12~35月龄儿童语言发育迟缓现状及相关影响因素分析

Prevalence of language developmental delay and associated factors among children aged 12 - 35 months

摘要

目的 探讨12~35月龄儿童语言发育迟缓现状及影响因素,为儿童语言发育迟缓的预防及早期干预提供参考。方法 选取2024年5月—2025年4月在汉中市人民医院儿保科体检的554名12~35月龄儿童为研究对象,采用早期语言发育进程量表评估儿童语言发育情况(得分≤P₁₀为异常)。通过问卷调查收集儿童一般资料、围生期情况、家庭养育环境等相关信息。采用χ²检验或Fisher确切概率法进行单因素分析,采用logistic回归分析儿童语言发育迟缓的相关影响因素。结果 12~35月龄儿童语言发育障碍检出率为18.41％(102/554)。有语言障碍家族史与语音和语言表达(A,OR=15.254,95%CI:4.410~52.762)、听觉感受和理解(B, OR=4.387,95%CI:1.471~13.081)、与视觉相关的感受和理解(C, OR=3.641,95%CI:1.071~12.381)维度及量表总分异常(OR=10.062,95%CI:3.196~31.669)呈正相关(P＜0.05);每日亲子互动时长＜1h与A(OR=2.566,95%CI:1.211~5.437)、B(OR=2.192,95%CI:1.120~4.291)、C维度(OR=2.530,95%CI:1.063~5.891)异常呈正相关(P＜0.05);每周同伴接触时间≤5h与A(OR=1.683,95%CI:1.036~2.733)、C(OR=1.806,95%CI:1.019~3.202)维度及量表总分异常(OR=1.715,95%CI:1.070~2.749)呈正相关(P＜0.05);照护人初中及以下文化程度与B(OR=2.769,95%CI:1.415~5.420)、C(OR=2.878,95%CI:1.189~6.964)维度异常呈正相关(P＜0.05);男童与A维度(OR=2.951,95%CI:1.726~5.046)及量表总分异常(OR=2.027,95%CI:1.233~3.332)呈正相关(P＜0.05);未接触电子产品与B维度(OR=0.049,95%CI:0.005~0.479)及量表总分(OR=0.060,95%CI:0.009~0.383)异常呈负相关(P＜0.05);10~12月龄开始添加块状食物与A维度异常呈负相关(OR=0.357,95%CI:0.178~0.717,P＜0.05);分娩方式为顺产与量表总分异常呈负相关(OR=0.607,95%CI:0.375~0.981,P＜0.05)。结论 汉中地区12~35月龄儿童语言发育迟缓发生率较高,其发生与遗传、家庭养育环境、电子产品使用情况等多种因素相关,应重视婴幼儿早期语言发育筛查、加强家庭指导,进行针对性的干预。

Abstract

Objective To determine the prevalence of language developmental delay (LDD) and identify its associated factors among children aged 12 - 35 months, in order to provide a reference for the prevention and early intervention of LDD. Methods A total of 554 children aged 12 - 35 months who underwent routine health examinations at the Department of Child Healthcare, Hanzhong People′s Hospital, between May 2024 and April 2025 were enrolled. Language development was assessed using the Early Language Milestone Scale, with scores at or below the 10th percentile classified as abnormal. General characteristics, perinatal factors, and the family-rearing environment were assessed via questionnaire. Univariate analyses were performed using the chi-square test or Fisher′s exact test, followed by logistic regression to identify factors associated with LDD. Results The prevalence of LDD was 18.41% (102/554). A family history of language disorder was positively associated with abnormalities in speech and language expression (domain A: OR=15.254, 95%CI: 4.410 - 52.762), auditory perception and comprehension (domain B: OR=4.387, 95%CI: 1.471 - 13.081), visual perception and comprehension (domain C: OR=3.641, 95%CI: 1.071 - 12.381), and the total scale score (OR=10.062, 95%CI: 3.196 - 31.669) (P<0.05). Parent-child interaction for <1h/d was positively associated with abnormalities in domains A (OR=2.566, 95%CI: 1.211 - 5.437), B(OR=2.192, 95%CI: 1.120 - 4.291), and C (OR=2.530, 95%CI:1.063 - 5.891) (P<0.05). Weekly peer contact time ≤5 h was positively associated with abnormal scores on dimension A (OR=1.683, 95% CI: 1.036 - 2.733), dimension C (OR=1.806, 95% CI: 1.019 - 3.202), and the total scale score (OR=1.715, 95% CI: 1.070 - 2.749) (all P<0.05). Caregiver education at junior high school level or below was positively associated with abnormalities in domains B (OR=2.769, 95%CI:1.415 - 5.420) and C (OR=2.878, 95%CI:1.189 - 6.964)(P＜0.05). Male sex was positively associated with abnormalities in domain A (OR=2.951, 95%CI:1.726 - 5.046) and the total score (OR=2.027, 95%CI:1.233 - 3.332) (P＜0.05). No exposure to electronic devices was negatively associated with abnormalities in domain B(OR=0.049, 95%CI:0.005 - 0.479) and the total score (OR=0.060, 95%CI:0.009 - 0.383) (P<0.05). Introduction of lumpy foods at 10 - 12 months was negatively associated with abnormalities in domain A (OR=0.357, 95% CI: 0.178 - 0.717), and vaginal delivery was negatively associated with an abnormal total score (OR=0.607, 95% CI: 0.375 - 0.981) (P<0.05). Conclusions The prevalence of LDD among children aged 12 - 35 months in Hanzhong is relatively high and is associated with multiple factors, including genetic factors, the home-rearing environment, and electronic media use. Greater attention should be paid to early language-development screening in infants and young children, together with strengthened family guidance, and targeted interventions.

关键词

语言发育迟缓 / 家庭环境 / 汉中地区 / 儿童

Key words

language developmental delay / family environment / Hanzhong / children

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基金资助

陕西省高等学校重点实验室建设项目(2024032)