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Study on Inborn and Outborn Neonatal Admissions in Relation to Gestational Maturity in Neonatal Intensive Care Unit at a Tertiary Care University Hospital in Upper Egypt 上埃及某三级大学医院新生儿重症监护病房中与胎龄有关的先天和先天新生儿入院情况研究
IF 0.3 Q4 Medicine Pub Date : 2021-01-01 DOI: 10.1055/s-0041-1736478
Safwat M. Abdel-Aziz, Enas A. Hamed, A. Shalaby
Neonatal morbidity and mortality rates indicate a country's socioeconomic status and the quality, and effectiveness of its health care system. This research aimed to identify the clinical pattern and causes of neonatal admission for inborn and outborn babies in a tertiary care university hospital and their outcomes. Over a year, this prospective hospital-based research was conducted in the neonatal intensive care unit (NICU) of Assiut Children's Hospital in Upper Egypt (January 1st to December 31st, 2020). Gender, birth weight, gestational age, postnatal age, delivery mode, delivery place, admission cause, hospital stay period, and neonatal outcomes were collected. A total of 1,638 newborns were admitted; 930 (56.8%) were preterm and 708 (43.2%) full-term. Inborn admissions were 1,056 (64.5%) and outborn 582 (35.5%). The majority of inborn admissions were preterm 726 (68.8%), and outborn were full-term 378 (64.9%). The commonest admission causes among inborn and outborn preterm infants were respiratory distress syndrome (84.3%) and congenital intestinal obstruction (22.5%), respectively, while multiple congenital anomalies were the commonest cause for admission among both inborn and outborn full-term babies. The mortality rate was 708 (43.2%), higher among inborn (50%) versus outborn (30.9%). The leading cause of death was respiratory distress syndrome among premature inborn with case fatality rate of (56.9%) and multiple congenital anomalies among premature outborn (60%), as well as inborn (67.4%), and outborn (42.6%) full-term neonates. In conclusion, the neonatal mortality rate was high among studied cases. Morbidity and mortality of respiratory distress syndrome and congenital anomalies were alarmingly high. Therefore, all health care providers must devote a considerable effort to improve health care delivered to these neonates.
新生儿发病率和死亡率表明一个国家的社会经济地位及其医疗保健系统的质量和有效性。这项研究旨在确定一所三级护理大学医院先天性婴儿和外胎婴儿入院的临床模式、原因及其结果。这项基于医院的前瞻性研究在上埃及Assiut儿童医院的新生儿重症监护室(NICU)进行了一年多(2020年1月1日至12月31日)。收集性别、出生体重、胎龄、出生后年龄、分娩方式、分娩地点、入院原因、住院时间和新生儿结局。共有1638名新生儿入院;930人(56.8%)早产,708人(43.2%)足月。新生儿入院人数分别为1056人(64.5%)和582人(35.5%)。大多数先天性入院者为早产726人(68.8%),早产378人(64.9%)。先天性和早产早产儿最常见的入院原因分别为呼吸窘迫综合征(84.3%)和先天性肠梗阻(22.5%),而先天性多发畸形是先天性和未出生的足月婴儿入院的最常见原因。死亡率为708(43.2%),先天性(50%)高于外胎(30.9%)。死亡的主要原因是先天性早产患者的呼吸窘迫综合征,病死率为56.9%,多发性先天性畸形患者为60%,以及先天性(67.4%)和外胎(42.6%)足月新生儿。总之,研究病例的新生儿死亡率较高。呼吸窘迫综合征和先天性畸形的发病率和死亡率高得惊人。因此,所有卫生保健提供者都必须付出相当大的努力来改善为这些新生儿提供的卫生保健。
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引用次数: 0
Homozygous Missense Mutation on Exon 22 of PKHD1 Gene Causing Fatal Autosomal Recessive Polycystic Kidney Disease 致死性常染色体隐性多囊肾病的PKHD1基因22外显子纯合错义突变
IF 0.3 Q4 Medicine Pub Date : 2021-01-01 DOI: 10.1055/s-0041-1725175
Sajina Sathyan, Femitha Pournami, G. Madhavilatha, Amrita Tuteja, Anand Nandakumar, Jyothi Prabhakar, Naveen Jain
Abstract Autosomal recessive polycystic kidney disease, described as a congenital hepatorenal fibrocystic syndrome, is a significant inherited cause of end stage renal failure in children with reported incidence of 1 in 20,000 live births. The clinical spectrum is wide. Antenatal findings of echogenic reniform enlarged kidneys associated with evidence of intrauterine renal failure in the form of severe oligoamnios are pathognomonic. Postnatal illness ranges from fatal respiratory failure due to pulmonary hypoplasia in neonates to chronic kidney disease in children, or later presentation of ductal plate malformation and portal hypertension. Advances in genetic diagnostic techniques have allowed recognition of genotypes. We report a novel homozygous missense variant on exon 22 of PKHD1 gene (chr6:51915067G > A; c.2167C > T) that results in the amino acid substitution of cysteine for arginine at codon 723 (p.Arg723Cys). The affected neonate presented with antenatal anhydramnios, classical radiological features, and severe hypoxic respiratory failure likely due to pulmonary hypoplasia and succumbed. The parents were found to be heterozygous carriers. Detection of the specific variant in the proband facilitated prenatal investigation in the next pregnancy.
