Table of Content

10 May 2020, Volume 28 Issue 5

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Management of emotional problems in children with attention deficit hyperactivity disorder

ZHANG Jin-song

2020, 28(5):  489-492.  DOI: 10.11852/zgetbjzz2020-0495

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The prevalence of emotional problems is high in children with attention deficit hyperactivity disorder(ADHD),including slight common emotional problems to serious mood disorders. It brings difficult to the management of ADHD children. It is necessary to integrate the management of emotional problem into the intervention plan of ADHD. The management plan should be classified,trans-discipline,step by step and comprehensive. According to the quality and level of emotional problems,the clinical professionals of different levels and domains implement the management program appropriate for his or her ability,take the evidence based intervention and treatment methods. The most serious disorder should take the priority to be treated,or treated at the same time. This article emphasises the assessments including the warning signs,screening scales,structure or semi-structure interview,diagnostic thinking,related psychotherapy and medication therapy.

Children's behavior inhibition test and behavior training

WEI Shu-zhen, YI Ming-ji

2020, 28(5):  493-496.  DOI: 10.11852/zgetbjzz2019-1909

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Behavior inhibition,as the core content of executive function,is the suppression of irrelevant information or behavior in order to complete tasks. Its early defects can easily lead to social communication disorders,working memory,emotional regulation,attention and other executive function problems. With the deeper understanding of behavioral inhibition,a series of mature test methods have emerged,including Stroop task,lateral inhibition,Navon task,Simon task,multi-source conflict task,etc. These behavioral inhibition test methods play an important role in the diagnosis of behavioral disorders. The development of executive function can be promoted by behavioral inhibition training for developing children. The early stage of behavioral inhibition healthy development can effectively improve children's self-control and attention,thereby improving the learning ability. Therefore,it is important to understand the test methods and behavior training of behavior inhibition for promoting the development of children's executive function.

Longitudinal study on parental sleep arrangements characteristics and associated factors for infants aged 0-3 months

FENG Wei-wei, XU Tao, WANG Hui-shan, ZHANG Yue, HUANG Xiao-na, PAN Xiao-ping, JIN Xi, MA Yuan, ZHANG Liang-fen, ZHANG Feng-hua, HUANG Guang-wen, WANG Nian-rong, LI Hong-hui, ZHANG Tong

2020, 28(5):  497-501.  DOI: 10.11852/zgetbjzz2019-0822

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Objective To longitudinally examine characteristics and associated factors of parental sleep arrangements for infants aged 0-3 months,in order to provide reference for the predictive guidance of infants' early parental sleep arrangements. Methods This was a longitudinal study of 156 infants with repeated measures from birth to 3 months in 5 cities of China from 2013 to 2015. The parental sleep arrangements were measured at 14 days,1 month,2 months and 3 months after birth. The statistical description and CMH chi-square test were conducted. The generalized linear mixed models were fitted to analyze the associated factors. Results The proportions of infants who fell asleep at night by parents holding,patting or accompanying beside the bed,and alone were 54. 4%,35. 9% and 9. 7%,respectively,and the proportion of falling asleep by holding increased over time (P＜0. 000 1). The proportions of asleep,drowsy but awake and fully awake when the infants were placed on the bed at bedtime were 63. 7%,28. 6% and 7. 7%,respectively,and the proportion of drowsy but awake decreased over time (P=0. 000 3). The proportions of co-sleeping,room-sharing without bed-sharing,slept on parents' arms or backs and in a separate room were 53. 8%,42. 4%,2. 0% and 1. 8%,respectively,and the proportion of co-sleeping increased over time (P＜0. 000 1). Parents' education level of university and above,household income of 5 100~8 000 yuan and father depression were statistically significant on sleep arrangements(OR=0. 46,2. 55,1. 60,0. 57,P<0. 05或<0. 001). Conclusions Parental sleep arrangements for infants in early stage mainly include falling asleep with soothing,putting infants to sleep asleep and co-sleeping,which need to strengthen predictive guidance.

Research on effect of social PEERS training for mother and children with autism spectrum disorder in Shanghai

ZU Yan-fei, DU Ya-song, YAO De-sheng, ZHOU Ying-qun, FAN Ning

2020, 28(5):  502-505.  DOI: 10.11852/zgetbjzz2019-0262

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Objective To implement the evidence-based social skills interventions,in order to enhance the social skills of children with autism spectrum disorder (ASD) and to reduce their mothers' depression,anxiety and uncertainty. Methods Chinese version of structural and peer-coaching social training manual of PEERS were adopted. ASD children and their mothers were simultaneously intervened for three and a half months once a week with 90 minutes each time. Children were conducted in group training while parents were conducted in group. Meanwhile,maternal disease uncertainty,cognition,anxiety and depression were also adjusted. Children's symptoms,social behavior as well as mothers' mood before and after intervention were evaluated. Maternal disease uncertainty was reassessed in six months. Results Significant differences existed on mothers' depression(t=-4. 585,P<0. 01),children's symptom(t=-3. 945,P<0. 01),behavior(t=-2. 068,P<0. 05) and sociality (t=-2. 315,P<0. 05) after intervention between intervention group and control group. Moreover,the difference was significant in intervention group before and after intervention(P＜0. 05). Conclusion The Chinese version of PEERS social training can help improve social skills of ASD children,and reduce their depression.

