| Objective To investigate the prognosis and effect factors according to following up the children with developmental disability containing intellectual impairment,deformed limb,physical disabled who were diagnosed in the sampling survey on disability in 0-6 years-old children in Beijing in 2004 and to provide theoretical basis for rehabilitation establishment programmed by government and society .Objects and Methods 269 objects are being followed, containing mentality 237 , deformed limb 57, physically disabled 26.Intelligence test adopts Gesell Developmental Scale, Wechsler Preschool and Primary Scale of Intelligence, Infant and Junior high school children Social Adapted Scale. Deformed limb was diagnosed according to diagnostic criterion of wean orthopedics which used widely in clinic and classification criterion for children in 2004 clinical symptom. Autism was diagnosed by CARS Scale,Clancy autism behavior scale and Conner parent symptom questionnaire. The prognosis of children is judged by the change of grade on disability containing advanced obviously, advanced, unchanged and deteriorated. The criterion is following: advanced obviously is definite the grade of this investigation higher than grade in 2004 two ranks. Advanced degree is definite the grade of this investigation is higher than 2004 one rank. Unchanged degree is definite the grade of two investigations is the same. Deteriorated degree is definite the grade of this investigation is lower than 2004. We adopted uniform diagnosis scale and determinant criterion and investigator in 2004 in order to decrease information bias and to increase the rate of following according to clue and telephone.Results The prospective objects are 288, the actual samples are 269, the rate is 93.40%; the rate of mental retardation is 92.94%, the rate of limb is 96.61%, the rate of autism is 100.00%. In 237 children with mental retardation, 124(52.32%) children are advanced obviously, 28(11.81%) children advanced, 60(25.32%) children no changed and 25 (10.55%) children deteriorated. In 56 children with deformed limb (besides one child was not diagnosed because of rejection from parents), 5(8.93%) children are advanced obviously, 14(25.00%) children advanced, 35(62.50%) children no changed and 2 (3.57%) children deteriorated. In 26 children with physically disabled, 4 (15.38%) children are advanced obviously, 4(15.38%) children advanced, 16(61.54%) children no changed and 2 (7.69%) children deteriorated.According to Logistic regression between prognosis and background data of children with mental retardation containing family, rehabilitation training, rehabilitation cost, knowledge and others in 2004.Results is classified variable containing 0 represents advanced (advanced obviously or advanced),1 represents unadvanced(unchanged/ aggravated). There are 152 children in advanced group and 85 children in unadvanced group.Atα=0.05,23 factors are relation to prognosis containing city/urban(χ~2 =14.000,P=0.000),receiving education (χ~2 =16.087 ,P=0.000),the type of education(χ~2 =6.709,P=0.010),culture degree of father(χ~2 =11.091,P=0.011),culture degree of mother(χ~2 =13.442,P=0.004),occupation of mother(χ~2 =4.309,P=0.038),rehabilitation treatment(χ~2 =17.563,P=0.000),home training(χ~2 =17.896,P=0.000),rehabilitation training of parents (χ~2 =21.363,P=0.000),early intervention of developmental disability (χ~2 =7.525,P=0.006),knowing how to training at home (χ~2 =22.788,P=0.000),future of children (χ~2 =6.055,P=0.014),rehabilitation results in future (χ~2 =4.312,P=0.038),believing the status will be improved according rehabilitation(χ~2=14.323,P=0.000),cost on rehabilition directly(χ~2=10.060,P=0.002),total fare(χ~2=8.647,P=0.003)),attitude to developmental lately(χ~2 =15.608,P=0.000),receiving technology of rehabilitation from society (χ~2 =5.779,P=0.016),the attitude of neighbors(χ~2 =7.598,P=0.006),the attitude of community(χ~2 =5.356,P=0.021),the attitude of infants (χ~2 =20.663,P=0.000),the age in 2004 (χ~2 =11.308,P=0.002),the degree of disability in 2004 (χ~2 =15.606 , P=0.001).According to factors analysis (KMO=0.792, Bartlett test P=0.000) we picked up seven factors containing rehabilitation,culture, cognition of parents, the attitude of society,cost,degree of deformity