Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India.
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.
Indian J Pediatr. 2018 Jul;85(7):498-503. doi: 10.1007/s12098-018-2613-4. Epub 2018 Feb 1.
To examine the impact of quality of early stimulation on cognitive functioning of toddlers living in a developing country.
The developmental functioning of 150 toddlers in the age range of 12-30 mo (53% boys; Mean = 1.76 y, SD = 0.48) was assessed by the mental developmental index of the Developmental Assessment Scale for Indian Infants (DASII). The StimQ questionnaire- toddler version was used to measure cognitive stimulation at home. The questionnaire consists of four subscales including availability of learning materials (ALM), reading activities (READ), parent involvement in developmental activities (PIDA), and parent verbal responsivity (PVR). Multivariate regression analysis was used to predict cognitive scores using demographic (age of child), socio-economic status (SES) (income, parental education), and home environment (subscale scores of StimQ) as independent variables.
Mean Mental Development Index (MDI) score was 91.5 (SD = 13.41), nearly one-fifth (17.3%) of the toddlers had MDI scores less than 80 (cognitive delay). Children with cognitive delay, relative to typically developing (TD, MDI score ≥ 80) cohort of toddlers, had significantly lower scores on all the subscales of StimQ and the total StimQ score. Despite the overall paucity of learning materials available to toddlers, typical developing toddlers were significantly more likely to have access to symbolic toys (P = 0.004), art materials (P = 0.032), adaptive/fine motor toys (P = 0.018), and life size toys (P = 0.036). Multivariate regression analysis results indicated that controlling for confounding socio-economic status variables, higher parental involvement in developmental activities (PIDA score) and higher parental verbal responsivity (PVR score) emerged as significant predictors of higher MDI scores and explained 34% of variance in MDI scores (F = 23.66, P = 0.001).
Disparities in child development emerge fairly early and these differences are not all linked to economic disparities. There is a need to develop evidence-based parenting interventions for primary prevention of developmental problems, especially in resource poor countries.
探讨发展中国家婴幼儿早期刺激质量对认知功能的影响。
采用印度婴幼儿发育评估量表(DASII)的心理发育指数评估 150 名 12-30 月龄(53%为男孩;平均年龄 1.76 岁,标准差 0.48 岁)婴幼儿的发育功能。使用 StimQ 问卷-幼儿版评估家庭中的认知刺激。问卷包括 4 个分量表,包括学习材料的可用性(ALM)、阅读活动(READ)、父母参与发展活动(PIDA)和父母言语反应性(PVR)。采用多元回归分析,以人口统计学(儿童年龄)、社会经济地位(SES)(收入、父母教育)和家庭环境(StimQ 分量表得分)为自变量,预测认知评分。
平均心理发育指数(MDI)评分为 91.5(标准差 13.41),近五分之一(17.3%)的婴幼儿 MDI 评分低于 80(认知延迟)。与认知正常(MDI 评分≥80)的婴幼儿相比,认知延迟的婴幼儿在 StimQ 的所有分量表和 StimQ 总分上的得分均显著较低。尽管婴幼儿可获得的学习材料总体匮乏,但认知正常的婴幼儿更有可能获得象征性玩具(P=0.004)、艺术材料(P=0.032)、适应/精细运动玩具(P=0.018)和生活大小的玩具(P=0.036)。多元回归分析结果表明,在控制混杂的社会经济地位变量后,父母更多地参与发育活动(PIDA 评分)和更高的父母言语反应性(PVR 评分)成为 MDI 评分较高的显著预测因素,解释了 MDI 评分 34%的变异(F=23.66,P=0.001)。
儿童发育方面的差异很早就出现了,这些差异并非都与经济差异有关。需要制定基于证据的育儿干预措施,以预防发展问题,特别是在资源匮乏的国家。