Table of Content

10 August 2022, Volume 30 Issue 8

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Professional Forum

Clinical intervention of language delays and language disorders

LIU Xue-man

2022, 30(8):  813-817.  DOI: 10.11852/zgetbjzz2022-0871

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Language delays and language disorders are the most common type of childhood developmental disorders. The exploratory design and initial attempts to implement a Chinese model of an evidence-based clinical intervention pathway for language delays and language disorders were guided by the Clinical Framework of children's language development and the concept of response to intervention (RTI).The early exploratory design also incorporated China's well developed nationwide maternal and children's health care system into the internationally recognized evidence-based tertiary clinical intervention pathway to achieve some initial Results in China.

Parent-implemented early language intervention strategies for children

HAO Yan, ZHAO Jin-zhu

2022, 30(8):  818-821.  DOI: 10.11852/zgetbjzz2022-0796

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Early language acquisition in children is a complex process. It is important to provide evidence-based interventions for children with language delays in early childhood to improve their prognosis. Conducting child early language interventions in natural contexts and training parents to incorporate language and communication opportunities into daily parent-child interactions, allowing children to learn the language and practice new skills in natural and authentic learning experiences, can maximize opportunities for children to learn the language and generalize skills, yet there is limited knowledge in this area in China. This article provides a review of parent-implemented strategies for early childhood language intervention.

Original Articles

Reliability and validity of grammar subscale of Children's Language Development Scale

CHEUNG Hin-Tat, LI Xue, LIAO Min

2022, 30(8):  822-827.  DOI: 10.11852/zgetbjzz2022-0131

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Objective To evaluate the reliability and validity of grammar subscale of Children's Language Development Scale(CLDS). Methods A stratified cluster sampling method was adopted to randomly select 1 704 preschool children(including 852 boys and 852 girls) in Chengdu from December 2018 to June 2019. Children's language ability was evaluated with CLDS, then the reliability and validity of the grammar subscale of CLDS were tested. Results There were 1 701 completed Results in sum. The grammar scale contained 40 items of picture selection after listening to a sentence. Internal consistency reliability Cronbach's α coefficient was 0.834, and the half-fold reliability was 0.795. The infit and outfit MNSQ values of the subjects and the items were 1.00, 0.93 and 0.99, 0.93 respectively. The discrimination validity was 1.73, and the reliability of the scale was 0.75. The infit MNSQ values of 40 items were between 0.86 and 1.2 logits, which fitted well with the Rasch model. The difficulty value of items ranged from -2.55 to 1.82 logits, and the individual ability value was between -2.78 and 5.0 logits. Conclusions The grammar subscale of the CLDS has good reliability and validity. It can be applied to simply and effectively measure 3- to 6-year-old children's grammar development, so as to provide reference for diagnosing and treating speech and language disorders in Chinese children.

Mediating role of home literacy environment between parental educationand children's vocabulary ability

GUO Fu-rong, ZHOU Mei-xiang, ZHOU Peng, CHEN Wei

2022, 30(8):  828-833.  DOI: 10.11852/zgetbjzz2022-0450

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Objective To explore the relationship among parental education, home literacy environment and children's vocabulary ability, so as to provide theoretical basis for making language readiness for kindergarten and promoting the fairness of education starting point. Methods A total of 84 children aged 3 to 4 years were randomly selected from 3 urban kindergartens and 1 rural kindergarten from November 2021 to January 2022. Participants' vocabulary ability was assessed by Peabody Picture Vocabulary Test-R (PPVT-R) and Expressive Vocabulary Test (EVT), and their parents were surveyed through a self-designed Home Literacy Environment Questionnaire. Data were analyzed by one-way ANOVA, correlation analysis and mediation effect analysis. Results 1) There were significant differences in home literacy environment and children's vocabulary ability between parents with different education levels (P<0.05). 2) Parental education was found to be positively correlated with home literacy environment and children's vocabulary ability(P<0.05), and the correlation coefficient between maternal education and the latter two was higher than that of paternal education (r=0.663,P<0.001). 3) Home literacy environment partially mediated the relationship between paternal education and children's vocabulary ability, and the model fit well (χ²/df=1.181, RMSEA=0.047, GFI=0.971, AGFI=0.898, TLI=0.985, CFI=0.994), with the mediating effect of 41.59%. Home literacy environment partially mediated the relationship between maternal education and children's vocabulary ability, and the model fit well (χ²/df=1.252, RMSEA=0.055, GFI=0.963, AGFI=0.886, TLI=0.982, CFI=0.992), with the mediating effect of 19.51%. Conclusions Home literacy environment mediates partially the effect of paternal and maternal education on children's vocabulary ability, but the mediating effect is different. Thus, parents should attach great importance to early vocabulary development, upgrade the quality of family reading environment.It is suggested that father should take more participation in family activities. For fathers with low education level, children's vocabulary development can be promoted by improving home literacy environment. Mothers with low education level are encouraged to improve their own language quality in addition to creating good home literacy environment.

