Developmental delays

发育迟缓
  • 文章类型: Journal Article
    背景:儿童发育迟缓在四个基本领域进行评估:粗大运动,精细电机,社会,和语言。早年的生活对孩子的发展至关重要,因此,父母必须意识到发育的里程碑,以便在发育迟缓的情况下进行早期诊断和治疗。这项研究评估了父母的知识,态度,以及有关儿童发展里程碑和相关“危险信号”的做法。
    方法:在利亚奎特国立医院儿科进行了一项横断面研究,卡拉奇.390父母至少有一个5岁以下的孩子,没有诊断出发育迟缓,在门诊就诊期间接受了采访。问卷由三个部分组成,以评估父母的知识,态度,和实践。
    结果:分别有59%和54%的父母对总体和精细运动里程碑了解不足;在社会领域,56%的受访者知识不足。42%的人对语言里程碑了解不足;29%的父母强烈同意他们的儿科医生提供有关发展里程碑危险信号的令人满意的信息。60%的父母强烈同意他们的孩子的发育迟缓会引起他们的关注。在发育迟缓的情况下,55%的家长表示会咨询普通儿科医生,11%的人更喜欢儿科神经科医生,21%的人选择了发育儿科医生,13%的人选择了家庭医生。发现居住和家庭系统与语言相关的里程碑相关,城市居民的知识掌握几率明显高于农村居民,而联合家庭中语言里程碑知识的可能性明显低于核心家庭。发现女性性别与积极态度显着相关。
    结论:我们的大多数受访者对发展里程碑的知识相当匮乏。这突出了需要设计方法来教育父母在这个问题上,使他们能够警惕地监测孩子的发育状况和任何相关的异常,并最终促进正确的行动方针。
    BACKGROUND: Developmental delays in children are assessed in four basic domains: gross motor, fine motor, social, and language. Early years of life are crucial in a child\'s development, so it is imperative that parents be aware of developmental milestones to facilitate early diagnosis and treatment in case of a developmental delay. This study assessed parental knowledge, attitude, and practices regarding children\'s developmental milestones and associated \"red flags\".
    METHODS: A cross-sectional study was conducted at the Department of Pediatrics at Liaquat National Hospital, Karachi. 390 parents, who had at least one child under 5 years of age, with no diagnosed developmental delay, were interviewed during outpatient clinic visits. The questionnaire consisted of three components to assess parental knowledge, attitude, and practices.
    RESULTS: 59% and 54% of parents had poor knowledge of gross and fine motor milestones respectively; In the social domain, 56% of the respondents had inadequate knowledge. 42% had inadequate knowledge of language milestones; 29% of parents strongly agreed that their pediatricians provide satisfactory information regarding red flags of developmental milestones. 60% of parents strongly agreed that their child\'s developmental delay would be a cause of concern for them. In the case of developmental delay, 55% of parents said they would consult a general pediatrician, 11% preferred a pediatric neurologist, 21% opted for a developmental pediatrician and 13% opted for a family physician. Residence and family systems were found to be associated with language-related milestones with significantly higher odds of knowledge among urban residents than rural ones and a significantly lower likelihood of language milestones knowledge among joint families than nuclear families. Female gender was found to be significantly associated with positive attitude.
    CONCLUSIONS: The majority of our respondents showed considerably poor knowledge regarding developmental milestones. This highlights the need to devise ways to educate parents on this subject to enable them to vigilantly monitor their child\'s developmental status and any associated abnormalities and ultimately facilitate the right course of action.
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  • 文章类型: Journal Article
    营养不良对儿童发育有严重和持久的影响。显然,几十年来,基于生物医学模式的食物和直接补充剂的干预措施未能产生预期的结果。鉴于心理社会刺激对发育结果的积极影响,我们认为观察到的失败与干预措施中不包括心理社会刺激有关.在这里,我们在中央邦的一个大型队列中测试心理社会刺激是否介导营养状况与运动和智力发育之间的关联,印度。
    在3岁以下儿童(N=275;男性=148,女性=127)中通过上臂中围(MUAC)测量营养状况,心理社会刺激用家庭清单进行评估,使用印度婴儿发育评估量表(DASII)评估运动和智力发育。我们评估了纳入心理社会刺激的25周干预模式对实验组95名营养不良儿童和对照组77名儿童的有效性。
    研究发现,心理社会刺激完全介导了营养状况与运动发育之间的关系[Effect=1.03,95%C.I.(0.19,2.04),p=0.05和智力发育[效应=0.49,95%C.I.(0.09,1.03),3岁以下儿童的p=0.05。营养状况显着预测了对儿童的心理社会刺激(R2=0.77)。分析干预计划的有效性显示,营养不良儿童的运动[t(81)=2.568,p=0.012]和智力发育[t(81)=4.506,p=0.001]的发育迟缓显着减少。
    研究结果表明,营养转化为积极的发育结果的儿童,只有在心理社会刺激的支架效应主要从家庭接受。整合心理社会刺激活动,比如讲故事,玩,工艺品,木偶,旅行等。在旨在解决营养不良的干预计划中,可能会在弥合营养不良儿童的发育迟缓方面产生丰厚的回报。
    UNASSIGNED: Undernutrition has severe and lasting consequences on child development. Evidently, the interventions based on the biomedical model with food and direct supplementation have failed to produce the desired outcomes for decades. In light of the established positive effects of psychosocial stimulation on developmental outcomes, we propose that the observed failures relate to not including psychosocial stimulation within the interventions. Here we test whether psychosocial stimulation mediates the association between nutritional status and motor and mental development in a large cohort from Madhya Pradesh, India.
