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    Communication disorders in children with autism spectrum disorder from speech language pathology perspective
    YANG Feng
    Chinese Journal of Child Health Care    2024, 32 (3): 233-236.   DOI: 10.11852/zgetbjzz2024-0114
    Abstract661)      PDF (722KB)(249)      
    Children with autism spectrum disorder (ASD) face varying degrees of difficulties in communication, language, and social interactions.This article analyzes the basic communication abilities, language development characteristics, and social pragmatic features of ASD children from the perspective of speech pathology, introduces corresponding assessment tools and proposes intervention strategies based on the International Classification of Functioning, Disability, and Health (ICF).Meanwhile, this article emphasizes the adoption of a comprehensive intervention model that involves medical, family, and school components to enhance the communication, language, and social skills of this group comprehensively, with the aim of effectively improving their overall quality of life.
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    Report on early childhood development practices in China from a global health perspective
    HUANG Yangmu, DANG Yuan
    Chinese Journal of Child Health Care    2024, 32 (1): 1-6.   DOI: 10.11852/zgetbjzz2023-1344
    Abstract510)      PDF (959KB)(192)      
    As the health disparities among children indirectly reflect the unfair distribution of national child healthcare, education, and other infrastructure, early childhood health development is a globally significant public health concern. On a global scale, 193 countries have endorsed The 2030 Agenda for Sustainable Development and have explored various development strategies. The government placing children's interests and their rights at the core of their efforts to achieve theSustainable Development Goals(SDGs) is essential, China has made substantial progress in improving children's well-being over several decades of continuous effort and practice. However, challenges persist, including regional development imbalances, insufficient service capabilities in impoverished rural areas, and emerging issues like obesity, myopia, and mental health problems. China still needs to meet the growing health needs of children fully. From a global health perspective, this article systematically reviews the current status of global early childhood health development, outlines the significant milestones and best practices in China's early childhood development efforts, and also anticipates the focus and challenges in early childhood development in China based on global trends, hoping to contribute to further research in this field.
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    Chinese Journal of Child Health Care    2024, 32 (4): 349-358.   DOI: 10.11852/zgetbjzz2024-0279
    Abstract358)      PDF (1552KB)(681)      
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    Chinese Journal of Child Health Care    2024, 32 (1): 7-9.   DOI: 10.11852/zgetbjzz2023-1279
    Abstract345)      PDF (481KB)(123)      
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    Chinese Journal of Child Health Care    2023, 31 (9): 929-934.   DOI: 10.11852/zgetbjzz2023-0679
    Abstract340)      PDF (1156KB)(624)      
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    Treatment and intervention of autism spectrum disorder in China and suggestions for further practice
    JING Jin
    Chinese Journal of Child Health Care    2023, 31 (9): 939-944.   DOI: 10.11852/zgetbjzz2023-0680
    Abstract319)      PDF (831KB)(449)      
    Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders with unknown etiology, high heterogeneity and rapidly increasing prevalence. Early education and training is the main method of rehabilitation. The intervention for ASD in China is still developing. Various medical and rehabilitation education institutions have carried out a variety of interventions, hoping to improve the function of ASD and reduce the family and social burden caused by ASD. Based on this, this article analyzes and expounds the progress in evidence-based practice of ASD, the current situation of ASD intervention in China, the limitations and the future development direction.
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    Establishment of early learning opportunities in nurturing care
    TONG Meiling
    Chinese Journal of Child Health Care    2024, 32 (2): 117-121.   DOI: 10.11852/zgetbjzz2024-0044
    Abstract310)      PDF (753KB)(135)      
    Both UNICEF and WHO mention that nurturing care is the most direct and effective approach to promoting early childhood development. Nurturing care emphasizes the importance of caregivers creating a suitable nurturing environment for the early development of children to promote their health and potential. The provision of early learning opportunities is an important aspect of creating a high-quality nurturing environment. This review focuses on the importance of establishing early learning opportunities, the methods of establishing early learning environments, implementing supportive strategies, and employing relevant evaluation methods, in order to provide reference and support for the establishment of early learning opportunities in nurturing care.
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    Effect of methylphenidate hydrochloride prolonged-release tablets on the growth of children with attention deficit hyperactivity disorder
    LI Rong, LI Nian, WU Dandan, HUANG Rong, CHEN Yinhua
    Chinese Journal of Child Health Care    2023, 31 (7): 731-735.   DOI: 10.11852/zgetbjzz2022-1339
    Abstract303)      PDF (513KB)(88)      
    Objective To analyze the effect of methylphenidate hydrochloride prolonged-release tablets on the growth and nutritionl intake of children with attention deficit hyperactivity disorder (ADHD), in order to provide scientific reference for drug therapy of ADHD. Methods ADHD children in Children′s Hospital of Nanjing Medical University were selected as study subjects, and were divided into treatment group and control group. The treatment group was given methylphenidate hydrochloride sustained release tablets, while the control group received behavior management. Height, weight, body composition measurement and 24 hour dietary survey analysis were monitored regularly. Results The Z scores of weigh-for-age(W/A-Z) ( t= 5.815, 6.708, 5.003, 2.234, P<0.001) andthe Z scores of body mass index-for-age(BMI/A-Z) ( t=3.776, 4.666, 6.431, 7.467, P<0.001), body composition measurement of protein content ( t=3.789, 4.087, 3.098, 2.889, P=0.001), skeletal musclecontent ( t=3.112, 2.890, 4.765, 5.221, P<0.001),fat content ( t=4.329, 3.879, 2.998, 2.567, P<0.001); 24-hour dietary assessment of energy ( t=11.657, 12.887, 5.091, 3.765, P<0.001), protein ( t=12.987, 14.098, 13.777, 12.987, P<0.001), fat ( t= 12.889, 12.012, 14.887, 13.987, P<0.001) and carbohydrate intake ( t= 13.889, 14.889, 15.098, 14.889, P<0.001)after 3-month,6-month,9-month,and 12-month treatmentwere lower than those in control group. The Z scrores of height-for-age (H/A-Z) of children in the treatment groupafter 6-month, 9-month and 12-month treatment were lower than those in control group( t=1.752, 2.625,5.961, P<0.001). Repeated measurement anova analysis showed that the time effect, intragroup effect and interaction effect of physical assessment, body composition (except for inorganic salts) and 24-hour dietary assessment between the treatment group and control group were statistically significant ( P<0.05). Conclusion The medication of methylphenidate hydrochloride prolonged-release tablets on ADHD children, with the treatment duration increasing, will have an impact on the height, weight, BMI and nutritionl intake of children.
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    Status of vitamin A, vitamin D and comorbidity of both deficiency in Chinese children
    YIN Shian, YANG Zhenyu
    Chinese Journal of Child Health Care    2024, 32 (3): 301-306.   DOI: 10.11852/zgetbjzz2024-0146
    Abstract279)      PDF (617KB)(348)      
    Vitamin A and vitamin D deficiencies or insufficiencies in children remain global public health problems. The deficiencies of both vitamin A and vitamin D exist in Chinese children, the deficiency of vitamin A is mainly marginal (about 30%) in children aged 0 - 12 years.Vitamin D deficiency and prevalence are common in healthy children aged 0 - 18 years, among which the severe deficiency rate is 2.46%, the deficiency rate is 21.57%, and the marginal deficiency rate is 28.71%.The deficiency rate gradually increases with the increase of age.Since the respective bioactive metabolites of vitamin A and vitamin D, retinoic acid and 1 and 25-dihydroxyvitamin D 3 have hormone-like properties, and both metabolites are synthesized from their vitamin precursors by different tissues and cells in the body, there may be a synergistic effect between both on target cells remotely by binding to nuclear hormone receptors.A high proportion of concurrent vitamin A and vitamin D deficiencies (comorbidities) in malnourished children under 5 years of age in low- and middle-income countries and poor areas will affect the immune response in a highly specific way, in addition to causing growth and developmental disorders (e.g., growth retardation, motor retardation), it also increases susceptibility to infectious diseases (e.g., recurrent respiratory infections, diarrhea), allergic diseases (e.g., asthma, atopic dermatitis), and neurodevelopmental disorders (touretic disorder, autism spectrum disorder).Therefore, children in the period of growth and development may benefit from supplementing with vitamin A and vitamin D.
