Briggs-Gowan Margaret J, Carter Alice S
Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Ave, MC-1410, Farmington, CT 06030, USA.
Pediatrics. 2008 May;121(5):957-62. doi: 10.1542/peds.2007-1948.
The goal was to examine whether children who screen positive for social-emotional/behavioral problems at 12 to 36 months of age are at elevated risk for social-emotional/behavioral problems in early elementary school.
The sample studied (N = 1004) comprised an ethnically (33.3% minority) and socioeconomically (17.8% living in poverty and 11.3% living in borderline poverty) diverse, healthy, birth cohort from a metropolitan region of the northeastern United States. When children were 12 to 36 months of age (mean age: 23.8 months; SD: 7.1 months), parents completed the Brief Infant-Toddler Social and Emotional Assessment and questions concerning their level of worry about their child's behavior, emotions, and social development. When children were in early elementary school (mean age: 6.0 years; SD: 0.4 years), parents completed the Child Behavior Checklist and teachers completed the Teacher Report Form regarding behavioral problems. In a subsample (n = 389), parents reported child psychiatric status.
Brief Infant-Toddler Social and Emotional Assessment screen status and parental worry were associated significantly with school-age symptoms and psychiatric disorders. In multivariate analyses that included Brief Infant-Toddler Social and Emotional Assessment status and parental worry, Brief Infant-Toddler Social and Emotional Assessment scores significantly predicted all school-age problems, whereas worry predicted only parent reports with the Child Behavior Checklist. Children with of-concern scores on the problem scale of the Brief Infant-Toddler Social and Emotional Assessment were at increased risk for parent-reported subclinical/clinical levels of problems and for psychiatric disorders. Low competence scores predicted later teacher-reported subclinical/clinical problems and parent-reported disorders. Worry predicted parent-reported subclinical/clinical problems. Moreover, the Brief Infant-Toddler Social and Emotional Assessment identified 49.0% of children who exhibited subclinical/clinical symptoms according to teachers and 67.9% of children who later met the criteria for a psychiatric disorder.
Screening with a standardized tool in early childhood has the potential to identify the majority of children who exhibit significant emotional/behavioral problems in early elementary school.
本研究旨在探讨12至36个月大时社会情感/行为问题筛查呈阳性的儿童在小学早期出现社会情感/行为问题的风险是否升高。
研究样本(N = 1004)来自美国东北部一个大都市地区,是一个种族多样(33.3%为少数族裔)、社会经济状况各异(17.8%生活在贫困中,11.3%生活在边缘贫困中)的健康出生队列。当儿童12至36个月大时(平均年龄:23.8个月;标准差:7.1个月),父母完成《婴幼儿社会和情感简短评估》以及关于他们对孩子行为、情绪和社会发展担忧程度的问题。当儿童进入小学早期时(平均年龄:6.0岁;标准差:0.4岁),父母完成《儿童行为清单》,教师完成关于行为问题的《教师报告表》。在一个子样本(n = 389)中,父母报告了孩子的精神状态。
《婴幼儿社会和情感简短评估》筛查状态及父母担忧与学龄期症状和精神障碍显著相关。在纳入《婴幼儿社会和情感简短评估》状态及父母担忧的多变量分析中,《婴幼儿社会和情感简短评估》得分显著预测了所有学龄期问题,而担忧仅预测了父母在《儿童行为清单》中的报告。在《婴幼儿社会和情感简短评估》问题量表上得分令人担忧的儿童,父母报告的亚临床/临床问题水平及精神障碍风险增加。低能力得分预测了后来教师报告的亚临床/临床问题及父母报告的障碍。担忧预测了父母报告的亚临床/临床问题。此外,《婴幼儿社会和情感简短评估》识别出49.0%根据教师表现出亚临床/临床症状的儿童,以及67.9%后来符合精神障碍标准的儿童。
在幼儿期使用标准化工具进行筛查有可能识别出大多数在小学早期出现显著情绪/行为问题的儿童。