    UNASSIGNED: Using a correlational design in children below 3 years of age (N = 275; Males = 148, Females = 127) nutritional status was measured through mid-upper arm circumference (MUAC), psychosocial stimulation was assessed with the HOME-inventory, and motor and mental development were assessed with the Developmental Assessment Scales for Indian Infants (DASII). We assessed the effectiveness of 25-week intervention model incorporating psychosocial stimulation on 95 undernourished children in experimental group and 77 in control group.
    UNASSIGNED: The study found that psychosocial stimulation fully mediated the relationship between nutritional status and the motor development [Effect = 1.03, 95% C.I. (0.19, 2.04), p = 0.05] and mental development [Effect = 0.49, 95% C.I. (0.09, 1.03), p = 0.05] in children under 3 years of age. Nutritional status significantly predicted the psychosocial stimulation to the child (R2 = 0.77). Analyzing the effectiveness of the intervention program revealed significant reduction in the developmental delays in both the motor [t(81) = 2.568, p = 0.012] and mental development [t(81) = 4.506, p = 0.001] of the undernourished children.
    UNASSIGNED: Findings indicate that nutrition translates into positive developmental outcomes in a child only with the scaffolding effects of psychosocial stimulation primarily received from home. Integrating psychosocial stimulation activities like storytelling, play, art and crafts, puppets, travel etc. in the intervention programs designed to address undernutrition may yield rich dividends in bridging the developmental delays among undernourished children.
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  • 文章类型: Journal Article
    背景:尽管已经证明了母亲营养摄入与儿童发育迟缓之间的关联,进餐时间与发育延迟之间的关联尚不清楚.我们研究了怀孕前和怀孕期间早餐摄入频率与儿童发育迟缓之间的关系。
    方法:在参加东北医疗超级银行项目三代队列研究的孕妇中,7491回答了所需的问题并进行了分析。从怀孕前到怀孕早期和怀孕早期到中期的早餐摄入频率分为四组:每天,5-6、3-4和0-2次/周。使用年龄和阶段问卷评估2岁和3.5岁的儿童发育迟缓,第三版。建立Logistic回归模型,以检查孕妇早餐摄入频率与2岁和3.5岁儿童发育迟缓之间的关系。
    结果:孕前至孕早期每天吃早餐的孕妇比例为78.1%,妊娠早期至中期为82.2%。2岁和3.5岁时发育迟缓的儿童比例分别为14.7%和13.4%,分别。与从孕前到孕早期每天吃早餐的妇女的孩子的风险相比,每周吃早餐0-2次的妇女的子女在2岁时发育迟缓的风险较高:比值比(OR)1.30,(95%置信区间[CI],1.02-1.66)。在孕早期至中期每周吃早餐0-2次的妇女的孩子中,2岁时发育迟缓的风险增加:OR1.75(95%CI,1.32-2.32)。从孕前到孕早期和孕早期到中期每周吃早餐0-2次的妇女的子女在3.5岁时发育迟缓的风险没有增加:OR1.06(95%CI,0.81-1.39和OR1.15(95%CI0.84-1.57),分别。
    结论:对于从孕前到中期早餐摄入频率较低的女性,其子女在2岁时发育迟缓有关联,但在3.5岁时没有关联。
    BACKGROUND: Although an association between maternal nutritional intake and developmental delays in children has been demonstrated, the association of the timing of meal intake and development delays remains unclear. We examined the association between breakfast intake frequency before and during pregnancy and developmental delay in children.
    METHODS: Of the pregnant women who participated in the Tohoku Medical Megabank Project Three-Generation Cohort Study, 7491 answered the required questions and were analyzed. The frequency of breakfast intake from pre- to early pregnancy and from early to mid-pregnancy was classified into four groups: daily, and 5-6, 3-4, and 0-2 times/week. Child developmental delays at age 2 and 3.5 years were assessed using the Ages & Stages Questionnaire, Third Edition. Logistic regression models were constructed to examine the association between breakfast intake frequency in pregnant women and developmental delays in children aged 2 and 3.5 years.
    RESULTS: The proportion of pregnant women who had breakfast daily was 78.1% in pre- to early pregnancy, and 82.2% in early to mid-pregnancy. The proportion of children with developmental delays was 14.7% and 13.4% at age 2 and 3.5 years, respectively. Compared with the risk in children of women who had breakfast daily from pre- to early pregnancy, children of women who had breakfast 0-2 times/week had a higher risk of developmental delays at 2 years of age: odds ratio (OR) 1.30, (95% confidence interval [CI], 1.02-1.66). The risk of developmental delays at age 2 years increased in the children of women who had breakfast 0-2 times/week in early to mid- pregnancy: OR 1.75 (95% CI, 1.32-2.32). The risk of developmental delays at age 3.5 years did not increase in the children of women who had breakfast 0-2 times/week from pre- to early and early to mid-pregnancy: OR 1.06 (95% CI, 0.81-1.39 and OR 1.15 (95% CI 0.84-1.57), respectively.