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    Factors associated with nursery care institution attendance for children aged 0 - 3 years old and the basic characteristics of nursery care institutions that children were enrolled in
    DONG Wenhong, YAO Xinmeng, XU Xin, LYU Lina, WANG Shasha, ZHENG Shuangshuang, WANG Lei, ZHU Bingquan, SHAO Jie
    Chinese Journal of Child Health Care    2024, 32 (2): 122-126.   DOI: 10.11852/zgetbjzz2023-0670
    Abstract265)      PDF (661KB)(89)      
    Objective To understand factors associated with children's attendance at nursery care institutions (NCIs) and the basic characteristics of the NCIs children were enrolled in, so as to provide scientific evidence for policymakers. Methods During November 2020 and January 2021, parents who visited the Department of Child Health Care in six selected maternal and children's hospitals, as well as nearby NCIs in Zhejiang were invited to finish an online questionnaire. Information such as children's sociodemographic characteristics, parents' knowledge, attitude and practice regarding nursery and feeding, etc. were collected. A total of 1 756 questionnaires were collected. Results Compared to children who were not in NCIs, children enrolled in NCIs were older (94.4% of children ≥24 months vs. 30.1%, χ 2=835.27), more likely to be from the local area (87.2% vs. 81.4%, χ 2=12.25), more likely to have parents with a college degree (mother:83.6% vs. 74.2%, χ 2=35.29; father:79.9% vs. 70.0%, χ 2=27.01), had a higher prevalence of family annual income >200 000 CNY (49.5% vs. 28.2%, χ 2=110.49), and were less likely to have their grandparents available to take care of them (16.7% vs. 26.8%, χ 2=31.4)The difference all have great significant.(P<0.05). In a multivariate Logistic regression model, the older the child, the more likely they were to attend an NCI (for children aged 6 - 23 months, OR=6.70; for children aged 24 - 35 months, OR=134.03; and for children aged 36 - 42 months, OR=699.33; P<0.05). Family annual income was positively associated with children's attendance at NCIs (for those earning 100 000 - 200 000 CNY/year, OR=1.63; for those earning 200 000 - 500 000 CNY/year, OR=2.96; and for those earning >500 000 CNY/year, OR=4.62, P<0.05). Conversely, the higher the level of grandparent involvement in daily care, the lower the attendance at NCIs (for children cared for by both parents and grandparents, OR=0.57; for those primarily cared for by grandparents, OR=0.26, P<0.05). For children who used to stay at NCIs, 82.8% stayed at institutions that only recruited children aged 0 - 3 years, 97.4% spent their whole day in NCIs, and 71.4% spent less than 3 000 CNY per month for NCI services. Additionally, over 95% of parents were satisfied with the food and care services in NCIs, as well as their children's physical development in NCIs. However, 32.1% of NCIs were reported by parents as having no room for breastfeeding. Conclusions Children's age, grandparent involvement in routine care, and family annual income are the main factors associated with children's attendance at NCIs. There is a greater need for more affordable and community-based NCIs, particularly for children under 2 years old. Additionally, more attention should be paid to the quality surveillance, assessment and management of NCIs.
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    Relationship between responsive caregiving for infants and young children and parenting confidence among caregivers
    LIU Panting, ZHANG Lei, HONG Qin, CHI Xia, TONG Meiling, QIAN Jun
    Chinese Journal of Child Health Care    2024, 32 (2): 133-137.   DOI: 10.11852/zgetbjzz2023-0689
    Abstract261)      PDF (501KB)(43)      
    Objective To investigate the current state of infant responsive caregiving and to analyze its correlation with caregiver parenting confidence, in order to provide theoretical basis for improving the level of responsive care for infants and young children. Methods A cross-sectional survey was conducted from October 2022 to February 2023 to select 1 028 infants and young children under 3 years old who underwent health examinations in the Department of Child Healthcare. Participants completed a general data questionnaire, the Karitane Parenting Confidence Scale, and the Infant Responsive Caregiving Scale. Hierarchical multiple linear regression analysis was used to investigate the related influencing factors of infant responsive care and to analyze the relationship between caregiver parenting confidence and responsive caregiving. Results The level of responsive caregiving was found to be associated with various factors such as infant age(χ 2=21.196), mode of pregnancy(Z=-2.072), history of pregnancy protection during pregnancy(Z=-4.713), history of pregnancy complications (Z=-4.504), gestational week at birth(χ 2=41.358), small for term infants(Z=-3.497), neonatal intracranial hemorrhage(Z=-5.425), neonatal hyperbilirubinemia(Z=-2.184), maternal education level(χ 2=9.419), family income(χ 2=11.211) as well as type of family (χ 2=15.360)(P < 0.05). Additionally, a significant correlation was observed between parenting confidence and responsive caregiving(r=0.421, P<0.001). Hierarchical multiple linear regression analysis revealed that caregiver parenting confidence had a significant positive effect on the level of responsive caregiving (B=0.623, P<0.05), even after controlling for the effect of demographic factors. Conclusion The level of infant responsive caregiving is influenced by caregiver parenting confidence, and increasing caregiver parenting confidence can effectively improve the quality of responsive caregiving for infants and young children.
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    Research progress on the effect of screen exposure on cognitive function in children
    LI Yang, JIA Xiangrui, CAO Jianqin, WU Hongmei, SU Hong, YU Hong
    Chinese Journal of Child Health Care    2023, 31 (12): 1331-1334.   DOI: 10.11852/zgetbjzz2023-0134
    Abstract241)      PDF (435KB)(163)      
    In recent years, advancements in science and technology have led to the widespread use of electronic devices such as mobile phones, iPads, TVs, and computers, making them an integral part of daily life. Consequently, children's exposure to electronic screens has significantly increased over time. This growing trend has raised concerns regarding the impact of screen exposure on children's cognitive function. To address this issue, this study conducts a comprehensive analysis of the current state of children's screen exposure, incorporating relevant literature from both domestic and international sources. Furthermore, this study discusses the effects of screen exposure on children's cognitive function and assesses the research progress, aiming to provide a theoretical foundation for promoting the physical and mental health development of children.
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    Nutrition intervention for faltering growth in children under 6 years old
    YU Xiaodan
    Chinese Journal of Child Health Care    2023, 31 (10): 1048-1050.   DOI: 10.11852/zgetbjzz2023-0914
    Abstract232)      PDF (396KB)(348)      
    A report published in 2020 on the Nutrition and Chronic Disease Status of Chinese Residents revealed that the rate of faltering growth in Chinese children under 6 years old is 4.8%. This paper focuses primarily on the influence of weight deviation and nutrient deficiency on height (length) in children, and proposes early intervention measures, in order to provide valuable insights for healthcare professionals in the early prevention and treatment of faltering growth in clinical practice.
