Centre for Appearance Research, University of the West of England, Bristol, UK.
Applied Statistics Group, University of the West of England, Bristol, UK.
Child Care Health Dev. 2021 Jan;47(1):31-39. doi: 10.1111/cch.12813. Epub 2020 Oct 15.
One of the most common congenital conditions in the world, cleft lip and/or palate (CL/P) has been shown to potentially impact long-term physical and developmental outcomes in affected children. However, little is known about the factors that contribute to such outcomes, and there is a lack of consensus about which screening tools may be most effective. The aims of the current study were (a) to assess parent-reported socioemotional and cognitive development in children born with CL/P at 18 months of age; (b) to identify factors associated with the incidence of developmental concerns; and (c) to assess the utility of the widely recommended Ages and Stages Questionnaires (ASQs) in identifying developmental concerns from an early age in the CL/P population.
Parent-reported questionnaire data were extracted from The Cleft Collective Cohort Study for 322 mothers of children with CL/P aged 18 months.
Mean scores across both ASQ measures indicated typical development in the study sample overall. However, 31.1% of children met a referral criterion on at least one domain. Child-related risk factors included problems with physical development and feeding method. Parent-related risk factors included the mother's levels of anxiety and depression and mother's marital status. Additional developmental concerns extracted from mothers' qualitative data included feeding difficulties, speech development, sleep patterns, aggressive behaviours, vision, oral health, hearing, breathing and motor skills.
The majority of children in this study were developing as expected at 18 months of age. However, parent-reported developmental concerns were identified in a minority of children, suggesting a need to screen for potential risk factors in routine practice. Further, the ASQ appears to offer a viable option in the early identification of developmental concerns in children with CL/P. A combined medical and systemic approach to healthcare is recommended to support the prevention of long-term developmental concerns in the child and poor psychological adjustment in parents.
唇腭裂（CL/P）是世界上最常见的先天性疾病之一，已被证明可能会对患病儿童的长期身体和发育结果产生影响。然而，人们对导致这些结果的因素知之甚少，也没有关于哪种筛查工具可能最有效的共识。本研究的目的是：（a）评估 18 个月大的唇腭裂患儿的父母报告的社会情感和认知发育情况；（b）确定与发育问题发生相关的因素；（c）评估广泛推荐的《年龄与阶段问卷》（ASQ）在早期识别唇腭裂人群中发育问题的效用。
从 The Cleft Collective Cohort Study 中提取了 322 名唇腭裂患儿母亲的问卷调查数据，这些患儿的年龄为 18 个月。
在研究样本中，两个 ASQ 指标的平均分数均表明存在典型发育。然而，至少有一个领域符合转诊标准的儿童占 31.1%。与儿童相关的风险因素包括身体发育和喂养方法问题。与父母相关的风险因素包括母亲的焦虑和抑郁程度以及母亲的婚姻状况。从母亲的定性数据中提取的其他发育问题包括喂养困难、言语发育、睡眠模式、攻击性行为、视力、口腔健康、听力、呼吸和运动技能。
在本研究中，大多数儿童在 18 个月时的发育符合预期。然而，少数儿童存在父母报告的发育问题，这表明在常规实践中需要筛查潜在的危险因素。此外，ASQ 似乎是早期识别唇腭裂儿童发育问题的可行选择。建议采用医疗和系统相结合的方法来提供医疗保健，以预防儿童的长期发育问题和父母的心理适应不良。