    CONCLUSIONS: For women with a low frequency of breakfast intake from pre- to mid-pregnancy there was an association with developmental delays in their children at age 2, but not at 3.5 years.
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  • 文章类型: Randomized Controlled Trial
    这项研究调查了在改善育儿的背景下,暴露于逆境的儿童是否会表现出较低的表观遗传年龄加速。有发育迟缓和外化行为问题的儿童(N=62;Mage=36.26个月;70.97%的男孩,29.03%女孩;71%拉丁裔,22.6%Black)来自一项更大的随机对照试验(RCT),将他们随机分配接受互联网提供的亲子互动治疗(iPCIT;n=30)或社区转诊(RAU;n=32)。表观遗传年龄加速是用儿科口腔表观遗传时钟估计的,用唾液。逆境是通过父母评估的,家庭,和邻里级累积风险指标。逆境与积极和消极育儿实践的时间2(T2)观察相互作用,以预测1.5年后的表观遗传年龄加速,不管治疗分配。当父母证明积极的(b=-0.15,p=.001)和消极的(b=-0.12,p=.01)育儿实践减少时,暴露于更多逆境的儿童表现出较低的表观遗传年龄加速度。
    This study examined whether children exposed to adversity would exhibit lower epigenetic age acceleration in the context of improved parenting. Children with developmental delays and externalizing behavior problems (N = 62; Mage = 36.26 months; 70.97% boys, 29.03% girls; 71% Latinx, 22.6% Black) were drawn from a larger randomized controlled trial (RCT), which randomized them to receive Internet-delivered parent-child interaction therapy (iPCIT; n = 30) or community referrals as usual (RAU; n = 32). Epigenetic age acceleration was estimated with the pediatric buccal epigenetic clock, using saliva. Adversity was assessed using parent, family, and neighborhood-level cumulative-risk indicators. Adversity interacted with Time 2 (T2) observations of positive and negative-parenting practices to predict epigenetic age acceleration 1.5 years later, regardless of treatment assignment. Children exposed to more adversity displayed lower epigenetic age acceleration when parents evidenced increased positive (b = -0.15, p = .001) and decreased negative (b = -0.12, p = .01) parenting practices.
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  • 文章类型: Journal Article
    妊娠早期孕妇的寨卡病毒(ZIKV)感染可导致先天性畸形,包括小头畸形,将全球注意力集中在这种新兴的病原体上。相比之下,妊娠晚期孕妇的ZIKV感染可导致没有小头畸形的新生儿的神经发育迟缓和隐睾。这里,我们评估了ZIKV感染雄性乳鼠的长期生育后果,相当于儿童先天性ZIKV感染,从包括下丘脑-垂体-性腺轴在内的多个角度来看,睾丸,精子,和社会行为。我们观察到ZIKV在小鼠下丘脑的持续存在,导致下丘脑-垂体-性腺轴长期激素缺乏。激素缺乏导致睾丸发育的有限延迟,精子质量和数量的下降,和异常的社交能力。这些损害可能会导致雄性小鼠的生育能力下降,根据较低的怀孕率判断,延长交货时间,后代质量下降。目前,这些观察在小鼠中转化为人类的程度尚不清楚,但对ZIKV暴露儿童的激素水平和生殖健康的纵向研究似乎是有必要的.孕妇妊娠晚期的重要性寨卡病毒(ZIKV)感染可导致没有小头畸形的儿童的神经发育迟缓和隐睾。然而,先天性ZIKV感染对这些儿童生育能力的影响尚不清楚.这里,使用有免疫能力的小鼠模型,我们发现先天性ZIKV感染可引起下丘脑-垂体-性腺轴的激素紊乱,导致生育能力下降和性偏好下降。我们的研究首次将ZIKV感染后的下丘脑与生殖系统和社会行为联系起来。尽管这些观察在小鼠中转化为人类的程度尚不清楚,这些发现确实提示ZIKV暴露儿童的生殖健康和激素水平应得到更多关注,以提高他们的生活质量.
    Zika virus (ZIKV) infection in pregnant women during the third trimester can cause neurodevelopmental delays and cryptorchidism in children without microcephaly. However, the consequences of congenital ZIKV infection on fertility in these children remain unclear. Here, using an immunocompetent mouse model, we reveal that congenital ZIKV infection can cause hormonal disorders of the hypothalamic-pituitary-gonadal axis, leading to reduced fertility and decreased sexual preference. Our study has for the first time linked the hypothalamus to the reproductive system and social behaviors after ZIKV infection. Although the extent to which these observations in mice translate to humans remains unclear, these findings did suggest that the reproductive health and hormone levels of ZIKV-exposed children should receive more attention to improve their living quality.