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    Influence of parent-child interaction on early childhood development outcome
    CAO Hui, YAN Shuangqin, GUAN Hongyan
    Chinese Journal of Child Health Care    2023, 31 (7): 770-774.   DOI: 10.11852/zgetbjzz2022-0811
    Abstract229)      PDF (570KB)(199)      
    Family environment plays a central role in children′s health, growth and development.Parent child interaction is an important indicator to evaluate the quality of parenting care, and high quality parent-child interaction is a key determinant of cognitive and psycho-social development.However, so far, there is still a lack of comprehensive discussion on the relationship between parent-child interaction and early childhood development outcomes in China.By searching the previous literature and analyzing researches related to parent-child interaction, this paper finds that parent-child interaction can have a positive impact on children′s cognitive function, emotional sociality, language ability and common children′s developmental behavior disorders, and parent-child interaction therapy can also produce a good intervention effect, so as to provide a new intervention path and evidence-based basis for promoting children′s early development based on parent-child interaction.In addition, it is also pointed out that more evaluation and guidance of parent-child interaction, intervention practice research of children with special developmental behavior problems need to be carried out in China in the future, so as to further promote the development of new service technologies for early childhood development in China.
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    Early identification and treatment on childhood anxiety disorders
    ZHANG Jinsong
    Chinese Journal of Child Health Care    2023, 31 (12): 1277-1279.   DOI: 10.11852/zgetbjzz2023-1196
    Abstract213)      PDF (537KB)(330)      
    Anxiety disorders are prevalent in children, and early identification and treatment are crucial to minimize their impact on children's development. There are several subtypes of anxiety disorders, and the symptoms in children are diverse and atypical, often manifesting as behavioral and physical responses. Raising awareness of early identification can be achieved by reinforcing correct understanding, enhancing foresight, focusing on high-risk children, and maintaining sensitivity. This article provides a brief overview of common manifestations for identifying anxiety symptoms, the process of early identification and diagnosis of anxiety disorders, and a treatment plan for childhood anxiety disorders that integrates preventive intervention and comprehensive treatment.
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    Early identification and treatment of emotion-related mental disorders in children and adolescents
    JIN Yu
    Chinese Journal of Child Health Care    2023, 31 (12): 1280-1285.   DOI: 10.11852/zgetbjzz2023-1195
    Abstract210)      PDF (833KB)(187)      
    It has been found that children and adolescents are highly susceptible to emotion-related mental disorders such as anxiety disorder, major depressive disorder, bipolar and related disorder. If left untreated, it may severely impact the normal functioning of individuals, family and society, indicating the importance of early detection and interventionin preventing and treatingchildren and adolescents who are at high risk for emotion-related mental disorders. This article reviews different types and risk factors of emotion-related mental disorders in biological, family and school contexts, and identifies effective early detection methods and intervention strategies for children and adolescents with emotion-related mental disorders.Further implications and recommendations for early detection and intervention are also discussed.
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    Evaluation and treatment of complex attention deficit hyperactivity disorder in childhood
    CHEN Li
    Chinese Journal of Child Health Care    2023, 31 (9): 935-938.   DOI: 10.11852/zgetbjzz2023-0845
    Abstract193)      PDF (501KB)(429)      
    Attention deficit hyperactivity disorder(ADHD) is one of the most common neurodevelopmental disorders in childhood. Complex ADHD in children is relatively unique. These cases differ from typical ADHD cases in various ways, such as the atypical age at which symptoms appear or the presence of complex coexisting conditions. Additionally, the symptoms and functional impairment experienced by children with complex ADHD tend to be more severe.Therefore, these children require comprehensive interdisciplinary evaluation and treatment, as well as long-term standardized follow-up and chronic disease management.
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    Status quo and related factors of Chinese vocabulary and grammar development in children aged 2 to 6 years
    LIU Huijuan, SONG Zhixiao, GAO Nannan, ZHANG Li, SUN Jin, QIAO Xiuyun, KE Jiamei, LI Yan
    Chinese Journal of Child Health Care    2023, 31 (7): 724-730.   DOI: 10.11852/zgetbjzz2022-0715
    Abstract192)      PDF (659KB)(114)      
    Objective To assess Chinese vocabulary and grammar development of children aged 2 to 6 years, and to analyze its development process and related influencing factors. Methods From July 2021 to February 2022, 198 children aged 2 to 6 years were included in the outpatient physical examination of Shandong Province Qianfoshan Hospital, who were divided into 8 groups by age with 0.5 years intervals. The enrolled children were assessed for vocabulary and grammar development, and the influencing factors were analyzed. Results 1) Vocabulary comprehension was partially not up to standard at 2 to 4 years old and up to standard at 4 to 6 years old. Children over 4 years old performed better than those under 4 years old in vocabulary expression. 2) There were more substandard items of grammar at the age of 2 to 3.5 years old than the age of 3.5 to 6 years old. Simple sentence patterns and noun phrases were acquired first, then the patterns of calculus and complex sentences. The semantics of action events were acquired first, followed by the characters, and finally the semantics of the orientation of the characters. 3) The main caregivers [grandmother ( Z=-2.96), primary school education ( H=10.96), housewife( H=16.55)] and the use of dialect communication( H=20.53), short interaction in the past week ( H=9.14), holding food in mouth( Z=-2.08), semi-liquid diet( H=10.07), eating solid food too late ( H=13.71) were associated with higher rate of vocabulary comprehension errors ( P<0.05). The main caregivers [grandmother ( Z=-2.25), primary school education ( H=15.28), housewife ( H=17.08)], the use of dialect communication ( H=13.65), short interaction in the past week ( H=8.03) and holding food in mouth ( Z=-2.59) were associated with higher vocabulary expression error rate ( P<0.05). The main caregivers [grandmother( Z=-3.08), primary school education( H=17.10), housewife( H=23.64)], the use of dialect communication( H=25.56), early exposure to electronic screens( H=9.21) and long screen time( H=14.70), and eating behavior [holding food in mouth( Z=-2.98), dislike chewing food( Z=-2.81), prefer porridge or rotten noodles ( Z=-1.99), late eating solid food ( H=12.56), picky eating ( Z=-2.18)] were associated with higher grammar error rates ( P<0.05). Conclusions There is a significant correlation of age with the development of vocabulary and grammar. Vocabulary comprehension is learned by the age of 4, while vocabulary expression and grammar are gradually mastered after 4 years old. Main caregivers, family parenting, language environment, screen time and dietary behavior are related to vocabulary and grammar development.
