,采用0~6岁儿童家庭养育环境量表、学龄前儿童饮食行为量表分别评估养育环境和饮食行为。采用多因素有序logistic回归分析DCD的影响因素。结果 张家港市学龄前儿童DCD异常及疑似检出率分别为4.82% 和7.84%。学龄前儿童DCD的患病风险,随着年龄增长(OR=0.574, 95%CI: 0.429~0.767)、主动进食能力的提高(OR=0.484, 95%CI:0.355~0.659 )而降低(P<0.001);情感温暖较差(OR=2.711, 95%CI: 1.234~5.956)、活动多样性较差与一般(较差:OR=9.300, 95%CI: 3.303~26.183;一般:OR=1.769,95%CI:1.100~2.843)、环境气氛较差与一般(较差:OR=4.244, 95%CI: 2.206~8.164;一般:OR=3.456,95%CI:1.413~8.452)及情绪性进食(OR=1.544,95%CI: 1.145~2.081)可增加其患病风险(P<0.05)。结论 张家港市学龄前儿童DCD的整体检出率偏高。儿童DCD发病与年龄、饮食行为及家庭养育环境等多种因素有关,可通过改善家庭环境及儿童饮食行为降低儿童DCD的风险。
Abstract
Objective To investigate the prevalence of developmental coordination disorder (DCD) among preschool children in Zhangjiagang City, and to identify associated influencing factors, so as to provide evidence for early identification and intervention. Methods A stratified random cluster sampling method was employed to recruit 1 391 preschool children (aged 3–6 years) from 13 kindergartens in Zhangjiagang City between May and June 2024. Motor coordination was assessed using the little Developmental Coordination Disorder Questionnaire (little DCDQ). The 0 - 6 Years Child Home Nurture Environment Questionnaire (CHNEQ) and the Preschooler's Eating Behavior Scale (PEBS) were used to evaluate family environment and dietary behaviors, respectively. Multivariate ordered logistic regression analysis was performed to identify factors influencing DCD status. Results The prevalence rates of abnormal DCD and suspected DCD were 4.82% and 7.84%, respectively. Multivariate analysis indicated that older age(OR=0.574, 95%CI: 0.429–0.767) and higher independent eating ability scores(OR=0.484, 95%CI: 0.355–0.659 ) were protective factors associated with a reduced risk of DCD(P<0.001). Conversely, risk factors included poor emotional warmth (OR=2.711, 95%CI:1.234–5.956), limited activity diversity (average:OR=1.769, 95%CI: 1.100 - 2.843; poor: OR=9.300, 95%CI: 3.303–26.183), unfavorable home atmosphere(average: OR=3.456, 95%CI: 1.413 - 8.452; poor: OR=4.244, 95%CI: 2.206–8.164), and emotional eating(OR=1.544,95%CI: 1.145–2.081)(P<0.05). Conclusions The detection rate of DCD among preschool children in Zhangjiagang City is relatively high. DCD status is significantly associated with age, dietary behaviors, and the family nurturing environment. Interventions focusing on improving family environments and fostering healthy eating habits may benefit children at risk.
关键词
发育性协调障碍 /
学龄前儿童 /
影响因素
Key words
developmental coordination disorder /
preschool children /
influencing factors
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参考文献
[1] 刘振寰.发育性运动协调障碍儿童的早期筛查与干预[J].中国儿童保健杂志,2024,32(5):475-479.
Liu ZH.Early screening and intervention of children with developmental coordination disorder[J].Chin J Child Health Care, 2024,32(5):475-479.(in Chinese)
[2] Garofalo M, Vansenne F, Sival AD, et al.Pathogenetic insights into developmental coordination disorder reveal substantial overlap with movement disorders[J].Brain Sci,2023,13(12): 1625.
[3] Persson I, Sampaio F, Samkharadze T, et al.Impact of developmental coordination disorder in childhood on educational outcomes in adulthood among neonatal intensive care recipients: A register-based longitudinal cohort study[J].BMJ Open, 2023, 13(9): e071563.
[4] Lino F, Chieffo DPR.Developmental coordination disorder and most prevalent comorbidities: A narrative review[J].Children (Basel), 2022, 9(7): 1095.
[5] Blank R, Barnett AL, Cairney J, et al.International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder[J].Dev Med Child Neurol, 2019, 61(3): 242-285.
[6] Gao J, Ke X, Huang D, et al.Effects of Baduanjin on motor function in children with developmental coordination disorders: Study protocol for a randomised controlled trial[J].BMJ open, 2024, 14(12): e084061.
[7] Steenbergen B, Valtr L, Dunford C, et al.Awareness about developmental coordination disorder[J].Front Public Health, 2024, 12: 1345257.
[8] 崔娓,戴霄天,林森然,等.上海市学龄前儿童运动协调能力现况[J].中国学校卫生,2019, 40(1): 20-22.
Cui W, Dai XT, Lin SR, et al.Movement coordination ability among preschool children in Shanghai[J].Chin J Sch Health, 2019,40(1):20-22.(in Chinese)
[9] 刘明霞,花静,柯李,等.中国儿童发育性协调障碍现况分析[J].中华儿科杂志, 2021, 59(11): 928-934.