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  • 文章类型: Journal Article
    生命的头两年,包括从受孕到2岁的时期,对孩子的成长和发展非常重要。这项研究旨在描述城市和农村地区6个月至2岁儿童的发育状况和影响其的环境因素。研究地点是有目的地选择的:选择了万隆市和西万隆地区的特定卫生中心,研究于2022年11月至12月进行。对6个月至2岁的健康儿童及其父母进行了横断面研究,谁同意参加这项研究。研究人员使用发育预筛选问卷进行发育测试,并对正常发育测试结果和发育延迟进行分类。在研究期间,346名儿童符合纳入标准,样本为164名(47.4%)男孩和182名(52.6%)女孩。城乡发育迟缓儿童之间没有显着差异。影响两个研究领域发育迟缓可能性的因素是儿童的年龄,暴露在屏幕上的时间,刺激,营养状况,以及母子手册的使用。
    The first two years of life, including the period from conception to 2 years of age, are very important for a child\'s growth and development. This study sought to describe the developmental status and the environmental factors that influence it in children aged 6 months to 2 years in urban and rural areas. The research sites were purposively selected: specific health centres in the city of Bandung and West Bandung district were chosen and the study was conducted from November to December 2022. A cross-sectional study was conducted with healthy children aged 6 months to 2 years and their parents, who agreed to participate in the study. Researchers performed developmental tests using the Developmental Pre-screening Questionnaire with classifications for normal developmental test results and developmental delays. During the study, 346 children met the inclusion criteria, resulting in a sample of 164 (47.4%) boys and 182 (52.6%) girls. There were no significant differences among children with developmental delays in urban and rural areas. The factors that influence the possibility of developmental delays in the two research areas were the child\'s age, exposure to screen time, stimulation, nutritional status, and the use of the mother-child handbook.
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  • 文章类型: Journal Article
    背景:发育监测,在全球范围内例行进行,对于及时识别有发育迟缓风险的儿童至关重要。通常通过评估适合年龄的里程碑成就并在健康监督访问期间应用临床判断来执行。与开发筛选和评估工具不同,监测通常缺乏标准化的定量措施,因此,它的解释往往是定性的和主观的。
    目的:在此,我们提出了一种新的方法,用于将发育监测评估汇总为一个统一的评分,以连贯地描述和监测儿童发育.我们描述了计算分数的程序,并证明了其有效捕获已知人群水平关联的能力。此外,我们发现该评分可用于描述纵向发育模式,这可能有助于跟踪和分类儿童的发育轨迹。
    方法:我们描述了发展监测评分(DSS),一个简单易用的工具,根据最近推出的以色列发育监测计划,量化在达到发育里程碑时失败的年龄依赖性严重程度。我们使用全国范围内的超过100万以色列儿童从出生到36个月大的队列来评估DSS,在2014年7月1日至2021年9月1日之间进行评估。我们测量了该评分对发育迟缓与母子特征之间已知关联的能力。此外,我们在连续访问中计算了一系列DSS来描述儿童的纵向发育,并应用聚类分析来识别这些发育轨迹的不同模式。
    结果:分析的队列包括1,130,005名儿童。DSS对队列亚群的评估,按已知的发育迟缓危险因素分层,揭示了发育迟缓与孩子和母亲特征之间的预期关系,包括人口统计和产科相关变量。平均而言,与足月儿童相比,早产儿的得分更差,与女童相比,男童的得分更差,母亲教育水平较低的情况相应地更糟。294,000名儿童获得了连续6次访问的得分轨迹。这些轨迹的聚类揭示了与临床经验一致的3种主要类型的发育模式:成功达到里程碑的儿童,最初倾向于失败但随着时间的推移而进步的孩子,和孩子的失败往往会随着时间的推移而增加。
    结论:建议的分数可以直接以其基本形式计算,并且可以很容易地以更精细的形式实现为基于Web的工具。它强调了发育迟缓与母亲和孩子的特征之间的已知和新颖的关系,证明其对监测和研究的潜在有用性。此外,它可以监测儿童的发展轨迹并对其进行表征。需要未来的工作来校准相对于其他筛查工具的分数,在全球范围内验证它,并将其整合到发育监测的临床工作流程中。
    Developmental surveillance, conducted routinely worldwide, is fundamental for timely identification of children at risk of developmental delays. It is typically executed by assessing age-appropriate milestone attainment and applying clinical judgment during health supervision visits. Unlike developmental screening and evaluation tools, surveillance typically lacks standardized quantitative measures, and consequently, its interpretation is often qualitative and subjective.
    Herein, we suggested a novel method for aggregating developmental surveillance assessments into a single score that coherently depicts and monitors child development. We described the procedure for calculating the score and demonstrated its ability to effectively capture known population-level associations. Additionally, we showed that the score can be used to describe longitudinal patterns of development that may facilitate tracking and classifying developmental trajectories of children.
    We described the Developmental Surveillance Score (DSS), a simple-to-use tool that quantifies the age-dependent severity level of a failure at attaining developmental milestones based on the recently introduced Israeli developmental surveillance program. We evaluated the DSS using a nationwide cohort of >1 million Israeli children from birth to 36 months of age, assessed between July 1, 2014, and September 1, 2021. We measured the score\'s ability to capture known associations between developmental delays and characteristics of the mother and child. Additionally, we computed series of the DSS in consecutive visits to describe a child\'s longitudinal development and applied cluster analysis to identify distinct patterns of these developmental trajectories.