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    Association between adolescent interpersonal distress and parent-child communication
    LI Mingyu, XIANG Yanqi, ZHANG Aidi, TAN Simin, SHAN Li, ZHU Li, ZHANG Yayi
    Chinese Journal of Child Health Care    2023, 31 (9): 975-979.   DOI: 10.11852/zgetbjzz2023-0186
    Abstract188)      PDF (664KB)(112)      
    Objective To identify the relationship between adolescent interpersonal distress and parent-child communication, in order to provide reference for improving teenagers' interpersonal communication ability. Methods From May to July 2022, totally 720 middle school students were selected into this study. Interpersonal Relationship Assessment Scale (IRAS) and Adolescent Parent-child Communication Psychological Questionnaire (PACT) were used to evaluate interpersonal distress and parent-child communication, respectively, then the association between the two in students at different grades was analyzed. Results The total score of interpersonal distress of middle school students was [8.00 (4.00,13.00)], and the detection rate of interpersonal distress was 46.53%(335/720). Logistic regression analysis showed that authoritarian paternal parenting style ( OR=8.750, 95% CI:2.041 - 7.511, P<0.05) was an independent risk factor for interpersonal distress in junior middle school students, while higher scores of mother-child communication motivation ( OR=0.363), mother-child communication ability ( OR=0.327) and parent-child communication motivation ( OR=0.203) were associated with lower risk of interpersonal distress of junior middle school students ( P<0.05). Neglectful maternal parenting style ( OR=6.575, 95% CI:1.792 - 24.126, P<0.05) was an independent risk factor for interpersonal distress among senior high school students, while higher scores of mother-child communication ability ( OR=0.286) and father-child communication motivation ( OR=0.439) were related to lower risk of interpersonal distress among senior high school students ( P<0.05). Conclusions It is worth paying attention to the problem of adolescent interpersonal disturbance. Changing parenting style and strengthening parent-child communication can help improve the interpersonal problems of adolescents.
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    Effect of the program for the education and enrichment of relational skills on school-age children with attention deficit hyperactivity disorder
    ZHU Peiying, CHU Liting, MA Chenhuan, PAN Lizhu, GUO Naiqi, LU Dingjie, WANG Yu
    Chinese Journal of Child Health Care    2023, 31 (9): 951-956.   DOI: 10.11852/zgetbjzz2022-1109
    Abstract178)      PDF (646KB)(128)      
    Objective To explore the effect of the program for the education and enrichment of relational skills (PEERS ®) on the social skills of children with attention deficit hyperactivity disorder (ADHD) aged 6 - 8 years, so as to provide evidence for the clinical application of this project in young ADHD children in China. Methods A total of 74 children aged 6 - 8 years who were diagnosed with ADHD in the Department of Child Health Care of Shanghai Children's Hospital from March to November 2021 were enrolled in this study, and were randomly divided into intervention group and control group. The intervention group received PEERS training for 14 weeks, while the control group did not receive any intervention until the intervention in this study was finished. Social Anxiety Scale for Children (SASC), Social Skills Parent Rating Scale for Primary School Students, Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) and Strengths and Difficulties Questionnaire (SDQ) were used for evaluation before and after the intervention. Results After 14 weeks of training, there was a statistically significant decrease in the fear of denial rating ( t=2.35), social avoidance distress score ( t=2.34) and total SASC score ( t=3.35) in the intervention group compared with those before intervention, and the scores were significantly lower than those in the control group( P<0.05). In terms of the Social Skills Parent Rating Scale for Primary School Students, scores of intention to interact ( t=3.70), group prestige ( t=2.84), social sensitivity ( t=6.31), masking ( t=2.34), individual sensitivity ( t=3.10), emotional sensibility ( t=3.33), expression skills ( t=5.95), interaction skills ( t=2.47), social expression and control ( t=7.24), social feelings ( t=7.71), emotional feelings and control ( t=3.78) and total scale score ( t=9.14) after intervention were significantly higher than those before intervention in the intervention group,which were significantly higher than those of the control group after intervention ( P<0.05). In terms of WFIRS-P, the intervention group had significantly higher scores for family ( t=3.06), learning/school ( t=3.65), self-concept ( t=2.44), social activity ( t=3.50), adventure activity score ( t=7.29) and total scale ( t=8.25) after intervention,which were significantly higher than those of the control group after intervention ( P<0.05).Except for conduct problems ( t=1.57, P=0.122) and hyperactive attention inability ( t=1.78, P=0.08),the intervention group had significantly lower scores for emotional symptoms ( t=3.01), peer interaction problems ( t=1.78) and total difficulty score ( t=5.72) after intervention,which were significantly higher than those of the control group after intervention ( P<0.05). After intervention, the hyperactivity-impulsivity score on the SNAP-Ⅳ scale was significantly lower in the intervention group than that before intervention ( t=2.29, P=0.025), and the decrease was more significant compared to the control group ( P<0.05). Conclusion PEERS training can significantly improve the social skills of ADHD children aged 6 - 8 years, and improve social function and some core symptoms of ADHD children.
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    Meta-analysis of the effect of exercise interventions on executive function among children and adolescents with attention deficit hyperactivity disorder
    SONG Yiling, FAN Biyao, BAI Xiaotian, YU Hongjun
    Chinese Journal of Child Health Care    2023, 31 (9): 1010-1016.   DOI: 10.11852/zgetbjzz2022-1568
    Abstract175)      PDF (1411KB)(133)      
    Objective To systematically evaluate the effects of exercise interventions on executive function among children and adolescents with attention deficit hyperactivity disorder (ADHD), in order to provide a basis for developing non-pharmacological treatments for children with ADHD. Methods Literature related to the effects of exercise interventions on executive function in children and adolescents with ADHD published to November 8th, 2022 was captured through searching PubMed, Web of Science, Cochrane Library, Embase, CNKI and Wanfang databases. Reviewer Manager 5.4 was used for Meta-analysis, combined effect sizes were calculated. Heterogeneity test, sensitivity analysis and subgroup analysis were performed. Egger's test in Stata 15.0 was used to test for publication bias in the literature. Results Fifteen studies with a total number of 592 participants with ADHD were included. Meta-analysis showed that exercise interventions improved inhibitory control ( SMD=0.54, 95% CI: 0.23 - 0.86, P<0.001), working memory ( SMD=0.61, 95% CI: 0.29 - 0.93, P<0.001), and cognitive flexibility ( SMD=0.66, 95% CI: 0.23 - 1.09, P=0.003) of ADHD children and adolescents. Subgroup analysis showed the following results: 1) Moderate-intensity exercise had a moderate effect on inhibitory control and working memory, and moderate-to-vigorous-intensity exercise had a moderate effect on cognitive flexibility( P<0.05). 2) Open-skilled sports had a moderate effect on inhibitory control, working memory and cognitive flexibility( P<0.05),while closed-skilled sports did not significantly improve executive functions ( P>0.05). 3) Exercising regularly two times/week produced a large effect on inhibitory control ( P<0.05), and a more frequent (≥3 times/week) had a moderate-to-large effect on cognitive flexibility. 4) Interventions ranging from 6 to 8 weeks had a positive effect on inhibitory control and cognitive flexibility, and interventions with 12 weeks had a moderate-to-large effect on working memory ( P<0.05). Conclusions Exercise interventions are effective in improving executive function in children and adolescents with ADHD. Moderate-intensity exercise is most effective in improving inhibitory control and working memory, and moderate- to high-intensity exercise interventions are required in order to improve cognitive flexibility. Open-motor skills improve executive function of ADHD children. Exercise 2 times/week for 6-8 weeks can improve inhibitory control, while improving working memory requires more frequent and longer periods of exercise intervention.
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    Early intervention of emotionalization and socialization on high-risk children
    XIONG Zhonggui, ZHENG Xiaoyun, BIAN Xiaoyan, XU Haiqing
    Chinese Journal of Child Health Care    2023, 31 (11): 1161-1164.   DOI: 10.11852/zgetbjzz2023-0985
    Abstract165)      PDF (662KB)(231)      
    High-risk children are confronted with a serial of medical issues, such as early development of emotionalization and socialization, in which there were significant difference in neurobehavioral development between high-risk children and normal children. Early intervention could promote healthy development of high-risk children. This study is aimed at early development of emotionalization and socialization to achieve the optimal potential development on high-risk children.