常染色体隐性多囊肾病,被称为先天性肝肾纤维囊性综合征,是儿童终末期肾衰竭的重要遗传原因,据报道发病率为2万分之一。临床范围很广。产前超声肾形肾脏肿大伴有严重羊水少的宫内肾功能衰竭的证据是典型的。产后疾病的范围从新生儿肺发育不全引起的致命呼吸衰竭到儿童慢性肾病,或后来出现导管板畸形和门静脉高压症。遗传诊断技术的进步使基因型识别成为可能。我们报道了ppkd1基因22外显子上的一个新的纯合错义变异(chr6:51915067G > a;c.2167C >t),导致密码子723处半胱氨酸取代精氨酸(p.Arg723Cys)。受影响的新生儿表现为产前羊水无,典型的放射学特征,以及可能由肺发育不全引起的严重缺氧性呼吸衰竭和死亡。双亲为杂合携带者。先证者中特异性变异的检测有助于下次妊娠的产前调查。
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引用次数: 0
Precision Medicine with Genetic Testing in Neonatal Intensive care 基因检测在新生儿重症监护中的应用
IF 0.3 Q4 Medicine Pub Date : 2021-01-01 DOI: 10.1055/s-0041-1733875
V. Anand, Femitha Pournami, Anand Nandakumar, Jyothi Prabhakar, Naveen Jain
The highest impact of genetic disorders through a human being ’ s lifespan isduring fetal, perinatal, and neonatal periods. Accurate diagnosis optimizes managementdecisions, and aids parent counseling. Medical professionals in the fi eld must therefore be cognizant of the foundations of genetic diseases and the indications, choices, prerequisites, and bene fi ts of selection of appropriate tests. Inappropriate selection of tests comes with several downsides — in the form of costs, inconclu-sive results, and ethical dilemmas. This article seeks to demystifysuccinctly,fromaclinician ’ sperspective,thevarious genetic tests available and aid selection of the most appropriate one in a given situation. We fi
遗传疾病在人的一生中影响最大的是胎儿期、围产期和新生儿期。准确的诊断优化管理决策,并有助于家长咨询。因此,该领域的医疗专业人员必须认识到遗传病的基础以及选择适当检测的适应症、选择、先决条件和益处。不恰当的测试选择带来了几个不利因素——以成本、不确定的结果和道德困境的形式。本文旨在从临床医生的角度,简明扼要地揭开各种基因检测的神秘面纱,并在特定情况下帮助选择最合适的基因检测。我们fi
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引用次数: 0
Blau Syndrome Complicated by Atypical Type IIa Takayasu Arteritis Blau综合征合并不典型IIa型高须动脉炎
IF 0.3 Q4 Medicine Pub Date : 2021-01-01 DOI: 10.1055/s-0041-1740463
Efstathia Danai C. Bikouli, A. Vazeou, M. Xatzipsalti, G. Servos, D. Delis, D. Maritsi
Abstract Blau syndrome (BS) is a rare, autosomal dominant monogenic autoinflammatory disease, usually presenting as a triad of symptoms (granulomatous dermatitis, uveitis, and nonerosive arthritis) and caused by gain-of-function mutations in the nucleotide oligomerization domain 2 (NOD2) gene. However, very few reports in children of copresence of BS with large vessel vasculitis exist. We hereby describe a case of BS associated with clinical features of Takayasu arteritis. An 8.5-year-old boy presented with hypertension, cardiac insufficiency, arthritis, and ocular disease. Among other investigations, he underwent cervical and chest computed tomography and computed tomography angiography scans that revealed the presence of type IIa Takayasu arteritis lesions. Genetic analysis revealed a heterozygous mutation of NOD2 gene leading to the amino acid exchange Arg-587-Cys in the NACHT domain of the NOD2 protein (R587C) as pathogenic cause of BS. He received treatment with prednisolone, methotrexate, and infliximab (antitumor necrosis factor-α) in addition to antihypertensive medication with a favorable clinical response. Cases of BS should be investigated for the coexistence of Takayasu arteritis. However, further research is required to delineate a possible common pathogenic mechanism between the two clinical entities.