    The analyzed cohort included 1,130,005 children. The evaluation of the DSS on subpopulations of the cohort, stratified by known risk factors of developmental delays, revealed expected relations between developmental delay and characteristics of the child and mother, including demographics and obstetrics-related variables. On average, the score was worse for preterm children compared to full-term children and for male children compared to female children, and it was correspondingly worse for lower levels of maternal education. The trajectories of scores in 6 consecutive visits were available for 294,000 children. The clustering of these trajectories revealed 3 main types of developmental patterns that are consistent with clinical experience: children who successfully attain milestones, children who initially tend to fail but improve over time, and children whose failures tend to increase over time.
    The suggested score is straightforward to compute in its basic form and can be easily implemented as a web-based tool in its more elaborate form. It highlights known and novel relations between developmental delay and characteristics of the mother and child, demonstrating its potential usefulness for surveillance and research. Additionally, it can monitor the developmental trajectory of a child and characterize it. Future work is needed to calibrate the score vis-a-vis other screening tools, validate it worldwide, and integrate it into the clinical workflow of developmental surveillance.
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    背景:尽管由于睡眠问题对儿童的发展以及儿童和家庭的白天行为的影响,人们越来越强调睡眠问题的重要性,身体健康,和生活质量,它们在临床实践中被忽视。然而,关于康复对睡眠问题的影响的研究很少。因此,在这项研究中,我们调查了强化康复计划对发育迟缓(DD)儿童睡眠问题的影响.
    方法:我们纳入了36例DD患儿(30例门诊患者,6名住院患者)及其护理人员完成了儿童睡眠障碍量表上的所有项目。在有DD的孩子中,19(59.3%)患有脑瘫(CP),13(40.7%)患有非CP起源的DD,其中6人(18.8%)早产,4(12.5%)有遗传原因,3人(9.4%)的来历不明。采用配对或非配对t检验评估强化康复计划后睡眠问题的变化,取决于连续变量的分布。
    结果:在强化康复计划之后,在36名患有DD的儿童中,启动和维持睡眠难度(DIMS)子评分显著改善(p<0.05).然而,总分或其他子分数没有显着改善,例如睡眠呼吸障碍(SBD),唤醒障碍(DA),睡眠-觉醒转换障碍(SWTD),过度嗜睡的障碍(DOES),和睡眠多汗症(SH)。在根据DD的原因进行亚组分析中,CP患儿的DIMS和DOES子评分有显著改善(p<0.05).
    结论:强化康复计划,包括每天两次以上的会议,有效缓解DD儿童的睡眠问题,尤其是那些有CP的。在睡眠问题中,强化康复计划在改善DIMS方面最有效。然而,需要对更多DD患者进行进一步的前瞻性研究和更标准化的方案来推广这种效应.
    Although the importance of sleep problems has been increasingly emphasized due to the effects on children\'s development and children\'s and families\' daytime behaviors, physical health, and quality of life, they have been overlooked in clinical practice. However, there have been few studies on the effects of rehabilitation on sleep problems. Therefore, in this study, we investigated the effects of an intensive rehabilitation program on sleep problems in children with developmental delays (DD).
    We included 36 children with DD (30 outpatients, 6 inpatients) and their caregivers who completed all items on the Sleep Disturbance Scale for Children. Of the children with DD, 19 (59.3%) had cerebral palsy (CP) and 13 (40.7%) had DD of non-CP origins, of which 6 (18.8%) had prematurity, 4 (12.5%) had genetic causes, and 3 (9.4%) had an unknown origin. Changes in sleep problems after the intensive rehabilitation program were evaluated using a paired or unpaired t-test, depending on the distribution of the continuous variables.
    After the intensive rehabilitation program, in 36 children with DD, there was a significant improvement in the difficulty in initiating and maintaining sleep (DIMS) sub-score (p < 0.05). However, there was no significant improvement in the total score or other sub-scores, such as those for sleep breathing disorders (SBD), disorders of arousal (DA), sleep-wake transition disorders (SWTD), disorders of excessive somnolence (DOES), and sleep hyperhidrosis (SH). In the subgroup analysis according to the cause of DD, children with CP had a significant improvement in DIMS and DOES sub-scores (p < 0.05).
    The intensive rehabilitation program, consisting of more than two sessions per day, effectively alleviated sleep problems in children with DD, especially in those with CP. Among the sleep problems, the intensive rehabilitative program was most effective at improving the DIMS. However, further prospective studies with a larger number of patients with DD and a more standardized protocol are necessary to generalize this effect.
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    尽管有一些证据表明母系结合障碍与儿童发育之间存在关联,研究主要集中在婴儿期的发展。我们旨在研究2岁以上儿童的母亲产后结合障碍与发育迟缓之间的关系。我们分析了参加东北医学超级银行项目出生和三代队列研究的8380对母子对的数据。产妇粘结障碍定义为分娩后1个月母婴粘结量表评分≥5。年龄和阶段问卷调查,第三版,由五个发展领域组成,用于评估2岁和3.5岁儿童的发育迟缓。进行了多逻辑回归分析,以检查出生后结合障碍和年龄调整后发育迟缓之间的关联。教育,收入,奇偶校验,对怀孕的感觉,产后抑郁症状,孩子的性,早产,出生缺陷。粘结障碍与2岁和3.5岁儿童的发育迟缓有关:比值比(95%置信区间)为1.55(1.32-1.83)和1.60(1.34-1.90),分别。粘结障碍仅在3.5岁时与沟通延迟有关。粘结障碍与粗大运动延迟有关,精细电机,解决问题,但不要拖延个人社会领域,2岁和3.5岁。总之,分娩后1个月母系结合障碍与2岁以上儿童的发育迟缓风险增加相关.
