Mental and Neuromotor Outcomes of Children with Psychomotor Retardation

身心發展遲緩兒童之智能發展與預後

廖華芳(Hua-Fang Liao) ； 李素菁(Su-Ching Lee) ； 宋維村(Wei-Tsen Soong) ； 曾嫦嫦(Chang-Chang Tseng) ； 蘇淑貞(Shu-Chen Su)

《中華民國物理治療學會雜誌》 21卷2期 (1996/04) Pp. 121-130

https://doi.org/10.29616/JPTAROC.199604.0004

摘要

鑑於兒童發展之變異性較高，早期無神經異常癥狀之身心發展遲緩兒童，長大後可能成為智能不足兒童、腦性麻痺兒童或正常兒童，但影響他們的預後之早期各項因素並不十分清楚。本研究長期追蹤80位非唐氏症之身心發展遲緩兒童，以探究早期之神經學檢查、發展評量、行為表現與後期智能不足之關聯。這些兒童中男性47位，女性33位。在4至48個月大開始檢查，並追蹤到24至99個月大，平均接受34個月之追蹤。這些兒童最後之診斷為：智能不足（57位）、協調不良型腦性麻痺兒童（6位）、痙攣型腦性麻痺兒童（2位）、正常（11位）及不確定（4位）。根據比西量表或貝萊氏兒童發展量表所得之測驗結果顯示：智能正常或臨界值者12位，輕度智能不足者6位，中度智能不足者27位，重度智能不足者35位。其中痙攣型腦性麻痺兒童之智能較差。早期與智能有關之因素包括：癲癇、獨立行走年齡、說有意義單字之年齡、頭圍小於3百分位數、父親之教育程度、「早期介入發展量表」與「學齡前兒童發展量表」之各項發展商數及智能不足現象（包括注視手、過度好動、流口水、吃玩具、重覆無意義的固定動作行為）。身心發展遲緩兒童之早期低肌肉張力程度與後來之智能發展、獨立行走年齡、疾病診斷皆無顯著關聯。在相關變項中，以「學齡前兒童發展量表」之「一般發展發展商數」及智能不足現象之數目最能預測其智能商數。

關鍵字

發展遲緩 ； 預後 ； 智能

並列摘要

To investigate the association between mental or neuro-motor outcomes and the earl conditions, 80 psychomotor retarded children who were non-Down's syndrome and without neurological impairment were included in this study. There were 47 boys and 33 girls. They were followed up from 4-48 months to 24-99 months old with the follow-up periods ranged from 12 to 54 months (mean=34 months). Among these children, the diagnoses at the last follow-up were: mental retardation (n=57), ataxic cerebral palsy (n=6), spastic cerebral palsy (n=2), within normal limit (n=11) and uncertain (n=4). Their mental functions at the last follow-up tested by Bayley Mental Scale or Binet-Simon tests were: 12 normal or borderline, 6 mild retarded, 27 moderate retarded, and 35 severe retarded. The mentalities of the spastic children were the worst among all the groups. The early neuro-developmental signs significantly correlated with the final mental outcomes. Those early signs included epilepsy, age of independent walking, age of meaningful speech, small head circumference, father's education, developmental quotients (DQ) of Early Intervention Developmental Profile and Chinese Child Development Profile (CCDI) and existing signs of mental deficiency. The degree of hypotonicily at the earlier age did not correlate with the mental or neuro-motor outcomes. The variables of initial evaluation, which were able to predict the later mental DQ best, were the DQ of the General Development of CCDI and the number of signs of mental deficiency.

並列關鍵字

Developmental delay ； outcome ； mentality