An Investigation About Growth And Development And Health Related Dysfunctional Status Of Adolescents With Disabilities

Objectives To investigate the pubertal development, puberty-related knowledge, attitudes and behaviours and health related dysfunctional status of adolescents with disabilities. Thus to provide basis for understanding the growth and development and functional status of adolescents with disabilities, as well as to provide references and suggestions for improving their puberty-related knowledge, attitudes and behaviours, alleviating their dysfunctional status and promoting their social inclusion.Methods Purposive sampling was used. First, one city in each five type cities of Shandong Province was selected randomly. Then one municipal comprehensive special school in each selected cities and the only one provincial special school were selected by purposive sampling. All the adolescents with disabilities aged between10to19years who could complete questionnaires independently or with assistance in those schools were recruited in the research. From December1st,2011to January15th,2012, questionnaire investigation was implemented. Questionnaires were sent to the responsible investigator for each special school. Subjects were investigated together and the questionnaires were returned after checking. The self-reported questionnaires included four parts:basic personal information sheet, pubertal development scale (PDS), puberty-related knowledge, attitudes and behaviours scale (puberty-KAB) and WHO disability assessment schedual2.0(WHODAS Ⅱ). Descriptive analysis, parametric analyses (t-test, ANOVA analysis), nonparametric analyses (chi-square test, Mann-Whitney U test for comparison between two groups, Kruskal-Wallis test for comparison including more than two groups) and Pearson correlation analysis were performed to analyze the basic information, pubertal development, puberty-KAB and dysfunctional status of subjects.Results A total of588questionnaires were distributed, of which544were returned and452(83.1%) were usable. Subjects were16.2(s=2.32) years old. There were4types of disability:hearing, visual, physical and multiple disability. Detailed information was as follows:1. The PDS scores were2.1(s=0.83) for boys and2.5(s=0.74) for girls on average.44.1%and30.2%of boys were in stages of midpubertal and latepubertal while81.5%and10.6%of girls were in stages of latepubertal and postpubertal. Chi-square test found that there was a significant difference in PCS distribution by gender (χ2=175.40, P<0.001);2. The average item score of puberty-KAB was3.4(s=0.48), which was between "3" and "4". T-test showed that there were significant differences in factors of psycho-social development (t=1.98, P=0.048), concerns over secondary sex characteristics (t=4.48, P<0.001) and romance sign (t=-5.59, P<0.001) by gender. A significant difference was found in puberty-KAB score by disability types by ANOVA analysis (F=5.05, P=0.002). LSD test found that subjects with hearing disability had significant higher score than other disabilities;3. The WHODAS Ⅱ total score was67.4(s=23.78) and the average item score was1.9(s=0.17), which was between "1=no" and "2=mild". Significant differences were found between4types of disabilites in aspects of six life domains. Except the domain of social participation, subjects with visual disability had significant lower scores on other domains than other disabilities;4. With pubertal development, puberty-KAB score became higher and then lower. There was no significant effect on WHODAS II total score by pubertal development. There was a negative correlation between WHODAS II total score and puberty-KAB score. Conclusion Most of the subjects are in the stages of midpubertal or above and girls develop earlier than boys. The puberty-KAB of subjects is just around average. The psycho-social development and healthy behaviours of subjects are well, while the physiological knowledge of subjects is relatively poor. Disability types influence the score of puberty-KAB and adolescents with hearing disability have higher scores than adolescents with other disabilities. Adolescents with disabilities are dysfunctioned in all life domains. With pubertal development, the level of puberty-related knowledge, attitudes and behaviours becomes better. But it descends from the stage of latepubertal. There is a negative correlation between WHODAS II total score and puberty-KAB score. Therefore, there is an urgent need to strengthen the health and development services for adolescents with disabilities. It is needed to increase their puberty-KAB, alleviate their dysfunctional status and promote their social inclusion through accessible interventions, so as to lay the foundation for the health and development services for adolescents with disabilities.