婴儿运动发育迟缓社区筛查方法研究

Research of community screening method of infant motor developmental delay

目的研究编制适宜社区使用的0~1岁婴儿运动发育迟缓筛查方法,为儿童脑瘫早期筛查与监测提供方法。方法 1）筛查方法设计：设计1~12个月龄的每月筛查内容,通过专家论证。2）信度、效度及应用研究：整群抽样1~12月龄婴幼儿2 711名,设计筛查阳性（n=59）与阴性病例（n=177）对照,进行重测信度研究;对阳性组和阴性组均进行DDST筛查,研究校标关联效度,对转诊的阳性儿童（n=32）评估发育情况及肌张力情况,进行应用研究。3）使用SPSS17.0进行统计学分析。结果 1）信度：具有专家信度;重测信度100%。2）效度：具有校标关联效度。运动筛查阳性与DDST结果及大运动迟缓阳性显著相关（r=0.77,P=0.000）。3）应用：筛查阳性率为2.18%。筛查阳性确诊运动发育迟缓65.63%,确诊运动发育迟缓和运动边缘状态率为100%,伴有肌张力异常43.75%。重症病例确诊脑瘫、中枢协调障碍、肌张功能不全各1例。结论本筛查方法适合社区儿童保健医生在系统体检时对0~1岁婴幼儿进行运动发育迟缓筛查,具有较好的信度和效度,具有应用价值。

Objective To research and design suitable development delay screening methods for monitoring 0~1year old infants within the community,and to provide methods for early screening and monitoring of children with cerebral palsy. Methods 1）Screening methods design：monthly screening content was designed to cover ages from 1~12 months,and passed through the expert argumentation.2）Study of the reliability,validity and application：Cluster sampling（n=2 711）was performed in infants aged 1~12months from 6community health service centers of three city districts.A positive group with positive cases（n=59）and a negative control group with negative cases（n=177）were all performed the test-retest reliability study,and two groups all carried out Denver Developmental Screening Test（DDST）to research criterion-related validity.Developmental condition and muscular tension of the positive referral cases evaluated for application study.3）Statistical analysis was performed by SPSS17.0. Results 1）Reliability：the method provided 100% professional reliability and test-retest reliability.2）Validity：the method possessed criterion-related validity and the positive testing of motor screening were significantly correlated with DDST results and gross motor developmental delay（r=0.77,P=0.000respectively）.3）Application：screening positive rate was 2.18%.Gross Motor developmental delay was diagnosed in 65.63% of the positive referral cases,but total rates of gross motor developmental delay and edge state was 100%,including 43.75% with abnormal tension of muscle.The diagnosis of cerebral palsy,central coordination disorder and muscular tension dysfunction each included 1case. Conclusion The screening method is suitable to child health care doctors for motor developmental delay screening among 0~1year old infants within the community,and with good reliability and validity has value in its application.