Liu MX, Hua J, Ke L, et al.Analysis of developmental coordination disorder in Chinese children[J].Chin J Pediatr, 2021, 59(11):928-934.(in Chinese)
[10] 王晓芬,欧光忠,邱伟毓.泉州市乡村3~6岁儿童发育性协调障碍现况及影响因素分析[J].中国健康教育,2023,39(5):468-473.
Wang XF, Ou GZ, Qiu WY.Current status and influencing factors of developmental coordination disorder in 3 - 6 years old children in rural areas of Quanzhou City[J].Chinese Journal of Health Education, 2023, 39(5): 468-473.(in Chinese)
[11] Roubaix AD, Velde DVD, Waelvelde HV.Parental report of early features of developmental coordination disorder: A qualitative study[J].Res Dev Disabil, 2023, 143: 104636.
[12] 耿姗姗,戴霄天,王天景,等.中文版小龄发育性协调障碍问卷信效度初步研究[J].临床儿科杂志, 2020, 38(12): 921-924.
Geng SS, Dai XT, Wang TJ, et al.The preliminary study on the reliability and validity of the Chinese version of the little Developmental Coordination Disorder Questionnaire[J].J Clin Pediatr, 2020,38(12):921-924.(in Chinese)
[13] 何守森,刘一霞,倪晨曦,等.城市3~6岁儿童家庭养育环境量表的编制及其信度效度研究[J].中国儿童保健杂志, 2009, 17(2): 134-136,139.
He SS, Liu YX, Ni CX, et al.3 - 6 Years Child Home Nurture Environment Scale: Development, reliability and validity[J].Chin J Child Health Care, 2009, 17(2): 134-136,139.(in Chinese)
[14] Jiang X, Yang X, Zhang Y, et al.Development and preli-minary validation of Chinese preschoolers' eating Behavior questionnaire[J].PLoS One, 2014, 9(2): e88255.
[15] 花静.儿童发育性协调障碍的早期识别和共病问题[J].中国儿童保健杂志,2025, 33(5): 465-471.
Hua J.Early identification and comorbidity of developmental coordination disorders in children[J].Chin J Child Health Care, 2025, 33(5): 465-471.(in Chinese)
[16] 中华预防医学会儿童保健分会,中国妇幼保健协会儿童早期发展专业委员会,中国康复医学会儿童康复专业委员会发育性协调障碍学组.儿童发育性协调障碍的筛查,评估和诊断指南(2025)[J].中华儿科杂志, 2025, 63(5): 444-453.
Child Health Branch, Chinese Preventive Medicine Association; Child Early Development Committee, Chinese Maternal and Child Health Association; Developmental Coordination Disorder Group, Pediatric Rehabilitation Committee, Chinese Association of Rehabilitation Medicin.Guideline for screening, assessment and diagnosis of developmental coordination disorder in children (2025)[J].Chin J Pediatr, 2025, 63(5): 444-453.(in Chinese)
[17] Lee EJ, Zwicker JG. Early identification of children with/at risk of developmental coordination disorder: A scoping review[J].Dev Med Child Neurol, 2021, 63(6): 649-658
[18] You HZ, Shi JY, Huang FF, et al.Advances in genetics and epigenetics of developmental coordination disorder in children[J].Brain Sci, 2023,13(6): 940.
[19] Mckenzie IA, Ohayon D, Li H, et al.Motor skill learning requires active central myelination[J].Science, 2014, 346(6207): 318-322.
[20] Subara-Zukic E, Cole MH, McGuckian TB, et al.Behavioral and neuroimaging research on developmental coordination disorder (DCD): A combined systematic review and Meta-analysis of recent findings[J].Front Psychol, 2022, 13: 809455.
[21] Emmenegger T, David G, Mohammadi S, et al.Temporal dynamics of white and gray matter plasticity during motor skill acquisition: A comparative diffusion tensor imaging and multiparametric mapping analysis[J].Cereb Cortex, 2024, 34(8): bhae344.
[22] Joshi S, Weedon BD, Esser P, et al.Neuroergonomic assessment of developmental coordination disorder[J].Sci Rep, 2022, 12(1): 10239.
[23] Emanuele M, Polletta G, Marini M,et al.Developmental coordination disorder: State of the art and future directions from a neurophysiological perspective[J].Children (Basel), 2022, 9(7):945.
[24] Guo XD, Li CT, Zhao J, et al. Adherence to different types of sports shapes motor competence development in preschool children[J].Sci Rep, 2025, 15(1): 26130.
[25] Gambra L, Cortese S, Lizoain P, et al. Excessive body weight in developmental coordination disorder: A systematic review and Meta-analysis[J].Neurosci Biobehav Rev, 2024, 164: 105806.
[26] 朱香昱,张旎,王端,等.儿童情绪行为问题—一个不能忽视的现象[J].中国实用儿科杂志, 2022, 37(11): 804-807.
Zhu XY, Zhang N, Wang D, et al.Emotional behavioral problems in children:A phenomenon that cannot be ignored[J].Chinese Journal of Practical Pediatrics, 2022, 37(11): 804-807.(in Chinese)
[27] Li JY, Jiang XP, Huang Z, et al.Exercise intervention and improvement of negative emotions in children: A Meta-analysis[J].BMC Pediatr, 2023, 23(1): 411.
基金
张家港市科技计划项目(ZKYL2323);张家港市科技计划项目(ZKYL2320)