家庭养育环境对0~3岁农村留守儿童可疑发育迟缓的影响

Effect of home environment on suspected development delay of left-behind children under 3 years of age in rural areas

目的 了解农村贫困地区0~3岁留守儿童可疑发育迟缓现状及家庭养育环境的影响。方法 采用横断面研究设计,于2018年选取5个国家级贫困县进行调查,使用修订版婴儿-学步儿家庭环境观察测评表(IT-HOME)评估儿童家庭养育环境,使用年龄与发育进程问卷-第三版(ASQ-3)对儿童早期发育情况进行筛查。卡方检验比较不同特征留守儿童早期可疑发育迟缓率的差异,多因素Logistic回归分析家庭养育环境对0~3岁农村留守儿童早期发育的影响。结果 共纳入878对3岁以下留守儿童及其看护人。0~3岁留守儿童总体可疑发育迟缓率为31.8%。控制了儿童性别、年龄、低出生体重、留守类型及看护人性别、年龄、民族、教育、抑郁和家庭拥有交通工具和电器数量后,缺乏刺激性的家庭环境是沟通、粗大动作、精细动作、问题解决、个人-社会五个能区以及总体可疑发育迟缓的危险因素,OR值分别为2.53(95%CI:1.51~4.24)、2.00(95%CI:1.12~3.57)、2.17(95%CI:1.31~3.61)、3.94(95%CI:2.42~6.42)、2.52(95%CI:1.47~4.32)、2.97(95%CI:1.95~4.51)。结论 调查地区0~3岁留守儿童早期发育状况不容乐观,缺乏刺激性的家庭养育环境会增加留守儿童早期可疑发育迟缓的风险。

Objective To understand the prevalence of suspected development delay of left-behind children under 3 years old in rural areas and the impact of home environment.Methods Five national poverty-stricken counties were selected to conduct the cross-sectional study in 2018.The modified Infant-Toddler Home Observation for Measurement of the Environment inventory(IT-HOME)was used to assess the home environment of left-behind family.Ages and Stages Questionnaires-Chinese,Third Edition(ASQ-3)were used to detect the suspected development delay of left-behind children.The chi-square test was used to compare the differences in the rates of suspected development delay among left-behind children with different characteristics,and multivariate logistic regression was applied to analyze the effects of home environment on the early development of rural left-behind children aged 0-3 years.Results A total of 878 pairs of left-behind children under the age of 3 and their caregivers were included.The overall suspected development delay rate for left-behind children aged 0-3 years was 31.8%.After controlling for children′s gender,age,low birth weight,left-behind type and caregivers′gender,age,ethnicity,education level,depression and the number of vehicles and appliances owned by the family,lack of a stimulating home environment was a risk factor for the communication,gross motor,fine motor,problem solving,and personal-social competence zones,as well as for overall suspected developmental delay,with OR s of 2.53(95%CI:1.51-4.24),2.00(95%CI:1.12-3.57),2.17(95%CI:1.31-3.61),3.94(95%CI:2.42-6.42),2.52(95%CI:1.47-4.32),and 2.97(95%CI:1.95-4.51),respectively.Conclusion The early development status of left-behind children aged 0-3 years in the survey areas is not optimistic,and the lack of a stimulating home environment increases the risk of suspected early development delays in left-behind children.