基于《年龄与发育进程问卷-第3版》调查的中国和美国1~66个月儿童发育状况的比较

Comparison in development of young children aged 1 to 66 months between China and U.S based on Ages and Stages Questionnaires(the third edition)

目的研究中国与美国1~66个月儿童的《年龄与发育进程问卷-第3版》(ASQ-3)常模数据,分析两国儿童发育的差异并探讨其产生的原因。方法资料来源于中、美ASQ-3常模数据。采用SAS 9.3和MS Excel进行统计分析,比较两国儿童每个ASQ-3月龄组各能区得分的平均值。结果中国常模总样本为4 452人,每个月龄组为218~227例;美国常模总样本为18 572例,每个月龄组为352~2 088例。中、美ASQ-3常模比较,沟通能区共有11个月龄组差异有统计学意义,≤10 m月龄组均为美国高于中国,~20 m月龄组互有高低,~54 m月龄组中国高于美国;粗大动作能区有15个月龄组差异有统计学意义,在≤20 m月龄组均为美国高于中国,~30 m月龄组互有高低,≥33 m月龄组及以后均为中国高于美国;精细动作能区有14个月龄组差异有统计学意义,≤24 m月龄组为美国高于中国,之后互有高低,但仍以美国较高为主;解决问题能区有15个月龄组差异有统计学意义,均为美国高于中国;个人-社会能区有17个月龄组差异有统计学意义,≤14 m月龄组美国高于中国,~36 m月龄组互有高低,其中5个差异有统计学意义的月龄组都是美国高于中国,≥42 m月龄组均为中国高于美国。结论中国0~2岁儿童的综合发育水平较美国儿童低,之后有逐渐赶上或超过的趋势。

Objective To compare the mean scores of norm groups in China and US for children aged 1 to 66 months using Ages and Stages Questionnaires,Third Edition（ASQ-3）,and examine the differences in development of young children in these two countries,including a discussion of plausible reasons for these differences.Methods Parents of children in China norm group completed the pencil-paper version of ASQ-3;and parents of US norm group either completed the pencil-paper version or the web version of ASQ-3.The mean scores of the children aged 1 to 66 months in the two norm groups on five developmental domains（i.e.,communication,gross Motor,fine Motor,problem solving,and personal social）were compared.Data were analyzed using SAS 9.3 and MS Excel.Results China norm group included 4,452 young children,and within each age interval,218 to 227 young children.A sample of 18,572 young children was recruited for US norm group,352 to 2,088 young children in each age interval.The results showed that the mean scores of the two norm groups were significantly different on11 age intervals（55%）in communication domain.US norm group scored higher than China norm group at 2,4,6,8,and 10 months;there were no major differences between the two groups between12-20 months;and China norm group scored higher between 22-54 months.In gross motor domain,significant differences were found in 15 age intervals（75％）.US norm group scored higher than China norm group in age intervals before 20 months;the two groups performed at similar level between 22 and 30 months;and China norm group outperformed US norm group in all age intervals after 33 months.In fine motor domain,the scores of the two norm groups were significantly different in 14 age intervals（70％）,and within the 14 age intervals,China norm group scored significantly higher than US norm group only at 54-month age interval.The scores of US norm group were higher than those of China norm group in all age intervals before 24 months.Though the two groups scored at a similar level in age intervals after 24 months,the scores of US norm group were slightly higher.In problem solving domain,significant differences were found in 15 age intervals between the two norm groups（75％）,and US norm group scored higher than China norm group in all age intervals except 54 months.In personal-social domain,significant differences were found in 17 age intervals（85％）.US norm group performed better than China norm group in the age intervals before 14 months.From 16 to 36 months age intervals,US norm group outperformed China norm group in five age intervals,but China norm group scored higher in the age intervals after 42 months.Conclusion Young children in China norm group scored significantly lower than their peers in US norm group on ASQ-3 in the age intervals younger than 24 months though their scores increased and eventually were similar or higher than the US norm group at older intervals.It is of great importance to pay close attention to early development of young children,since developmental delays at an early age may have a far more significant impact on the child,family,and our society than we could imagine.