幼儿语言发育迟缓的家庭环境危险因素

Analysis of the home environmental risk factors associated with language development delay in toddlers

目的分析幼儿语言发育迟缓(LDD)的家庭环境因素,为LDD早期干预提供依据。方法选择2020年7月28日—2021年1月27日于北京协和医院儿童保健门诊诊断为LDD的55例16~30个月龄幼儿作为病例组,筛选同期正常儿保查体的同年龄组71例幼儿作为对照组,使用中文早期语言与沟通发展量表普通话版作为标准化评估工具,并对父母和主要照养人的文化水平、家庭环境、出生情况进行问卷调查,分析各因素与幼儿语言发育落后的相关性。结果两组家庭环境有方言情况差异无统计学意义(P>0.05)。与对照组相比,LDD组独生子女家庭比例少,父母及主要照养人本科及以上文化程度稍少,保姆或(外)祖父为主要照养人比例更多,幼儿屏幕时间较长,开始观看屏幕月龄更小,更多幼儿的父母陪伴时间<2 h/d、屏幕时间≥2 h/d、开始观看屏幕月龄<12月,差异有统计学意义(P<0.05)。Logistic回归分析显示:开始观看屏幕月龄<12月(OR=9.562,95%CI:3.106~29.437)、屏幕时间≥2 h/d (OR=3.222,95%CI:1.169~8.884)、主要照养人是(外)祖父或保姆(OR=7.034,95%CI:1.930~25.634)是幼儿语言发育落后的危险因素(P<0.05)。结论屏幕暴露年龄过早、屏幕暴露过长以及(外)祖父或保姆作为主要照养人是幼儿语言发育迟缓的危险因素。应避免婴幼儿过早或过长时间观看媒体屏幕,鼓励父母照料幼儿。

Objective To explore the influencing factors in family associated with language development delay(LDD) of toddlers, in order to provide evidence for early intervention of LDD. Methods A total of 55 children aged 16 to 30 months and diagnosed with LDD in Peking Union Hospital from July 28 th, 2020 to January 27 th, 2021 were enrolled in this study.Meanwhile, 71 typical developed children who took physical examination in this hospital were selected as control group.Children′s language development was identified by Chinese Communicative Development Inventory-Putonghua version(CCDI-P).The correlations of language development with educational level of parents and main caregivers, family environment, birth status were analyzed. Results There was no difference on domestic dialect between the two groups(P>0.05).Compared with control group, LDD group had less toddlers from only-child family, less parents or main caregiver with bachelor or higher educational degree, more introverted caregivers, more grandfather or nanny as the main caregiver, longer screen time and earlier exposure to screen, more proportion of parental company <2 h/d, screen time ≥2 h/d and being exposed to screen <12 months old(P<0.05).Logistic regression analysis revealed that the onset age for screen ≤12 months old(OR=9.562, 95%CI:3.106-29.437), screen time≥2 h/d(OR=3.222,95%CI:1.169-8.884) and grandfather or nanny as the main caregivers(OR=7.034,95%CI:1.930-25.634) were the risk factors for LDD of toddlers(P<0.05). Conclusions Besides being exposed to screen too early or too long, grandfather or nanny as the main caregiver is the home environmental risk factor associated with language development delay in toddlers.So it is supposed to avoid early screen exposure, to reduce the screen time, and to encourage parents to take care of their children personally.