Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA.
Department of Pediatrics-Pediatric Hospital Medicine, Children's Hospital Colorado, Aurora, Colorado, USA.
Child Care Health Dev. 2021 Jul;47(4):471-476. doi: 10.1111/cch.12858. Epub 2021 Mar 8.
Previous studies have described the effect of sociodemographic factors on early development. We describe development of a simple cumulative risk index (CRI) based on four sociodemographic factors and explore the concurrent and predictive relationship of this index to a measure of the cognitive home environment in early childhood and to later school functioning.
This was a secondary data analysis of children from an urban pediatrics clinic. Baseline data were collected at 10-23 months (n = 324) with primary follow-up 6 months later at 18-35 months (n = 179) and secondary follow-up at 8-10 years (n = 68). A CRI score was derived at baseline using maternal education, marital status, race/ethnicity and child insurance. Baseline and primary follow-up included three subscales of the STIMQ, a measure of the cognitive home environment. Effectiveness of CRI was examined using analysis of variance (ANOVA) with linear contrasts. Chi-square examined differences in school function between children from CRI high-risk (CRI 3-4) and low-risk (CRI 0-2) families.
CRI had a negative impact in early childhood on STIMQ subscale scores (p < 0.007-0.05) that increased as the number of risk factors increased (p < 0.05). Significantly more children from high-risk families (CRI 3-4) were rated as having poor school performance than children from low-risk families (CRI 0-2) (p < 0.05).
We showed that a practice-friendly CRI, based on characteristics typically available in the medical record, could help identify families less likely to support development concurrently at 1 year of age and predictively at 2-3 years. School functioning at 8 to 10 years was also significantly better in children with a low CRI at 1 year. The CRI could be a useful tool for both clinicians and researchers needing a simple tool for risk assessment.
先前的研究已经描述了社会人口因素对早期发育的影响。我们描述了一个基于四个社会人口因素的简单累积风险指数（CRI）的开发，并探讨了该指数与早期儿童认知家庭环境的测量以及后来的学校功能之间的并发和预测关系。
这是一项对城市儿科诊所儿童的二次数据分析。基线数据在 10-23 个月（n=324）时收集，主要随访在 18-35 个月（n=179）时进行，次要随访在 8-10 岁（n=68）时进行。基线时使用母亲的教育程度、婚姻状况、种族/民族和儿童保险来计算 CRI 评分。基线和主要随访包括认知家庭环境的 STIMQ 三个分量表。使用方差分析（ANOVA）和线性对比来检验 CRI 的有效性。卡方检验了 CRI 高风险（CRI 3-4）和低风险（CRI 0-2）家庭的儿童在学校功能方面的差异。
CRI 在幼儿时期对 STIMQ 分量表得分有负面影响（p<0.007-0.05），随着危险因素数量的增加而增加（p<0.05）。来自高风险家庭（CRI 3-4）的儿童中，有更多的儿童被评为学习成绩较差，而来自低风险家庭（CRI 0-2）的儿童则较少（p<0.05）。
我们表明，一种基于医疗记录中通常可用的特征的实用友好型 CRI，可以帮助识别在 1 岁时不太可能同时支持发育的家庭，并在 2-3 岁时进行预测。在 1 岁时 CRI 较低的儿童，其 8 至 10 岁时的学校功能也显著更好。CRI 对于需要简单风险评估工具的临床医生和研究人员来说可能是一个有用的工具。