Study on the correlation between cognitive ability and learning disability in children

LIU Zi-zi, XU Xiao-yu, PAN Ning, JIN Yu-ying, GUO Xu-ning, LI Xiu-hong

2022, 30(8):  834-838.  DOI: 10.11852/zgetbjzz2021-1427

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Objective To analyze the correlation between cognitive processing defects and different types of learning disabilities in second- to fifth-grade pupils, so as to provide reference for targeted intervention measures. Methods A total of 1 905 second- to fifth-grade pupils in Guangzhou were randomly selected by stratified cluster sampling. Children with learning disabilities were screened by the Pupil Revised-Screening for Learning Disability (PRS) and the Dyslexia Checklist for Chinese Children(DCCC). Data were analyzed by χ² test, t test and Logistic regression. Results Children with written expression disorder (OR=2.70, 95%CI: 1.01 - 7.18), attention disorder (OR=4.44, 95%CI: 1.50 - 13.10) and visual perception disorder (OR=2.93, 95%CI: 1.35 - 6.35) were more likely to have learning disabilities. Children with attention disorder had a higher risk of verbal learning disorder (OR=9.02, 95%CI: 1.82 - 44.84), and children with visual perception disorder had a higher risk of non-verbal learning disorder (OR=4.01, 95%CI: 1.59 - 10.10).Children with attention disorder (OR=6.06, 95%CI: 1.88 - 19.49) and visual perception disorder (OR=4.61, 95%CI: 1.76 - 12.04) had a higher risk of developing mixed learning disorder. Conclusions Multi-dimensional cognitive impairment is related to the occurrence of learning disabilities. Specifically, children with attention impairment and visual perception impairment are more likely to have verbal learning impairment, and non-verbal learning impairment, respectively. Mixed learning impairment is significantly related to both attention impairment and visual perception impairment.

Preliminary study on the reliability and validity of the Chinese Version ofParent-Child Interaction Feeding Scale

JIA Ni, XU Meng-xue, DING Mei-qi, YAN Shuang-qin, ZHANG Qing-lan, WANG Bao-zhen, LI Yuan-yuan, GUAN Hong-yan

