| Objectives To describe the status of executive function in preschoolers from Ma'anshan City,and to analyze the risk factors associated with executive function deficits.Furthermore,to explore the comorbidity between executive function deficits and emotional and behavioral problems in preschool children.Methods From April 2014 to June 2015,we investigated preschool children aged 3 to 6 years who came from Ma'anshan city.The data collection included general demographic characteristics,birth status and breeding etc.Execution function using the the parents' version of Behavior Rating Inventory of Executive Function-Preschool,emotional and behavioral problems using the parents' version of strengths and difficulties questionnaire,hyperactivity problems using Conners' abbreviated symptom questionnaire,autistic behavior using Clancy autism behavior scale,respectively,were evaluated by parents or other primary adopters.Using the chi-square test to compare the detection rate of preschool children's executive function deficits among the different groups of the general demographic characteristics,birth status and breeding etc.Binary logistics regression model was used to analyze the effects of different birth status and breeding on executive function in preschool children.The Chi-square test was used to compare the detection rate of executive function deficits and emotional and behavioral problems in preschool children.Regression analysis model was used to analyze the effects of emotional and behavioral problems on preschool chidlren's executive function.Results A total of 3 771 preschool children aged 3 to 6 years old were enrolled actually,of which 53.7%(2 026/3 771)were boys,and 91.2%(3 439/3 771)of children are only children.88.8%(3 349/3 771)of children lived in urban areas in the past six months.The detection rate of inhibit,shift,emotional control,working memory,plan/organize and GEC deficits in preschoolers was respectively 7.0%,3.3%,2.6%,23.4%,5.9% and 8.6%.The mode of delivery for cesarean section of children's inhibit and Global Executive composite(GEC)abnormal detection rates were 8.3% and10.1%,higher than the natural childbirth children(6.4%,7.8%),the difference was statistically significant(2=4.779,P < 0.05;?2=6.134,P < 0.05);There was a significant difference in the detection rate of working memory deficits between parental rearing time ratio before the age of 3(?2=10.290,P<0.01).After adjusting the general demographic characteristics,cesarean section will increase the risk of inhibit deficits(OR=1.30,95%CI : 1.01-1.68)and working memory deficits(OR=1.35,95%CI:1.07-1.71).The abnormal detection rate of emotional symptoms,conduct problems,hyperactivity,peer problems,prosocial behavior and total difficulties deficits in preschoolers was respectively 6.3%,7.4%,15.1%,23.0%,10.9% and 7.6%.The abnormal detection rate of emotional symptoms,conduct problems,hyperactivity,peer problems,prosocial behavior and total difficulties deficits among executive function deficits groups was respectively 25.0%,34.3%,34.3%,22.3%,18.3% and 40.6%.The detection rate of the above emotional and behavioral problems in the normal group was 5.1%,5.3%,12.0%,21.4%,4.9% and 9.8% respectively,and the results of ?2test showed statistically significant difference(P <0.01).?2analysis showed that the difference of detection rate of emotional and behavioral problems(emotional symptoms,conduct problems,hyperactivity,peer problems,prosocial behavior and total difficulties)between different groups sorted by executive functions(inhibit,emotional control,working memory,plan/organize,GEC)deficits was statistically significant(P < 0.01).The difference of detection rate of