本文選題：發(fā)育性協(xié)調(diào)障礙　切入點：家庭環(huán)境　出處：《蘇州大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討兒童的家庭環(huán)境、嬰幼兒期早期動作發(fā)育及智商與學(xué)齡前兒童發(fā)育性協(xié)調(diào)障礙（Developmental Coordination Disorder, DCD）的相關(guān)性，為DCD的早期診斷和干預(yù)提供依據(jù)。 方法：根據(jù)知情同意的原則，在蘇州市區(qū)隨機(jī)整群抽取8所幼兒園，DCD診斷按照《美國精神障礙診斷與統(tǒng)計手冊》第4版（DSM-IV）的診斷標(biāo)準(zhǔn)，采用兒童健康狀況調(diào)查問卷評估兒童的家庭環(huán)境和動作發(fā)育情況，兒童運動評估成套實驗（Movement Assessment Battery for Children, M-ABC）評定兒童的運動能力，韋克斯勒學(xué)齡前期兒童智力量表（Wechsler Preschool and Primary Scale of Intelligence,WPPSI）評估兒童的智商情況。 結(jié)果：①家庭住房面積中，在小面積和中面積住房兒童中，DCD的患病率高于大面積住房的兒童，并有顯著性差異（X~2分別為12.86和20.93, P均小于0.01），在中面積住房兒童中，DCD的患病率仍高于大面積住房的兒童，亦有顯著性差異（X~2=8.21, P0.01），表明家庭住房面積與DCD發(fā)病有關(guān)；家庭年收入中，低收入家庭兒童中，DCD的患病率高于中收入和高收入家庭的兒童，并有顯著性差異（X~2分別為26.67和50.67，P均小于0.01），在中收入家庭兒童中，DCD的患病率仍高于高收入的家庭，亦有顯著性差異（X~2=11.99, P0.01），表明家庭年收入與DCD發(fā)病相關(guān)；母親文化程度中，小學(xué)及以下家庭的兒童中，DCD患病率高于中學(xué)和大學(xué)及以上家庭的兒童，有顯著統(tǒng)計學(xué)差異（X~2分別為75.89和152.94，P均小于0.01），中學(xué)的家庭兒童中，DCD患病率仍高于大學(xué)及以上家庭的兒童，亦有顯著統(tǒng)計學(xué)差異（X~2=16.63, P0.01），表明母親的文化程度與DCD發(fā)病有關(guān)；父親文化程度中，小學(xué)及以下家庭的兒童中，DCD患病率高于中學(xué)和大學(xué)及以上家庭的兒童，并有顯著性差異（X~2分別為84.24和201.07，P均小于0.01）。中學(xué)的家庭兒童中，DCD患病率仍高于大學(xué)及以上家庭的兒童，亦有顯著性差異（X~2=27.20, P0.01），表明父親的文化程度與DCD發(fā)病相關(guān)；不同家庭結(jié)構(gòu)及父母婚姻狀況兒童中，DCD患病率無顯著差異（X~2=2.41、0.92, P0.05）；Logistic回歸分析顯示DCD的影響因素分別為父親文化程度、母親文化程度、家庭年收入及家庭住房面積。②DCD組的兒童中，Kaup值均數(shù)為16.51±3.60，正常組兒童中Kaup值均數(shù)為16.22±2.04，經(jīng)統(tǒng)計學(xué)檢驗，二組兒童中未呈現(xiàn)明顯的統(tǒng)計學(xué)差異（t=1.055, P=0.292），提示DCD兒童中的體格生長均在正常值范圍中；DCD組兒童中，開始獨立坐的月齡為（7.50±1.71）月，而正常組兒童中為（6.95±1.55）月，DCD兒童明顯晚于正常組兒童（t=3.288，P0.01），獨立坐月齡≥8個月兒童中，DCD患病率高于6-7個月與7-8個月的兒童，并有統(tǒng)計學(xué)差異（X~2分別為21.23、49.11，P均小于0.01），而獨立坐月齡在6-7個月與7-8個月兒童中，DCD患病率無顯著性差異（X~2=3.76, P=0.53），表明兒童開始獨立坐的時間晚于8個月與DCD發(fā)病有關(guān)；DCD組兒童中，開始獨立爬的月齡為（8.95±2.33）月，而正常組兒童中為（8.25±1.83）月，DCD兒童明顯晚于正常組兒童（t=3.306，P0.01），獨立爬月齡≥9個月兒童中，DCD患病率高于7-8個月與8-9個月的兒童，并有統(tǒng)計學(xué)差異（X~2分別為6.502、9.915, P均小于0.01），而獨立爬月齡7-8個月與8-9個月兒童中，DCD患病率無顯著性差異（X~2=0.07, P=0.78），表明兒童開始獨立爬的時間晚于9個月與DCD發(fā)病有關(guān)；DCD組兒童中，開始獨立走的月齡為（13.13±2.13）月，而正常組兒童中為（12.63±1.62）月，DCD兒童明顯晚于正常組兒童（t=2.671, P0.01），獨立走月齡≥15個月兒童中，，DCD患病率高于12-13個月與13-15個月的兒童，并有統(tǒng)計學(xué)差異（X~2分別為15.11、30.17, P均小于0.01），而獨立走月齡在12-13個月與13-15個月中，DCD兒童患病率無顯著性差異（X~2=1.21，P=0.271），表明兒童開始獨立走的時間晚于15個月與DCD發(fā)病有關(guān)；DCD組兒童中，開始獨立進(jìn)食的月齡為（18.98±6.50）月，而正常組兒童中為（18.96±7.54）月，二組兒童無統(tǒng)計學(xué)差異（t=0.033, P=0.974）；Logistic回歸分析顯示DCD的影響因素分別為獨立爬的時間、獨立坐的時間、獨立走的時間。③DCD組兒童的總智商得分（94.34±6.37）顯著低于正常組兒童（101.51±5.03），有統(tǒng)計學(xué)差異（t=6.79, P0.01），而操作智商中，其得分（88.49±9.48）亦顯著低于正常組兒童（103.58±7.69），有統(tǒng)計學(xué)差異（t=9.50，P0.01），但在語言智商中，其得分（100.78±5.53）與正常組兒童語言智商得分（99.19±5.22）相比，未達(dá)到顯著差異（t=1.61, P0.05）。DCD組智力不平衡的比例高于正常組兒童，差異統(tǒng)計學(xué)意義顯著（X~2=9.465, P0.01）。 結(jié)論：①家庭環(huán)境中，父母親的文化程度是DCD最主要的影響因素，父母的文化程度越低，其子女DCD的患病率越高；家庭住房面積與年收入也是DCD的影響因素，住房面積越小，年收入越低，DCD的患病率越高。②嬰幼兒期動作發(fā)育推遲是DCD的危險因素，DCD組兒童獨立坐、獨立爬和獨立走的時間均晚于正常組兒童；獨立坐的時間≥8個月、獨立爬的時間≥9個月、獨立走的時間≥15個月是嬰幼兒期DCD的危險因素。③學(xué)齡前兒童的智商偏低，尤其是操作智商偏低和智商發(fā)展不平衡是DCD的危險因素。
