Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Am J Prev Med. 2019 Apr;56(4):530-539. doi: 10.1016/j.amepre.2018.11.018. Epub 2019 Feb 14.
A negative relationship between adverse childhood experiences and both physical and mental health in adulthood is well established, as is the positive impact of parenting on child development and future health. However, few studies have investigated unique influences of adverse childhood experiences and positive parenting together within a large, diverse early childhood sample.
The study used data on all children aged 0-5 years (n=29,997) from the National Survey of Children's Health 2011/2012 to examine effects of positive parenting practices and adverse childhood experiences on early childhood social-emotional skills and general development. All analyses were performed in 2017 and 2018.
More than a third of the sample reported experiencing at least one adverse childhood experience. More than a fourth (26.7%) met study criteria for social-emotional deficits, and 26.2% met criteria for developmental delay risks. The number of adverse childhood experiences exhibited negative marginal associations with social-emotional deficits and developmental delay risks, whereas the number of positive parenting practices showed independent protective effects. Risks associated with an absence of positive parenting were often greater than those of four or more adverse childhood experiences, even among no/low adversity families. The population attributable fractions for social-emotional deficits and developmental delay risks were 17.3% and 13.9% (translating to prevalence reductions of 4.5% and 3.6%) when adopting all positive parenting practices and 4.5% and 7.2% (prevalence reductions of 1.2% and 1.9%) when eliminating adverse childhood experiences.
The number of adverse childhood experiences was associated with both social-emotional deficits and developmental delay risks in early childhood; however, positive parenting practices demonstrated robust protective effects independent of the number of adverse childhood experiences. This evidence further supports promotion of positive parenting practices at home, especially for children exposed to high levels of adversity.
不良的儿童期经历与成年期的身心健康呈负相关，这一点已得到充分证实，而育儿对儿童发展和未来健康的积极影响也同样得到了证实。然而，在一个大型的、多样化的幼儿样本中，很少有研究调查不良儿童经历和积极育儿的共同影响。
本研究使用了 2011/2012 年全国儿童健康调查中所有 0-5 岁儿童（n=29997）的数据，以调查积极的育儿实践和不良儿童经历对幼儿社会情感技能和全面发展的影响。所有分析均于 2017 年和 2018 年进行。
超过三分之一的样本报告至少经历过一次不良的儿童期经历。超过四分之一（26.7%）的儿童符合社会情感缺陷的研究标准，26.2%的儿童符合发育迟缓风险的标准。不良儿童经历的数量与社会情感缺陷和发育迟缓风险呈负相关，而积极的育儿实践则表现出独立的保护作用。缺乏积极育儿的风险往往大于经历四种或更多不良儿童经历的风险，即使在没有/低不良经历的家庭中也是如此。采用所有积极的育儿实践可使社会情感缺陷和发育迟缓风险的人群归因分数分别降低 4.5%和 3.6%（即患病率分别降低 1.2%和 1.9%），消除不良儿童经历可使社会情感缺陷和发育迟缓风险的人群归因分数分别降低 4.5%和 7.2%（即患病率分别降低 1.2%和 1.9%）。
儿童期经历的数量与幼儿的社会情感缺陷和发育迟缓风险都有关；然而，积极的育儿实践表现出了强大的保护作用，独立于不良儿童经历的数量。这一证据进一步支持在家中推广积极的育儿实践，尤其是对那些经历过高逆境的儿童。