摘要布劳综合征(BS)是一种罕见的常染色体显性单基因自身炎症性疾病,通常表现为三重症状(肉芽肿性皮炎、葡萄膜炎和非侵蚀性关节炎),由核苷酸寡聚结构域2(NOD2)基因的功能获得突变引起。然而,很少有儿童BS合并大血管血管炎的报道。我们在此描述一个与大动脉炎临床特征相关的BS病例。一名8.5岁男孩出现高血压、心功能不全、关节炎和眼病。在其他调查中,他接受了颈部和胸部计算机断层扫描以及计算机断层扫描血管造影术扫描,显示存在IIa型大动脉炎病变。遗传分析显示,NOD2基因的杂合突变导致NOD2蛋白(R587C)NACHT结构域中的氨基酸交换Arg-587-Cys成为BS的致病原因。除了降压药物外,他还接受了泼尼松龙、甲氨蝶呤和英夫利昔单抗(抗肿瘤坏死因子-α)的治疗,临床疗效良好。BS病例应调查大动脉炎的共存情况。然而,还需要进一步的研究来描述这两种临床实体之间可能的共同致病机制。
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引用次数: 1
Tea or Thrush?: A Case of Nonaccidental Oral Injury in an Infant 茶还是画眉?:一例婴儿非意外口腔损伤
IF 0.3 Q4 Medicine Pub Date : 2021-01-01 DOI: 10.1055/s-0041-1733869
Meryam Jan, Kathleen Dully, C. Kostecki, R. Alexander
Abstract A 5-month-old girl child patient presented to the emergency department for oral thrush and poor feeding but instead demonstrated concern for abuse after physical exam, as findings were consistent with oral injury. Correct identification of the oral findings as traumatic necessitated navigating language and cultural issues before the mechanism of injury and abuse determination could be made. Exploring the involvement of other caregivers was a crucial piece for investigation of the clinical scenario. The incidence of child abuse and pediatric oral injuries concerning for abuse were reviewed in this case report.
摘要一名5个月大的女童患者因口腔鹅口疮和进食不良而被送往急诊科,但在体检后表现出对虐待的担忧,因为检查结果与口腔损伤一致。在确定伤害和虐待的机制之前,必须正确识别口头调查结果是否具有创伤,这就需要处理语言和文化问题。探索其他护理人员的参与是临床场景调查的关键部分。本病例报告回顾了儿童虐待和儿童口腔损伤的发生率。
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引用次数: 0
Streptococcal Throat Carriage among Primary School Children Living in Uyo, Southern Nigeria 奈及利亚南部尤约市小学生链球菌喉部感染
IF 0.3 Q4 Medicine Pub Date : 2021-01-01 DOI: 10.1055/s-0040-1722274
K. Edem, E. Ikpeme, M. Akpan
Abstract Surveillance of the carrier state for β-hemolytic streptococcal (BHS) throat infections remains essential for disease control. Recent published works from Sub-Saharan Africa have suggested a changing epidemiology in the burden of BHS throat infections. The objective of the present study was therefore to determine the prevalence and pattern of BHS throat carriage in school-aged children in Uyo, Akwa Ibom State. This was a prospective cross-sectional study of 276 primary school children in Uyo. Subjects were recruited by multistage random sampling. Obtained throat swabs were cultured on 5% sheep blood agar. Lancefield grouping on positive cultures was done by using the Oxoid Streptococcal Grouping Latex Agglutination Kit, United Kingdom. Antimicrobial susceptibility testing was done with the disk diffusion method. Associations were tested with Fischer's exact test. The prevalence of BHS carriage was 3.3%. Group C Streptococcus was identified in 89% of isolates and Group G Streptococcus in 11%. Younger age and larger household size were associated with asymptomatic streptococcal throat infections. Antimicrobial susceptibility was highest with cefuroxime and clindamycin (89% of isolates each), while 78% of isolates were susceptible to penicillin. None of the tested isolates was susceptible to co-trimoxazole. The prevalence of streptococcal throat carriage in the study area was low. There were no Group A Streptococcus isolates suggesting an evolving epidemiology of BHS disease in the study area.