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    Application of early start Denver model in the rehabilitation of children with autism spectrum disorder of different conditions
    ZHANG Chao
    Chinese Journal of Child Health Care    2023, 31 (7): 736-740.   DOI: 10.11852/zgetbjzz2022-0971
    Abstract165)      PDF (503KB)(102)      
    Objective To analyze the effect of Early Start Denver Model (ESDM) in the rehabilitation of children with autism spectrum disorder (ASD) with different degrees of condition. Methods A total of 120 ASD patients treated in Xinzheng Hospital of Traditional Chinese Medicine from February 2018 to April 2019 were enrolled in this study, and were randomly divided into experimental group ( n=60) and control group( n=60).Children in each group was divided into grade Ⅰ, Ⅱ, and Ⅲ according to the fifth edition of Diagnostic and Statistical Manual of Mental Disorders(DSM-5).The experimental group was treated with ESDM, while the control group was given traditional rehabilitation.Childhood Autism Rating Scale(CARS) and the Psychoeducational Profile-Third Edition(PEP-3) were used to evaluate the rehabilitation effect before intervention and six months after intervention. Results After 6 months of intervention, the CARS score of children with grade Ⅰ andⅡ ASD in the experimental group was significantly lower than that in the control group( t=4.447, 6.280, P<0.05).There was no statistically significant difference between the test group and the control group in the grade Ⅲ CARS scores ( t=0.159, P=0.875).The scores of imitation, emotional expression, social interaction and nonverbal behavior in the PEP-3 score of children in experimental group of grade Ⅰ and Ⅱ were significantly different from those of the control group ( χ2=3.908, 4.910, 6.112, 4.185, P<0.05), butthere were no significant differences the PEP-3 scores in grade Ⅲ children between the two groups ( P>0.05). Conclusion The ESDM model was more effective in children with mild to moderate autism compared to the conventional intervention model, especially in improving imitation, emotional expression, social activities and nonverbal behavior in children with autism, but no significant advantage is found in children with severe autism.
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    Reliability and validity test of Chinese version of the Sensitivity to Punishment and Sensitivity to Reward Questionnaire for Adolescence
    LI Zhanquan, ZHU Lin, CHEN Zekai
    Chinese Journal of Child Health Care    2023, 31 (9): 980-985.   DOI: 10.11852/zgetbjzz2023-0163
    Abstract159)      PDF (1362KB)(90)      
    Objective To revise the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), and to evaluate its validity and reliability in Chinese adolescents. Methods Standard forward-backward translation procedure, cross-cultural adaptation and pilot test were used in the translation of the SPSRQ.From Jan.17th to Sept.30th in 2022,totally 1 350 adolescents were tested by random sampling and grade stratified sampling. The data were classified into two groups, data of one group were used to conduct exploratory factor analysis and item analysis, and data of the other group were used to conduct confirmatory factor analysis, criterion validity test and reliability test. Results The Chinese version of SPSRQ-A contained two dimensions of reward sensitivity and punishment sensitivity, with 16 items in reward sensitivity and 21 items in punishment sensitivity, whose cumulative contribution of variance accounted for 54.321% of total variance. Confirmatory factor analysis showed that the fitting indexes met the statistical standard ( χ2/df=3.156, RMSEA=0.059, SRMR=0.0617, CFI=0.906, NNFI=0.900). Item-content validity index(I-CVI) was 0.800 - 1.000, and scale-content validity index/average(S-CVI/Ave) was 0.970. There was significant correlation between the scores of two dimensions and the scores of two criterion scales ( r=-0.453 - 0.604, P<0.001). The Cronbach's α coefficient of the scale and each dimension ranged from 0.883 to 0.953, the split-half reliability coefficient of the scale was 0.887. Conclusion The Chinese version of SPSRQ-A shows good reliability and validity, which can be used as an effective tool to evaluate the reinforcement sensitivity of Chinese adolescents.
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    Status quo and influencing factors for language development in children aged 18 months
    XIA Bin, WANG Jie, LIU Qiaoyun, CHEN Siqi, LI Luanluan, YU Xiaodan
    Chinese Journal of Child Health Care    2023, 31 (11): 1196-1201.   DOI: 10.11852/zgetbjzz2023-0241
    Abstract156)      PDF (601KB)(137)      
    Objective To know about current status and influencing factors of language development among 18-month-old children, so as to provide guidance for early intervention. Methods A total of 362 children aged 18 months who took routine physical examination in the Department of Child Health Center of Changning Maternal and Infant Health Care Hospital in Shanghai from October 2021 to March 2022 were selected into this study, including 176 boys and 186 girls. Children were screened for language development by using the Early Language Milestone Scale, with the total score≤ P 10 as abnormal. The demographic information, family conditions, behavior habits and feeding behaviors were collected using questionnaire. Univariate analysis and multiple regression analysis were performed to analyze influencing factors of language development. Results The prevalence of language development delay among 18-month-old children was 9.9%, with 11.9% in boys and 8.1% in girls. The score of voice and speech (11.14±2.62 vs. 12.45 ± 3.20) and the total score of language development (35.19±3.90 vs. 36.68 ± 4.02) in boys were significantly lower than those of girls ( t=-4.244, -3.591, P<0.05). Multiple regression analysis showed that mother or (maternal) grandparents as the major caregiver ( β=1.188, 0.279, 0.217, 1.735, P<0.05) and higher education level of caregivers ( β = 1.027, 0.267, 0.161, 1.485, P<0.05) had positive effects on the scores of voice and speech, auditory perception and understanding, visual related understanding and expression and total score of language development. However, longer screen time ( β =-0.452, -0.612, P<0.05) and delayed timing to introducing solid food ( β =-0.515, -0.613, P<0.05) are negatively correlated with voice and speech development and overall language development of children. Conclusion Children at 18 months of age have a higher rate of abnormal language development, especially in boys; this can be facilitated by choosing an appropriate caregiver, controlling screen time and adding solid foods to the diet at the right time.
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    Research progress on the placental exposure to microplastics and the impact of microplastics on fetus
    XU Anqi, ZHAI Lingling
    Chinese Journal of Child Health Care    2023, 31 (11): 1235-1240.   DOI: 10.11852/zgetbjzz2023-0227
    Abstract152)      PDF (703KB)(89)      
    Microplastics are harmful to the environment and human, which has been receiving high attention in recent decades. The fetal period is a very vulnerable stage throughout the life course. However, maternal exposure to microplastics is likely to influence fetus through placenta. The study provides an overview of global microplastic exposure and maternal exposure during pregnancy, and details placental exposure, potential adverse effects on the fetus, and possible mechanisms, with the aim of providing some ideas for further studies.
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    Research progress on sensory characteristics of autism spectrum disorder
    LI Xiang, FAN Lili
    Chinese Journal of Child Health Care    2023, 31 (9): 1000-1004.   DOI: 10.11852/zgetbjzz2022-1518
    Abstract149)      PDF (608KB)(201)      
    Autism spectrum disorder(ASD) is a complex neurodevelopmental disorder that begins in early development. Sensory abnormalities are common among ASD children and were included in the diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. Sensation is an important cornerstone for the development of advanced functions such as cognition and social interaction. Accurately grasping the sensory characteristics of ASD is the key to better understanding its advanced dysfunction such as social interaction. In this review, current related researches on ASD sensory characteristics are sorted out and integrated, aiming to provide reference for early screening, individualized intervention and basic research of ASD.
