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婴幼儿发育迟缓中父母关注与专业评估之间的关系——一项基于医院的研究。

The relationship between parental concerns and professional assessment in developmental delay in infants and children--a hospital-based study.

作者信息

Chen I-Chun, Lee Hsin-Chien, Yeh Geng-Chang, Lai Chien-Hong, Chen Shih-Ching

机构信息

Department of Physical Medicine and Rehabilitation, Taipei Medical University and Hospital, Taipei, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2004 May;67(5):239-44.

Abstract

BACKGROUND

Developmental delay (DD) in infants and children is one of the chief complaints of parents. It has been established that the concerns of parents are as accurate as quality screening tests. Some kinds of concerns are particularly useful in the early detection of associated developmental problems. The purpose of this study was to investigate the relationship between the main parental concerns and the final diagnosis based on professional assessment of children who are suspected to have DD.

METHODS

One-hundred and 1 infants or children were recruited into this study. The major concerns of parents were elicited and categorized by various developmental domains: speech, motor, behavioral, cognitive, global, and non-specific developmental problems. All children underwent comprehensive combined assessments by professionals in the hospital, and were classified into 6 subtypes: speech, motor, behavioral, cognitive, and global DD, and normal development.

RESULTS

Our results revealed that parental concerns about speech, motor, and behavioral development yielded a high sensitivity to the final diagnosis of the same developmental domain (77-89%). However, concerns about cognitive and global DD had limited sensitivity (15-36%). On the other hand, concerns about global, speech, and motor DD had relatively higher positive predictive values (55-77%). Comparatively, cognitive or behavioral concerns had lower positive predictive values (25-33%).

CONCLUSIONS

Such results indicate that parents play an important role in detecting speech, motor and behavioral DD in children. Parental concerns about cognition and behavior should be questioned in terms of their association with the real problem. This information may be useful in establishing trends in understanding the discrepancy or relationship between parental concerns and professional assessments in DD.

摘要

背景

婴幼儿发育迟缓(DD)是家长们的主要诉求之一。已经确定,家长们的担忧与高质量筛查测试的准确性相当。某些担忧在早期发现相关发育问题方面特别有用。本研究的目的是调查家长的主要担忧与基于对疑似患有DD儿童的专业评估得出的最终诊断之间的关系。

方法

本研究招募了101名婴幼儿。家长的主要担忧通过各种发育领域进行引出和分类:言语、运动、行为、认知、整体和非特异性发育问题。所有儿童均在医院接受了专业人员的综合联合评估,并被分为6种亚型:言语、运动、行为、认知和整体发育迟缓,以及发育正常。

结果

我们的结果显示,家长对言语、运动和行为发育的担忧对相同发育领域的最终诊断具有较高的敏感性(77 - 89%)。然而,对认知和整体发育迟缓的担忧敏感性有限(15 - 36%)。另一方面,对整体、言语和运动发育迟缓的担忧具有相对较高的阳性预测值(55 - 77%)。相比之下,对认知或行为的担忧阳性预测值较低(25 - 33%)。

结论

这些结果表明,家长在检测儿童言语、运动和行为发育迟缓方面发挥着重要作用。家长对认知和行为的担忧与实际问题的关联值得质疑。这些信息可能有助于确立理解家长担忧与发育迟缓专业评估之间差异或关系的趋势。

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