[Abstract]:Objective: To explore the correlation between children's family environment, early childhood motor development and intelligence quotient and Developmental Coordination Disorder (DCD), so as to provide evidence for early diagnosis and intervention of DCD.
Methods: according to the principle of informed consent, in 8 kindergartens in Suzhou city were randomly selected, according to the DCD diagnosis. American Diagnostic and Statistical Manual of mental disorders > Fourth Edition (DSM-IV) diagnostic criteria, the health status of children questionnaire assessing children's family environment and movement development, the movement assessment battery for children (Experiment Movement Assessment Battery for Children, M-ABC) to assess children's athletic ability, Wechsler preschool children intelligence scale (Wechsler Preschool and Primary Scale of Intelligence, WPPSI) to assess children's IQ.
Results: the family housing area, in a small area and in the area of housing in children, the prevalence rate of DCD is higher than that of children in a large area of housing, and there was significant difference (X~2 = 12.86 and 20.93, P were less than 0.01), in the area of housing in children, the prevalence of DCD was higher than that of a large area of housing the children also had a significant difference (X~2=8.21, P0.01), shows that family housing area associated with DCD; family income, children in low-income families, the prevalence rate of DCD is higher than the income and high income families, and there was significant difference (X~2 = 26.67 and 50.67, were less than P 0.01) in children, family income, the prevalence of DCD was still higher than high income families, there was significant difference (X~2=11.99, P0.01), shows that the associated with family income DCD; mother's education, primary school and below the families of children, the prevalence rate of DCD is higher than that in middle schools and University and above the families of children, with significant difference (X~2 = 75.89 and 152.94, P were less than 0.01), middle school children, the prevalence rate of DCD was higher than that of college and above the families of children, also have significant difference (X~2=16.63, P0.01), showed that the degree of mother culture associated with DCD; father's education, primary school and below the families of children, the prevalence of DCD was higher in high school and college and above the families of children, and there was significant difference (X~2 = 84.24 and 201.07, P were less than 0.01). Middle school children, the prevalence rate of DCD was higher than that of college and above the families of children. There was also a significant difference (X~2=27.20, P0.01), suggesting that the onset of culture degree and DCD father; children of different family structure and marriage status of parents, the prevalence rate of DCD had no significant difference (X~2=2.41,0.92, P0.05); Logistic regression analysis showed that DCD 褰卞搷鍥犵礌鍒嗗埆涓虹埗浜叉枃鍖栫▼搴

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