Laucht M, Esser G, Schmidt M H, Ihle W, Löffler W, Stöhr R M, Weindrich D, Weinel H
Kinder- und Jugend-psychiatrische Klinik, Zentralinstitut für Seelische Gesundheit, Mannheim.
Prax Kinderpsychol Kinderpsychiatr. 1992 Oct;41(8):274-85.
In a prospective longitudinal study the development of N = 362 children will be followed over four time points (T1-T4) from birth to school age utilizing a comprehensive battery of instruments. Aims of the study are the description of the developmental course of children born at differing degrees of biological and psychosocial risk, the identification of early predictors of developmental disorders and their compensation, as well as the analysis of the processes and mechanisms underlying differential developmental patterns. The results of waves 1 and 2 show that early development from 3 to 24 months is quite unstable. Depending on the examined domain of development up to 3/4 of the disturbances of infancy have remitted by the later age, whereas nearly a fifth of the hitherto well children developed new disturbances. Both risks have a marked negative effect on development. While biological risks go hand in hand with impaired motor functioning, psychosocial risks adversely affect cognitive and social-emotional competence. However, the relative weight of risk factors changes during the first two years with biological risks becoming less important and psychosocial risk factors gaining influence. Single risk factors identified as being prognostically very unfavourable are very low birth weight and neonatal seizures. Of the psychosocial risks a pattern of unfavourable family characteristics such as low educational level, history of broken home or mental health problems of parents and chronic difficulties is related most strongly to poor outcome.
在一项前瞻性纵向研究中，将使用一系列综合工具，对362名儿童从出生到学龄的四个时间点（T1 - T4）的发育情况进行跟踪。该研究的目的是描述出生时面临不同程度生物和心理社会风险的儿童的发育过程，确定发育障碍的早期预测因素及其代偿情况，以及分析不同发育模式背后的过程和机制。第一波和第二波的结果表明，3至24个月的早期发育相当不稳定。根据所考察的发育领域，高达3/4的婴儿期障碍到后期已缓解，而近五分之一此前发育良好的儿童出现了新的障碍。这两种风险都对发育有显著的负面影响。生物风险与运动功能受损相伴，而心理社会风险则对认知和社会情感能力产生不利影响。然而，在头两年中，风险因素的相对权重发生了变化，生物风险变得不那么重要，而心理社会风险因素的影响则在增加。被确定为预后非常不利的单一风险因素是极低出生体重和新生儿惊厥。在心理社会风险中，诸如低教育水平、家庭破裂史、父母心理健康问题和长期困难等不利家庭特征模式与不良结局的关联最为密切。
