学龄前儿童发育性协调障碍危险因素分析

发布时间：2018-03-14 05:33

  本文选题：发育性协调障碍　切入点：家庭环境　出处：《苏州大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：探讨儿童的家庭环境、婴幼儿期早期动作发育及智商与学龄前儿童发育性协调障碍（Developmental Coordination Disorder, DCD）的相关性，为DCD的早期诊断和干预提供依据。 方法：根据知情同意的原则，在苏州市区随机整群抽取8所幼儿园，DCD诊断按照《美国精神障碍诊断与统计手册》第4版（DSM-IV）的诊断标准，采用儿童健康状况调查问卷评估儿童的家庭环境和动作发育情况，儿童运动评估成套实验（Movement Assessment Battery for Children, M-ABC）评定儿童的运动能力，韦克斯勒学龄前期儿童智力量表（Wechsler Preschool and Primary Scale of Intelligence,WPPSI）评估儿童的智商情况。 结果：①家庭住房面积中，在小面积和中面积住房儿童中，DCD的患病率高于大面积住房的儿童，并有显著性差异（X~2分别为12.86和20.93, P均小于0.01），在中面积住房儿童中，DCD的患病率仍高于大面积住房的儿童，亦有显著性差异（X~2=8.21, P0.01），表明家庭住房面积与DCD发病有关；家庭年收入中，低收入家庭儿童中，DCD的患病率高于中收入和高收入家庭的儿童，并有显著性差异（X~2分别为26.67和50.67，P均小于0.01），在中收入家庭儿童中，DCD的患病率仍高于高收入的家庭，亦有显著性差异（X~2=11.99, P0.01），表明家庭年收入与DCD发病相关；母亲文化程度中，小学及以下家庭的儿童中，DCD患病率高于中学和大学及以上家庭的儿童，有显著统计学差异（X~2分别为75.89和152.94，P均小于0.01），中学的家庭儿童中，DCD患病率仍高于大学及以上家庭的儿童，亦有显著统计学差异（X~2=16.63, P0.01），表明母亲的文化程度与DCD发病有关；父亲文化程度中，小学及以下家庭的儿童中，DCD患病率高于中学和大学及以上家庭的儿童，并有显著性差异（X~2分别为84.24和201.07，P均小于0.01）。中学的家庭儿童中，DCD患病率仍高于大学及以上家庭的儿童，亦有显著性差异（X~2=27.20, P0.01），表明父亲的文化程度与DCD发病相关；不同家庭结构及父母婚姻状况儿童中，DCD患病率无显著差异（X~2=2.41、0.92, P0.05）；Logistic回归分析显示DCD的影响因素分别为父亲文化程度、母亲文化程度、家庭年收入及家庭住房面积。②DCD组的儿童中，Kaup值均数为16.51±3.60，正常组儿童中Kaup值均数为16.22±2.04，经统计学检验，二组儿童中未呈现明显的统计学差异（t=1.055, P=0.292），提示DCD儿童中的体格生长均在正常值范围中；DCD组儿童中，开始独立坐的月龄为（7.50±1.71）月，而正常组儿童中为（6.95±1.55）月，DCD儿童明显晚于正常组儿童（t=3.288，P0.01），独立坐月龄≥8个月儿童中，DCD患病率高于6-7个月与7-8个月的儿童，并有统计学差异（X~2分别为21.23、49.11，P均小于0.01），而独立坐月龄在6-7个月与7-8个月儿童中，DCD患病率无显著性差异（X~2=3.76, P=0.53），表明儿童开始独立坐的时间晚于8个月与DCD发病有关；DCD组儿童中，开始独立爬的月龄为（8.95±2.33）月，而正常组儿童中为（8.25±1.83）月，DCD儿童明显晚于正常组儿童（t=3.306，P0.01），独立爬月龄≥9个月儿童中，DCD患病率高于7-8个月与8-9个月的儿童，并有统计学差异（X~2分别为6.502、9.915, P均小于0.01），而独立爬月龄7-8个月与8-9个月儿童中，DCD患病率无显著性差异（X~2=0.07, P=0.78），表明儿童开始独立爬的时间晚于9个月与DCD发病有关；DCD组儿童中，开始独立走的月龄为（13.13±2.13）月，而正常组儿童中为（12.63±1.62）月，DCD儿童明显晚于正常组儿童（t=2.671, P0.01），独立走月龄≥15个月儿童中，，DCD患病率高于12-13个月与13-15个月的儿童，并有统计学差异（X~2分别为15.11、30.17, P均小于0.01），而独立走月龄在12-13个月与13-15个月中，DCD儿童患病率无显著性差异（X~2=1.21，P=0.271），表明儿童开始独立走的时间晚于15个月与DCD发病有关；DCD组儿童中，开始独立进食的月龄为（18.98±6.50）月，而正常组儿童中为（18.96±7.54）月，二组儿童无统计学差异（t=0.033, P=0.974）；Logistic回归分析显示DCD的影响因素分别为独立爬的时间、独立坐的时间、独立走的时间。③DCD组儿童的总智商得分（94.34±6.37）显著低于正常组儿童（101.51±5.03），有统计学差异（t=6.79, P0.01），而操作智商中，其得分（88.49±9.48）亦显著低于正常组儿童（103.58±7.69），有统计学差异（t=9.50，P0.01），但在语言智商中，其得分（100.78±5.53）与正常组儿童语言智商得分（99.19±5.22）相比，未达到显著差异（t=1.61, P0.05）。DCD组智力不平衡的比例高于正常组儿童，差异统计学意义显著（X~2=9.465, P0.01）。 结论：①家庭环境中，父母亲的文化程度是DCD最主要的影响因素，父母的文化程度越低，其子女DCD的患病率越高；家庭住房面积与年收入也是DCD的影响因素，住房面积越小，年收入越低，DCD的患病率越高。②婴幼儿期动作发育推迟是DCD的危险因素，DCD组儿童独立坐、独立爬和独立走的时间均晚于正常组儿童；独立坐的时间≥8个月、独立爬的时间≥9个月、独立走的时间≥15个月是婴幼儿期DCD的危险因素。③学龄前儿童的智商偏低，尤其是操作智商偏低和智商发展不平衡是DCD的危险因素。
[Abstract]:Objective: To explore the correlation between children's family environment, early childhood motor development and intelligence quotient and Developmental Coordination Disorder (DCD), so as to provide evidence for early diagnosis and intervention of DCD.
