家庭认知环境对儿童早期语言发育的影响:一项上海市的回顾性病例对照研究

The Influence of Family Cognitive Environment on Early Childhood Language Development:a Retrospective Case-control Study in Shanghai

背景儿童早期语言发育迟缓发生率高、早期识别率低,对儿童其他维度的早期发展有显著负面影响。家庭认知环境是影响儿童早期语言发育的关键因素。目的本研究旨在探索家庭认知环境对儿童早期语言发育的影响,从家庭认知环境的社区干预角度,为儿童早期的语言发育促进提供理论证据。方法采用回顾性病例对照研究,对2018—2020年在上海市某社区卫生服务中心儿童保健门诊体检的4307名儿童在1、2、3周岁时采用上海市小儿发育筛查量表Ⅱ(DenveRⅡ)进行发育筛查,将筛查出的语言发育迟缓的172名儿童作为观察组,以年龄作为配对因素,按照1∶3的比例纳入516名语言发育正常的儿童作为对照组。收集两组儿童出生基本特征、父母人口学特征、母亲孕期和分娩特征以及家庭认知环境特征信息。采用Logistic回归分析探讨儿童早期语言发育迟缓的影响因素。结果早期语言发育迟缓的儿童共172名,发生率为3.99%,其中,1岁儿童57名(33.14%),2岁儿童92名(53.49%),3岁儿童23名(13.37%)。病例组儿童男性、早产、母亲文化程度为高中以下比例高于对照组(P<0.05)。病例组儿童的总体家庭认知环境及情感温暖、社会适应、语言环境和忽视环境弱于对照组(P<0.05)。儿童早产、母亲文化程度低(高中以下)、家庭认知环境不良是儿童早期语言发育迟缓的危险因素(P<0.05)。结论在2岁前进行语言发育干预是有效降低儿童语言发育迟缓率的关键。社区儿童保健医生指导优化家庭养育环境、协助建立良好亲子沟通和交流互动,是促进儿童早期语言发育的有效策略,尤其要关注出生胎龄小和母亲文化程度低的家庭,为其提供更有针对性的亲子活动和亲子沟通方面的干预和指导。

Background The incidence of delay language development in early childhood is high,and the early recognition rate is low,which has a significant negative impact on the early childhood development of otheRdimensions.The family cognitive environment is a key factoRaffecting early childhood language development.Objective This study aimed to explore the influence of family cognitive environment on early childhood language development,and provide theoretical basis for promoting early childhood language development from the perspective of community intervention on family cognitive environment.Methods A retrospective case-control study was conducted on 4307 children who were admitted to a community child healthcare department in Shanghai from 2018 to 2020.The Shanghai Pediatric Development Screening ScaleⅡ(DenveRⅡ)was used foRdevelopmental screening,which was conducted at the child's age of 1,2,and 3 years old.A total of 172 children with delay language development were selected as the case group,and 516 children with normal language development were included in the control group,which was determined by the matching factoRof age,with a ratio of the numbeRof children in the case and control groups being 1∶3.The following information of children in both groups were collected,including children's basic birth characteristics,parental demographic characteristics,maternal pregnancy and childbirth characteristics,and family cognitive environment characteristics.The Logistic regression analysis was used to explore the influencing factors of delay early childhood language development.Results A total of 172 children with delayed early language development had an incidence rate of 3.99%,among them,1-year-old,2-year-old,and 3-yeaRold children accounted foR33.14%(57 cases),53.49%(92 cases),and 13.37%(23 cases),respectively.The proportions of male children,children with premature birth,and children with maternal education of high school and below were higheRin the case group than those in the control group(P<0.05).The overall family cognitive environment,emotional warmth,social adaptation,linguistic environment,and neglectful environment of the children in the case group were less favorable compared to those in the control group(P<0.05).premature birth,low maternal education,and pooRfamily cognitive environment were risk factors of delay early childhood language development(P<0.05).Conclusion Interventions foRlanguage development before the age of 2 were key to effectively reducing the rate of delay childhood language development.Guiding and optimizing the family caregiving environment,assisting in establishing good parent-child communication and interaction by community child healthcare doctors could be effective strategies foRpromoting early childhood language development.Community child healthcare doctors should pay special attention to children with young gestational age and low maternal education,and provide more targeted interventions and guidance on parent-child activities and communication.