1~6岁儿童语言发育迟缓的相关因素分析

Analysis of related factors of language development delay in children aged 1-6 years

目的 探讨1~6岁儿童语言发育迟缓的相关因素,为促进儿童语言发育提供科学依据。方法 选取2019年1月至2021年1月于首都医科大学附属北京儿童医院保健中心就诊的1~6岁儿童,以确诊为语言发育迟缓的儿童为病例组,同期进行儿童健康体检且语言发育水平正常的儿童为对照组。对比两组儿童的基本特征和家庭养育行为的差异,采用多因素logistic回归分析影响儿童语言发育的因素,并按照儿童性别和年龄进行分层分析。结果 本研究共纳入516例语言发育迟缓儿童(语言发育迟缓组)和608名语言发育正常儿童(对照组)。与对照组相比,语言发育迟缓组男童占比较高(75.6%比61.0%),平均年龄较低[(2.3±0.8)岁比(3.6±0.9)岁],儿童父亲和母亲的文化程度均较低(大专/本科及以上,66.5%比85.2%,69.2%比86.3%),初次接触电子屏幕的年龄较低(<1岁,30.6%比1.5%)、平均每日接触电子屏幕时间较长(≥2.0 h,40.5%比10.0%),家长与其平均每日亲子互动时间较短(<0.5 h,20.0%比11.8%),差异均有统计学意义(P<0.001)。多因素logistic回归分析显示,父亲和母亲的文化程度为大专/本科及以上,儿童语言发育迟缓风险降低(OR=0.29,95%CI:0.16~0.54,P<0.001;OR=0.42,95%CI:0.22~0.80,P=0.009);相对于初次接触电子屏幕年龄<1岁的儿童,初次接触电子屏幕年龄1~<2岁、2~<3岁、≥3岁儿童的语言发育迟缓风险降低(OR=0.19,95%CI:0.08~0.45,P<0.001;OR=0.03,95%CI:0.01~0.07,P<0.001;OR=0.01,95%CI:0.00~0.02,P<0.001);相对于平均每日接触电子屏幕时间<0.5 h的儿童,平均每日接触电子屏幕时间≥2.0 h儿童的语言发育迟缓风险升高(OR=3.45,95%CI:1.84~6.47,P<0.001)。分层分析发现,男童组及不同年龄组儿童中初次接触电子屏幕年龄均与儿童语言发育迟缓存在关联(P<0.05)。结论 父母文化程度、屏幕暴露是儿童语言发育迟缓的重要影响因素,应引起关注,早期干预。

Objective To explore the related factors of language developmental delay in children aged 1-6 years and provide scientific evidence for promoting language development in children. Methods Children aged 1-6 years in the Health Care Center of Beijing Children’s Hospital of Capital Medical University from January 2019 to January 2021 were divided into case group(children diagnosed with language development delay) and control group(children with healthy physical examination result and normal language development). The differences in the basic characteristics and parental caring practices between the two groups were compared. Multivariate logistic regression was applied to explore the related factors of language development delay, moreover, stratified analysis was conducted by children’s gender and age. Results A total of516 children with language development delay(case group) and 608 children with normal language development(control group) were included. The case group had a higher proportion of boys(75.6% vs. 61.0%), a lower mean age [(2.3 ± 0.8) years vs.(3.6 ± 0.9) years], a lower educational level of both the child’s father and mother(college/bachelor’s degree and above,66.5% vs. 85.2% and 69.2% vs. 86.3%, respectively), a lower age of first screen exposure(<1 year, 30.6% vs. 1.5%), longer average daily screen exposure(≥ 2.0 h, 40.5% vs. 10.0%), and shorter average daily parent-child interactions(<0.5 h, 20.0%vs. 11.8%) compared with the control group, which all showed statistically differences(P<0.001). The multivariate logistic analysis showed that the risk of child language development delay was reduced in children whose father and mother was college/bachelor’s degree or higher education(OR = 0.29, 95%CI: 0.16-0.54, P<0.001;OR = 0.42, 95%CI: 0.22-0.80,P = 0.009). The children whose age of first screen exposure was 1-< 2 years, 2-< 3 years and ≥ 3 years old had lower risk of language development delay(OR = 0.19, 95%CI = 0.08-0.45, P<0.001;OR = 0.03, 95%CI = 0.01-0.07, P<0.001;OR = 0.01, 95%CI = 0.00-0.02, P<0.001) compared with the children whose age of first screen exposure was less than one year old. Children with average daily screen exposure of 2.0 h or more had a higher risk of language development delay(OR = 3.45, 95%CI = 1.84-6.47, P<0.001) compared with children with average daily screen exposure of 0.5 h or less. The stratified analysis revealed that age at first screen exposure was associated with language development delay among children in the boys group and different age groups(P<0.05). Conclusions More attention and early intervention should be put on the parents’ educational level and screen exposure which are the important factors in children’s language development delay.