School of Public Health, Addis Ababa University, Addis Ababa, Oromia, Ethiopia.
Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
J Epidemiol Community Health. 2020 Jun;74(6):489-594. doi: 10.1136/jech-2019-213019. Epub 2020 Mar 4.
Early childhood is a dynamic period of physical, psychosocial and cognitive development, where age appropriate intervention during the preschool years influences psychosocial, behavioural and academic achievement of children. This study evaluated the impact of a comprehensive preschool intervention on psychosocial, cognitive and behavioural school preparedness among children in Addis Ababa, Ethiopia.
Employing a cluster-sampling design, 150 preschool children who received the basic preschool curriculum (non-intervention) were compared with 100 randomly selected children who received a comprehensive preschool curriculum (intervention) using the Early Development Instrument (EDI) in five domains. Sample t-tests compared means of domain scores. Binary logistic regression analysed proportions of vulnerability in domains and overall.
There were no group differences in gender, age, special need status or child's first language. Intervention children had higher domain scores on social competence (mean difference 0.67 (SE=0.26)), emotional maturity (mean difference 0.77 (SE=0.29)), language and cognitive development (mean difference 0.67 (SE=0.40)), communication and general knowledge (mean difference 0.82 (SE=0.34)). Accounting for confounding variables, intervention children had a lower chance of overall vulnerability to domain problems (adjusted OR (AOR)=0.38; 95% CI 0.13 to 1.15), language and cognitive development (AOR=0.21; 95% CI 0.03 to 1.64), and social competence (AOR=0.20; 95% CI 0.08 to 0.45).
The comprehensive intervention was associated with better outcomes on early childhood development across four domains. It is recommended to extend this programme to other areas of Ethiopia, where children do not have appropriate school preparation, to reduce risk of school dropout, negative personal and societal outcomes.
儿童早期是身体、心理社会和认知发展的活跃时期，在此期间，对学龄前儿童进行适当年龄的干预会影响儿童的心理社会、行为和学业成就。本研究评估了综合学前干预对埃塞俄比亚亚的斯亚贝巴儿童心理社会、认知和行为上学准备的影响。
采用整群抽样设计，使用早期发展工具（EDI）在五个领域，将接受基本学前课程（非干预）的 150 名学龄前儿童与随机选择的 100 名接受综合学前课程（干预）的儿童进行比较。样本 t 检验比较了各领域得分的平均值。二元逻辑回归分析了各领域和整体脆弱性的比例。
组间在性别、年龄、特殊需求状况或儿童第一语言方面没有差异。干预儿童在社会能力（平均差异 0.67（SE=0.26））、情绪成熟度（平均差异 0.77（SE=0.29））、语言和认知发展（平均差异 0.67（SE=0.40））、沟通和一般知识（平均差异 0.82（SE=0.34））方面的领域得分更高。考虑到混杂变量，干预儿童整体面临领域问题的脆弱性较低（调整后的比值比（AOR）=0.38；95%CI 0.13 至 1.15）、语言和认知发展（AOR=0.21；95%CI 0.03 至 1.64）和社会能力（AOR=0.20；95%CI 0.08 至 0.45）。
综合干预与四个领域的儿童早期发展的更好结果相关。建议将该方案扩展到埃塞俄比亚其他地区，在这些地区，儿童没有适当的学校准备，以降低辍学风险、个人和社会负面后果。