Value of body mass index in differential diagnosis between postural tachycardia syndrome and vasovagal syncope in children and adolescents

JIA Wan-ru, WU Min, WANG Jia-qi, GU Ying, ZHANG Qi-yi, SHEN Jie, JIAO Fu-yong, LIN Jing

2020, 28(5):  506-510.  DOI: 10.11852/zgetbjzz2020-0297

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Objective To analyze the statistical distribution of body mass index (BMI) in children with postural tachycardia syndrome (POTS) and children with vasovagal syncope (VVS), and to explore the application value of BMI in distinguishing the two diseases. Methods A total of 260 children and adolescents who complained of unexplained syncope were enrolled in this study from June 2015 to December 2019, and were divided into POTS group (n=110) and VVS group (n=150) after definite diagnosis by HUTT. Meanwhile, 82 subjects who took physical examination were selected as the control group. The data of BMI was collected after measuring the height and weight of all subjects in the same room, and its statistical difference among the three groups above was described. Then the receiver operating characteristic (ROC) curve was used to evaluate the value of BMI in distinguishing POTS and VVS. Results The average BMI of children in control group, POTS group and VVS group were (20. 51±2. 91) kg/m², (18. 17±3. 12)kg/m² and (19. 91±3. 69)kg/m², respectively. The BMI of children in POTS group was significantly lower than that in control group and VVS group (P＜0. 001). However, there was no statistically significant difference between VVS group and control group (P＝0. 195). As for the BMI difference among the three VVS subtypes, the statistically difference was significant(F＝3. 229,P＝0. 042). The area under the ROC curve of BMI was 0. 644 (95%CI: 0. 577-0. 711, P＜0. 001). Taking 19. 30 kg/m² as threshold BMI for VVS children and adolescents, the predicted sensitivity and specificity were 56. 0% and 71. 8%, respectively. Conclusions Children and adolescents with POTS have the significantly lower BMI than those with VVS. Thus, BMI is an acceptable auxiliary method to discriminate POTS and VVS combined with medical history, physical examination and other auxiliary examinations.

Research on the personality characteristics and self-consciousness of Muslim female orphans in an orphanage

YU Xue, DAI Xiu-ying, LI Qiu-li, LI Lin-gui

2020, 28(5):  511-515.  DOI: 10.11852/zgetbjzz2019-1031

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Objective To understand the personality characteristics and self-consciousness of Muslim female orphans in an orphanage,so as to provide scientific basis for further psychological intervention. Methods The general situation questionnaire,Eysenck personality questionnaire (EPQ for children) and Piers Harris child self-awareness scale (PHCSS) were used to investigate 40 Muslim female children in an orphanage in from February to May in 2014. At the same time,a control study was conducted on 254 other Muslim girls in the same school. Results Muslim female orphans(2. 90±2. 82) got lower scores than the normal Muslim female group(4. 28±2. 82) and the national girl norm(4. 27±2. 24) in P dimension,the difference was statistically significant (P<0. 01). But the scores in L dimension(16. 83±3. 44) were significantly higher compared with normal Muslim female group(13. 56±4. 31) and the national girl norm(14. 41±3. 65)(P<0. 01),and the scores in E dimension(13. 90±4. 37) were significantly lower than that of the national girl norm(16. 34±3. 44) (P<0. 01). The scores in gregarious factor of Muslim female orphans group(7. 83±1. 97) was significantly lower than normal Muslim female children(9. 13±1. 78) (P<0. 05),and the other factors of self-awareness and total scores were significantly lower than those of the Chinese urban girl norm except for behavioral factors and anxiety factor (P<0. 01). The personality deviation of Muslim female orphan group(50. 0%,60. 0%)were significantly higher than normal Muslim female group(21. 7%,27. 6%) in the E and L dimension (P<0. 01). The relatives and friends group got significantly higher scores in N dimension compared with siblings' group(14. 00±7. 62,6. 40±2. 88,P<0. 05). But the grandparent group got significantly lower scores in L dimension compared with siblings' group(15. 92±3. 75,19. 80±0. 45,P<0. 05). Each factor score of EPQ was not statistically different between different academic performance groups in Muslim female orphans,but was statistically different in self-consciousness total score,as well as behavioral and gregarious factor scores (P<0. 05 or <0. 01). The poorer academic performance,the more obvious the character and behavioral defects. Conclusion The mental health condition of Muslim female orphans is poor,obviously in character limitations and low level of self-consciousness.

Genetic heritability with autism spectrum disorder and related factors of clinical characteristics among 36 pairs of twins

WANG Yi, QIN Qian, TANG Xin-rui, ZHANG Ying, LU Ping, ZHU Ye, DONG Ping, LI Hui-ping, LI Dong-yun, XU Xiu, XU Qiong

2020, 28(5):  516-520.  DOI: 10.11852/zgetbjzz2019-1541

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Objective To analyze the concordance, genetic heritability with autism spectrum disorder(ASD),establish regression model among 36 pairs of twins,and to explore related factors of outcome of neurodevelopmental scale. Methods Partial twins were collected from Children's Hospital of Fudan University from 2016 to 2018, and those who met the inclusion criteria that at least one twin was ASD or both twins were neuro-typical (NT) were enrolled in this study. General data of the participants were collected, and sociability and development quotient (DQ) were assessed by Autism Diagnostic Observation Schedule (ADOS) and Griffiths Mental Developmental Scales (GMDS). The model was established by R language and software package-mets. Results The concordance rate of monozygotic twins was 66. 7%, while 16. 7% for dizygotic twins among 36 pairs. The best fist of ASD risk factors was AE model including gender and weight covariance and the heritability of ASD diagnosis was 90. 4%(95%CI:65. 2%~115. 7%), but clinical covariates and genetic factors had no significant effect on ASD prediction. AE fitted model of ADOS-RRB best included ASD diagnosis, weight, birth type and age, while CE fitted model of ADOS-SA included gender, age, maternal education, and way of conception. CE fitted model of GMDS-DQ included ASD diagnosis, premature and gender. And non-shared environmental factors had significant effects on clinical characteristics of ASD (ADOS-RRB, P=0. 000 2; ADOS-SA, P<0. 000 1; GMDS-DQ,P<0. 000 1). Conclusion Genetic factor is an important factor in the occurrence of ASD, and non-shared environmental factor has a certain correlation with the clinical evaluation results of ASD.