摘要监测β-溶血性链球菌(BHS)咽喉感染的携带者状态对疾病控制至关重要。撒哈拉以南非洲最近发表的研究表明,BHS咽喉感染负担的流行病学正在发生变化。因此,本研究的目的是确定阿夸伊博姆州Uyo的学龄儿童中BHS喉咙运输的患病率和模式。本研究是一项前瞻性横断面研究,研究对象为尤约市276名小学生。研究对象采用多阶段随机抽样方法。获得的咽拭子在5%羊血琼脂上培养。使用英国Oxoid Streptococcal grouping Latex Agglutination Kit对阳性培养物进行Lancefield分组。药敏试验采用纸片扩散法。这些关联用费舍尔的精确测试进行了检验。BHS携带率为3.3%。在89%的分离株中鉴定出C组链球菌,在11%的分离株中鉴定出G组链球菌。无症状链球菌咽喉感染与年龄较小和家庭规模较大有关。头孢呋辛和克林霉素的敏感性最高(各占89%),而78%的分离株对青霉素敏感。所有分离株对复方新诺明均不敏感。研究地区链球菌咽部携带的流行率较低。研究地区未发现A群链球菌分离株,提示BHS疾病的流行病学正在演变。
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引用次数: 0
Evaluation of Patients Referred to Children's Medical Center Laboratory for Diagnosis of Mucopolysaccharidoses: Eight Years' Experience from Iran 转诊至儿童医学中心实验室诊断粘多糖的患者评估:来自伊朗的八年经验
IF 0.3 Q4 Medicine Pub Date : 2021-01-01 DOI: 10.1055/s-0041-1740059
Rokhsareh Jafaryazdi, S. Shams, A. Setoodeh, R. S. Badv, V. Ziaee, F. Abbasi, Mohammad Taghi Haghi Ashtiani, Fatemeh Mozafari, L. Shafeghat
Mucopolysaccharidoses (MPSs) are rare lysosomal storage diseases, resulting from deficiencies of enzymes responsible for Glycosaminoglycans (GAGs) degradation. This leads to accumulation of GAGs in tissues and their excretion in urine, with a wide variety of manifestations. Early diagnosis of MPSs is strictly recommended due to available therapy that can slow down disease progression during the early ages. This study aimed to evaluate patients with suspected MPS referred to Children's Medical Center laboratory over eight years. We also evaluated the usefulness of urine GAG as a screening test for identification of such patients. A total of 1414 patients (40% female, 60% male, with mean age 3.1 ± 4.1years) have participated in this study. The urinary GAG analysis (uGAG) was performed by 1, 9-dimethyl-methylene blue (DMMB) and Berry spot test (BST). All patients with positive and mild positive results or with disease-related symptoms were evaluated in terms of definitive diagnosis, received treatments, morbidity, and mortality rate. In 407 (36.5%) patients uGAG were positive or mild positive, of which 26.3% suffered from one of the types of MPSs, 28.5% suffered from other diseases, 32.9% were undiagnosed, 12.3% were apparently healthy, and 19 died. The negative predictive value of uGAG test in our study was 100%. About 21% of MPSs patients received enzyme replacement therapy, while four patients underwent stem cell transplants. The rest received supportive care. We concluded that a combination of DMMB and BST methods has acceptable sensitivity for screening suspicious MPS patients.