2022, 30(8):  839-844.  DOI: 10.11852/zgetbjzz2021-1244

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Objective To introduce Nursing Child Interaction (PCI) Feeding Scale into China, and to assess the reliability and validity of PCI Feeding Scale in Chinese parent-child dyads. Methods Under the recommended steps by the International Testing Committee, PCI Feeding Scale was translated, then Chinese Version of Parent-Child Interaction Feeding Scale (PCI-FS-C) was developed. From June 2018 to January 2019, 310 parent-child dyads from four hospitals in Beijing, Yinchuan, Lanzhou and Maanshan were selected by convenience sampling, and PCI-FS-C was adopted to code their feeding interaction. Reliability was evaluated by internal consistency (Cronbach's α coefficient) and test-retest reliability (inter-item consistency) conducted with 10% of the samples randomly selected. Six samples were selected to evaluate rater reliability. Chinese Version of Infant-Toddler Home Observation Measurement of the Environment (IT-HOME-C) was used to exam the concurrent validity by Spearman correlation in 41 samples. Multivariate linear regression was used to evaluate discriminant validity. Results Totally 273valid mother-infant dyads were included in this study. The Cronbach's α coefficients of total score, caregiver and infant subscale scores were 0.846, 0.805 and 0.690, respectively. Both caregiver subscale (r=0.778) and PCI-FS-C (r=0.847) had excellent test-retest reliability, while the infant subcale showed acceptable test-retest reliability (r=0.480) (P< 0.01). For rater reliability, the Kendall coefficient of PCI-FS-C was 0.860. PCI-FS-C, caregiver subscale and infant subscale were moderately associated with IT-HOME-C (r=0.526, 0.506, 0.427, P＜0.05). After controlling for mixed factors, there were significant differences among different age groups in PCI-FS-C, caregiver subscale and infant subscale (b=3.24, 2.31, 0.92). Conclusions PCI-FS-C is a valid assessment for Chinese mother-infants, which fills the gap for assessment using an Objective measurement of caregiver/parent-child interaction in China. Enlarged sample size is suggested for culture-adapted study in future.

Network comparison of aggressive behavior in children with attention deficit hyperactivity disorder and their parents

CHAI Run-yu, WANG Kang-cheng, LIN Hua-wei, ZHANG Jun-ying, XING Jie, ZHANG Hua, CAO Ai-hua

2022, 30(8):  845-850.  DOI: 10.11852/zgetbjzz2021-0338

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Objective To analyze the interaction between aggression in children with attention deficit hyperactivity disorder(ADHD) and parental aggression by network analysis. Methods From January to December 2019,108 children diagnosed with ADHD according to Diagnostic and Statistical Manual of Mental Disorders(Fifth Edition)(DSM-5) were enrolled as ADHD group. Another 110 typical development children were included in control group. Children in two groups filled out Aggression Questionnaire(AQ) and their parents completed Vanderbilt ADHD Parent Rating Scale(VADPRS). The aggressive behaviors of children and parents between ADHD group and control group were compared and their correlation was analyzed. Results The scores of physical aggression,verbal aggression and irritability of children in ADHD group were significantly higher than those of control group(t=5.03,2.94,5.92, P<0.01). Parents of ADHD children were significantly more aggressive than the control group,and their scores of parental irritability(t=3.83,3.70) and parental hostility(t=2.69,3.06) were significantly higher(P<0.01). There was a significant correlation between parental aggression and ADHD children's aggression(P<0.05). Network analysis showed that there were different aggressive network structures between ADHD children and normal control children,and the global network intensity was significantly stronger in ADHD group(Z=2.06,P<0.05). Conclusions Both ADHD children and their parents have a higher level of aggressive behavior than normal children. Aggression of parents and ADHD children affect each other,and aggression of ADHD children is significantly more influenced by parents than controls.

Chain mediating effects of sleep quality and depression on neurotic personality and executive function in adolescents with adverse childhood experiences

PENG Lian-hua, LIU Dong-dong, ZHU Xiao, JIANG Shan, XU Ping, MAO Ping

2022, 30(8):  851-855.  DOI: 10.11852/zgetbjzz2021-1097

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Objective To explore the mediating role of sleep quality and depression between neurotic personality and executive function in adolescents with adverse childhood experiences(ACEs),so as to provide reference for improving executive function of adolescents. Methods From July to October 2020,the executive function,depression,sleep quality and neuroticism of 324 adolescents with ACEs were investigated by psychological assessment scale. Pearson correlation analysis was used to analyze the relationship between the variables. Structural equation model was used to analyze the mediating role of sleep quality and depression between neuroticism and executive function. Results 1) The total score and each dimension scores of neuroticism,sleep quality,depression of adolescents with ACEs were positively correlated with executive function(r=0.13 - 0.91,P<0.05). 2) Neuroticism significantly predicted executive function of adolescents with ACEs(β=0.31,t=5.24,P<0.001). Sleep quality and depression played mediating roles between neuroticism and executive function of adolescents with ACEs,and mediation effects were 20.3% and 21.9%,respectively. Meanwhile,sleep quality and depression played a chain mediating role between neuroticism and executive function,with a mediation effect of 9.4%. Conclusions Neuroticism can not only directly predict the executive function of adolescents with ACEs,but also indirectly predict the executive function of adolescents with ACEs through the chain mediating effect of sleep quality and depression.