Influence of parenting style on anxiety level of adolescents with social anxiety disorder

YANG Han-shu, WU Jing-yi, LIU Wen-jing, YANG Zhi, CHENG Wen-hong, XIAO Ze-ping

2020, 28(5):  521-524.  DOI: 10.11852/zgetbjzz2019-1198

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Objective To explore the influence of parenting style on the anxiety level of adolescents with social anxiety disorder,and the mediating effect of coping style between parenting style and social anxiety disorder. Methods A total of 120 adolescents diagnosed with social anxiety disorder (SAD) by DSM-5 were selected as participants from May 2018 to May 2019,and 120 children matched by gender and age were selected as control group. The Screening Scale for Child Anxiety Related Emotional Disorders,Egna Minnenav Barndoms Uppfostran and Cope-Style Scale for Middle School Students were used for assessment. Results The father rejection,mother rejection and mother overprotection of the SAD group were all higher than those of control group (t=7. 14,8. 85,2. 67, P<0. 05),while father emotional warmth and mother emotional warmth of the SAD group were lower than those of control group (t=-7. 36,-8. 29,P<0. 05). Father's rejection,emotional warmth and overprotection were significantly positively correlated with anxiety level (r=0. 195-0. 317,P<0. 05). Mother's rejection and overprotection were significantly positively correlated with anxiety level (r=0. 232-0. 253,P<0. 05). The individual emotional coping style plays a completely mediating role between the emotional warmth of the mother and the anxiety level of the SAD group,with the mediating effect of 0. 439 7. Conclusions The parenting style of adolescents with social anxiety disorder has an important influence on the level of adolescents' anxiety. So it is suggested to create a harmonious family atmosphere for children. Moreover,empathetic coping plays an important mediating role between mothers' emotional warmth and adolescents' social anxiety.

Mediating role of temperament in the effect of family environment on preschool children's social ability

LIU Guo-yan, LI Jie-xuan, ZHU Xiao-hui, XIAO Li-mei

2020, 28(5):  525-528.  DOI: 10.11852/zgetbjzz2019-1473

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Objective To investigate the status quo of children's temperament,family environment and social ability,and to explore the mediating role of temperament in the effect of family environment on preschool children's social ability. Method A total of 757 preschool children aged 3~6 years were randomly selected in Shenzhen and were investigated by the 3~7 Years Old Children's Temperament Questionnaire,Family Environment Scale and Children Social Ability Test in April 2019. Results 1) There were significant differences on the total social ability scores of children with different gender,age and temperament types (F=7. 896,9. 877,12. 696,P<0. 01). 2) Activity level,reaction intensity and reaction threshold in temperament were negatively correlated with the total score of family environment (r=-0. 16,-0. 12,-0. 21,P<0. 01) and the total score of social ability (r=-0. 21,-0. 16,-0. 29,P<0. 01). The total score of family environment,adaptability and phobotaxis were positively related to the total score of social ability (r=0. 29,0. 31,0. 41,P<0. 01). 3) The mediating effects of family environment on children's social ability were through seven dimensions of activity level (9. 53%),phobotaxis (27. 80%) and response threshold (16. 93%) in temperament. Conclusion Temperament plays an intermediary role in the influence of family environment on preschool children's social ability.

Study on the structure and characteristics of multiple intelligences in boys with autism spectrum disorders aged 4—8 years

WANG Yu, WANG Fang, ZOU Yuan-yuan, ZHANG Ying-ying, ZOU Xiao-bing

2020, 28(5):  529-532.  DOI: 10.11852/zgetbjzz2020-0311

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Objective To analyze the structure and characteristics of multiple intelligences in children with autism spectrum disorders (ASD). Methods cross-sectional study was conducted in this study. Totally 63 ASD boys with average age of (6. 18±1. 16) years old were enrolled as ASD group from August 2018 to February 2019, meanwhile 69 typical boys with average age of (5. 98±1. 10) years old were selected as control group. The Chinese Version of Multiple Intelligences Development Scale-A (CMIDAS-A) was used to assess the multiple intelligences of the children. Results he scores of kinesthetic intelligence, interpersonal and intrapersonal intelligence of ASD boys were significantly lower than those of typical boys(Z=5. 053, 3. 177, 6. 398, P＜0. 05), while there was no significant differences on the scores of language intelligence, mathematics-logic intelligence, spatial intelligence, musical intelligence and natural intelligence between the two groups(P＞0. 05). Conclusions Compared with TD boys, ASD boys are weak in kinesthetic intelligence, interpersonal and intrapersonal intelligence, and their dominant intelligences were mathematics-logic and music intelligences. So it is supposed to make individualized intervention measures according to the interest and advantages of ASD children.

