兒童發展評估：一區域教學醫院之報告

A Developmental Assessment for Children : Report from A Regional Teaching Hospital

背景及目的：兒童發展遲緩的原因很多，早期療育可減輕社會之負擔。政府自1995年起成立通報中心並提供早期療育服務，但是實際的發生率仍偏低。本研究目的為探討台中縣兒童發展遲緩之概況及分類。方法：研究期間為2010年4月至11月，由醫師與社服人員爲小於6歲之兒童進行初步篩檢，懷疑之個案轉至小兒科、復健科、身心科及耳鼻喉科等專科醫師使用發展遲緩測驗工具做進一步評估。結果：共評估200個案例，大於3歲且小於6歲有75.5%；有90%來自大里市及鄰近區域。結果有45位是確診、25位是疑似案例，發展遲緩的類別顯示語言及溝通發展遲緩佔最多。結論：3歲以下的案例比率偏低且有地緣相關性，語言及溝通發展遲緩的比例最高。在政府相關單位的努力下，期能整合各專業醫療團隊參與，使發展遲緩兒童能及早被發現並接受早期療育，改善生活品質並減輕日後對家庭與社會的負擔。

Purposes: Developmental delays (DD) in children are embedded within a larger context and result from many different causes. Early intervention in DD helps a child advance in all areas of development and contributes to a reduction in economic and social burdens. Since 1995, the government has actively provided a wide variety of resources to establish notification and referral centers and offer intervention services; however, the actual detection rate has not yet reached the expected incidence rate. This study was initiated in Jen-Ai hospital and supported by the Health Bureau of Taichung County. The aim was to explore the profiles and classifications of DD among children living in urban communities. An effort to assess the potential causes and incidence was also attempted. Methods: During the study period (April to November 30, 2010), preliminary assessment and screenings for children younger than age 5 and with possible DD were conducted by pediatricians with the assistance of general physicians or social workers. Children with possible DD were referred to pediatric, rehabilitative, psychiatric, psychological, or as ear nose and throat specialists. Developmental assessment instruments were also utilized. Results: A total of 200 children were evaluated in this study. Most participants (75.5%) were older than 3 and 90% lived in surrounding areas. Forty-five children were identified with DD and 25 with suspected DD. Most referrals were community-based. The most common types of delays among the participants were in language and communication development.Conclusions: A lower rate of participation in DD screening was found for children under the age of 3. Geographic allocation and resource accessibility were significantly associated with participation. Language and communication delays were predominant. With the dedicated support of government policies and relevant healthcare authorities, the participation of professional medical teams and various specialties will provide early detection and intervention for children with DD, thereby enabling them to improve their quality of life and reduce familial and social burdens in the future.