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身体惩戒、剥夺与 17 个国家发展迟缓的差异风险。

Physical Discipline, Deprivation, and Differential Risk of Developmental Delay Across 17 Countries.

机构信息

Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts.

Massachusetts Department of Public Health, Boston.

出版信息

J Am Acad Child Adolesc Psychiatry. 2021 Feb;60(2):296-306. doi: 10.1016/j.jaac.2020.02.016. Epub 2020 Mar 19.

DOI:10.1016/j.jaac.2020.02.016
PMID:32201317
Abstract

OBJECTIVE

Parenting behaviors have been studied largely in isolation with regard to child development in cross-national contexts. We examine and compare the relative strength of association between physical discipline and deprivation with risk of children's socioemotional and cognitive developmental delay in a cross-national sample.

METHOD

The sample was drawn from the UNICEF Multiple Indicator Cluster Survey. Analyses used observations with data on parental physical discipline, parenting behaviors associated with deprivation, and child developmental outcomes. The present analysis included 29,792 children aged 36-59 months across 17 countries. Using the Early Child Development Index, risk for cognitive or socioemotional developmental delay was indicated if a child could not accomplish 2 or more items within that specific subdomain. Overall risk for delay was indicated if a child was at risk in either subdomain. Associations among discipline, deprivation, and delay were assessed using multivariable logistic regression.

RESULTS

Five of the 7 exposures were associated with risk of overall developmental delay. Physical discipline (odds ratio [OR] = 1.49 [95% CI = 1.39, 1.59]; p < .001) had the largest association with risk for socioemotional delay. Not having books (OR = 1.62 [95% CI = 1.42, 1.84]; p < .001) and not counting with the child (OR = 1.47 [95% CI = 1.32, 1.64]; p < .001) had the largest associations with risk of cognitive delay.

CONCLUSION

The exposures of physical discipline and deprivation measured here have distinct associations with risk of socioemotional and cognitive delay cross-nationally. Programmatic and clinical interventions should seek to act on adversities that are relevant to the targeted delay.

摘要

目的

在跨国背景下,父母教养行为在儿童发展方面的研究大多是孤立进行的。我们在跨国样本中检查和比较了身体惩戒和剥夺与儿童社会情感和认知发展延迟风险之间的关联相对强度。

方法

该样本来自联合国儿童基金会多指标类集调查。分析使用了关于父母身体惩戒、与剥夺相关的养育行为以及儿童发展结果的数据进行观察。本分析包括来自 17 个国家的 29792 名 36-59 个月大的儿童。使用早期儿童发展指数,如果儿童在特定子领域内无法完成 2 项或更多项目,则表示认知或社会情感发育迟缓的风险。如果儿童在任何一个子领域内存在风险,则表示存在总体发育迟缓的风险。使用多变量逻辑回归评估纪律、剥夺和延迟之间的关联。

结果

7 种暴露因素中有 5 种与整体发育延迟风险相关。身体惩戒(优势比[OR] = 1.49 [95%置信区间[CI] = 1.39, 1.59];p <.001)与社会情感延迟风险的关联最大。没有书(OR = 1.62 [95% CI = 1.42, 1.84];p <.001)和不与孩子交流(OR = 1.47 [95% CI = 1.32, 1.64];p <.001)与认知延迟风险的关联最大。

结论

这里测量的身体惩戒和剥夺暴露因素与跨国社会情感和认知延迟风险有明显的关联。计划和临床干预措施应寻求针对与目标延迟相关的逆境采取行动。

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