Effect of neonatal maternal separation on oxytocin levels and behaviors in rats

LAI Xi, WU Xiao-feng, YANG Ting, CHEN Jie, LI Ting-yu

2020, 28(5):  533-537.  DOI: 10.11852/zgetbjzz2019-1259

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Objective To investigate the effects of neonatal maternal separation on behavior and mental problems in rat,and to explore the effects of maternal separation on oxytocin and related molecules expression and neurodevelopment in rats. Methods Neonatal SD rats were randomly divided into control group and neonatal maternal separation group(NMS group). Rats in NMS group were separated from their mothers for 2 hours from 1 to 14 days after birth. Behavioral tests were performed at the age of 6 weeks old,including open-field tests,three-chambered tests,elevated-plus maze and forced-swimming tests. The expression of CD38 protein in rat hypothalamus was detected by Western blot. The serum OXT level was detected by ELISA. Results In the NMS rats,the time[control vs. NMS:(29. 19±3. 55)s,(55. 90±4. 03)s,P<0. 001]and frequency of self-grooming(6. 67±0. 74 vs. 9. 53±0. 73,P<0. 05) increased significantly,suggesting an increase of stereotyped behavior. And the interaction time with unfamiliar rats was decreased [(350. 40±41. 25)s,(260. 30±33. 43)s,P<0. 05],suggesting that social function of NMS rats was impaired; the decreased time spent in open-arms [(78. 15±20. 95)s vs. (36. 45±5. 35)s,P<0. 05] of elevated-plus-maze in the central area of the open-field [(153. 7±34. 41)s vs. (13. 84±4. 80)s,P<0. 01)] and the increasing frequency of defecation(1. 72±0. 24,3. 25±0. 26,P<0. 001)suggesting the increased anxiety-like behavior of rats; the immobility latency[(59. 02±8. 64)s,(33. 97±5. 87)s,P<0. 05]and the shortened total struggling time in the forced swimming test,suggesting the depressive behavior of NMS rats. In addition,the expression of hypothalamic CD38(P＜0. 01) protein and the serum OXT level(P＜0. 05) were significantly lower in NMS rats. Conclusions 1) Maternal and child isolation in early life may lead to autism-like behavior,anxiety and depression-like behavior in adult rats. 2) Maternal-infant separation may reduce the release of OXT by reducing the expression of CD38 protein in hypothalami,thereby leading to abnormal behaviors.

Characteristics of emotional ability in children with attention deficit hyperactivity disorder

XU Xin-yun, CHEN You-qing

2020, 28(5):  538-542.  DOI: 10.11852/zgetbjzz2019-1050

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Attention deficit hyperactivity disorder (ADHD) is characterized by persistent inattention, hyperactivity, impulsivity and other clinical symptoms. Among them, emotional dysfunction is one of the clinical manifestations of ADHD. This article combs the characteristics of ADHD children's facial emotion recognition, emotional response, emotional regulation and behavioral problems, as well as the neurophysiological mechanism of ADHD children's emotional ability, with a view toproviding some references for a more in-depth understanding of the emotional capabilities of children with ADHD and,suggesting possible directions for future research.

Advances on the application of immersive virtual reality technology in the treatment of autism spectrum disorders

CHEN Jing, DU Ya-song

2020, 28(5):  543-546.  DOI: 10.11852/zgetbjzz2019-0615

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The treatment of autism spectrum disorder (ASD) is limited and the burden of this disease is heavy. This paper is aimed to introduce the advances on the application of immersive virtual reality technology in the treatment of ASD,thereby providing new ideas for the treatment of ASD patients.

Research progress of general movements assessment

MA Liang, RAN Ni, FENG Xue-ying, SHAN Yan-chun, YI Ming-ji

2020, 28(5):  547-550.  DOI: 10.11852/zgetbjzz2019-0860

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General movements (GMs) are the most common and complex spontaneous movement patterns in infants. Based on general movements assesment(GMA),the neurodevelopmental outcomes,especially the motor outcomes,can be well predicted in the later stages of infants. GMA prediction has high sensitivity and specificity. According to the concept of optimization,a detailed assessment method is put forward. The detailed assessment is a supplement and explanation to the global assessment. Especially when the global assessment results are marginal and difficult to judge,the detailed assessment is more conducive to the judgment of prognosis. This article reviews the research progress on the global and detailed evaluation of the quality of general movements.

Research advances on the genomic biomarkers of autism spectrum disorder

WEI Nian-jin, WANG Yu

2020, 28(5):  551-554.  DOI: 10.11852/zgetbjzz2019-0762

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Autism spectrum disorder (ASD) is a neurodevelopmental disease characterized by impairment social interaction,repetitive behaviors and restricted interest. Recent studies have demonstrated dramatically increasing prevalence of ASD,reaching to 1∶59. However,the etiology and pathogenesis of ASD remain unknown. Early diagnosis and early intervention are crucial to the rehabilitation of ASD. In recent years,researches on biological markers of ASD has made great progress,especially in genomics,including gene mutation,copy number variation,single nucleotide polymorphism and epigenetic. This review will summarize the research progress on genomic biomarkers of ASD.

Research progress on common comorbidities in children with autism spectrum disorders

ZHOU Yu-nan, ZHAO Hong-bo, JIANG Zhi-mei

2020, 28(5):  555-558.  DOI: 10.11852/zgetbjzz2019-0996

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Autism spectrum disorder (ASD) is a set of neurodevelopmental disorders that occurs in early life. ASD children are often comorbid with ADHD,epilepsy,sleep disorders,gastrointestinal problems,immune abnormalities,anxiety,affective disorders and other diseases. This review focuses on the current research on ADHD,epilepsy,sleep disorders,gastrointestinal problems,respectively and summarized in terms of the epidemiological characteristics,the impact on clinical symptoms and treatment methods of ASD children.