Review

Relationship between gesture and early language development of children with autism spectrum disorder

LIU Yue, GU Qin

2022, 30(8):  856-859.  DOI: 10.11852/zgetbjzz2021-0018

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Autism spectrum disorder(ASD) is a group of children persistent complex developmental disorders of nervous system characterized by social and interactive obstacle. Nonverbal communication ability,including the use of gestures,is found abnormal in the early stage and is closely linked with language development. This paper reviews the effects of common gestures on language.

Research progress in gestures defect in children with autism spectrum disorder

CAI Ting-ting, MA Bing-xiang, KONG Ya-min, ZHANG Ying-dan, ZHANG Xiao-meng, GU Shuang-long

2022, 30(8):  860-864.  DOI: 10.11852/zgetbjzz2021-0927

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Gestures precede language and promote language development. The types and functions of gestures in children with autism spectrum disorder(ASD) have atypical use and development,and the slow development of gesture-language trajectories can become a key early behavior marker for children with ASD. The development of gestures is significantly related to the later language,cognition,social interaction and ASD diagnosis. Early evaluation and monitoring of gesture function should be carried out in ASD children. Personalized training based on the characteristics of gestures,and intervention using gestures as an intermediary can promote language,cognitive and social development,thus to improve rehabilitation effects.

Family parenting and early childhood language development

SHEN Shi-fang, SHAO Jie

2022, 30(8):  865-868.  DOI: 10.11852/zgetbjzz2021-1294

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Language learning is the product of the interaction between children's learning ability and language environment, which occurs in the social environment where children actively participate in. Differences in language ability begin to appear in infants and toddlers, and run through and affect people throughout their lives. In recent years, more and more domestic and foreign scholars have studied the effect of family parenting on early childhood language development. Understanding the influence of family parenting on the early language development of children can provide basis for formulating prevention and intervention strategies from the perspective of family parenting to promote the best development of early childhood language.

International quality monitoring and assessment of early childhood care and education

HUANG Ying, TONG Lian

2022, 30(8):  869-873.  DOI: 10.11852/zgetbjzz2021-0276

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High-quality early childhood education and care (ECEC) benefits to children, families and society in short and long term. It is crucial to establish quality monitoring and assessment system of ECEC. There is no monitoring system of ECEC in China at current stage. Meanwhile, there is a lack of professional and standardized quality assessment tools for ECEC. This study summarizes ECEC quality monitoring and assessment systems including government regulatory agencies, assessment content and Methods in international organizations, developed countries and regions. It is suggested that the government should establish a holistic ECEC quality monitoring and assessment system, emphasizing on the assessment on structural quality, process quality and outcome quality of ECEC. By making policies, developing professional evaluation tools and conducting relative researches, a government-leading and multi-party participated ECEC quality supervision system is expected to set up so as to ensure the healthy and high-quality development of childcare institutions.

Research progress on the effect of drug therapy on the physical growth of children and adolescents with attention-deficit/hyperactivity disorder

DENG Lan-liu, CHEN Li

2022, 30(8):  874-878.  DOI: 10.11852/zgetbjzz2021-0395

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Attention-deficit/hyperactivity disorder (ADHD) is a common chronic neurodevelopmental disorder in childhood, which has a significant impact on children's academic performance, interpersonal communication, social functioning, as well as the whole family and society.The incidence of ADHD has been on the rise over the past few decades.Stimulants such as methylphenidate (MPH) and selective norepinephrine reuptake inhibitors such as atomoxetine (ATX), are both commonly used drugs in ADHD treatment.Parents are concerned about the possible negative effects of medication on the physical growth of ADHD children.This article reviews the effects, mechanisms and management of drug therapy on the physical growth of ADHD children, in order to improve the compliance of clinical drug therapy.

