Cadman D, Walter S D, Chambers L W, Ferguson R, Szatmari P, Johnson N, McNamee J
Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont.
CMAJ. 1988 Jul 1;139(1):31-6.
To determine the accuracy of various predictors of school problems, we conducted a 3-year prospective study of 1999 children who began school in the Niagara region of Ontario in 1980. During the year before school entry the parents gave a health, developmental and behavioural history during an interview with a community health nurse, and the children underwent vision and hearing screening tests and the Denver Developmental Screening Test (DDST). At the end of the 1980-81 school year the kindergarten teachers rated the children's learning problems. At the end of the 1982-83 school year the presence of school problems was ascertained, and the predictive accuracy of items from the preschool history and examination and of the kindergarten teachers' ratings was calculated. The health, developmental and behavioural history with or without the DDST was found to predict later school problems with acceptable accuracy. The kindergarten teachers' ratings gave slightly more accurate predictions. We conclude that in communities where prompt diagnostic evaluation and effective therapeutic or preventive help can be provided to children identified as being at high risk, health professionals may play a useful role in screening for future school problems.
为了确定各种学校问题预测指标的准确性，我们对1999名于1980年在安大略省尼亚加拉地区开始上学的儿童进行了一项为期3年的前瞻性研究。在入学前一年，家长在接受社区健康护士访谈时提供了健康、发育和行为方面的病史，孩子们接受了视力和听力筛查测试以及丹佛发育筛查测试（DDST）。在1980 - 1981学年末，幼儿园教师对孩子们的学习问题进行了评分。在1982 - 1983学年末，确定了是否存在学校问题，并计算了学前病史和检查项目以及幼儿园教师评分的预测准确性。发现有或没有DDST的健康、发育和行为病史能够以可接受的准确性预测后来的学校问题。幼儿园教师的评分给出的预测稍微更准确一些。我们得出结论，在能够为被确定为高危的儿童提供及时诊断评估和有效治疗或预防帮助的社区中，健康专业人员在筛查未来的学校问题方面可能发挥有益的作用。