Study on family environment and development-related risk factors of children with attention deficit hyperactivity disorder

LI Yan, DU Ya-song, JIANG Wen-qing, QIAN Yun, LIU Yue

2020, 28(5):  559-562.  DOI: 10.11852/zgetbjzz2019-1491

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Objective To explore the influence of family environment and developing-related factors on the children's attention deficit hyperactivity disorder (ADHD),so as to provide the basis for early prevention and treatment of ADHD. Methods Totally 132 ADHD children in Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine were enrolled in this study from 2014 to 2017. And 82 healthy children were selected as control group. The family environment,parental stress and early development two groups were analyzed and compared by multivariate Logistic regression. Results There were significant differences between two groups on maternal pregnancies (t=3. 540),pregnancy accidents (χ²=18. 678),birth accidents (χ²=6. 523),major diseases (χ²=5. 527),dependency (χ²=22. 760),primary dependants (χ²=11. 831),parenting style (χ²=10. 440),parental relationship (χ²=8. 198) and parental stress (t=5. 217) (P<0. 05). Logistic regression analysis revealed that the abnormal conditions during maternal pregnancy(OR=7. 233,95%CI:1. 640—31. 898),negative discipline (OR=3. 759,95%CI:1. 429—9. 887) and different parenting attitudes (OR=2. 860,95%CI:1. 041—7. 859) were risk factors for ADHD. Breastfeeding (OR=0. 128,95%CI:0. 032—0. 514),general parenting(OR=0. 026,95%CI:0. 003—0. 223) and easy parenting(OR=0. 021,95%CI:0. 002—0. 225) were protective factors of ADHD. Conclusion The perinatal abnormality,family education and family relationship are the influencing factors of ADHD,which should be paid more attention.

Study on the associations between parenting stress and anxiety symptoms among urban preschoolers

XU Yi, YAN Qiong, TONG Lian

2020, 28(5):  563-566.  DOI: 10.11852/zgetbjzz2019-1129

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Objective To know about the levels of parenting stress and anxiety symptoms in preschoolers, and to explore the associations between them. Methods A total of 1107 children aged 3 to 6 years were recruited from 3 kindergartens in urban areas by convenient cluster sampling in June 2017, and their parents were asked to fill out the questionnaire. The anxiety symptoms were assessed by Spence Preschool Anxiety Scale, and the parenting stress were assessed by short version of Parenting Stress Index 4/PST-4-SF. Results The overall prevalence of anxiety symptoms in preschoolers was 3. 3%(34/1 107). The prevalence of generalized anxiety symptoms, social anxiety symptoms and separation anxiety symptoms in preschoolers were 3. 1%, 3. 7% and 3. 1%. Parenting stresses with positive anxiety symptoms in preschoolers were significantly higher than those with negative anxiety symptoms(P＜0. 01). Multivariate linear regression analysis showed that the parental distress and difficult child were positively correlated with the level of anxiety symptoms in preschoolers (B=-0. 17,-0. 46, P<0. 01). The less cost in children under 3 years old, the higher level of anxiety symptoms in children would be(B=-1. 14,P=0. 01). On the contrary, the higher the cost after three years of age, the more anxiety symptoms in children (B=1. 19, P=0. 02). Conclusion Parenting stress and family's costs on children in different age stages have significantly positive association with children's anxiety symptoms.

Study on the correlation between social-emotion and screening risk of autism spectrum disorders in children

MU Li-juan, ZHAI Yan-tao

2020, 28(5):  567-570.  DOI: 10.11852/zgetbjzz2020-0430

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Objective To explore the association between social-emotional problems and the preliminary screening risk of autism spectrum disorders (ASD) in children aged 16-30 months, so as to provide reference for figuring out the high risk characteristics and early screening ASD. Methods A survey was conducted on 542 children who came to Fangshan Maternal and Children Health Hospital for routine health care from January 2018 to November 2019. Children's primary caregivers completed the Ages and Stages Questionnaire:social-emotional (ASQ-SE) for the children's age group under the guidance of trained doctors. On the same day or at adjacent times,primary caregivers were instructed to complete Modified Checklist for Autism in Toddlers-Revised with Follow Up (M-CHAT-R/F) under the guidance of doctors who were unaware of the ASQ-SE results. The correlation between ASQ-SE scores and M-CHAT-R scores was analyzed. Results Children with abnormal social emotion scored significantly higher on M-CHAT-R than children with normal social emotion (U_{18 months}=5 004. 00,U_24months=5 491. 50,U_{30 months}=409. 00,P＜0. 001). A higher proportion of children with abnormal social emotion were at risk of ASD as preliminary screened by M-CHAT-R (18 months:86. 96%,24 months:90%,30 months:80%). ASQ-SE scores were positively correlated with M-CHAT-R scores (r_{18 months}=0. 724,r_{24 months}=0. 693,r_{30 months}=0. 783,P＜0. 01). Conclusions Most of the children with social-emotional problems are at risk of ASD,and should be given more concern to,especially to younger children with social-emotional problems. Moreover,it is recommended that doctors should adopt the M-CHAT-R/F scale for ASD preliminary screening according to the actual situation.

