Screening And Physical Condition Survey Of Children With Developmental Behavior Disorder Based On "Internet +" Platform

Objective: To screen and understand the physical condition of children with developmental behavior disorder based on the "Internet +" platform,establish electronic health records for children,and realize early screening and nutrition management.Methods:(1)Establish "child development and health" WeChat public account and children's electronic archives management platform.(2)Participants : 1262 children were enrolled in the the department of children health care of children's hospital affiliated to chongqing medical university and three community service centers;1262 children with developmental behavior disorder were enrolled in the rehabilitation institution.(3)Monitoring methods : Warning signs checklist(WSC),autism spectrum disorder early identification "five no" behavior screening checklist andattention deficit hyperactivity disorder screening checklist(Swanson,Nolan,and pelham-iv rating scales(SNAP-IV)were used to screen the children for developmental behavioral disorders,and the abnormal children for follow-up diagnosis in the superior hospital.Physical measurement and Z-score conversion of physical development of children were included,and physical condition of children with developmental behavior disorder,especially those with autism spectrum disorder,was analyzed.Results:(1)1326 children were finally included during the period of operation of the platform from July 2017 to September 2011,including 64 children with developmental disorder in special education institutions entering the platform for health management,and 1262 children entering the platform for development screening outside institutions.Among the children screened,there were 1114 cases with normal developmental behavior screening,among which 56.28%(627/1114)were boys and78.90% were infants.There were 148 cases of abnormal developmental behavior screening in children,73.65%(109/148)in boys and 64.86% in infants and preschool children.(2)Screening and follow-up of the "early warning signs of children's psychological and behavioral development problems" : There were 121 abnormal cases of children in warning sign screening,when screening positive rate was 10.02%(121/1207),and 32 cases were lost to follow-up.51 cases diagnosed developmental behavior disorder children,and diagnosis rate was 57.30%(51/89),including 40 men.Screening age ranged from 0.75 to 5.33,with an average of 2.53±1.11 years,diagnosis of age ranged from 1.25 to 6.08,with an average of2.55±1.45 years,and there is no no statistical difference between the average age at screening and diagnosis of age(P = 0.922).After follow-up,51 children with developmental behavior disorder were diagnosed,including 10 cases of total developmental delay(DD),22 cases of autism spectrum disorder(ASD),16 children with language development delays /language developmental,2 cases of attention deficit hyperactivity disorder(ADHD),and intellectual disability(ID)was reported in 1 patient.(3)The early screening and follow-up of ASD : There were 7 positive cases,1 lost case and 6 confirmed cases of ASD including 5 men.The screening age ranged from 1.25 to 2.00 years old,with an average of 1.64±0.25 years old;the diagnosis age ranged from 1.58 to 2.08 years old,with an average of1.92±0.20 years old;there was no statistical difference between the screening age and the diagnosis age(P = 0.060).(4)ADHD screening and follow-up : SNAP-IV screening positive rate was 17.41%(35/201),9 lost cases,and 8 cases of ADHD diagnosis including 5 men.The screening age ranged from 4.5 to 9.00 years,with an average of 7.04±1.61 years,the diagnosis age ranged from 4.50 to 9.08 years,with an average of 7.52±1.60 years.there was no statistical difference between the screening age and thediagnosis age(P = 0.561).(5)The total screening and follow-up:There was no significant difference between the screening age and the diagnosis age of children with ASD,DD,ADHD and language development delay/language disorder(P > 0.05).Besides,the positive rate and diagnosis rate in infancy were lower than other ages(P < 0.001).58 cases of children with developmental behavior disorder were confirmed by follow-up,including 10 cases of DD,23 cases of ASD,language development delays/language developmental in 16 cases;8 cases of ADHD;1 was ID.(6)Physical status of children with developmental behavior disorder:After the diagnosis,comparing the physical condition of normal children with developmental behavior disorder children,the detection rate of small head circumference and abnormal Z value was higher in children with developmental behavior disorder(P=0.020 ? 0.010).Further comparison of the physical condition of children with autism spectrum disorder and normal children,we found that the Z value of weight and height in ASD group were higher than normal children,the differences were statistically significant(P = 0.014,0.007).The detection rate of children with small head circumference and abnormal Z value in the ASD group were higher than the normal group(P = 0.021,0.010).Shortness or growth retardation,low body weight,weight loss,high body weight,overweight,and excessive head circumference were detected in the two groups of children.There was no statistical difference(P > 0.05).Conclusion:(1)The early screening of developmental behavioral disorders based on "Internet +" is urgent and effective: "Internet +" joint development behavior disorder early screening started late,slow progress.With the help of "Internet +",early screening and follow-up diagnosis of children with developmental behavioral disorder have reduced the screening and diagnosis age of children with developmental behavioral disorder,We did not find a significant diagnosis delay,and the three screening scales complement each other,enabling early screening for developmental behavioral disorders,early diagnosis and good referral;(2)We have realized the physical monitoring of children with developmental behavior disorder:It was found that children with developmental behavior disorder have abnormal physical development,especially those with autism spectrum disorder,which may be related to the characteristics of ASD children's diseases,providing scientific basis for the comprehensive assessment of the nutritional status of children with ASD and the nutritional intervention in the later period.