澳大利亚偏远地区胎儿酒精谱系障碍儿童的运动技能损害：利利万项目
Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project.
作者信息
Lucas Barbara R, Doney Robyn, Latimer Jane, Watkins Rochelle E, Tsang Tracey W, Hawkes Genevieve, Fitzpatrick James P, Oscar June, Carter Maureen, Elliott Elizabeth J
机构信息
Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Sydney, Australia.
The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
出版信息
Drug Alcohol Rev. 2016 Nov;35(6):719-727. doi: 10.1111/dar.12375. Epub 2016 Feb 16.
INTRODUCTION AND AIMS
We aimed to characterise motor performance in predominantly Aboriginal children living in very remote Australia, where rates of prenatal alcohol exposure (PAE) are high. Motor performance was assessed, and the relationship between motor skills, fetal alcohol spectrum disorders (FASD) and PAE was explored.
DESIGN AND METHODS
Motor performance was assessed using the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition Complete Form, in a population-based study of children born in 2002 or 2003 living in the Fitzroy Valley, Western Australia. Composite scores ≥2SD (2nd percentile) and ≥1SD (16th percentile) below the mean were used respectively for FASD diagnosis and referral for treatment. FASD diagnoses were assigned using modified Canadian Guidelines.
RESULTS
A total of 108 children (Aboriginal: 98.1%; male: 53%) with a mean age of 8.7 years was assessed. The cohort's mean total motor composite score (mean ± SD 47.2 ± 7.6) approached the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition normative mean (50 ± 10). Motor performance was lower in children with FASD diagnosis than without (mean difference (MD) ± SD: -5.0 ± 1.8; confidence interval: -8.6 to -1.5). There was no difference between children with PAE than without (MD ± SE: -2.2 ± 1.5; confidence interval: -5.1 to 0.80). The prevalence of motor impairment (≥-2SD) was 1.9% in the entire cohort, 9.5% in children with FASD, 3.3% in children with PAE and 0.0% both in children without PAE or FASD.
DISCUSSION AND CONCLUSIONS
Almost of 10% of children with FASD has significant motor impairment. Evaluation of motor function should routinely be included in assessments for FASD, to document impairment and enable targeted early intervention.[Lucas BR, Doney R, Latimer J, Watkins RE, Tsang TW, Hawkes G, Fitzpatrick JP, Oscar J, Carter M, Elliott EJ. Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project. Drug Alcohol Rev 2016;35:719-727].
引言与目的
我们旨在描述生活在澳大利亚极偏远地区的原住民儿童的运动表现，该地区产前酒精暴露（PAE）率很高。对运动表现进行了评估，并探讨了运动技能、胎儿酒精谱系障碍（FASD）和PAE之间的关系。
设计与方法
在一项基于人群的研究中，使用布鲁因inks - 奥塞雷茨基运动熟练度测试第二版完整表格，对2002年或2003年出生在西澳大利亚菲茨罗伊山谷的儿童进行运动表现评估。分别使用低于平均值≥2标准差（第2百分位数）和≥1标准差（第16百分位数）的综合分数进行FASD诊断和转介治疗。FASD诊断采用改良的加拿大指南。
结果
共评估了108名儿童（原住民：98.1%；男性：53%），平均年龄8.7岁。该队列的平均总运动综合分数（平均值±标准差47.2±7.6）接近布鲁因inks - 奥塞雷茨基运动熟练度测试第二版的标准平均值（50±10）。FASD诊断儿童的运动表现低于未诊断儿童（平均差异（MD）±标准差：-5.0±1.8；置信区间：-8.6至-1.5）。有PAE的儿童与无PAE的儿童之间无差异（MD±标准误：-2.2±1.5；置信区间：-5.1至0.80）。整个队列中运动障碍（≥-2标准差）的患病率为1.9%，FASD儿童中为9.5%，有PAE的儿童中为3.3%，无PAE或FASD的儿童中为0.0%。
讨论与结论
几乎10%的FASD儿童存在明显的运动障碍。FASD评估应常规纳入运动功能评估，以记录障碍并实现有针对性的早期干预。[卢卡斯BR，多尼R，拉蒂默J，沃特金斯RE，曾TW，霍克斯G，菲茨帕特里克JP，奥斯卡J，卡特M，埃利奥特EJ。澳大利亚偏远地区胎儿酒精谱系障碍儿童的运动技能损害：利利万项目。药物酒精评论2016；35：719 - 727]
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