    Although there is some evidence regarding an association between maternal bonding disorder and child development, studies have mainly focused on development during the period of infancy. We aimed to examine the associations between maternal postnatal bonding disorder and developmental delays in children beyond 2 years of age. We analyzed data from 8380 mother-child pairs who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Maternal bonding disorder was defined as Mother-to-Infant Bonding Scale score of ≥5 at 1 month after delivery. The Ages & Stages Questionnaires, Third Edition, which consists of five developmental areas, was used to assess developmental delays in children at 2 and 3.5 years of age. Multiple logistic regression analyses were conducted to examine the associations between postnatal bonding disorder and developmental delays after adjustment for age, education, income, parity, feelings toward pregnancy, postnatal depressive symptoms, child\'s sex, preterm birth, and birth defects. Bonding disorder was associated with developmental delays in children at 2 and 3.5 years of age: the odds ratios (95% confidence intervals) were 1.55 (1.32-1.83) and 1.60 (1.34-1.90), respectively. Bonding disorder was associated with delay in communication only at 3.5 years of age. Bonding disorder was associated with delay in gross motor, fine motor, and problem solving, but not delay in the personal-social domain, at 2 and 3.5 years of age. In conclusion, maternal bonding disorder 1 month after delivery was associated with an increased risk of developmental delays in children beyond 2 years of age.
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  • 文章类型: Journal Article
    依恋和生物行为追赶(ABC)是一种干预措施,旨在增强高危婴儿的社会情绪和调节功能。然而,将ABC用于患有智力障碍/发育迟缓(ID/DD)的婴幼儿和新颖的文化背景,比如南非,可能需要适应。本研究旨在,因此,探讨临床专家对南非ID/DD儿童使用ABC的意见和照顾者的看法。它还试图纳入获得ID/DD的儿童的家庭的经验,以及交付的干预者,ABC在南非首次实施。对18名参与者进行了半结构化访谈。主题分析阐明了12个主要主题:干预优势,关注的问题,和建议(专家);关注照顾者与儿童的关系,和干预目标和持续时间(护理人员);ABC的好处,和文化考虑(ABC收件人);有重点和有针对性的,反馈的价值,支持性监督,工作联盟,和经历的挑战(ABC干预)。实践和培训建议包括针对父母的心理教育和针对ID/DD特定干预者的培训,扩大监管能力,建立干预者的文化/语言敏感性和能力,访问推荐网络,包括当地社区卫生工作者作为干预者,以及会议组织方式的更大灵活性。
    Attachment and Biobehavioral Catch-up (ABC) is an intervention targeted at enhancing the socioemotional and regulatory functioning of at-risk infants. However, to use the ABC for infants/toddlers with intellectual disabilities/developmental delays (ID/DD) and in novel cultural contexts, such as South Africa, adaptations may be required. This study aimed, therefore, to explore the opinions of clinical experts and perceptions of caregivers regarding the use of ABC for children with ID/DD in South Africa. It also sought to incorporate the experiences of families of children with ID/DD who received, and intervenors who delivered, ABC in its first implementation in South Africa. Semi-structured interviews were conducted with 18 participants. Thematic analysis explicated 12 main themes: Intervention Strengths, Points of Concern, and Recommendations (Experts); Focus on Caregiver-child Relationship, and Intervention Targets and Duration (Caregivers); Benefits of ABC, and Cultural Considerations (ABC Recipients); Focused and Targeted, Value of Feedback, Supportive Supervision, Working Alliance, and Challenges Experienced (ABC Intervenors). Practice and training recommendations include psychoeducation for parents and training for intervenors that is ID/DD-specific, expanding supervision capacity, building intervenors\' cultural/linguistic sensitivity and competence, accessing referral networks, including local Community Health Workers as intervenors, and greater flexibility in how the sessions are organized.
