肯尼亚学龄前儿童的发育评分及功能障碍患病率
Developmental Scores and Prevalence of Functional Difficulty Among Preschool Children in Kenya.
作者信息
de Kadt Julia, Jeyam Anita, Muuo Sheru W, Okello George, Jolley Emma, Schmidt Elena
机构信息
Sightsavers, Haywards Heath, UK.
Sightsavers, Nairobi, Kenya.
出版信息
Child Care Health Dev. 2025 Mar;51(2):e70037. doi: 10.1111/cch.70037.
BACKGROUND
Disability-inclusive early childhood development and education (ECDE) plays a crucial role in ensuring that all children, including those with disabilities, reach their developmental potential. However, there is little data on the prevalence of disability in mainstream ECDE in most low- and middle-income countries (LMICs), or on early learning and developmental outcomes of children with disabilities in these classrooms.
METHODS
Data were collected on 1756 children aged 3-9 years enrolling in ECDE at 18 schools in Homa Bay or Turkana Counties, Kenya, at the start of the 2021 and 2022 school years. The UNICEF/Washington Group Child Functioning Module (CFM) measured the prevalence of functional difficulty, and the International Development Early Learning Assessment (IDELA) measured child development and learning.
RESULTS
Mainstream classes in sampled preschools included significant proportions of children with functional difficulties (19.9% in Homa Bay; 8.8% in Turkana). In both sites, the odds of having at least one functional difficulty were significantly higher among those aged 5 and above (OR = 2.82 for Homa Bay; 5.76 for Turkana). Multivariate regression found no relationship between functional difficulty and sex or household income. Among children aged 2-4 years in Homa Bay, functional difficulty was most often reported in the domain of controlling behaviour (4.4%), whereas in Turkana, mobility (1.4%) was most common. For children aged 5 and above in Homa Bay, difficulty with accepting change (11%) was most frequently reported, whereas in Turkana it was anxiety (6%). Median IDELA scores were 49 in Homa Bay and 31 in Turkana. Scores increased with child age. Regression models accounting for age- and school-level clustering found no statistically significant differences by sex. Functional difficulties were associated with lower median IDELA scores in Turkana only (β = -5.44 [-8.86, -2.02]).
CONCLUSION
Findings highlight the importance of appropriate, sustainable support for inclusive ECDE in both settled communities and refugee settings.
背景
包容性残疾幼儿发展与教育（ECDE）在确保所有儿童，包括残疾儿童，发挥其发展潜力方面发挥着关键作用。然而，在大多数低收入和中等收入国家（LMICs），关于主流ECDE中残疾患病率的数据很少，也没有关于这些班级中残疾儿童早期学习和发展成果的数据。
方法
在2021年和2022学年开始时，收集了肯尼亚霍马湾或图尔卡纳县18所学校1756名3至9岁入学ECDE儿童的数据。联合国儿童基金会/华盛顿小组儿童功能模块（CFM）测量功能困难的患病率，国际发展早期学习评估（IDELA）测量儿童发展和学习情况。
结果
抽样幼儿园的主流班级中有相当比例的儿童存在功能困难（霍马湾为19.9%；图尔卡纳为8.8%）。在两个地点，5岁及以上儿童至少有一项功能困难的几率显著更高（霍马湾的优势比为2.82；图尔卡纳为5.76）。多变量回归发现功能困难与性别或家庭收入之间没有关系。在霍马湾2至4岁的儿童中，功能困难最常出现在行为控制领域（4.4%），而在图尔卡纳，行动能力方面（1.4%）最为常见。对于霍马湾5岁及以上的儿童，最常报告的是接受变化方面的困难（11%），而在图尔卡纳是焦虑方面（6%）。霍马湾的IDELA中位数分数为49，图尔卡纳为31。分数随儿童年龄增长而增加。考虑到年龄和学校层面聚类的回归模型未发现性别之间有统计学显著差异。仅在图尔卡纳，功能困难与较低的IDELA中位数分数相关（β = -5.44 [-8.86, -2.02]）。
结论
研究结果凸显了在定居社区和难民环境中为包容性ECDE提供适当、可持续支持的重要性。
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