Methods: according to the principle of informed consent, in 8 kindergartens in Suzhou city were randomly selected, according to the DCD diagnosis. American Diagnostic and Statistical Manual of mental disorders > Fourth Edition (DSM-IV) diagnostic criteria, the health status of children questionnaire assessing children's family environment and movement development, the movement assessment battery for children (Experiment Movement Assessment Battery for Children, M-ABC) to assess children's athletic ability, Wechsler preschool children intelligence scale (Wechsler Preschool and Primary Scale of Intelligence, WPPSI) to assess children's IQ.
Results: the family housing area, in a small area and in the area of housing in children, the prevalence rate of DCD is higher than that of children in a large area of housing, and there was significant difference (X~2 = 12.86 and 20.93, P were less than 0.01), in the area of housing in children, the prevalence of DCD was higher than that of a large area of housing the children also had a significant difference (X~2=8.21, P0.01), shows that family housing area associated with DCD; family income, children in low-income families, the prevalence rate of DCD is higher than the income and high income families, and there was significant difference (X~2 = 26.67 and 50.67, were less than P 0.01) in children, family income, the prevalence of DCD was still higher than high income families, there was significant difference (X~2=11.99, P0.01), shows that the associated with family income DCD; mother's education, primary school and below the families of children, the prevalence rate of DCD is higher than that in middle schools and University and above the families of children, with significant difference (X~2 = 75.89 and 152.94, P were less than 0.01), middle school children, the prevalence rate of DCD was higher than that of college and above the families of children, also have significant difference (X~2=16.63, P0.01), showed that the degree of mother culture associated with DCD; father's education, primary school and below the families of children, the prevalence of DCD was higher in high school and college and above the families of children, and there was significant difference (X~2 = 84.24 and 201.07, P were less than 0.01). Middle school children, the prevalence rate of DCD was higher than that of college and above the families of children. There was also a significant difference (X~2=27.20, P0.01), suggesting that the onset of culture degree and DCD father; children of different family structure and marriage status of parents, the prevalence rate of DCD had no significant difference (X~2=2.41,0.92, P0.05); Logistic regression analysis showed that DCD 褰卞搷鍥犵礌鍒嗗埆涓虹埗浜叉枃鍖栫▼搴

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