Department of Child Development, KK Women's and Children's Hospital, Singapore.
Department of Paediatrics, KK Women's and Children's Hospital, Singapore.
Ann Acad Med Singap. 2024 Jun 28;53(6):361-370. doi: 10.47102/annals-acadmedsg.202489.
This study aimed to evaluate the prevalence of developmental and emotional/ behavioural concerns in maltreated children and to examine the impact of adverse family/caregiver risk factors on these outcomes.
We analysed family demographic and baseline data of 132 maltreated children and their caregivers from a family support programme in Singapore. We examined the associations of 3 main risk factors (i.e., caregiver mental health, educational attainment, and family socio-economic status [SES]) with developmental/behavioural outcomes using multivariable logistic regression, controlling for caregiver relationship to the child. Caregiver mental health was assessed using the Patient Health Questionnaire 9 (PHQ-9) and General Anxiety Disorder 7 (GAD-7) tools. Developmental/behavioural outcomes were assessed using the Ages and Stages Questionnaires (ASQ-3), ASQ-Social-Emotional (ASQ-SE), and the Child Behaviour Checklist (CBCL).
The children ranged in age, from 2 months to 3 years 11 months (median age 1.7 years, interquartile range [IQR] 0.9-2.6). Among caregivers, 86 (65.2%) were biological mothers, 11 (8.3%) were biological fathers, and 35 (26.5%) were foster parents or extended family members. Low family SES was associated with communication concerns on the ASQ-3 (adjusted odds ratio [AOR] 3.04, 95% CI 1.08-8.57, P=0.04). Caregiver mental health concerns were associated with increased behavioural concerns on the CBCL (AOR 6.54, 95% CI 1.83-23.33, P=0.004) and higher scores on the ASQ-SE (AOR 7.78, 95% CI 2.38-25.38, P=0.001).
Maltreated children with caregivers experiencing mental health issues are more likely to have heightened emotional and behavioural concerns. Those from low SES families are also at increased risk of language delay, affecting their communication.
本研究旨在评估受虐待儿童的发育和情绪/行为问题的流行情况，并探讨不良家庭/照顾者风险因素对这些结果的影响。
我们分析了新加坡一个家庭支持计划中 132 名受虐待儿童及其照顾者的家庭人口统计学和基线数据。我们使用多变量逻辑回归检查了 3 个主要风险因素（即照顾者的心理健康、教育程度和家庭社会经济地位[SES]）与发育/行为结果的关联，同时控制了照顾者与孩子的关系。照顾者的心理健康使用患者健康问卷 9（PHQ-9）和广泛性焦虑症 7（GAD-7）工具进行评估。发育/行为结果使用年龄和阶段问卷（ASQ-3）、ASQ-社会情感（ASQ-SE）和儿童行为检查表（CBCL）进行评估。
儿童年龄从 2 个月到 3 岁 11 个月不等（中位数年龄为 1.7 岁，四分位距[IQR]为 0.9-2.6）。在照顾者中，86（65.2%）为亲生母亲，11（8.3%）为亲生父亲，35（26.5%）为养父母或大家庭成员。低家庭 SES 与 ASQ-3 上的沟通问题相关（调整后的优势比[OR]3.04，95%置信区间[CI]1.08-8.57，P=0.04）。照顾者的心理健康问题与 CBCL 上的行为问题增加相关（OR 6.54，95%CI 1.83-23.33，P=0.004）和 ASQ-SE 上的得分较高相关（OR 7.78，95%CI 2.38-25.38，P=0.001）。
有照顾者心理健康问题的受虐待儿童更有可能出现情绪和行为问题。来自低 SES 家庭的儿童也更有可能出现语言延迟，从而影响他们的沟通。