in 2004 and age in 2004.Outcome of multiple analysis is following(Forward: Wald):culture degree of mother(χ~2 =5.174,P=0.023),rehabilitation training of parents(χ~2 =9.192,P=0.02),rehabilitation treatment on children (χ~2 =4.313,P=0.038),the attitude of society (χ~2 =11.664,P=0.001),the age in 2004(χ~2 =10.541,P=0.001),degree of disability in 2004 (χ~2 =21.594,P=0.000).There are interactions between education and rehabilitation training and degree of deformity in 2004 respectively. There are interactions between education and rehabilitation training and cognition of parents on rehabilitation status in future respectively.According to logistic regression on children with deformed limb,results is classified variable containing 0 represents advanced(advanced obviously or advanced) containing 19 children,1 represents unadvanced(unchanged/ aggravated) containing 37 children.Atα=0.05, prognosis is relation to attitudes of parents to future of children (χ~2 =3.939,P=0.047),total fare (χ~2 =4.235,P=0.040),sorts of incorporative deformity(χ~2 =6.694,P=0.010).According to Fisher's exact test of data from children with physical disability,8 children are advanced and 18 not advanced.At the criterionα=0.05, factors contain receiving education(P=0.021),rehabilitation training of parents (P=0.036),results of Gesell in 2004(P=0.017),the degree of deformity in 2004(P=0.014).According to logistic regression between rehabilitation training and background data of children, we acquire factors affecting rehabilitation training on children. Variable is classified containing 0 represents children receiving rehabilitation training, 1 represents children not receiving rehabilitation training. There are 188 children in group 0 and 85 children in group 1.Atα=0.10,sex(χ~2 =5.878,P=0.015),type of family(χ~2 =3.516,P=0.061),income per month(χ~2 =2.715,P=0.099),early intervention of developmental disability (χ~2 =4.348,P=0.037),the attitude to the future of children (χ~2 =3.006,P=0.083),misgivings to children (χ~2 =2.985,P=0.084),service provided by community (χ~2 =5.791,P=0.016),living ensurement fee(χ~2 =3.835,P=0.050),sorts of incorporative deformity (χ~2 =3.629,P=0.057). Results of multiple analyses are following (Forward: Wald): income per month(χ~2 =4.624,P=0.032),early intervention on developmental disability (χ~2 =24.62,P=0.000),cognition on ability of children earning his living(χ~2 =7.559,P=0.006),sorts of incorporative deformity (χ~2 =4.420,P=0.036).The cognition of early intervention on developmental disability is relatively scarcity.62.83% parents of intellectual disabled children are optimistic to children. All parents are positive to early intervention on developmental disability. All children need rehabilitation training and medical treatment.Conclusion Because of speciality of development of children with disability, the prognosis of children with developmental disability might be influenced by many factors and appear different results. The rate of advanced results in mental retardation is highest and deformed limb lowest.The prognosis of chindren with mental retardation is relation to culture degree of mother,rehabilitation training of parents,rehabilitation treatment on children,the attitude of society,the age in 2004,degree of disability in 2004. The prognosis of chindren with deformed limb is relation to attitudes of parents to future of children is relation to prognosis,total fare,sorts of incorporative deformity. The prognosis of children with physical disability is relation to receiving education,rehabilitation training of parents,results of Gesell in 2004,the degree of deformity in 2004. The cognition of early intervention on developmental disability of parents whose children with mental retardation is relatively scarcity.parents whose children is being with mental retardation or physical disability are optimistic to rehabilitation results. The attitude to early intervention of developmental disability of parents is positive.The total cost of children with physical disability is highest, children with mental retardation is lowest. All children need rehabilitation training and medical treatment. Key words developmental disability;prognosis;mental;limb;physical... |
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