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1、AgesandStagesQuestionnaireat3YearsforPredictingIQat5 6Years幼儿3岁时的发育情况 年龄和发育阶段问卷结果 能预测其5 6岁时的IQ 1 Contens BackgroundObjectivesMethodsResultsDiscussionStrengthsandlimitationsConclusionsImplications 2 Abbreviations ASQ Ages StagesQuestionnaires 年龄与发育阶段问卷 CI ConfidenceInterval 可信区间 EDEN EtudedesDetermin
2、antsPre etPost natalsduDeveloppementdel Enfant 伊甸园队列 IQR InterquartileRange 四分位数间距 ROC ReceiverOperatingCharacteristic 受试者 接受者工作特征 SDQ StrengthsandDifficultiesQuestionnaire 长处与困难问卷 WPPSI III WechslerPreschoolandPrimaryScaleofIntelligence ThirdEdition 韦氏学龄前儿童智力量表 第3版 3 EDEN EtudedesDeterminantsPre et
3、Post natalsduDeveloppementdel Enfant TheEDENmother childcohortstudyaimstoexamineprenatalandpostnataldeterminantsofchilddevelopment growth andhealth Participantswererecruitedbetween2003and2006amongpregnantwomenfollowedinPoitiersandNancyuniversitymaternities Exclusioncriteriaweremultiplepregnancies 多胎
4、妊娠 aknownhistoryofdiabetes non Frenchspeakersorreaders orplanstomoveoutofthestudyregioninthenext3years 4 Background 5 1 Theidentificationofyoungchildrenatriskforlatersuboptimaldevelopmentiskeytothedesignandimplementationofearlypreventiveorinterventionalstrategies 2 Parentalreportinstrumentsaredesign
5、edtobeusedinprimarycareforfirstlineclinicalscreeningofinfantandpreschoolchilddevelopment 3 TheAges StagesQuestionnaires ASQ arethemostcommonlyusedquestionnairestoidentifyyoungchildrenatriskfordevelopmentaldelay 6 4 Previousevidencefromapopulationofchildrenbornpretermshowedthatthe36 monthASQpredicted
6、schooldifficultiesatage5 5 ThereisagapinknowledgeaboutthepredictivevalueofearlyASQscoresforlatercognitivefunctioning suchasIQ inthegeneralpediatricpopulation 7 Objectives 8 1 Toinvestigatethepredictivevalueofthe36 monthASQscoreforIQatage5to6yearsinalargepopulation basedcohortstudy 2 Tosearchforother
7、child maternal andfamily relatedfactorsassociatedwithlowIQoncethe36 monthASQscoreistakenintoaccountandtodeterminewhethersuchfactorscouldinteractintherelationshipbetweenthe36 monthASQscoreandlaterIQ 9 Methods 10 11 1 Measuresofchilddevelopment 2 136 MonthASQScore FrenchSecondEdition Parentsanswer6que
8、stionsineachof5domainsofdevelopment communication 沟通 grossmotor 粗大动作 finemotor 精细动作 problem solvingskills 解决问题能力 andadaptiveskills 适应能力 USnormsareavailableforeachdomain andanydomainscreened 2SDsbelowthemeanisconsideredapositivescreening Thisstudyusedthesumorthe5domainscores producingascorebetween0an
9、d300 12 1 Measuresofchilddevelopment 2 2IQWiththeWechslerPreschoolandPrimaryScaleofIntelligence ThirdEditionatAge5to6YearsWhenthechildwas5to6yearsold cognitiveassessmentwasperformedbytrainedpsychologists TheWPPSI IIIincludes7subtestsusedtocomputeaverbalIQ aperformanceIQ andafull scaleIQ IQwasconside
10、redlowifitwas 85 13 Whenthechildrenwere3yearsold mothersfilledoutaquestionnairereportingsociodemographicstatusforthefamilyandspecificdataoncurrentmaternalhealth togetherwiththeASQ Whenthechildrenwere5to6yearsold acognitiveassessmentwasconductedbytrainedpsychologists 1 Measuresofchilddevelopment 14 2
11、 Factorsincludedintheanalysis 1 Child scharacteristics gender whetherthechildwasafirstbornchild behavioralproblemsatage3 ratedviatheStrengthsandDifficultiesQuestionnaire SDQ andwhetherthechildhadstartedpreschoolatage3 2 Maternalcharacteristics maternaleducationallevel occupation anddepressivesymptom
12、sassessedwiththeCenterforEpidemiologicStudies Depressionscale 3 Familycharacteristics parents occupationandfinancialdifficultiesreportedbytheparentswhenthechildwas3 15 3 Statisticalanalysis 1 ChildrenincludedinthecurrentanalysiswerefirstcomparedwiththeotherchildrenintheEDENcohortwhowerenotincluded 2
13、 Resultsforthe36 monthASQscoreandthe5 to6 yearWPPSI IIIevaluationweredescribedasmeans SDsandmedianwithinterquartileranges IQRs 3 Thereceiveroperatingcharacteristic ROC curvelinkinglowIQ 85 andASQscorewasusedtodeterminetheoptimalcutoffvaluefortheASQscore 4 A3 stepanalysiswasthenconductedwithlogisticr
14、egression 5 StatisticalanalyseswereperformedinSASsoftwareversion9 3 16 Results 17 ASQscoresweredeterminedatameanageof37 3 0 8months Themean36 monthASQscorewas270 30 withamedianof280 IQR260 290 IQwasmeasuredatameanageof67 2 1 8months TheMeanIQwas103 13 and69children 7 3 hadanIQ 85 Allchild maternal a
15、ndfamilyfactorsstudied exceptgenderandmaternaldepressivesymptoms weresignificantlyassociatedwithASQscore 18 1 CharacteristicsoftheStudypopulation andcomparedwithchildrenintheEDENCohortbutnotincludedinthestudy 19 ChildrennotincludedweremoreoftenfromNancyCenter werelessoftenfirstborn hadmotherswithlow
16、ereducationallevels andhadparentswithloweroccupationallevelsthanchildrenincluded 20 21 2 IQatage5to6yearsaccordingto36 monthASQscore ROCcurve 22 Theareaunderthecurvewas0 78 95 confidenceinterval CI 0 72 0 84 即IQ 85的幼儿ASQ值小于正常组的概率为0 78 TheoptimalcutoffvalueforpredictinglowIQwas270 sensitivitywas0 77 specificitywas0 68 Positivepredictivevaluewas0 16 thenegativepredictivevaluewas0 97 提示3岁时ASQ得分 270的幼儿5 6岁时IQ 85的可能性小 ROC曲线下面积与工具诊断准确度高低高0 90 1 00 excellent A 中0 80 0 90 good B 0 70 0 80 fair C 低0 60 0