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    Research advance in the application of music therapy in pediatric medicine overseas
    ZHANG Dandan, YANG Yanyi, LIN Qian, XIA Ying, WANG Guyi, LU Wenjing, ZHANG Yongjun
    Chinese Journal of Child Health Care    2023, 31 (9): 1005-1009.   DOI: 10.11852/zgetbjzz2022-0578
    Abstract146)      PDF (546KB)(120)      
    In recent years, because of wide audience, good safety, good efficacy and other characteristics, music therapy has been more and more recognized by clinical practice of pediatric medicine. Scholars have conducted extensive studies on the theory and practice of music therapy, and believed that music therapy is an effective auxiliary means in pediatric medical diagnosis and treatment, which can play a positive role in relieving symptoms, releasing pressure and regulating emotions. This paper reviews the application of music therapy in pediatric clinical practice in recent years, summarizes the impact of music therapy on the diagnosis and treatment of pediatric diseases, in order to provide reference for the application of music therapy in related fields.
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    Theoretical models and empirical studies progress in the influence of adverse childhood experiences on lifelong health
    WEI Ruihong, WAN Yuhui
    Chinese Journal of Child Health Care    2023, 31 (12): 1320-1324.   DOI: 10.11852/zgetbjzz2022-1563
    Abstract144)      PDF (1287KB)(118)      
    Adverse childhood experiences (ACEs) are associated with lifelong health, but the underlying mechanisms of the association are not well understood. By searching previous literature, this review combs the theoretical models of the health effects of ACEs and related confirmatory studies, in order to help researches better understand and recognize the potential mechanism of ACEs affecting physical and mental health.
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    Case report of GAND syndrome caused by GATAD2B gene mutation and literature review 
    LUO Guangjin, ZHANG Xuan, LI Xiaoping, Yuan Aiyun, Hou Mei, Chen Jun
    Chinese Journal of Child Health Care    2023, 31 (11): 1270-1272.   DOI: 10.11852/zgetbjzz2022-0998
    Abstract143)      PDF (938KB)(109)      
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    Follow-up study on the effects of comprehensive intervention on children with autism spectrum disorder
    ZHANG Ting, SHAO Zhi, YANG Guang, TAO Hongmei, PENG Shuai, ZHANG Yaru, WANG Yi, PENG Yuanqin
    Chinese Journal of Child Health Care    2023, 31 (9): 969-974.   DOI: 10.11852/zgetbjzz2022-1400
    Abstract143)      PDF (649KB)(118)      
    Objective To analyze the changes in clinical symptoms, language ability, social adaptation, social communication, and Theory of Mind (ToM) skills of children with autism spectrum disorder (ASD) for 1 year after intervention cessation, who have already finished comprehensive intervention and had improved clinical symptoms and social adaptation. Methods Thirty-five children with ASD diagnosed in Chongqing Rehabilitation and Treatment Center for Children with ASD from 2015 to 2020 were selected in this study, and 35 typically developed children were enrolled. ASD children were 3 to 7 years old when receiving intervention, with an average age of (4.60±1.14) years old. ASD children were assessed at pre-intervention (T1), post-intervention (T2), and 1 year after the end of the intervention (T3) by the Childhood Autism Rating Scale (CARS), Psycho-Educational Profile, 3rd edition (PEP-3), Wechsler Preschool and Primary Scale of Intelligence, 4th edition (WPPSI-Ⅳ), Normal Development of Social Skills from Infant to Junior High School Children(S-M), Social Responsiveness Scale (SRS) and ToM task, while the typically developed children received assessment by WPPSI-Ⅳ, SRS and ToM task. Results Comprehensive intervention significantly improved clinical symptoms, social adaptation and language development of ASD children. There was no significant change in CARS scores between T2 and T3. Children with ASD showed significantly lower SRS score and ToM abilities compared to the typically developed children. CARS scores at T2 and T3, as well as WPPSI-Ⅳ intelligence quotient at T3 significantly predicted ToM ability of ASD children at T3. S-M score at T2 significantly predicted SRS score of ASD children at T3. Conclusions The improvements in clinical symptoms and social adaptation that ASD children gained with comprehensive interventions remain stable after the intervention is withdrawn. The development of ToM and social communication abilities in ASD children is influenced by different psychological abilities.
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    Association between executive function and behavioral problems in school-age children with attention deficit hyperactivity disorder
    ZHANG Yu, YANG Yuankui, GUO Jing, XIE Fan, YUAN Xiaofang, FENG Jingwen, ZHANG Yi
    Chinese Journal of Child Health Care    2023, 31 (9): 1017-1023.   DOI: 10.11852/zgetbjzz2022-0260
    Abstract139)      PDF (863KB)(132)      
    Objective To explore the characteristics of executive function in school-age children with attention deficit hyperactivity disorder (ADHD) and its correlation with behavioral problems, so as to provide a theoretical basis for clinical intervention. Methods Thirty-two children with ADHD admitted to the Outpatient Clinic of Child Psychology Department, The First People's Hospital of Changzhou from May 2020 to December 2020 were selected into this study. Meanwhile 37 healthy children matched by age and sex were recruited. The Stroop test, Digit Distance Test (DST) and Wisconsin Card Test (WCST) were used for assessment, and parents completed the Parent Symptom Questionnaire (PSQ).The differences in executive function tests and questionnaire results between the two groups were compared, and the correlation was analyzed. Results 1) The scores of learning problems, impulse-hyperactivity and hyperactivity index in ADHD group were significantly higher than those of healthy children ( t=4.44, 2.63, 2.51, P<0.05). 2) There was no statistically significant difference in the results of DST test between ADHD children and healthy children ( t=1.84, 0.26, P>0.05), while the rate of persistent error in WCST in ADHD children was significantly higher than that in healthy children ( t=2.46, P=0.02). In the Stroop test, the positive numbers of card B, card C and interference of ADHD children were significantly lower than those in healthy children ( t=2.81, 4.67, 3.86, P<0.05).The rate of executive function disorder in ADHD group and healthy group was 81.25% and 43.24%, respectively, and the difference was significantly different ( χ 2=10.40, P<0.05), of which the rate of abnormal Stroop test result was significantly higher (68.75%).3) There was no significant correlation of DST and WCST test results with PSQ score; however, card A and card C test time of Stroop test, and interference amount time of the Stroop test were mildly correlated with the psychosomatic disorder index, learning problems index, impulsivity-hyperactivity index, and hyperactivity index ( r=0.35-0.47, P<0.05). 4) Logistic regression analysis showed that the persistent error rateand the number of correct cards C were independent predictive factors for ADHD ( P<0.05). The area under the curve (AUC) of the working characteristic curve for the persistent error rate and correct card C was 0.743 and 0.783, respectively ( Z=0.491, P=0.624). The maximum Jorden index was 0.459 (sensitivity 1.000, specificity 0.459) when the persistent error rate was 4.23 and the maximum Jorden index was 0.498 when the number of correct cards C was 44.5 (sensitivity 0.811, specificity 0.688). Conclusions Executive dysfunction is highly prevalent in school-age children with ADHD and is associated with behavioral problems. Executive function tests can be used as an auxiliary indicator to the diagnosis of ADHD.
