儿童心理行为发育问题预警征象在0～6岁儿童发育筛查中的应用价值OA
Application value of early warning signs for children's psychological and behavioral developmental problems in developmental screening of children aged 0 to 6 years
目的 探讨儿童心理行为发育问题预警征象(简称预警征)在 0～6 岁儿童发育筛查中的应用效果.方法 采用整群抽样法,选取 2023 年 1 月—2024 年 9 月在北京市朝阳区妇幼保健院发育行为门诊及语言门诊就诊的 0～6 岁儿童为研究对象,共纳入 230 名.所有儿童均采用格塞尔发育量表进行测评,同时实施预警征筛查,对相关测评数据进行分析和比较.结果 格塞尔发育量表测评结果显示,语言能区发育商的性别差异显著(P<0.05);适应性、大运动、精细动作、语言能区发育商的年龄差异显著(均 P<0.05);早产儿精细动作能区的发育商显著低于足月儿(P<0.05);低出生体质量儿的适应性、大运动、精细动作能区的发育商均显著低于正常出生体质量儿(均 P<0.05).预警征阳性条目数不同儿童的适应性、大运动、精细动作能区发育商的差异有统计学意义(均 P<0.05),预警征阳性条目数≥2 条者各能区发育商均呈低于阳性条目数 1 条及 0 条者的趋势.一致性分析发现:以格塞尔发育量表结果为参照标准,预警征检测的灵敏度为 91.4%,特异度为 4.9%;一致性检验Kappa 值为 0.04.结论 预警征对儿童心理行为问题的早期筛查具有重要意义,其灵敏度高但特异度偏低.因此,对筛查阳性儿童需进一步评估、定期监测随访,以避免出现假阳性率过高的情况.
Objective To explore the application value of early warning signs for children's psychological and behavioral developmental problems in developmental screening of children aged 0 to 6 years.Methods By cluster sampling method,a total of 230 children aged 0 to 6 years who visited the Developmental Behavioral Clinic and Language Clinic of Beijing Chaoyang Maternal and Child Health Care Hospital from January 2023 to September 2024 were enrolled as research subjects.All children were assessed with the Gesell developmental schedules and screened by the early warning signs simultaneously.The relevant data were analyzed and compared.Results The results of Gesell developmental schedules showed that there was a significant gender difference in developmental quotient of language domain(P<0.05);significant age differences were observed in the developmental quotients of adaptive behavior,gross motor,fine motor,and language domains(P<0.05).The developmental quotient of the fine motor domain in preterm infants was significantly lower than that in full-term infants(P<0.05).The developmental quotients of adaptive behavior,gross motor,and fine motor domains in low birth weight infants were significantly lower than those in normal birth weight infants(P<0.05).Significant differences were found in developmental quotients of adaptive behavior,gross motor,and fine motor domains among children with different numbers of positive early warning signs(P<0.05).Children with≥2 positive early warning signs tended to have lower developmental quotients in all domains compared with those with 1 and 0 positive early warning sign.Consistency analysis revealed that,using the results of the Gesell developmental schedules as the reference standard,the sensitivity of early warning signs screening was 91.4%and the specificity was 4.9%,with a Kappa value of 0.04 in consistency test.Conclusion Early warning signs are of great significance for the early screening of children's psychological and behavioral problems,and are characterized by high sensitivity but low specificity.Therefore,further evaluation,regular monitoring,and follow-up are required for children with positive screening results to reduce the high false-positive rate.
吕莹;段琳琳;王玲;李秋菊
北京市朝阳区妇幼保健院(中国 北京 100012)北京市朝阳区妇幼保健院(中国 北京 100012)北京市朝阳区妇幼保健院(中国 北京 100012)北京市朝阳区妇幼保健院(中国 北京 100012)
儿童心理行为发育问题预警征象格塞尔发育量表儿童发育筛查
early warning signs for children's psychological and behavioral developmental problemsGesell developmental schedulesdevelopmental screening of children
《教育生物学杂志》 2026 (4)
289-293,5
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