Eadie Patricia, Levickis Penny, McKean Cristina, Westrupp Elizabeth, Bavin Edith L, Ware Robert S, Gerner Bibi, Reilly Sheena
Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia.
Genetics, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Front Pediatr. 2022 Feb 4;10:826817. doi: 10.3389/fped.2022.826817. eCollection 2022.
Screening and surveillance of development are integral to ensuring effective early identification and intervention strategies for children with vulnerabilities. However, not all developmental skills have reliable screening processes, such as early language ability.
We describe how a set of early life factors used in a large, prospective community cohort from Australia are associated with language abilities across the preschool years, and determine if either an accumulation of risk factors or a clustering of risk factors provide a feasible approach to surveillance of language development in preschool children.
There were 1,208 children with a 7-year language outcome. The accumulation of early life factors increased the likelihood of children having low language skills at 7-years. Over a third of children with typical language skills (36.6%) had ≤ two risks and half of the children with low language (50%) had six or more risks. As the number of factors increases the risk of having low language at 7-years increases, for example, children with six or more risks had 17 times greater risk, compared to those with ≤ two risks. Data collected from 1,910 children at 8- to 12-months were used in the latent class modeling. Four profile classes (or groups) were identified. The largest group was developmentally enabled with a supportive home learning environment (56.2%, = 1,073). The second group was vulnerable, both developmentally and in their home learning environment (31.2%, = 596); the third group was socially disadvantaged with a vulnerable home learning environment (7.4%, = 142); the final group featured maternal mental health problems and vulnerable child socio-emotional adjustment (5.2%, = 99). Compared to developmentally enabled children, the risk of low language at 7-years was greater for children in the three other groups.
The cumulative and cluster risk analyses demonstrate the potential to use developmental surveillance to identify children within the first years of life who are at risk of language difficulties. Importantly, parent-child interaction and the home learning environment emerged as a consistent cluster. We recommend they be adopted as the common focus for early intervention and universal language promotion programs.
发育筛查与监测对于确保为脆弱儿童制定有效的早期识别和干预策略至关重要。然而，并非所有发育技能都有可靠的筛查流程，比如早期语言能力。
我们描述了澳大利亚一个大型前瞻性社区队列中使用的一系列早期生活因素如何与学前儿童期的语言能力相关，并确定危险因素的累积或聚集是否为监测学龄前儿童语言发育提供了一种可行的方法。
有1208名儿童有7岁时的语言发育结果。早期生活因素的累积增加了儿童在7岁时语言技能低下的可能性。超过三分之一语言技能正常的儿童（36.6%）有≤2个危险因素，而一半语言能力低下的儿童（50%）有6个或更多危险因素。随着因素数量的增加，7岁时语言能力低下的风险增加，例如，有6个或更多危险因素的儿童风险是有≤2个危险因素儿童的17倍。从1910名8至12个月大的儿童收集的数据用于潜在类别建模。识别出四个概况类别（或组）。最大的一组在支持性的家庭学习环境中发育良好（56.2%，n = 1073）。第二组在发育和家庭学习环境方面都很脆弱（31.2%，n = 596）；第三组在社会上处于不利地位且家庭学习环境脆弱（7.4%，n = 142）；最后一组有母亲心理健康问题且儿童社会情感适应脆弱（5.2%，n = 99）。与发育良好的儿童相比，其他三组儿童在7岁时语言能力低下的风险更大。
累积和聚类风险分析表明，利用发育监测来识别生命最初几年有语言困难风险的儿童具有潜力。重要的是，亲子互动和家庭学习环境成为一个一致的聚类。我们建议将它们作为早期干预和通用语言促进项目的共同重点。
