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早产儿(<30 周)发生发育性协调障碍风险的儿童的入学准备情况:一项前瞻性队列研究。

School Readiness in Children Born <30 Weeks' Gestation at Risk for Developmental Coordination Disorder: A Prospective Cohort Study.

机构信息

Department of Physiotherapy, University of Melbourne, Melbourne, Australia.

Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.

出版信息

J Dev Behav Pediatr. 2022;43(5):e312-e319. doi: 10.1097/DBP.0000000000001031. Epub 2021 Oct 28.

Abstract

OBJECTIVE

The objective of this study was to determine whether school readiness differs between children born <30 weeks' gestation who are classified as at risk for developmental coordination disorder (DCD) and those who are not.

METHODS

This study was a prospective cohort study of children born <30 weeks' gestation. Children were classified as at risk for DCD at a corrected age of 4 to 5 years if they scored <16th centile on the Movement Assessment Battery for Children-Second Edition (MABC-2), had a full scale IQ score of ≥80 on the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV), and had no cerebral palsy. Children were assessed on 4 school readiness domains: (1) health/physical development [Physical Health domain of Pediatric Quality of Life Inventory (PedsQL), Pediatric Evaluation of Disability Inventory Computer Adaptive Test, and Little Developmental Coordination Disorder Questionnaire], (2) social-emotional development (Strengths and Difficulties Questionnaire and PedsQL psychosocial domains), (3) cognitive skills/general knowledge (WPPSI-IV), and (4) language skills (WPPSI-IV).

RESULTS

Of 123 children assessed, 16 were ineligible (IQ < 80 or cerebral palsy: n = 15; incomplete MABC-2: n = 1); 28 of 107 (26%) eligible children were at risk for DCD. Children at risk for DCD had poorer performance on all school readiness domains, with group differences of more than 0.4 SD in health/physical development, social-emotional development, and language skills and up to 0.8 SD for cognitive skills/general knowledge compared with those not at risk of DCD.

CONCLUSION

Being at risk for DCD in children born <30 weeks' gestation is associated with challenges in multiple school readiness domains, not only the health/physical domain.

摘要

目的

本研究旨在确定是否存在发育性协调障碍(DCD)风险的<30 周早产儿和无 DCD 风险的<30 周早产儿在入学准备方面存在差异。

方法

本研究为前瞻性队列研究,纳入<30 周早产儿。在纠正年龄为 4 至 5 岁时,如果儿童的运动评估测试第二版(MABC-2)评分<第 16 百分位数、韦氏学龄前及小学智力量表第四版(WPPSI-IV)的全量表智商得分≥80,且无脑瘫,则认为存在 DCD 风险。儿童入学准备评估分为 4 个领域:(1)健康/身体发育[儿童生活质量问卷(PedsQL)的身体健康领域、残疾儿童评估量表电脑适应性测试(PEDI)和小儿发育协调障碍问卷],(2)社会情感发展(长处与困难问卷和 PedsQL 心理社会领域),(3)认知技能/一般知识(WPPSI-IV),(4)语言技能(WPPSI-IV)。

结果

在评估的 123 名儿童中,有 16 名不符合条件(智商<80 或脑瘫:n=15;MABC-2 不完整:n=1);107 名符合条件的儿童中,28 名(26%)有 DCD 风险。与无 DCD 风险的儿童相比,有 DCD 风险的儿童在所有入学准备领域的表现均较差,在身体健康、社会情感发展和语言技能方面的差异超过 0.4 个标准差,在认知技能/一般知识方面的差异高达 0.8 个标准差。

结论

<30 周早产儿存在 DCD 风险与多个入学准备领域的挑战有关,而不仅仅是身体健康领域。

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