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    New concepts of complementary feeding in infants and toddlers
    WANG Zhixu
    Chinese Journal of Child Health Care    2024, 32 (4): 362-367.   DOI: 10.11852/zgetbjzz2024-0250
    Abstract138)      PDF (1443KB)(267)      
    Infants go through a transition period before fully adapting to a diversified balanced diet after being breastfed, during which foods introduced other than milk, aimed at supplementing energy and nutrients, are referred to as complementary foods. The process of introducing complementary foods is called complementary feeding (CF). The purpose and significance of adding complementary foods include not only supplementing energy and nutrients, but also promoting the development of eating skills and fine motor functions, establishing healthy eating and food-related psychological behaviors, preventing food allergies and other allergic diseases, and materializing diversity of children's gut flora. The feeding suggestions of introducing red meat paste first other than iron-fortified baby rice flour at the age of 6 months, and rapidly achieving diversified food exposure, is comply with the above principles. This article analyzes the purpose of infant CF, reviews the historical development of CF, and interprets relevant feeding recommendations based on new concepts of CF.
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    Chain mediating role of psychological resilience and emotional balance between daily stress and depression in adolescents
    WANG Yao, YU Zengyan
    Chinese Journal of Child Health Care    2023, 31 (9): 1033-1037.   DOI: 10.11852/zgetbjzz2023-0098
    Abstract133)      PDF (792KB)(94)      
    Objective To explore the chain mediating effect of psychological resilience and emotional balance in the association between daily stress and adolescent depression, in order to provide a theoretical basis for improving adolescent depression and other emotional problems. Methods The Adolescent Stressful Life Events Scale, the Positive and Negative Affect Scale for Children (PANAS-C), the Connor-Davidson Resilience Scale and Center for Epidemiologic Studies Depression Scale (CES-D) were used to investigate 1 153 middle school students from a middle school in Heilongjiang Province in September 2022 by a cluater sampling method. The characteristics of depressive symptoms were first analyzed by chi-square test and binary Logistic regression model, and then structural equation modeling was used to test the chain mediating role of psychological resilience and positive/negative emotions in the association between daily stress and adolescent depression. Results Among 1 153 junior high school students, 474 (41.1%) had depressive symptoms, and the detection rates of depreesion were significantly different among students with different gender, grade and left-behind experience ( χ 2=6.12, 9.71, 13.89, P<0.05). Higher scores of daily stress and negative emotions were risk factors for adolescent depression in the post-epidemic era ( OR = 1.03, 95% CI: 1.02 - 1.04; OR = 1.12, 95% CI: 1.10 - 1.14), while positive emotions were protective factors for adolescent depression ( OR = 0.94, 95% CI:0.92 - 0.96). Independent mediating effects of psychological resilience, positive and negative emotions in the association between daily stress and adolescent depressive symptoms levels were significant, and the mediating effects were 4.09%, 5.22% and 39.90%, respectively, as were the chain mediating effects (mediating effects were 3.88%, 4.13%). Conclusion Daily stress predicts adolescent depression directly and also indirectly through the chain mediating effects of psychological resilience and emotional balance.
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    Research advance in the role of gut microbiota in attention deficit hyperactivity disorder
    ZHENG Jie, CHEN Yanhui
    Chinese Journal of Child Health Care    2023, 31 (9): 986-989.   DOI: 10.11852/zgetbjzz2022-1269
    Abstract131)      PDF (464KB)(150)      
    The microbial-gut-brain axis (MGB), which is composed of gut microbiota and its metabolites together with the central nervous system, neuroendocrine system, neuroimmune system and autonomic nervous system, is considered to be a bridge between environmental risk factors and pathological mechanisms of ADHD. Monoamine neurotransmitter levels and hypothalamic-pituitary-adrenal (HPA) axis disturbances, which have received much attention in ADHD research, are closely related to MGB imbalance. Given that the differences in geographical environment and dietary habits may cause regional differences in the intestinal microbial composition, exploring the influence of living habits on the specific characteristics and metabolites of intestinal microbes in different regions and their role in the pathological process of ADHD is helpful to understand the mechanism of MGB involving in ADHD and to provide a basis for accurate ADHD prevention and treatment strategies as well as life guidance.
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    Randomized controlled trial of the evidence-based therapy based on behavioral parent training group in alleviating Chinese children with symptoms of externalized behavior problems
    GAO Liru, QIN Yiming, QU Zhiyong
    Chinese Journal of Child Health Care    2023, 31 (9): 957-962.   DOI: 10.11852/zgetbjzz2022-1039
    Abstract129)      PDF (1096KB)(109)      
    Objective To analyze the effect of the evidence-based therapy based on Behavioral Parent Training (BPT) on alleviating the symptoms of common externalizing behavior problems in Chinese children by a randomized controlled trial. Methods From Nov.2019 to Apr.2020,a total of 141 children aged 6-12 and their parents were randomly divided into intervention group ( n=72) and control group ( n=69). Parents in the intervention group received BPT for 10 times, while the control group was given no intervention procedure. The Eyberg Child Behavior Inventory (ECBI) was used to assess children's behavior at baseline and after the intervention. Results Finally 114 children finished assessment before and after intervention, of whom 62 children were in the intervention group, and 52 children were in the control group. Post-test scores of ECBI, oppositional defiant behavior (ODB), attention deficit hyperactivity disorder behavior and unnamed factor in the intervention group were significantly lower thanthose of the control group( F=6.13, 4.34, 4.17, 7.41, P<0.05), but there was no significant difference in the score of conduct problem behavior between the two groups ( P>0.05). After intervention, the scores of ECBI and four specific dimensions of children in the intervention group were significantly lower than those before intervention, but there was no significant difference in the ECBI score between pre-test and post-test for the control group ( P>0.05). Except for conduct problem, the pre-test and post-test difference scores of ECBI and other 3 dimensions in the intervention group were significantly higher than those in the control group ( t=2.76, 2.05, 2.44, 3.12, P<0.05). Conclusion BPT can effectively alleviate common externalized behavior problems of children, which may provide useful reference for taking evidence-based intervention, reducing the occurrence and development of children's externalizing behavior problems.
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    Preliminary study on the application of mobile terminal in the early screening for autism spectrum disorder in children at home
    LI Yicheng, ZHANG Yuanyuan, HUO Yanyan, WU Dan, MA Ling, QIU Xiaoyan, MA Chenhuan, WANG Jian, LUO Jieming, LI Tianshu, XU Jing, ZHOU Jie, SUN Tingting, SHEN Hongying, XU Lei, WANG Yu, CHEN Jinjin
    Chinese Journal of Child Health Care    2023, 31 (9): 963-968.   DOI: 10.11852/zgetbjzz2022-1484
    Abstract129)      PDF (1383KB)(102)      
    Objective To explore the clinical application value of using mobile terminal for early screening of autism spectrum disorder (ASD) in children aged 0 - 36 months in Shanghai, in order to guide early family intervention. Methods A stratified sampling method was used to randomly select 12 secondary and tertiary maternal and child health care institutions in Shanghai. Children aged 0 - 36 months who underwent routine community physical examination were selected. The revised ASD early screening scale was used as the screening tool to conduct ASD early screening online at home. The primary and secondary screening rate, screening positive rate, positivity distribution and related influencing factors were analyzed. Results A total of 2 748 infants and toddlers participated in the early screening of ASD in the community, with a total of 3 472 screenings and 3 317 valid screenings, representing a valid screening rate of 95.54% and a secondary screening rate of 19.10%. There were 308(9.62%) cases with abnormal screening results, among which the positive rate of boys was 12.44%, significantly higher than that of girls (6.51%) ( χ 2=33.45, P<0.05). Among those who were screened ≥2 times, 68 children had abnormal screening at least for 1 time, 34 children finally had normal follow-up result with home intervention based on the community health promotion guidance, and the effective rate of home intervention was 50%. There were significant differences in the distribution of screening dimension failures among different age groups. Failure in gross motor skills was concentrated before 12 months of age, failure in language and fine motor skills was concentrated between 18 and 24 months of age, and failure in personal social skills was concentrated between 24 and 30 months of age. The majority (65.17%) represented "no speech" behavior among children who failed in the "five no" screening test. Conclusions The mobile terminal has good clinical application value in early screening of ASD in children at home. Promoting early ASD intervention in community-family is helpful to mobilize the subjective initiative of home and community, improve the early identification capabilities of caregivers and primary care professionals, guide caregivers to understand the law of early development of children and provide responsive care, so as to better prevent ASD and reverse ASD outcomes effectively.
