一個發展遲緩兒童早療介入計畫的成果與相關因素

Outcomes and Associated Factors of Children with Developmental Delay in an Early Intervention Program

目的：這個研究探討一個針對發展遲緩兒童的區域整合性早療介入計畫的留滯率與成效，並且探討與治療成效相關的因素。方法：我們收集了在2009 年2 月至2012 年1 月之間，進入台灣北部一項區域整合性早療介入計畫未滿六歲的發展遲緩兒童。孩童的主要照顧者在初次進入計畫時（前測）與經過六個月的追蹤之後（後測），分別填寫學齡前兒童行為發展量表 (CCDI)，個案留滯率的定義為進入早療計畫六個月後仍持續進行療育並完成後測。結果：共有186 位發展遲緩兒童（平均年齡為4.0 ± 1.4 歲）加入研究，其中128(68.8%) 位是男孩。在六個月後，有90 (48.4%) 位兒童仍持續在早療計畫中。與失去追蹤的孩童相比，留滯在計畫之中的孩童有顯著的較低的出生體重 (p < 0.05) 與顯著的較輕的基準體重 (p < 0.05)。CCDI 所測量的兒童發展有六個面向在介入期間有顯著的進步 (p < 0.05 to p< 0.01)。兒童介入時的年齡較小與兒童發展的進步顯著相關 (p < 0.05)。結論：該研究提供發展遲緩兒童與其家長關於早療介入計畫的有效性實證證據，以及成果相關因素的線索。

Objectives: In this study, we intended to evaluate the retaining rate and effectiveness in a regional integrated early intervention (EI) program for children with developmental delay (DD), and to study the factors associated with outcomes outcome. Methods: During the period from February 2009 to January 2012, we enrolled children of less than 6 years in age who attended the program at a regional medical center in northeastern Taiwan in this study. The caregivers of the children were asked to fi ll out the Chinese Child Development Inventory (CCDI) at both the fi rst visit and the 6-month follow-up visit. Retaining was defi ned as a child who was eligible in the program and completed the assessment at month 6. Results: Totally, 186 children with DD (mean age: 4.0 ± 1.4 years) were recruited in this study, and 128 (68.8%) of the subjects were boys. Six months after the initial assessment, 90 (48.4%) children were retained in the EI program. Compared to children who lost follow-up, those who retained had signifi cantly lower birth weight (p < 0.05) and lower body weight (p < 0.05) at baseline. Six dimensions of children’s development measured by CCDI were signifi cantly improved during a 6-month intervention (p < 0.05 to p < 0.01). Younger age of children at recruitment was signifi cantly correlated with better improvements in children’s development (p < 0.05). Conclusion: This study involved a comprehensive assessment for the outcome and their associated factors of an integrated EI program for children with DD. These fi ndings could provide useful clues for making future improvements to its implementation.