Neonatal nutrition and early childhood development

LIU Li, WEI Si-meng, JIANG Te

2022, 30(8):  879-883.  DOI: 10.11852/zgetbjzz2021-1142

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Early childhood development refers to the growth and development of the physical, psychological and social ability of the fetus to the preschool children, which is affected by the genetic environment and other aspects. Quality nutrition of newborns is an important material basis for the early development of children. Breastfeeding in neonatal period, neonatal diseases screening, and proper feeding of premature and low birth weight infants are all key factors in promoting early child development. This review will comprehensively summarize its role in the early development of children from the perspective of neonatal nutrition, so as to provide a new orientation and reference for better optimizing maternal and infant nutrition and promoting the early childhood development.

Meta Analysis

Systematic review on the effect of gluten-free and casein-free diets inchildren with autism spectrum disorder

QU Ling-ling, WAN Yan-nan, CHENG Qian

2022, 30(8):  884-889.  DOI: 10.11852/zgetbjzz2021-0249

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Objective To systematically interview the effects of gluten-free and casein-free (GFCF) diets in children with autism spectrum disorder(ASD), in order to provide scientific reference for clinical treatment. Methods Literature searches were conducted in PubMed, EBSCO, Cochrane Library, SpringerLink, Vip, Wan-fang and China National Knowledge Internet (CNKI) database. Only randomized controlled trails were included, and the quality of the literature was evaluated. Results A total of 7 studies with 181 ASD samples were included. Seven articles all studied the effects of GFCF diets on core symptoms of ASD, five articles showed that the GFCF diets could not improve the core symptoms of ASD. Two articles studied the effects of GFCF diets on gastrointestinal symptoms of ASD, but neither of them showed that GFCF diets could improve the gastrointestinal symptoms of ASD. Conclusion GFCF diets could not improve the core symptoms and gastrointestinal symptoms of ASDchildren.

Research hotspots and frontiers of childhood adversity

JIANG Shen, YE Xin-xin, YI Qian, SONG Pei-ge

2022, 30(8):  890-894.  DOI: 10.11852/zgetbjzz2021-0798

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Objective To analyze the research hotspots and frontiers of childhood adversity, so as to provide reference for preventing childhood adversity and promoting children's health. Methods The Web of Science Core Collection Database was retrieved to collect the literatures related to childhood adversity from January 1st, 2011 to December 31st, 2020, and the number of published papers and published journals were counted. CiteSpace software was used to draw the institutions or regional cooperative networks, journals cited frequency analysis diagram and keyword co-occurrence diagram so as to analyze the research status and hotspots of childhood adversity. Results A total of 8 080 publications were included, and the annual number of published articles was increasing. King's College London and Harvard University were the main institution, with 332 and 226 articles respectively. The United States and England were the leading countries in published papers. A total of 8 080 articles were published in 77 journals, among which Child Abuse Neglect and Am J Psychiat were important sources of academic research, with 3 792 and 3 206 cited frequency respectively. The current research hotspots focused on abuse, household dysfunction, depression and mental health. Mental disorder, disease, physical abuse and intimate partner violence were the frontier fields. Conclusions There are great prospects in the field of childhood adversity. Abuse, household dysfunction, depression and mental health are current research hotspots. Mental disorder, disease, physical abuse and intimate partner violence are the research frontiers of childhood adversity.