粘多糖病(mps)是一种罕见的溶酶体积存病,由负责糖胺聚糖(GAGs)降解的酶缺乏引起。这导致GAGs在组织中积聚并随尿液排出,表现多样。mps的早期诊断是严格推荐的,因为现有的治疗可以在早期减缓疾病的进展。本研究旨在评估8年来儿童医学中心实验室的疑似MPS患者。我们还评估了尿液GAG作为鉴别此类患者的筛查试验的有效性。共纳入1414例患者,其中女性40%,男性60%,平均年龄3.1±4.1岁。采用1,9 -二甲基亚甲基蓝(DMMB)和Berry斑点试验(BST)进行尿GAG分析(uGAG)。所有阳性和轻度阳性结果或有疾病相关症状的患者在明确诊断、接受治疗、发病率和死亡率方面进行评估。407例(36.5%)患者ugg阳性或轻度阳性,其中26.3%患有一种mps, 28.5%患有其他疾病,32.9%未确诊,12.3%明显健康,死亡19例。在我们的研究中,uGAG试验的阴性预测值为100%。约21%的mps患者接受了酶替代治疗,而4例患者接受了干细胞移植。其余患者接受支持性治疗。我们的结论是,DMMB和BST方法联合筛查可疑MPS患者具有可接受的敏感性。
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引用次数: 0
Primary Disseminated Hydatid Disease Involving Multiple Organs in a Pediatric Patient: A Rare Case Report 小儿多器官原发性播散性包虫病1例罕见病例报告
IF 0.3 Q4 Medicine Pub Date : 2021-01-01 DOI: 10.1055/s-0041-1731306
Nishu Gupta, Gunjan Jindal, Hanish Singla, D. Garg
Abstract Hydatid disease is a parasitic infestation by Echinococcus genus of tapeworm, resulting from ingestion of tapeworm eggs and leading to formation of cysts predominantly in the liver and lungs. Multiorgan involvement in children is unusual. We present a case of a 12-year-old female with multiple organ involvement. Patient had history of abdominal pain, breathlessness, irritability and vomiting. Plain radiograph showed a large ovoid calcific lesion projected over the liver. Abdominal sonography demonstrated multiple hydatid cysts in the liver, spleen and left kidney. Ultrasound findings were further confirmed by contrast-enhanced computed tomography that showed additional hydatid cysts in bilateral lungs. All accessible cysts were excised on laparotomy. Cystic hydatid disease should be suspected in all pediatric patients with multiple cystic lesions, especially in endemic areas.
摘要包虫病是绦虫棘球绦虫属的一种寄生虫感染,由摄入绦虫卵引起,主要在肝脏和肺部形成囊肿。儿童多器官受累并不常见。我们报告一个12岁的女性多器官受累的病例。患者有腹痛、呼吸困难、烦躁和呕吐史。x线平片显示肝脏上有一个巨大的卵形钙化灶。腹部超音波显示肝脏、脾脏及左肾有多个包虫囊肿。超声结果进一步证实了对比增强计算机断层扫描显示双侧肺有额外的包虫囊肿。所有可触及的囊肿均在剖腹手术中切除。囊性包虫病应怀疑所有儿童患者多发性囊性病变,特别是在流行地区。
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引用次数: 1
Bronchial Clearance Physiotherapy in Pediatrics. A Controlled, Randomized, Multicenter Study of the Short-Term Effects on Respiration during Outpatient Care for Infants with Acute Bronchiolitis 儿科的支气管清除物理疗法。急性毛细支气管炎患儿门诊期间呼吸短期影响的对照、随机、多中心研究
IF 0.3 Q4 Medicine Pub Date : 2021-01-01 DOI: 10.1055/s-0041-1731304
S. Sebban, D. Evenou, C. Jung, C. Fausser, S. Durand, M. Bibal, V. Geninasca, M. Saux, J. Jeulin
Abstract Objectives The use of chest physiotherapy (CP) has not, to date, been shown to be effective in the care of infants hospitalized for bronchiolitis. However, it has not yet been studied in outpatient settings. The aim of our study was to examine the short-term benefit of CP with the increased exhalation technique (IET) on the respiratory conditions of nonhospitalized infants. Methods Our research consisted of a multicenter, randomized, controlled, single-blind study of infants under 1 year old. A decrease in the severity score of the infants' respiratory condition was compared between two groups: one receiving CP and one without CP. Eighty-two infants were randomized: 41 in the CP group and 41 in the control group. Blinded assessors determined the Wang Clinical Severity Score at inclusion (T0) and 30 minutes later (T1) for each group. Results Improvement in the severity score was observed for 29 infants (70.7%) in the group receiving CP, compared with 4 infants (9.76%) in the control group (p < 0.001). The mean decrease in the Wang Clinical Severity Score was −2 (±1.32) in the group receiving physiotherapy compared with −0.22 (±0.99) in the control group (p < 0.001). Conclusion For outpatient care of infants with bronchiolitis, the results of this study suggest that CP with IET leads to a short-term improvement of mucus airway obstruction parameters.