    La intervención de Afectividad y Alcance del Bio-comportamiento (ABC) está dirigida a mejorar el funcionamiento socioemocional y regulatorio de los infantes bajo riesgo. Sin embargo, para usar el ABC para infantes y niños pequeñitos con discapacidades intelectuales / retrasos en el desarrollo (ID/DD) y dentro de nuevos contextos culturales, tal como en Sudáfrica, se requieren adaptaciones. Este estudio se propuso, por tanto, explorar las opiniones de expertos clínicos y las percepciones de quienes prestan el cuidado acerca del uso del ABC con niños con ID/DD en Sudáfrica. También buscaba incorporar las experiencias de familias de niños con ID/DD que recibían, así como de practicantes de la intervención que ofrecían el servicio de ABC durante su primera implementación en Sudáfrica. Se llevaron a cabo entrevistas semiestructuradas con 18 participantes. Análisis temáticos explicaron los 12 principales temas: Puntos Fuertes de la Intervención, Puntos que Preocupan y Recomendaciones (Expertos); Enfoque en la Relación Cuidador-Niño y Metas de Enfoque y Duración de la Intervención (Cuidadores); Beneficios del ABC y Consideraciones Culturales (Quienes recibían el ABC); Lo Enfocado y Diseñado como Meta, Valor de Ideas Recibidas, Supervisión con Apoyo, Alianza de Trabajo y Retos Experimentados (Practicantes de la Intervención ABC). Las recomendaciones de práctica y entrenamiento incluyen la psico-educación de padres, entrenamiento a quienes practican la intervención específicamente orientada a ID/DD, expandir la capacidad de supervisión, formar la sensibilidad y competencia cultural/lingüística de quienes practican la intervención, acceso a los sistemas de referencias, incluir Trabajadores de Salud Comunitarios como practicantes de la intervención y mayor flexibilidad en cómo organizar las sesiones.
    L\'attachement et le rattrapage bio-comportemental (en anglais Attachment and Biobehavioral Catch-up, soit ABC) est une intervention ciblée sur l\'amélioration du fonctionnement socio-émotionnel et régulatoire de bébés à risques. Cependant, pour utiliser l\'ABC pour des bébés/jeunes enfants avec des retards intellectuels et des retards du comportement (ID/DD) et dans des contextes culturels nouveaux, comme l\'Afrique du Sud, des adaptations pourraient être nécessaires. Par conséquent cette étude s\'est donné pour but d\'explorer les opinions d\'experts cliniques et les perceptions des personnes prenant soin d\'un bébé quant à l\'utilisation de l\'ABC pour des enfants avec ID/DD en Afrique du Sud. On a aussi cherché à incorporer les expériences de familles d\'enfants avec ID/DD qui ont reçu l\'ABC, ainsi que des intervenants qui l\'ont facilité, dans sa première mise en oeuvre en Afrique du Sud. Des entretiens semi-structurés ont été faits avec 18 participants. Une analyse thématique a explicité 12 thèmes principaux: Forces de l\'Intervention, Points d\'Inquiétude, et Recommandations (Experts); Accent sur la Relation Personne prenant soin de l\'enfant-enfant et Cibles d\'Intervention et Durée d\'Intervention (Personnes prenant soin d\'un bébé); Bénéfices de l\'ABS, et Considérations Culturels (personnes ayant reçu l\'ABC); Ciblé et Centré, Valeur du Retour, Supervision de Soutien, Alliance entre entités, et Défis Vécus (Intervenants ABC). Les recommandations de pratique et de formation incluent une psychoéducation pour les parents, une formation pour les intervenants qui est spécifique à l\'ID/DD, l’élargissement de la capacité de supervision, le développement de la sensibilité et de la compétence culturelle/linguistique des intervenants, l\'accès aux réseau d\'orientation, y compris des Travailleurs de Santé Communautaires en tant qu\'intervenants, et une plus grande flexibilité dans la manière dont les sessions sont organisées.
    Die Anpassung des Programms „Attachment and Biobehavioral Catch-up“ an Säuglinge und Kleinkinder mit geistigen Behinderungen und Entwicklungsverzögerungen in Südafrika: Überlegungen und Empfehlungen von lokalen Akteur:innen „Attachment and Biobehavioral Catch-up; ABC) ist eine Intervention, die darauf abzielt, die sozio-emotionalen und regulatorischen Funktionen von gefährdeten Säuglingen zu verbessern. Wenn der ABC bei Säuglingen/Kleinkindern mit geistigen Behinderungen/ Entwicklungsverzögerungen (disabilities/developmental delays; ID/DD) und in neuen kulturellen Kontexten - wie z. B. in Südafrika - angewendet wird, können jedoch Anpassungen erforderlich sein. Ziel dieser Studie war es daher, die Meinung von klinischen Expert:innen und die Wahrnehmung von Betreuungspersonen in Bezug auf die Anwendung des ABC für Kinder mit ID/DD in Südafrika zu untersuchen. Außerdem sollten die Erfahrungen von Familien mit Kindern mit ID/DD, die bei seiner Ersteinführung in Südafrika an ABC teilgenommen hatten, und diejenigen der durchführenden Interventions-Fachkräfte einbezogen werden. Mit 18 Teilnehmenden wurden halbstrukturierte Interviews geführt. Aus einer thematischen Analyse ergaben sich 12 Hauptthemen: Stärken der Intervention, Bedenken und Empfehlungen (Expert:innen); Fokus auf die Beziehung zwischen Betreuungsperson und Kind sowie Ziele und Dauer der Intervention (Betreuungspersonen); Vorteile des ABC und kulturelle Überlegungen (ABC-Teilnehmende); Fokussiert- und Zielgerichtetheit, Wert des Feedbacks, unterstützende Supervision, Arbeitsbündnis und erlebte Herausforderungen (ABC-Interventions-Fachkräfte). Zu den Empfehlungen für Praxis und Ausbildung gehören Psychoedukation für die Eltern und eine ID/DD-spezifische Ausbildung für die Interventions-Fachkräfte, eine Erweiterung der Supervisionskapazitäten, Förderung der kulturellen/sprachlichen Sensibilität und Kompetenz der Interventions-Fachkräfte, Zugang zu Überweisungsnetzwerken, Einbeziehung lokaler „Community Health“-Kräfte als Interventions-Fachkräfte und eine größere Flexibilität bei der Organisation der Sitzungen.