Clinical Research

Results of Gesell Developmental Scale of 2- to 3- year-old children with autism spectrum disorder or developmental language disorder

WU Man-hong, DENG Xue-mei, LIN Hua-zhao, YU Chu-lan, ZENG Liu-yuan, YANG Yun

2022, 30(8):  895-899.  DOI: 10.11852/zgetbjzz2021-0706

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Objective To compare the developmental characteristics of 2- to 3- year-old children with autism spectrum disorder(ASD) or developmental language disorder(DLD) by Gesell Developmental Scale(GDS),in order to provide evidence for early diagnosis and intervention. Method From March 2020 to March 2021,children with ASD(n=78) and DLD(n=80) were evaluated by GDS,their development characteristics were analyzed and compared retrospectively. Results 1) The average developmental quotient(DQ) of ASD children was lower than that of DLD children. Except for the gross motor,the DQs of adaptability,fine motor,language and personal-social in ASD children were significantly lower than those of DLD group(t=16.043,6.208,14.219,10.811,P<0.001). 2) The language development of ASD children was predominantly severely and moderately impaired(48.72%,33.33%),while the language development of DLD children was most mildly impaired(77.5%). Fifty percent of ASD children had a mild impairment in personal-social area and no one case was normal. However,68.75% of DLD children had a mild impairment in personal-social area,and 30% of personal-social DQ was at normal or borderline level. Conclusions Except for the gross motor energy area,the average DQs of other developmental areas in ASD children are lower than those in DLD children. Familiarity with the Gesell developmental characteristics of ASD children and DLD children is helpful for the early identification,rehabilitation and education plan development as well as the prognosis of children with ASD and DLD.

Association between anxiety of adolescents and parental styles

CONG En-zhao, CHEN Hai-ying, WANG Yun, HU Yao, YANG Wei-min, WU Yan

2022, 30(8):  900-903.  DOI: 10.11852/zgetbjzz2021-1065

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Objective To study the relationship between adolescent anxiety and parenting styles,in order to provide reference for promoting adolescents' mental health. Method A cluster sampling method was adopted. Totally 6 195 junior and senior high school students in Xinxiang City of Henan Province was selected into this study from 2014 to 2017,and were assessed by general demographic data questionnaire,Parental Bonding Instrument(PBI),The Screen for Child Anxiety Related Emotional Disorders(SCARED) and Kutcher Adolescent Depression Scale-11( KADS-11). Logistic regression analysis was used to explore the association between adolescent anxiety and parenting styles. Results There were 6 194 valid questionnaires,including 2 586(41.8%) males and 3 608(58.2%) females. There was no significant difference in the detection rate of anxiety between male and female students(χ²=3.400,P>0.05). Adolescents' anxiety was negatively correlated with care(OR=0.969,95%CI:0.953 - 0.984,P＜0.001) and encouragement from mothers(OR=0.974,95%CI:0.953 - 0.994,P=0.013).However,adolescents' anxiety was positively related to maternal control(OR=1.088,95%CI:1.064 - 1.113,P< 0.001) and paternal control(OR=1.042,95%CI:1.019 - 1.066,P<0.001). There was also a significant positive correlation of comorbidity of anxiety and depression with maternal control(OR=1.065,95%CI:1.035 - 1.096,P<0.001) and paternal control(OR=1.068,95%CI:1.038 - 1.099,P<0.001). Conclusions Parental care is a protective factor for adolescent anxiety,while parental control is a risk factor,especially father control is a risk factor for comorbidity of anxiety and depression in adolescents.

