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识别有持续发育迟缓高风险的婴幼儿。

Identifying Infants and Toddlers at High Risk for Persistent Delays.

作者信息

McManus Beth M, Robinson Cordelia C, Rosenberg Steven A

机构信息

Department of Health Systems, Management and Policy, Colorado School of Public Health, Children's Outcomes Research Group, Children's Hospital Colorado, 13001 E. 17th Place, MS B117, Aurora, CO, 80045, USA.

JFK Partners, University of Colorado School of Medicine, Aurora, CO, USA.

出版信息

Matern Child Health J. 2016 Mar;20(3):639-45. doi: 10.1007/s10995-015-1863-2.

Abstract

OBJECTIVES

Little is known about the extent to which a developmental delay identified in infancy persists into early childhood. This study examined the persistence of developmental delays in a large nationally representative sample of infants and toddlers who did not receive early intervention.

METHODS

In a sample (n ≈ 8700) derived from the early childhood longitudinal study, birth cohort, we examined developmental changes between 9 and 24 months. Motor and cognitive delays were categorized as none, mild, and moderate/severe. Adjusted ordinal logistic regression models estimated the likelihood of worse developmental delay at 24 months.

RESULTS

About 24 % of children had a cognitive delay and 27 % had a motor delay at either 9- or 24-months. About 77 % of children with mild and 70 % of children with moderate/severe cognitive or motor developmental delay at 9-months had no delay at 24-months. Children with mild cognitive delay at 9-months had 2.4 times the odds of having worse cognitive function at 24-months compared to children with no cognitive delay at 9 months. Children with moderate/severe cognitive delay at 9-months had three times the odds of having worse cognitive abilities at 24-months than children who had no cognitive delay at 9-months. Similar results were found for motor skills.

CONCLUSIONS

Developmental delays in infants are changeable, often resolving without treatment. This work provides knowledge about baseline trajectories of infants without and without cognitive and motor delays. It documents the proportion of children's delays that are likely to be outgrown without EI and the rate at which typically-developing infants are likely to display developmental delays at 2-years of age.

摘要

目的

对于婴儿期发现的发育迟缓持续至幼儿期的程度,人们了解甚少。本研究在一个未接受早期干预的、具有全国代表性的大型婴幼儿样本中,考察了发育迟缓的持续性。

方法

在取自儿童早期纵向研究出生队列的一个样本(n≈8700)中,我们考察了9至24个月之间的发育变化。运动和认知迟缓被分为无、轻度和中度/重度。经调整的有序逻辑回归模型估计了24个月时发育迟缓加重的可能性。

结果

约24%的儿童在9个月或24个月时存在认知迟缓,27%的儿童存在运动迟缓。9个月时存在轻度认知或运动发育迟缓的儿童中,约77%在24个月时无迟缓。9个月时存在轻度认知迟缓的儿童,与9个月时无认知迟缓的儿童相比,24个月时认知功能较差的几率是其2.4倍。9个月时存在中度/重度认知迟缓的儿童,与9个月时无认知迟缓的儿童相比,24个月时认知能力较差的几率是其3倍。运动技能方面也发现了类似结果。

结论

婴儿期的发育迟缓是可变的,通常无需治疗即可缓解。这项研究提供了关于有无认知和运动迟缓的婴儿基线轨迹的知识。它记录了在未接受早期干预的情况下可能不再存在发育迟缓的儿童比例,以及正常发育的婴儿在2岁时可能出现发育迟缓的比率。

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