婴幼儿期单缝颅缝早闭患儿的行为调整。
Behavioral adjustment of toddler and preschool-aged children with single-suture craniosynostosis.
机构信息
Chicago, Ill.; Seattle, Wash.; St. Louis, Mo.; and Atlanta, Ga. From the Department of Surgery, Northwestern University; Departments of Psychology and Plastic Surgery, Shriners Hospital for Children; Psychiatry and Behavioral Medicine, Seattle Children's Hospital; Departments of Psychiatry and Behavioral Sciences and Epidemiology, University of Washington; Department of Psychology, The Chicago School of Professional Psychology; Department of Psychology, St. Louis Children's Hospital; Department of Pediatrics, Washington University School of Medicine; Craniofacial Team, Children's Healthcare of Atlanta.
出版信息
Plast Reconstr Surg. 2012 Sep;130(3):635-647. doi: 10.1097/PRS.0b013e31825dc18b.
BACKGROUND
The purpose of this study was to confirm initial reports of elevated behavior problems in children with single-suture craniosynostosis, using multiple informants, longitudinal analyses, and a control group. The authors hypothesized that children with single-suture craniosynostosis would have higher levels of maladjustment than comparison children, particularly at the older age and in selected areas of previously observed vulnerability: attention and social adjustment.
METHODS
The Child Behavior Checklist was completed by 436 mothers (219 with single-suture craniosynostosis) and 371 fathers (177 with single-suture craniosynostosis) when children were aged approximately 19 months, and by 361 mothers (175 with single-suture craniosynostosis) and 303 fathers (142 with single-suture craniosynostosis) when children were aged approximately 37 months. A minimum of one caregiver/teacher report was available for 169 of these children (74 with single-suture craniosynostosis) using the Caregiver-Teacher Report Form.
RESULTS
Average Child Behavior Checklist/Caregiver-Teacher Report Form externalizing, internalizing, and total scores for all informants were consistently higher (worse) for children with single-suture craniosynostosis than for control group children, but most differences were small and statistically nonsignificant. No differences associated with suture site were found. At the oldest age point, both mothers and fathers (but not teachers) generated higher average scores for patients than for controls on scales measuring attention and social problems, with small to medium effect sizes (0.20 to 0.32).
CONCLUSIONS
On average, toddlers/preschoolers with single-suture craniosynostosis show behavioral development that is largely indistinguishable from same-aged peers of similar socioeconomic background. The predictive significance of small group differences in attention and social adjustment will be assessed in a follow-up of this cohort at age 7.
背景
本研究的目的是通过多信息源、纵向分析和对照组，证实先前报道的单一颅缝早闭儿童行为问题增加的现象。作者假设，单一颅缝早闭儿童的适应不良水平会高于对照组儿童，尤其是在年龄较大和之前观察到的脆弱领域：注意力和社会适应。
方法
当儿童大约 19 个月大时，436 名母亲（219 名患有单一颅缝早闭）和 371 名父亲（177 名患有单一颅缝早闭）填写了儿童行为检查表，当儿童大约 37 个月大时，361 名母亲（175 名患有单一颅缝早闭）和 303 名父亲（142 名患有单一颅缝早闭）填写了儿童行为检查表。使用照顾者-教师报告表，至少有一名照顾者/教师为其中 169 名儿童（74 名患有单一颅缝早闭）提供了报告。
结果
所有信息源的儿童行为检查表/照顾者-教师报告表的平均外部、内部和总分对于单一颅缝早闭儿童来说都高于（更差）对照组儿童，但大多数差异较小且无统计学意义。未发现与缝合线位置相关的差异。在最年长的年龄点，母亲和父亲（但不是教师）在测量注意力和社会问题的量表上为患者生成的平均得分均高于对照组，具有小到中等的效应量（0.20 至 0.32）。
结论
平均而言，单一颅缝早闭的幼儿/学龄前儿童的行为发展与具有相似社会经济背景的同龄儿童基本无法区分。在对该队列进行 7 岁时的随访中，将评估在注意力和社会适应方面小群体差异的预测意义。
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