中国西部农村 0-3 岁儿童认知发展轨迹：流行率、风险因素与学龄前认知的关系。
Trajectories of child cognitive development during ages 0-3 in rural Western China: prevalence, risk factors and links to preschool-age cognition.
机构信息
International Business School, Shaanxi Normal University, No. 620, West Chang'an Avenue, Chang'an District, Xi'an, 710119, Shaanxi, China.
Department of Health Policy and Management, Gillings School of Global Health, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
出版信息
BMC Pediatr. 2021 Apr 26;21(1):199. doi: 10.1186/s12887-021-02650-y.
BACKGROUND
Cognitive development after age three tends to be stable and can therefore predict cognitive skills in later childhood. However, there is evidence that cognitive development is less stable before age three. In rural China, research has found large shares of children under age three are developmentally delayed, yet little is known about the trajectories of cognitive development between 0 and 3 years of age or how developmental trajectories predict later cognitive skills. This study seeks to describe the trajectories of child cognitive development between the ages of 0-3 years and examine how different trajectories predict cognitive development at preschool age.
METHODS
We collected three waves of longitudinal panel data from 1245 children in rural Western China. Child cognitive development was measured by the Bayley Scales of Infant Development when the child was 6-12 months and 22-30 months, and by the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition when the child was 49-65 months. We used the two measures of cognitive development before age three to determine the trajectories of child cognitive development.
RESULTS
Of the children, 39% were never cognitively delayed; 13% were persistently delayed; 7% experienced improving cognitive development; and 41% experienced deteriorating development before age 3. Compared to children who had never experienced cognitive delay, children with persistent cognitive delay and those with deteriorating development before age 3 had significantly lower cognitive scores at preschool age. Children with improving development before age 3 showed similar levels of cognition at preschool age as children who had never experienced cognitive delay.
CONCLUSIONS
Large shares of children under age 3 in rural Western China show deteriorating cognitive development from infancy to toddlerhood, which predict lower levels of cognition at preschool age. Policymakers should invest in improving cognitive development before age 3 to prevent long-term poor cognition among China's rural children.
背景
三岁以后的认知发展趋于稳定，因此可以预测儿童后期的认知能力。然而，有证据表明，三岁以前的认知发展不太稳定。在中国农村，研究发现，大量三岁以下的儿童发育迟缓，但人们对 0 至 3 岁儿童认知发展的轨迹以及发展轨迹如何预测后期认知技能知之甚少。本研究旨在描述 0-3 岁儿童认知发展的轨迹，并探讨不同轨迹如何预测学龄前儿童的认知发展。
方法
我们从中国西部农村的 1245 名儿童中收集了三波纵向面板数据。儿童认知发展在 6-12 个月和 22-30 个月时通过贝利婴儿发展量表进行测量，在 49-65 个月时通过韦氏学前和小学智力量表第四版进行测量。我们使用三岁前的两种认知发展衡量标准来确定儿童认知发展的轨迹。
结果
在这些儿童中，39%从未出现认知延迟；13%持续延迟；7%认知发展得到改善；41%在三岁前认知发展恶化。与从未经历认知延迟的儿童相比，持续存在认知延迟和三岁前认知发展恶化的儿童在学龄前的认知得分明显较低。三岁前认知发展得到改善的儿童在学龄前的认知水平与从未经历认知延迟的儿童相似。
结论
中国西部农村大量三岁以下儿童在婴儿期到幼儿期表现出认知恶化，这预示着他们在学龄前的认知水平较低。政策制定者应投资于三岁前的认知发展，以防止中国农村儿童长期认知能力低下。
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