Romano Elisa, Tremblay Richard E, Farhat Abdeljelil, Côté Sylvana
School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
Pediatrics. 2006 Jun;117(6):2101-10. doi: 10.1542/peds.2005-0651.
Children with hyperactive symptoms are often referred to mental health services. Given the frequency and persistent nature of hyperactivity, it is important to better understand its developmental course. This study identified the different developmental trajectories of hyperactive symptoms from 2 to 7 years and tested early predictors of high-level and persistent hyperactivity. These data may lead to earlier detection of at-risk children and to more effective interventions that take into account developmental considerations.
Four data-collection cycles of a nationwide survey of Canadian children were used to track the early development of hyperactivity. Children were 0 to 23 months at the first cycle in 1994 and 6 to 7 years at the fourth cycle in 2000.
Hyperactivity data were gathered from mothers on a biennial basis beginning when children were 24 months old. Information on potential prenatal and postnatal predictors was gathered from mothers at the first cycle.
Group-based semiparametric mixture modeling was used to estimate developmental trajectories, and logistic-regression analysis identified predictors of hyperactivity.
Four trajectories of hyperactive symptoms were identified: very low, low, moderate, and high. Statistically significant predictors for high and persistent hyperactivity, after controlling for all other factors, were maternal prenatal smoking, child male gender, maternal depression, and hostile parenting.
For the majority of children, the frequency of hyperactive symptoms decreased or remained low from 2 to 7 years. However, 7 children in 100 were classified as having high initial levels of hyperactive symptoms that persisted over time. Several prenatal and early postnatal risk factors identified these children, although additional variables will need to be identified to accurately predict high and persistent hyperactivity. Findings suggest that preventive interventions could target high-risk families during pregnancy and early childhood.
有多动症状的儿童常常会被转介至心理健康服务机构。鉴于多动症状出现的频率及其持续性，更好地了解其发展过程很重要。本研究确定了2至7岁多动症状的不同发展轨迹，并测试了高水平和持续性多动的早期预测因素。这些数据可能有助于更早地发现有风险的儿童，并采取更有效的干预措施，同时考虑到发展因素。
利用对加拿大儿童进行的全国性调查的四个数据收集周期来追踪多动症状的早期发展情况。1994年第一个周期时儿童年龄为0至23个月，2000年第四个周期时儿童年龄为6至7岁。
从孩子24个月大开始，每两年从母亲那里收集一次多动症状数据。在第一个周期从母亲那里收集有关潜在产前和产后预测因素的信息。
采用基于群体的半参数混合模型来估计发展轨迹，逻辑回归分析确定多动症状的预测因素。
确定了多动症状的四种轨迹：极低、低、中度和高。在控制了所有其他因素后，高水平和持续性多动的统计学显著预测因素为母亲产前吸烟、儿童男性性别、母亲抑郁和敌意育儿方式。
对于大多数儿童来说，多动症状的频率从2岁到7岁会降低或保持在低水平。然而，每100名儿童中有7名被归类为初始多动症状水平较高且随时间持续存在。几个产前和产后早期风险因素可识别出这些儿童，不过还需要确定其他变量以准确预测高水平和持续性多动。研究结果表明，预防性干预措施可以针对孕期和幼儿期的高危家庭。