Correlation between serum vitamin D and tic disorder

YOU Hai-zhen, ZHOU Yi-fang, XIE Jing, JIN Zhi-juan, WANG Guang-hai, SUN Ke-xing

2022, 30(8):  904-907.  DOI: 10.11852/zgetbjzz2021-0524

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Objective To explore the association of vitamin D(VD) level with tic disorder (TD) symptom severity and clinical classification, in order to provide evidence for comprehensive diagnosis and treatment of TD. Methods From March 2020 to November 2020, a total of 225 TD children (TD group) and 228 healthy children (control group) in Shanghai Children's Medical Center, Affiliated to Shanghai Jiao Tong University School of Medicine, were retrospectively enrolled in this study. According to the Yale Global Tic Severity Scale (YGTSS), children in the TD group were divided into mild TD group (≤25 points)and moderate to severe TD group(＞25 points). According to the DSM-Ⅴ clinical classification standard, children with TD were divided into provisional tic disorder group (PTD group), chronic tic disorder group (CTD group) and Tourette syndrome group (TS group). The correlation between vitamin D deficiency and the development of TD was analyzed. Results Serum VD level of children in TD group was significantly lower than that of the control group[(22.18±6.29) ng/ml,(26.14±6.48) ng/ml, t=6.60,P<0.001], and the proportion of insufficient or lacking VD (89.8%) was high in the control group (75.9%) (χ²=15.35, P<0.001). Serum VD level of the moderate to severe TD group was lower than that of the mild TD group and the control group (F=23.85, P<0.001). Serum VD level of TD children was negatively related to the severity of symptoms (r=-0.215, P=0.001). The difference in VD levels among three clinical subtypes of TD and the control group was statistically significant (F=16.93, P<0.001). Among them, the CTD group had the lowest VD level, which was significantly lower than the control group.The proportion of insufficient or lack of serum VDin children with TD subtypeswas higher than that of the control group (χ²=15.91, P<0.001). Conclusions VD deficiency is more common in children with TD. There is a certain correlation between the degree of VD deficiency and the severity of tic disorder symptoms and clinical subtypesin children with TD. The detection of vitamin D level can be used as an auxiliary examination for children with TD, providing new clinical ideas for the treatment of TD.

Mediating effect of anxiety in the relationship between family cohesion and self-awareness in children with developmental retardation

REN Yan-wei, YANG Zhi-liang, LI Ling-hui

2022, 30(8):  908-911.  DOI: 10.11852/zgetbjzz2021-0924

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Objective To investigate the level of self-awareness of children with developmental delay, and to explore the mediating role of anxiety in family cohesion and self-awareness. Methods Convenience sampling method was adopted to select 200 children with developmental retardation from July 2019 to April 2021. General information questionnaire, Family Adaptability Cohesion Scale, Second Edition (FACES-II), DSM-5 Level 2-Anxiety-Child Age 11 - 17 and Children's Self-Consciousness Scale were used to investigate. Results The total score of self-consciousness in 200 children with developmental delay was 45.87±4.15. Family cohesion was negatively correlated with the total score of self-consciousness (r＝-0.607, P<0.01), and positively related to anxiety of children (r=0.416, P<0.001).There was a negative correlation between anxiety of children and self-consciousness (r＝-0.367, P<0.01). The mediating effect test showed that the anxiety of children played a partial mediating role in the relationship between family cohesion and self-consciousness, with 95%CI (-0.257,-0.043). The mediating effect value was -0.077, accounting for 9.50% of the total effect. Conclusions The self-awareness of children with developmental delay is low. More attention should be paid to anxiety of these children. Meanwhile, a good family atmosphere and harmonious parent-child relationship are helpful to improve the mental health and self-awareness of children with developmental delay.

Experience Exchange

Clinical features and influencing factors of children with language delay

ZHANG Ying, WANG Jun-feng, DING Yan-hua

2022, 30(8):  912-915.  DOI: 10.11852/zgetbjzz2021-0910

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Objective To investigate the clinical features and high influencing factors of language delay in children, in order to provide reference for the early detection and intervention. Methods From November 2019 to July 2020, a total of 126 children with language delay in the Department of Child Health Care, Children's Hospital of Fudan University were enrolled in case group. While 100 normally developed children who visited the hospital from May to July 2020 were selected as control group. Children in case group were assessed by Gesell test. For both groups, a self-designed questionnaire about individual information and family environment was used to collected related information, including gestational age, pregnancy interval, delivery mode, birth weight, initial walking age, main caregivers, screen time and maternal education level. Results The first visit age for 126 children with language delay was (29.2±4.5) months. The ratio of boys and girls was 2.7∶1. Developmental quotients (DQs) of language, gross motor, fine motor, adaptive and social in Gesell Development Scale were 49.9±16.3, 73.5±15.4, 72.4±18.1, 70.2±16.2 and 60.4±16.4, respectively. The ratio of the preterm birth in the case group was higher than that in the control group(χ²=4.873, P<0.05). For children in the case group, the initial walking age was later than that in the control group [(14.7±2.4) months vs. (12.6±2.0) months, t=5.766, P<0.05]. The screen time of children in case group was longer than that of the control group [(3.6±1.9) h vs. (1.20±1.0) h, t=10.587, P<0.05]. The level of maternal education of case group was lower than that of control group (t=7.973, P<0.05). There were no significant differences in the main caregiver, pregnancy interval and delivery mode between the two groups (P>0.05). Conclusions Children with language delay may suffer from problems in other developmental areas as well. The longer screen time, lower maternal education and preterm birth may be the influencing factors for language delay in childhood.

