Department of Paediatrics, Faculty of Medicine, University of Calgary, Alberta, Canada.
BMC Pediatr. 2010 Mar 25;10:19. doi: 10.1186/1471-2431-10-19.
Children at highest risk of developmental problems benefit from early identification and intervention. Investigating factors affecting child development at the time of transition to school may reveal opportunities to tailor early intervention programs for the greatest effectiveness, social benefit and economic gain. The primary objective of this study was to identify child and maternal factors associated with children who screened at risk of developmental problems at school entry.
An existing cohort of 791 mothers who had been followed since early pregnancy was mailed a questionnaire when the children were aged four to six years. The questionnaire included a screening tool for developmental problems, an assessment of the child's social competence, health care utilization and referrals, and maternal factors, including physical health, mental health, social support, parenting morale and sense of competence, and parenting support/resources.
Of the 491 mothers (62%) who responded, 15% had children who were screened at high risk of developmental problems. Based on a logistic regression model, independent predictors of screening at high risk for developmental problems at age 5 were male gender (OR: 2.3; 95% CI: 1.3, 4.1), maternal history of abuse at pregnancy (OR: 2.4; 95% CI: 1.3, 4.4), and poor parenting morale when the child was 3 years old (OR: 3.9; 95% CI: 2.1, 7.3). A child with all of these risk factors had a 35% predicted probability of screening at high risk of developmental problems, which was reduced to 13% if maternal factors were favourable.
Risk factors for developmental problems at school entry are related to maternal well being and history of abuse, which can be identified in the prenatal period or when children are preschool age.
发育问题风险最高的儿童受益于早期识别和干预。研究影响儿童在入学过渡期发展的因素可能揭示机会，以定制最有效的早期干预计划，实现最大的社会效益和经济效益。本研究的主要目的是确定与入学时筛查出发育问题风险的儿童相关的儿童和产妇因素。
一项现有的队列研究纳入了 791 名自早孕以来一直随访的母亲，当孩子 4 至 6 岁时，向她们邮寄了一份问卷。问卷包括发育问题筛查工具、儿童社会能力评估、医疗保健利用和转诊情况，以及产妇因素，包括身体健康、心理健康、社会支持、育儿士气和能力感、育儿支持/资源。
在 491 名（62%）回应的母亲中，有 15%的孩子筛查出发育问题高风险。基于逻辑回归模型，5 岁时筛查出发育问题高风险的独立预测因素是男性性别（OR：2.3；95%CI：1.3，4.1）、妊娠时产妇受虐待史（OR：2.4；95%CI：1.3，4.4）和孩子 3 岁时育儿士气差（OR：3.9；95%CI：2.1，7.3）。如果产妇因素良好，具有所有这些风险因素的儿童筛查出发育问题高风险的预测概率为 35%，降至 13%。
入学时发育问题的风险因素与产妇的健康状况和受虐待史有关，这些因素可以在产前或儿童学龄前识别。