emotional symptoms,conduct problems,peer problems,prosocial behavior and total difficulties between different groups sorted by shift score was statistically significant(P<0.01).After adjusting the confounding factors,inhibit deficits will increase the risk of emotional symptoms(OR=2.96,95%CI: 2.03-4.33),conduct problems(OR=13.85,95%CI: 13.00-19.19),hyperactivity(OR=15.61,95%CI: 11.40-21.39),peer problems(OR=1.65,95%CI: 1.22-2.24),total difficulties(OR=15.52,95%CI:11.14-21.63)and prosocial behavior(OR=2.49,95%CI: 1.78-3.47)abnormal.Shift deficits will increase the risk of emotional symptoms(OR=7.03,95%CI: 4.41-11.22),conduct problems(OR=3.22,95%CI: 1.92-5.39),hyperactivity(OR=1.80,95%CI:1.12-2.87),peer problems(OR=5.05,95%CI: 3.22-7.93),total difficulties(OR=8.23,95%CI: 5.10-13.27)and prosocial behavior(OR=1.93,95%CI: 1.12-3.31)abnormal.Emotional control deficits will increase the risk of emotional symptoms(OR=12.02,95%CI: 7.10-20.34),conduct problems(OR=19.60,95%CI: 11.60-33.10),hyperactivity(OR=6.17,95%CI: 3.81-10.00),peer problems(OR=2.59,95%CI:1.54-4.35),total difficulties(OR=28.53,95%CI: 16.30-49.95)and prosocial behavior(OR=2.25,95%CI: 1.34-3.78)abnormal.Working memory deficits will increase the risk of emotional symptoms(OR=2.78,95%CI: 2.10-3.68),conduct problems(OR=3.85,95%CI: 2.97-4.98),hyperactivity(OR=9.68,95%CI: 7.87-11.90),peer problems(OR=2.15,95%CI:1.78-2.60),total difficulties(OR=9.63,95%CI:7.35-12.60)and prosocial behavior(OR=2.24,95%CI: 1.79-2.82)abnormal.Plan/organize deficits will increase the risk of emotional symptoms(OR=3.54,95%CI:2.35-5.32),conduct problems(OR=6.00,95%CI: 4.15-8.67),hyperactivity(OR=7.51,95%CI: 5.49-10.28),peer problems(OR=2.55,95%CI:1.83-3.55),total difficulties(OR=13.36,95%CI: 9.30-19.19)and prosocial behavior(OR=3.30,95%CI:2.32-4.70)abnormal.GEC deficits will increase the risk of emotional symptoms(OR=4.73,95%CI: 3.36-6.64),conduct problems(OR=10.40,95%CI: 7.63-14.17),hyperactivity(OR=8.85,95%CI: 6.74-11.63),peer problems(OR=2.95,95%CI:2.24-3.90),total difficulties(OR=22.04,95%CI: 15.85-30.65)and prosocial behavior(OR=3.00,95%CI:2.22-4.06)abnormal.?2analysis showed that the difference of detection rate of hyperactive problem and subthreshold autism trait between different groups sorted by executive function deficits was statistically significant(P < 0.001).After adjusting the confounding factors,inhibit deficits will increase the risk of hyperactive problem(OR=10.10,95%CI:7.56-13.50)and subthreshold autism trait(OR=7.37,95%CI:5.42-10.03)abnormal.Shift deficits will increase the risk of hyperactive problem(OR=1.92,95%CI:1.13-3.24)and subthreshold autism trait(OR=4.77,95%CI:3.04-7.50)abnormal.Emotional control deficits will increase the risk of hyperactive problem(OR=9.77,95%CI:6.36-15.01)and subthreshold autism trait(OR=7.70,95%CI:4.92-12.05)abnormal.Working memory deficits will increase the risk of hyperactive problem(OR=5.43,95%CI:4.31-6.85)and subthreshold autism trait(OR=5.80,95%CI:4.50-7.48)abnormal.Plan/organize deficits will increase the risk of hyperactive problem(OR=5.40,95%CI:3.95-7.37)and subthreshold autism trait(OR=7.14,95%CI:5.19-9.81)abnormal.GEC deficits will increase the risk of hyperactive problem(OR=8.19,95%CI:6.25-10.72)and subthreshold autism trait(OR=9.73,95%CI:7.34-12.90)abnormal.Conclusions Executive functions deficits problems of preschool children in Ma'anshan are mainly concentrated on the working memory.Cesarean section and other risk factors were not conducive to the normal development of executive function.There is a comorbid phenomenon between executive function deficits and emotional and behavioral problems. |
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