Correlation of knowledge, belief and behavior regarding adolescence with psychological resilience of Uygur left-behind primary and middle school students in Kashgar rural area

DU Wen-ge, WU Guo-bao, YE Gang, GUO Yong-song

2022, 30(8):  920-923.  DOI: 10.11852/zgetbjzz2021-0455

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Objective To understand the psychological resilience and knowledge, beliefs and behaviors of Uyghur left-behind primary and secondary school students in rural Kashgar and the relationship between the two, so as to provide reference for the physical and mental health intervention and good development of left-behind students. Methods Taking the class as the smallest sampling unit,a stratified random cluster sampling method was used to select 1 864 primary and middle school students in rural areas of Kashgar.Psychological toughness,knowledge,belief and behavior regarding adolescence of students were investigated.T-test, Pearson correlation analysis and multiple linear regression analysis were used to analyze data. Results The average score of knowledge, belief and behavior regarding adolescence of Uyghur left-behind primary and middle school students in Kashgar rural area was 45.63±18.76, 66.43±8.23, and 82.36±8.54,respectively.And the average score of mental resilience was 87.65±11.86. The multiple linear regression analysis after controlling for confounding factors showed that the target focus dimension of mental resilience (β=0.12), the positive cognitive dimension (β=0.09), the emotional control dimension (β=0.08), and the family support dimension ( β=0.06), the interpersonal assistance dimension (β=0.09), and the total score of mental resilience (β=0.42) all had significantly positive predictive effect on knowledge, belief and behavior (P<0.01). Conclusions The psychological resilience of Uyghur left-behind primary and secondary school students is positively correlated with knowledge, belief and behavior. Families, schools and society should pay more attention to health education for Uyghur left-behind primary and secondary school students in rural Kashgar.

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Effect of family sandplay therapy in children with separation anxiety disorder

NI Bo, XIAO Xu-wu, SUN Jin, JIANG Lin, MA Li, HU Dan, LIU Xue-mei, LIU Xiao-chan

2022, 30(8):  924-928.  DOI: 10.11852/zgetbjzz2021-0318

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Objective To study the effect of family sandplay therapy on preschool children with separation anxiety disorder(SAD),in order to provide basis for developing an effective intervention model. Methods Sixty children with SAD were randomly selected from Dalian Women and Children's Medical Center Group from January 1st,2019 to December 30th 2020,and were divided into control group(n=30) and treatment group(n=30). The control group was given health education on SAD,while sandplay therapy and health education on SAD were implemented in treatment group with the frequency of 1 to 2 times/week,40 minutes/time. The Spence Children's Anxiety Inventory(Chinese version) was administered before,after 7,14 and 21 interventions. The treatment reports of the therapists and the treatment feelings of family members were recorded. Results After 21 times of family sandplay intervention,the scores of generalized anxiety,social fear,obsessive-impulsive disorder,physical injury fear,separation anxiety and total anxiety of children in the treatment group were significantly lower than those of the control group(t=2.002,7.300,8.160,12.138,11.676,9.370, P<0.001). Before and after intervention,the differences in scores of generalized anxiety,social fear,obsessive-impulsive disorder,physical injury fear,separation anxiety,and total anxiety in the treatment group were significantly higher than those in the control group(t=6.758,3.953,3.478,5.471,7.027,6.012,P<0.001). After 14 and 21 interventions,the total anxiety score of the treatment group was lower than that of the control group(t=3.934,7.889,P<0.001). Conclusion Family sandplay therapy can reduce the anxiety level of preschool children with SAD after a certain course of treatment.