Application analysis of the Chinese simplified version of M-CHAT in children aged 3 to 4 years

CHEN Qiang, YUAN Bin, XU Wen-juan, QI Xiao-bing, YANG Li-yong, QI Yang-yang

2020, 28(5):  571-573.  DOI: 10.11852/zgetbjzz2019-1709

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Objective To explore the application value of Chinese simplified version of M-CHAT to screen autism spectrum disorder (ASD) in children aged 3 to 4 years,and to establish appropriate thresholds. Methods A total of 48 ASD children aged 3 to 4 years and 96 normal developing children were selected as subjects from January 2018 to December 2018. The Chinese simplified version of M-CHAT was used and ROC curve was drawn to evaluate the value of the scale in screening ASD among children aged 3 to 4 years. Results Using the Chinese simplified version of M-CHAT in screening ASD in children aged 3 to 4 years old,the area under the curve(AUC) was 0. 94 (95%CI:0. 893―0. 975). When the cutoff point was divided into 13,the Chinese simplified version of M-CHAT showed the highest ability to distinguish ASD from non-ASD. Its sensitivity was 0. 94 (95% CI:0. 828―0. 987),specificity was 0. 82 (95% CI:0. 732―0. 893),Youden index was 0. 76,positive probability ratio was 5. 29 (95% CI:3. 400-8. 200) and negative probability ratio was 0. 08 (95% CI:0. 030―0. 200). The positive predictive value was 72. 58% and the negative predictive value was 96. 34%. Conclusion The Chinese simplified version of M-CHAT shows strong ability to screen ASD children aged 3 to 4 years,and is well worth popularizing and applying in ASD screening for children aged 3 to 4 years.

Study on the association of media use with sleep habits and quality among preschool children

JIANG Lin, MA Ying, XING Yan-fei, LIN Sui-fang

2020, 28(5):  574-578.  DOI: 10.11852/zgetbjzz2019-1963

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Objective To explore association of media use with sleep habits and sleep quality among pre-schoolers in Guangzhou, in order to provide reference for improving children's sleep quality. Methods A total of 876 children aged 3 to 5 years were randomly recruited to this cross-sectional study in 2016. A self-designed questionnaire was used to investigate child media use information, and child sleep habits and sleep quality were derived from the Children's Sleep Habits Questionnaire (CSHQ). Results Daily use of media device was associated with later bedtime (β=11. 4 min, 95% CI: 6. 0 ─16. 8), shorter nocturnal sleep duration (β=-0. 20 h, 95% CI:-0. 31─-0. 08), shorter total sleep duration (β=-0. 20 h, 95%CI:-0. 04 ─-0. 02), as well as higher total CSHQ score (β=1. 91, 95%CI:0. 80 ─3. 02), scores of bedtime resistance (β=0. 61, 95%CI: 0. 17 ─ 1. 05), sleep anxiety (β=0. 38, 95%CI: 0. 06 ─0. 70) and daytime sleepiness (β=0. 59, 95%CI :0. 13 ─1. 06). Children who consumed screen time ≥ 30 mintues/time had later bedtime (β=9. 0 min, 95%CI: 3. 0 ─14. 4) and shorter total sleep duration (β=-0. 20 h, 95% CI:-0. 36 ─-0. 03), as well as higher total CSHQ score (β=2. 01, 95% CI:0. 88─3. 14) and higher scores of bedtime resistance (β=0. 68, 95%CI: 0. 23─1. 12),sleep duration (β=0. 32, 95%CI: 0. 10 ─0. 53), sleep anxiety (β=0. 38, 95% CI: 0. 06 ─0. 71) and daytime sleepiness (β=0. 70, 95% CI:0. 23 ─1. 18). Children who started to use media devices before 2 years old tended to have higher total CSHQ score (β=1. 67, 95% CI:0. 26 ─3. 11) and higher sleep onset delay score (β=0. 17, 95% CI:0. 03 ─ 0. 30) than those started to use devices after age 2 years. Moreover, children who started to use media devices before 2 years old(β=1. 67,95%CI:0. 26-3. 11), who had daily use of media device(β=1. 91,95%CI:0. 80-3. 0) and who consumed screen time≥30 mintues/time(β=2. 01,95%CI:0. 88-3. 14) tended to have gigher total CSHQ Score respectively, indicating that their general sleep quality were probably poorer than their counterparts. Conclusion Early exposure to media use, high frequency of electric devices use, and long screen time are associated with poor sleep habits and sleep quality among pre-schoolers, which is supposed to be attached great importance.

Relationship between psychological behavior problems and parental health literacy in preschool children

ZHANG Ling-li, HU Xiao-ping, WAN Xiao-xian, GUO Sheng-nan, LUO Zhen-zhou

2020, 28(5):  579-582.  DOI: 10.11852/zgetbjzz2019-1734

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Objective To explore the relationship between the psychological behavior problems of preschool children and the health literacy of their parents, in order to provide reference for early intervention of children's psychological behavior problems. Methods Totally 4 120 preschool children and their parents were selected from 13 kindergartens in Guangming district of Shenzhen by stratified cluster random sampling method from May to July 2018. The Strengths and Difficulties Questionnaire (SDQ) and Shenzhen citizens' health literacy questionnaire were used for data collection. Logistic regression model was used to analyze the relationship between the psychological behavior problems of preschool children and their parental health literacy. Results The detection rate of psychological behavior problems among preschool children was 34. 9% (1 436/4 120), including 6. 5% reported total difficulties, 5. 6% experienced emotional problems, 8. 9% having conduct problems, 13. 4% exhibited hyperactivity/ inattention, 14. 4% experienced peer problems and 9. 2% having prosocial behaviors. The detection rate of total difficulties, emotional problems, conduct problems, hyperactivity/inattention, peer problems and prosocial behaviors among boys and girls were 7. 3% vs. 5. 5%, 4. 8% vs. 6. 5%, 9. 7% vs. 7. 8%, 15. 5% vs. 10. 7%, 15. 8% vs. 12. 7%, 11. 1% vs. 6. 7%, respectively, and the differences were statistically significant (χ²=5. 626, 5. 506, 4. 212, 19. 846, 7. 650, 23. 863, P＜0. 05) . Multiple regression indicated that the risk factors for psychological problems included the low parental health literacy(OR=1. 294), low basic concept of knowledge(OR=1. 293), low healthy behavior(OR=1. 412), and low basic health skills(OR=1. 193)(P＜0. 05). Conclusion Psychological behavior problems are prevalent among preschool children. And low parental health literacy is an important factor in preschool children's psychological behavior development.