抽象目标 迄今为止,胸部物理疗法(CP)的使用尚未被证明对因毛细支气管炎住院的婴儿有效。然而,它尚未在门诊环境中进行研究。我们研究的目的是检验CP与增加呼气技术(IET)对非住院婴儿呼吸状况的短期益处。方法 我们的研究包括一项针对1岁以下婴儿的多中心、随机、对照、单盲研究。比较两组婴儿呼吸系统疾病严重程度评分的下降情况:一组接受CP,一组不接受CP。82名婴儿被随机分组:CP组41名,对照组41名。盲法评估员确定纳入时的王临床严重程度评分(T0)和30 分钟后(T1)。后果 与对照组的4名婴儿(9.76%)相比,接受CP组的29名婴儿(70.7%)的严重程度评分有所改善(p < 0.001)。与对照组的−0.22(±0.99)相比,接受物理治疗组的王临床严重程度评分平均下降了−2(±1.32)(p < 0.001)。结论 对于毛细支气管炎婴儿的门诊护理,本研究结果表明,CP和IET可短期改善粘液气道阻塞参数。
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引用次数: 0
Inclusive Education for Children with Special Needs and Autism: Status in the Schools of Puducherry, India 对有特殊需求和自闭症儿童的包容性教育:印度普杜切里学校的现状
IF 0.3 Q4 Medicine Pub Date : 2021-01-01 DOI: 10.1055/s-0041-1735882
Sujitha Mukkiri, P. Kandasamy, M. Subramanian, Venkatesh Chandrasekaran, S. Kattimani
Abstract Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting social interaction and communication. Children with autism are at risk of school exclusion because of the inherent problems in behavior and communication. This study was performed in Puducherry to determine whether inclusive education is practiced for children with ASD and to ascertain the difficulties faced by educators in the schools that enroll children with ASD. This study was performed in the mainstream (regular) and special schools of Puducherry between November 2018 and February 2019. The mainstream schools were contacted over the telephone, by e-mail, and by regular post, and the investigator contacted the special schools in person. Data were collected using a semistructured proforma. A total of 66 schools participated in the survey (60 mainstream and 6 special schools). Among 60 mainstream schools comprising 3,967 children, 18 (0.45%) were children with special needs (CWSN) and 2 (0.05%) had ASD. In the six special schools comprising 2,167 children, 1,844 (85%) were CWSN and 323 (15%) were those with ASD. Among the 60 mainstream schools, only 14 (23.3%) schools had provision for special educators, accounting for 42 teachers. Behavioral problems were commonly reported in special schools. Enrollment of children with ASD is negligible in mainstream schools compared with special schools in Puducherry. More studies are needed to explore the reason for the same and to explore the feasibility of providing access to disabled children in mainstream schools.
摘要自闭症谱系障碍(ASD)是一种影响社会交往和沟通的神经发育障碍。自闭症儿童由于行为和沟通方面的固有问题,有被学校排斥的风险。这项研究是在普杜切里进行的,目的是确定是否对自闭症谱系障碍儿童实施包容性教育,并确定招收自闭症谱系疾病儿童的学校的教育工作者面临的困难。这项研究于2018年11月至2019年2月在普杜切里的主流(普通)和特殊学校进行。通过电话、电子邮件和常规邮件联系了主流学校,调查人员亲自联系了特殊学校。使用半结构化形式表收集数据。共有66所学校参加了调查(60所主流学校和6所特殊学校)。在包括3967名儿童的60所主流学校中,18所(0.45%)是有特殊需求的儿童,2所(0.05%)患有自闭症谱系障碍。在由2167名儿童组成的六所特殊学校中,1844名(85%)为CWSN,323名(15%)为ASD。在60所主流学校中,只有14所(23.3%)学校配备了特殊教育工作者,占42名教师。行为问题在特殊学校很常见。与普杜切里的特殊学校相比,ASD儿童在主流学校的入学人数微不足道。需要进行更多的研究,以探索同样的原因,并探索在主流学校为残疾儿童提供入学机会的可行性。
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引用次数: 2
期刊
Journal of Child Science
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