    南アフリカにおける知的障がいおよび発達遅延のある乳幼児に対する愛着と生物行動学的キャッチアップの適応:現地の関係者の考察と提言 愛着と生物行動学的キャッチアップ (ABC) は、リスクのある乳幼児の社会情緒的・調節的機能を高めることを目的とした介入である。しかし、知的障がい・発達遅延 (ID/DD) のある乳幼児や南アフリカのような新しい文化的背景でABCを使用するためには、-適応させることが必要だろう。そこで本研究では、南アフリカのID/DD児に対するABCの使用について、臨床専門家の意見と養育者の認識を調査することを目的とした。また、南アフリカで初めてABCを実施したID/DDの子どもの家族と、ABCを実施した介入者の経験も取り入れることを目指した。18名の参加者に対して半構造化面接を実施した。主題分析により、12の主要なテーマが明らかにされた。介入の長所、懸念点、推奨事項 (専門家) 、養育者と子どもの関係性への焦点、介入目標と期間 (養育者) 、ABCの利点、文化的配慮 (ABC受益者) 、焦点と目標、フィードバックの価値、支持的スーパービジョン、作業同盟、経験された困難 (ABC介入者) 。実践と訓練に関する推奨事項には、親に対する心理教育、介入者に対するID/DDに特化した訓練、スーパービジョン能力の向上、介入者の文化的/言語的感受性と能力の構築、地域のコミュニティヘルスワーカーを介入者に加えた紹介ネットワークへのアクセス、セッションの構成方法における柔軟性の向上が含まれている。.
    “依恋和生物行为追赶” (ABC) 是一种旨在增强高危婴儿社交情感和调节功能的干预措施。然而, 在南非等新的文化背景下, 将ABC用于智力残疾或发育迟缓 (ID/DD) 的婴幼儿, 可能需要进行调整适应。因此, 本研究旨在探讨临床专家的意见和护理人员对南非ID/DD儿童使用ABC的看法。研究还试图将接受ABC的ID/DD儿童家庭以及实施ABC的干预者的经验融入南非首次开展ABC的实践中。对18名参与者进行了半结构化访谈。主题分析阐述了12个主题:干预优势、关注点和建议 (专家) ;关注护理人员与儿童的关系、干预目标和持续时间 (护理人员) ;ABC的好处和文化考量 (ABC受众) ;重点突出、目标明确、反馈价值、支持性监督、工作联盟和经历的挑战 (ABC干预者) 。实践和培训建议包括对父母进行心理教育和针对ID/DD的干预者培训, 扩大监督能力, 培养干预者的文化、语言敏感性和能力, 使用转诊网络, 将当地“社区卫生工作者”纳入干预者, 以及如何更加灵活地组织课程。.
    برنامج التعلق واللحاق السلوكي الحيوي (ABC) هو تدخل يستهدف تعزيز الأداء الاجتماعي والعاطفي والتنظيمي للرضع المعرضين للخطر. ومع ذلك ، فإنه يحتاج إلى تكييف وتعديل حتى يمكن استخدامه للرضع / الأطفال الصغار الذين يعانون من إعاقات ذهنية / تأخيرات في النمو وفي السياقات الثقافية الجديدة ، مثل جنوب إفريقيا. تهدف هذه الدراسة إلى استكشاف آراء الخبراء الاكلينيكيين وتصورات مقدمي الرعاية فيما يتعلق باستخدام ABC للأطفال الذين يعانون من إعاقات ذهنية أو تأخر نمو (DD-ID) في جنوب إفريقيا. كما سعت إلى دمج تجارب أسر الأطفال والمختصين الذين تعاملوا مع برنامج (ABC) في أول تطبيق له في جنوب إفريقيا. أجريت مقابلات شبه منظمة مع 18 مشاركا. أسفر التحليل الموضوعي عن 12 موضوعًا رئيسيًا: جوانب القوة في التدخل ، جوانب تدعو للقلق ، والتوصيات (الخبراء) ؛ التركيز على العلاقة بين مقدم الرعاية والطفل ، وأهداف التدخل ومدته (مقدمو الرعاية) ؛ فوائد ABC والاعتبارات الثقافية (متلقو ABC) ؛ التركيز والاستهداف ، قيمة التعليقات ، الإشراف الداعم ، تحالف العمل ، والتحديات التي تم مواجهتها. (متدخلو ABC). تتضمن توصيات الممارسة والتدريب التثقيف النفسي للآباء وتدريب المتدخلين في الإعاقة الذهنية وتأخر النمو ، وتوسيع القدرة على الإشراف ، وبناء الحساسية والكفاءة الثقافية / اللغوية للمتدخلين ، والوصول إلى شبكات الإحالة ، بما في ذلك العاملين في الصحة في المجتمع المحلي كمتدخلين ، ومرونة أكبر في كيفية تنظيم الجلسات.
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