Related factors of functional constipation in children and its effects on social adaptability and temperament

ZHUO Lin, WU Cheng, LI Chuan-ying

2020, 28(5):  583-586.  DOI: 10.11852/zgetbjzz2019-1138

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Objective To explore the related factors of functional constipation in children and its effects on temperament and social adaptability,in order provide data and basis for the diagnosis and intervention of functional constipation. Methods A self-designed child functional constipation related factors questionnaire,3-to 7-Year-Old Children's Temperament Scale, and Infants and Young Children - Junior High School Students Social Adaptability Scale were used in this study. Totally 103 children aged 3-5 years old who had difficulty in defecating and met the Roman Ⅳ diagnostic criteria for children's functional constipation were selected as research objects from September 2018 to May 2019. Meanwhile,94 healthy children who came to the outpatient department of Children's Hospital Affiliated to Anhui Medical University for normal physical examination were selected as the control group. Results Less consumption of fruits and vegetables,less water,less exercise,no defecation training,blaming children for defecation mistakes,and holding back while playing toys were the risk factors for functional constipation(OR=8. 154,6. 653,2. 728,0. 251,18. 620,6. 732,P＜0. 05). In terms of temperament dimension,there was a significant difference on regularity and phobotaxis score between children with functional constipation and children in the control group (t=-10. 48,-10. 33,P<0. 05). In terms of social adaptability,there were significant differences on independent living ability and collective activity ability between children with functional constipation and children in the control group (t=6. 71,-3. 03,P<0. 05). Conclusions The adjustment of eating habits,strengthening the amount of exercise,early defecation training and relieving mental pressure have a good effect on preventing the occurrence of functional constipation. In addition,functional constipation has an impact on children's psychological and behavioral development and social adaptability. Parents should patiently encourage and guide the children to help them build up confidence,which will not only have better effects on the treatment of functional constipation,but also promote the comprehensive development of children's physical and mental health.

Influence of screen exposure on developmental behavior in infants

ZHOU Shan-shan, YAN Shuang-qin, CAO Hui, GAO Guo-peng, CAI Zhi-ling, GU Chun-li, LIU Ting-ting, WANG Hao, LIU Zi-jian, TAO Fang-biao

2020, 28(5):  587-589.  DOI: 10.11852/zgetbjzz2019-1115

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Objective To explore the relationship between screen exposure and developmental behavior of 18 months old children,so as to provide evidence for reducing video exposure in infants. Methods From December 2016 to December 2017, a self-designed questionnaire was used to collect the screen exposure time of 18-month-old infants who underwent 4-2-1 physical examination, and the social demographic characteristics, screen exposure of parents and other information were also collected. ASQ-3 was used to test the communication, physical development and other abilities of infants. Results The average daily screen time was 40. 8 minutes, of which 172 (26. 1%) were more than one hour. Multivariate binary Logistic regression found that infants with screen time more than 1 hour per day had lower risk of severe and mild developmental delay in communication domain aged 18 months old[OR=1. 55(95%CI:1. 05-2. 28), OR=3. 57(95%CI:1. 49-8. 53), respectively], with statistically significant differences (P＜0. 05). Conclusions Longer screen exposure has a negative effect on children's communication development. Public awareness of the impacts of screen exposure in infants should be raised to reduce the occurrence of language retardation in children.

Analysis of refractive state in preschool children with subnormal vision

FENG Jing-jing, CHEN Wei, WANG Li-hua, TONG Huan, XING Shan-shan, PU Jia-ning

2020, 28(5):  590-593.  DOI: 10.11852/zgetbjzz2019-1743

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Objective To investigate the distribution of refractive state in 3- to 6-year-old children with subnormal vision,and to analyze the relationship between different refractive types and amblyopia. Methods A descriptive study method was adopted to select 1 644 3- to 6-year-old children (3 288 eyes) with subnormal vision. Refraction and corrected visual acuity were detected after cycloplegia using 1% atropine ointment. The distribution of refractive state,the incidence rate of anisometropia,astigmatism and amblyopia at different age stages were studied. Results The majority of the children were hyperopia. The first refractive causes of amblyopia were compound hyperopic astigmatism (60. 04%). With the increase of age,the proportion of children with hyperopia decreased gradually while myopia increased. The rate of anisometropia was 14. 05%,significantly decreased with increased age (χ²=37. 31,P＜0. 01). There was a significant decrease in anisometropia with increased anisometropia (χ²=79. 181,P＜0. 01). Difference was statistically significant on astigmatism diopter and astigmatism axis in different age groups (χ²=95. 919,150. 79, P＜0. 01). The rate of amblyopia was 12. 77%. The incidence of amblyopia was higher when the spherical equivalent difference between the two eyes was not less than 1 diopter. There was a significant increase in the occurrence of amblyopia with increased anisometropia (χ²=379. 15,P＜0. 01). Conclusions The majority of 3- to 6-year-old children with subnormal vision have hyperopia. Hyperopia,astigmatism,and anisometropia are prone to cause amblyopia.

