看看两岁时的神经发育

Q4 Medicine Quaderni ACP Pub Date : 2022-01-01 DOI:10.53141/qacp.2022.112-117
G. Segre, Ilaria Costantino, Francesca Scarpellini, Valeria Tessarollo, A. Clavenna, M. Bonati
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引用次数: 0

摘要

当儿童出现心理障碍时,即使是轻微的障碍,早期诊断也是必不可少的,以便提供及时和适当的干预,从而改善儿童的症状和发展。早期识别可以预防不同程度的短期和长期后果,对个人、他或她的家庭和整个社会都是如此。因此,儿科医生的观点和临床知识在早期识别潜在疾病方面的重要性,但父母的观点也很重要。因此,在初步诊断时积极让父母参与是很重要的。在这方面,在NASCITA项目中,启动了一个研究分支,旨在在父母、儿科医生和神经精神病学家/心理学家之间建立一种共同的、积极的方法,用于2岁健康评估(健康儿童访问)阶段。使用了三个测试:M-CHAT-R(修订后的幼儿自闭症检查表)来评估语言、社交技能、行为、感觉区域;父母压力指数(简称PSI-SF),用以验证父母感知到的孩子的要求与他或她充分处理这些要求的能力之间的差异程度;DERS(情绪调节困难量表)来强调每个父母在识别、解释和管理他们的情绪方面的困难。45名家庭儿科医生在两岁时对380名父母(142对夫妇、215名母亲和23名父亲)进行了检查。总共有33名儿童(9%)出现危险,得分≥3分,其中1名为高危儿童。64名儿童(16.8%)至少有一位家长PSI-SF检测呈阳性,19名儿童(5%)至少有一位家长DERS检测呈阳性。儿科医生将三次测试的结果与临床评估结合起来,并根据这些结果评估儿童的状况后,可以向父母提供关于出现的情况的简明描述,并向专家提供总结报告。这样的努力导致父母-儿科医生-神经精神病学家三位一体及时、共享的沟通,包括干预的特异性,并有助于反应的有效性。
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Uno sguardo al neurosviluppo raggiunto ai due anni d’età
When a psychological disorder appears in a child, even a mild disorder, early diagnosis is essential in order to provide a timely and appropriate intervention that can improve, both, the child’s symptoms and development. Early identification can prevent consequences of differing levels, in the short and long term, and in the individual, in his or her family, and in society as a whole. Hence the importance of paediatrician’s point of view and clinical know-how in identifying potential disorders early, but also the parents’ views. It is therefore important to actively involve parents upon initial diagnosis. In this regard, within the NASCITA Project, a study branch aimed at building a shared, active approach between parents, paediatricians and neuropsychiatrists/psychologists was activated for the age 2-year health assessments (wellchild visits) phase. Three tests were used: the M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) to evaluate language, social skills, behaviour, sensory areas; the PSI-SF (Parenting Stress Index –Short Form) to verify the degree of discrepancy perceived by the parent between the child’s requests and his or her ability to deal with them adequately; the DERS (Difficulties in Emotion Regulation Scale) to highlight the difficulties of each parent in recognising, interpreting, and managing their emotions. The tests were given to 380 parents (142 couples, 215 mothers and 23 fathers) by 45 family paediatricians during the wellchild visit held at two years of age. In all, 33 children (9%) resulted at risk, with a score of ≥3, 1 of whom was found to be at high risk. For 64 children (16.8%) at least one of the parents tested positive for PSI-SF and for 19 (5%) children at least one parent tested positive with the DERS. After combining the results obtained from the three tests and the clinical evaluation, and assessing the child’s condition with respect to those results, the pediatrician can provide the parents with a concise description of what emerged and provide a summarised report for the specialist. Such an effort leads to timely, shared communication within the parentpaediatrician-neuropsychiatrist triad that includes specificity of intervention and that can contribute to the effectiveness of the response.
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Quaderni ACP
Quaderni ACP Medicine-Pediatrics, Perinatology and Child Health
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33
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