台南某地區醫院學齡前初次就診之疑似發展遲緩兒童社會情緒初探

目的：本研究以台南某地區醫院，初次就診聯合評估門診為研究對象，分析6歲以前學齡前兒童的評估結果，同時探討社會情緒發展之相關表現。研究方法：採病歷回溯法，將2017年間初次求診的6歲前學前兒童，共57位，登錄其基本資料和各項評估結果後，以描述性統計分析就診年齡及各類型發展遲緩比例，同時使用卡方檢定分析各類型發展遲緩相關性及社會情緒發展特性。研究結果：本研究結果顯示，就診性別男生45位（78.95%），女生12位（21.05%），平均就診年齡為3歲4個月，以兩歲就診為最大宗，接著是四歲，3歲以前佔50%。語言發展遲緩的人數最多（75%），其次是認知發展遲緩者（37%），粗大動作發展遲緩者佔35%，而精細動作發展遲緩者佔33%。本研究發現有一半以上兒童在情緒行為與社會適應功能有不同程度地困難，進一步探討社會情緒發展困難之兒童，發現其中伴隨語言發展遲緩佔76.67%，且語言在各類別同質性檢定達統計上的顯著。結論：台南某地區醫院學前兒童中，初次就診發展遲緩聯合評估門診之幼兒平均就診年齡為3歲4個月，3歲以前兒童佔50%，顯示仍有空間增加三歲前發展遲緩兒童之篩檢及介入。就診兒童評估結果最常見的是語言發展遲緩。有一半以上的兒童在情緒行為與社會適應功能有不同程度地困難，且大部分伴隨語言遲緩，建議針對兒童發展遲緩，詳細而全面的評估仍有其必要性，可以協助家長及跨團隊確認兒童核心問題，並擬定整合性治療計畫，以早期提升兒童社會情緒問題促進整體發展能力。以上結果將可作為早療臨床人員在擬定介入計畫和安排後續轉介療育時的參考依據。

關鍵字

發展遲緩；社會情緒發展；早期療育

並列摘要

Objectives: The study collected and analyzed the data of children who underwent clinical assessment due to developmental delay (DD) in a district hospital in Tainan County. We also discussed social-emotional development. Methods: The sample included 57 preschool children who visited our department for evaluation of developmental problems during January 2017 to December 2017. The joint evaluation reports of the subjects were analyzed using descriptive statistics and chi-square test. Results: The results of this study showed that there were 45 boys (78.95%) and 12 girls (21.05%). The average age was 40 months, and was 50% before the age of three. Speech DD (75% of all) was the main problem, 53% of children who had social-emotional difficulties. Among the children with social-emotional difficulties, 76.67% had speech DD. Conclusions: There is still room to increase the screening and intervention of children suspected DD before the age of three. More than half of children had social-emotional difficulties, and most of them were accompanied by speech DD. A comprehensive assessment of children with DD is still necessary. These results may enhance understandings of DD problems in preschool children, especially for all participants of early intervention program.