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    Influence of family support on the effect of early intervention on motor function in high-risk children
    QIN Yueyi, TIAN Tian, LU Xiao
    Chinese Journal of Child Health Care    2023, 31 (11): 1168-1173.   DOI: 10.11852/zgetbjzz2022-1419
    Abstract129)      PDF (739KB)(134)      
    Objective To explore the relationship between the involvement degree of family intervention and the effect of motor function intervention on high-risk infants aged 0 to 3 years, in order to provide ideas for early intervention strategies for high-risk infants. Methods From June 2020 to April 2022, 81 high-risk infants with motor development retardation were included in this study for follow-up. All children received regular intervention in hospital and family guidance, and were divided into group with intervention frequency of <15min/d and group with intervention frequency of ≥15min/d according to the average length of daily family intervention. The level of children′s motor function was evaluated with Peabody Developmental Motor Scale (PDMS-2) before and 3 months after the intervention, and the intervention effect was compared. Results After intervention, gross motor development quotient (GMQ), fine motor development quotient (FMQ) and total motor development quotient (TMQ) of all children were significantly higher than those before intervention ( t=5.250, 5.601, 5.705, P<0.05). Further group comparison showed that the GMQ, FMQ and TMQ both in children aged 0 - 12 months and 13 - 36 months were significantly higher than those before intervention in group with intervention frequency of <15min/d and group with intervention frequency of ≥15min/d ( P<0.05), but the GMQ, FMQ and TMQ of children aged 0 - 12 months after intervention were significantly higher than those of children aged 13 - 36 months ( P<0.05). Families of children with abnormal cranial MRI were more likely to devote more time to the intervention each day than families of children without abnormalities (χ 2=4.516, P=0.034), and GMQ, FMQ and TMQ all improved significantly more in families of children with abnormal cranial MRI after the intervention ( t=2.104,2.264,2.757, P<0.05). Conclusions The early intervention training mode of hospital rehabilitation intervention combined with family intervention has a good promotion effect on improving the motor function of high-risk children with motor retardation aged 0 - 3 years. Family interventions that involve a higher level of investment and an early start are more likely to improve children′s motor development. The findings of the child′s cranial MRI have a certain influence on the family motivation and the effectiveness of the intervention.
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    Nutritional status and its influencing factors of children aged 1 - 5 years with cerebral palsy in Shenzhen
    WANG Jinggang, LI Qingyun, YU Chunyu, YUN Guojun, TONG Nan, CAO Jianguo
    Chinese Journal of Child Health Care    2023, 31 (11): 1180-1184.   DOI: 10.11852/zgetbjzz2023-0070
    Abstract129)      PDF (628KB)(155)      
    Objective To investigate the nutritional status of children aged 1 - 5 years with cerebral palsy in Shenzhen, and to determine its influencing factors, in order to provide evidence for clinical nutritional intervention. Methods This multicenter study was performed in ten maternal and child healthcare hospitals from October 2020 to August 2022. A total of 1 094 1- to 5-year-old children with cerebral palsy were involved in the survey. General data of the children were collected, meanwhile body weight, height/body length were measured. Nutritional status was evaluated according to the child growth and development standards issued by WHO. Multivariate Logistic regression analysis was performed to test factors that may affect nutritional status. Results The prevalence of malnutrition among children with cerebral palsy aged 1 - 5 years was 17.91%. GMFCS level, feeding difficulty and parental knowledge level of nutrition were the factors significantly influencing the nutritional status of children with cerebral palsy ( P<0.05). Higher GMFCS score and feeding difficulty were the risk factors for malnutrition with cerebral palsy, while parental knowledge level of nutrition was a protective factor. There was no significant difference in the prevalence of malnutrition among children with different clinical classification, constipation or not, same educational background of parents ( P >0.05). Conclusions The malnutrition prevalence rate in children with cerebral palsy aged 1 - 5 years appears to be low in Shenzhen, China. GMFCS levels, the severity of feeding difficulties, and parental knowledge level of nutrition are factors that affect the nutrition status of this population.
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    Status quo of screen exposure and its determinants in 3- to 6-year-old children in Minhang district, Shanghai
    CHEN Min, ZHANG Hongmei, KANG Shurong, LI Yun
    Chinese Journal of Child Health Care    2024, 32 (1): 26-30.   DOI: 10.11852/zgetbjzz2023-0004
    Abstract129)      PDF (549KB)(131)      
    Objective To investigate the screen exposure status in 3- to 6-year-old children in Minhang district and to analyze its determinants, so as to provide a basis for scientific intervention of screen exposure in children. Methods A total of 1 035 children aged 3 to 6 years were selected from 30 classes in 10 kindergartens in Minhang district by multi-stage cluster sampling in October 2022. An online questionnaire survey was conducted by their parents. Screen exposure was difined as spending more than one hour on video products per day. Multivariate Logistic regression model was adopted to analyze the determinants of children screen exposure. Results Among 1 035 children, 730 experienced screen exposure (70.53%). The average time of daily screen exposure was (1.67±0.98)h. The daily screen exposure time of children aged 3, 4, 5 and 6 years at weekends was (1.77±1.13), (1.76±1.04), (1.98±1.10)h and(2.08±1.22)h, respectively, and the difference was statistically significant ( F=3.98, P<0.01). Multivariate Logistic analysis showed that age group of 5 years old ( OR=1.79, 95% CI:1.19 - 2.68), the caregivers using video products for 1 - 2hours/day ( OR=2.61, 95% CI:1.90 - 3.60) and >2hours/day ( OR=2.10, 95% CI:1.35 - 3.27) when accompanying children, parents supporting children using video products( OR=1.59, 95% CI:1.17 - 2.15), children using video products before bedtime( OR=1.94, 95% CI:1.32 - 2.86), and unsupervised use of video products for children( OR=1.94, 95% CI:1.36 - 2.77) were independent risk factors for children's screen exposure( P<0.05). Father's education level of bachelor( OR=0.61,95% CI:0.43 - 0.89), master and above( OR=0.49, 95% CI:0.34 - 0.73) was a protective factor for children's screen exposure( P<0.05). Conclusions Attention should be paid to the problem of screen exposure of 3 -to 6 - year-old children. Targeted efforts should be made to popularize the knowledge of the harm of early screen exposure to children among caregivers, caregivers are advocated for the rule formulation of screen behavior, scientifically regulate children's screen exposure behaviors, and increase parent-child communication, so as to reduce the adverse effects of screen exposure on children's health.
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