Study on the relationship between lifestyle and obesity among 327 students in a middle school in Changji City,Xinjiang

LI Ji-meng, TUERXUNJIANG Maimaitiming, WANG Xian-hua, WU Hui-ling, WANG Qian

2020, 28(5):  594-597.  DOI: 10.11852/zgetbjzz2019-0971

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Objective To understand the factors affecting adolescent obesity in middle school students, in order to provide information for future research and prevention of obesity. Methods In March 2019, a middle school was randomly selected from a middle school in Changji City, Xinjiang. Totally 330 students aged 12 to 15 years in this school were randomly selected according to the school number to investigate their lifestyle. The relationship between life style and obesity was analyzed. Results The detection rate of obese adolescents was 5. 3% (17/330). There were significant differences on the proportions of unhealthy food (such as barbecue and fried food), fast food (such as hamburger fried chicken), homework quantity, fatigue in study and life, and more than 40 minutes of extracurricular physical exercise between obese students and non-obese students(χ²=20. 219, 41. 398, 32. 103, 12. 359, 19. 608, P<0. 05). Binary Logistic regression analysis showed that eating of fast food such as hamburger fried chicken three days or more per week(OR=1. 766,95%CI:1. 018-3. 061,P=0. 043), eating barbecue and fried food three days or more per week(OR=2. 230,95%CI:1. 125-4. 419,P=0. 022)were the risk factors for adolescent obesity, while less homework after class was a protective factor (OR=0. 397, 95%CI:0. 174-0. 904,P=0. 028). Conclusions The bad eating behavior and work quantity of middle school students are related to adolescent obesity. Students should be trained to form good eating habits, reduce the amount of work accordingly in order to reduce the occurrence of obesity and promote their healthy and good growth.

Observation on the effect of amplitude integrated electroencephalogram in brain function monitoring of neonatal brain injury

WANG Jin, GENG Qi-lei, CAI Jin-lan

2020, 28(5):  598-600.  DOI: 10.11852/zgetbjzz2019-1023

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Objective To analyze the effect of amplitude integrated electroencephalography (EEG) on brain function monitoring in neonates with brain injury,in order to provide scientific evidence for clinical treatment of neonatal brain injury. Methods A total of 60 full-term infants with fetal distress were selected as the observation group from February 2017 to January 2019,and 60 healthy infants in the same period were selected as control group. Subjects were monitored by amplitude-integrated EEG. Amplitude integrated EEG abnormalities,graphs, the normal sleep arousal cycle status and epileptiform activity were recorded in the two groups. The amplitude and narrowband voltage values of the amplitude of the integrated EEG background activity of the two groups were compared. The relationship between abnormal amplitude integrated EEG pattern and imaging was compared;Relationship between the neuronal behavior and neurological specific protein in children with abnormal amplitude integrated EEG were evaluated. Results The abnormal rate of amplitude integrated EEG in the observation group was 8. 33%,significantly higher than that in control group (0. 0%) (χ²=5. 217,P=0. 022). The rate of normal sleep arousal cycle in the observation group was significantly lower than that in the control group (90. 0% vs. 100. 0%,χ²=6. 316,P=0. 011). No epileptiform activity was observed in the control group,but 1 case occurred in the observation group. Of the 5 children with amplitude-enhanced EEG abnormalities,3 had normal head B examination,MRI showed subarachnoid hemorrhage in 1 case,1 had discontinuous normal voltage with abnormal sleep arousal cycle,accompanied by epileptiform activity,and 3 patients with neurobehavioral assessment were lagged behind and the rest were normal. The NSE and S-100 in the observation group were significantly higher than those in control group,and the NSE and S-100 in children with abnormal amplitude-integrated EEG were significantly higher than those in children with normal amplitude-enlarged EEG (F=8. 751,6. 325,P<0. 01). Conclusions Amplitude-integrated EEG has a high value in monitoring of brain function in neonates with brain injury. It can better judge the condition of children and is of great value of guiding clinical diagnosis and treatment.

Analysis of the detection of anemia and growth development in children aged 0 to 6 years in Xinjiang Regional Health Checkup

ABUDUHELILI·Abudukadier, FANG Xian, MAIMAITI·Yasen

2020, 28(5):  601-604.  DOI: 10.11852/zgetbjzz2019-1494

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Objective To analyze the anemia and physical development of children aged 0 to 6 years in Xinjiang from 2016 to 2017, and to understand the anemia and dysplasia of children aged 0 to 6 years in various regions of Xinjiang, in order to provide reference for nutritional health care and intervention of children under 6 years old. Methods Children aged 0 to 6 years who participated in the free regional medical examination from 2016 to 2017 were selected as the research objects. The detection of anemia and physical development evaluation were described. Chi-square test was used to compare the anemia degree and physical development among different years and different regions. Bonferroni method was used to adjust the test level in comparison of multiple groups. Results The detection rates of children′s anemia in 2016 and 2017 were 28.46% and 23.21%, respectively. The height and weight of children aged 1 to 24 months in the region could meet the WHO standards, but the height and weight of children at the age of 2 to 6 years old were lower than the WHO standards. The physical development status of children aged 3 to 6 years in Xinjiang has reached the average level in China, but there were differences between Xinjiang regions (P<0.01). In detail, the overweight detection rate in eastern Xinjiang (0.25%) was significantly higher than that in southern Xinjiang (0.05%) and northern Xinjiang (0.10%)(P＜0.05). While the detection rates of low body weight (0.17%) and growth retardation (0.19%) in southern Xinjiang were significantly higher than those in eastern Xinjiang (0.08%, 0.12%) and northern Xinjiang (0.08%, 0.07%)(P＜0.05). Conclusion Children aged 0 to 6 years in Xinjiang are in good physical development, and the malnutrition index is at the domestic average level. The most important issue for children′s nutrition is the control of anemia, and it is supposed to develop localized personalized health management programs and policies to promote child health.