父母及教师对学龄前儿童行为问题评估的一致性及差异研究

Consistency and Discrepancy between Parents-and Teachers-assessed Behavioral Problems in Preschoolers

背景儿科医生经常面临父母和教师对孩子行为问题报告不一致的情况,但既往关于父母和教师对学龄前儿童行为问题评估的研究较少。目的调查重庆市主城区学龄前儿童行为问题的现状,探讨父母及教师对学龄前儿童行为问题评估的一致性及差异。方法于2018年6月,采用分层整群抽样法,在重庆市主城区幼儿园抽取学龄前儿童2698例。儿童家长填写Conners父母用症状问卷(PSQ),教师填写Conners教师量表(TRS),比较基于PSQ和TRS的行为问题检出情况。结果最终纳入问卷被有效回收的学龄前儿童2660例(98.59%)。基于PSQ的儿童行为问题检出率为14.47%(385/2660),男童高于女童〔17.91%(245/1368)比10.84%(140/1292),P<0.001〕;基于TRS的儿童行为问题检出率为4.44%(118/2660),男童亦高于女童〔6.29%(86/1368)比2.48%(32/1292),P<0.001〕。PSQ中,男童在学习问题、心身问题、多动指数上的检出率高于女童(P<0.05);TRS中,男童在品行问题、多动指数上的检出率高于女童(P<0.05)。PSQ中,男童在品行问题、学习问题、冲动-多动问题、多动指数4个因子上的得分高于女童(P<0.05);TRS中,男童在品行问题、多动问题、注意力不集中-被动问题、多动指数4个因子上的得分高于女童(P<0.05)。Spearman秩相关分析结果显示:在男童中,TRS中品行问题、注意力不集中-被动问题、多动指数得分与PSQ中品行问题、学习问题、冲动-多动问题、多动指数得分呈正相关,TRS中多动问题得分与PSQ中品行问题、冲动-多动问题、多动指数得分呈正相关(rs值为0.056~0.113,P<0.05),TRS中多动问题得分与PSQ中焦虑问题得分呈负相关(rs=-0.059,P<0.05);在女童中,TRS中各因子得分与PSQ中各因子得分无相关关系(P>0.05)。结论家长反映的学龄前儿童行为问题检出率较教师高,家长及教师对学龄前儿童行为问题的评估虽然存在一定差异,但在品行问题、多动方面的评估一致性较好。

Background Pediatricians often receive inconsistent reports from parents and teachers on children's behavior,but there are few available studies on comparing parents and teachers'evaluation of preschool children's behavior problems.Objective To investigate the prevalence of behavioral problems in preschoolers from Chongqing's main urban areas,and to explore the consistency and discrepancy between parents-and teachers-assessed behavioral problems in these children.Methods In June 2018,2698 preschoolers were sampled by cluster sampling from kindergartens in the main urban area of Chongqing.For understanding the prevalence of behavioral problems in them,their behaviors were rated by their parents using the Conners Parent Symptom Questionnaire(PSQ),and by their teachers using the Conners Teacher Rating Scale(TRS).And parents-and teachers-assessed results were compared.Results The survey obtained a response rate of 98.59%,involving 2660 children that were finally included.In accordance with parents'assessment,the prevalence of behavioral problems was 14.47%in preschool children(385/2660),and that in boys was higher than in girls〔17.91%(245/1368)vs 10.84%(140/1292),P<0.001〕.According to teachers'assessment,the prevalence of behavioral problems was 4.44%in preschool children(118/2660),and that in boys was also higher than in girls〔6.29%(86/1368)vs 2.48%(32/1292),P<0.001〕.Parents'assessment showed that boys had higher prevalence of learning problem,psychosomatic problems,and higher hyperactivity index,while teachers'assessment showed that boys had higher prevalence of conduct problems and higher hyperactivity index.In comparison with girls,boys had higher prevalence of behavior problems in in four factors of PSQ,namely learning problem,conduct problems,impulsivity-hyperactivity and hyperactivity index,and higher prevalence of behavior problems in all four factors of TRS.Spearman correlation analysis indicated that scores rated for boys by teachers in terms of conduct problems,inattention-passivity,and hyperactivity index in TRS were positively correlated with scores rated for them by parents in terms of conduct problems,learning problems,impulse-hyperactivity,and hyperactivity index in PSQ;that scores rated for boys by teachers in terms of hyperactivity problems in TRS were positively correlated with scores rated for them by parents in terms of conduct problems,impulse-hyperactivity,and hyperactivity index in PSQ(rs ranged from 0.056 to 0.113,P<0.05);that scores rated for boys by teachers in terms of hyperactivity problems in TRS were negative correlated with scores rated for them by parents in terms of anxiety problems(rs=-0.059,P<0.05).In girls,the scores of each factor in TRS were not correlated with those in PSQ(P>0.05).Conclusion The prevalence of behavior problems in preschoolers assessed by parents was higher than that assessed by teachers.Although there are some differences between the assessment by parents and teachers,there is a good consistency in their assessment of conduct problems and hyperactivity.