发育性协调障碍儿童功能性行为特征探究【摘要】目的探讨发育性协调障碍(developmentaicoordinationdisorder,DCD)儿童的功能性行为特征，为DCD的诊断和干预提供依据。方法以DSM-IV为诊断标准，结合DCDQ问卷在苏州市区2所小学进行筛查，筛选出41名DCD儿童，按1：1设立对照组，进行功能性行为活动和心理-行为研究。结果DCD儿童体育爱好项目数大于2项、全部参加学校设置的体育课程、每天户外活动时间大于2h、1岁前能熟练爬行、6岁前参加游戏和7岁会用毛笔写字、参加弹琴和6岁前参加画画或涂鸦兴趣班的比例明显低于对照组，差异均有统计学意义(x2值分别为56.69,13.46,18.25,49.98,59.89,35.90,16.63,46.99,P值均＜0.01)。多元线性回归分析中，体育爱好项目数大于2项、每天户外活动时间大于2h、1岁前熟练爬行和6岁前参加游泳对M-ABC的总障碍分产生影响。此外，Conners父母评价量表DCD组儿童品行问题、心身障碍、焦虑因子得分均显著高于对照组(t值分别为2.92,2.71,3.68,P值均＜0.01),学习问题因子得分也高于对照组(t=2.46,P＜0.05)o结论DCD儿童存在功能性活动缺陷和心理-行为问题，DCD的干预模式应采取结合日常性活动训练和心理-行为问题治疗的综合性模式。【关键词】发育障碍；行为；因素分析，统计学；对比研究；儿童【】R179B844.1【文献标识码】A【】1000-9817(2007)06-0587-03FunctionalBehaviorTraitsAmongChildrenwithDevelopmentalCoordinationDisorder/HUA激ng,ZHUQing-qing,GUGui-xiong.TheChildren"sHospitalofSoochowUniversity,Suzhou(215003),激angsuProvince,China【Abstract】ObjectiveToinvestigatethefunctionalbehaviortraitsofthechildrenwithdevelopmentalcoordinationdisorder(DCD)soastoprovideevidencefordiagnosisandintervention.MethodsForty-oneDCDchildrenfromtwoprimaryschoolswerescreenedwithDSM-IVandDCDQ.Acasecontrolstudyonfunctionalactivityandpsycho-behaviorwasconductedaccordingtotheprincipleof1*1matching.ResultsThequalityofDCDchildrenwerelowerthanthecontrolsiftheyhavingmorethantwointerestedmovementitems,participatingalltheschoolgymnasticcurriculum,spendingmorethantwohoursonoutdooractivity,crawlingbeforeoneyearold,swimmingbeforesixyearsold,writingwithbrushpenbeforesevenyearsold,playingpiano,andpaintingordoodlebeforesixyearsold,withstatisticsignificance(x2valueswere56.69,13.46,18.25,49.98,59.89,35.90,16.63and46.99respectively,alltheP<0.01).Analysisofmultipielinearregressionindicatedthatthereweresuch4factorsashavingmorethantwointerestedmovementitems,spendingmorethantwohoursoutdooractivitycrawlingbeforeoneyearoldandswimmingbefore6yearsoldinfluencedtheM-ABCdysfunctionscores.Additionally,assessedbytheConnersparentaiRatingScale,theDCDchildren"scoresoftheconduct,psychosomaticanxiousproblemswerelowerthanthecontrols(tvalueswere2.92,2.71and3.68,alltheP<0・01).ConclusionTherearedeficiencyinfunctionalactivityandpsycho-behavioralaspectsamongtheDCDchildren.Itisnecessarytointegratethetrainingofdailyactivityandtreatmentinpsycho-behavioralproblemsintotheDCDinterventionmodel.【Keywords】Developmentdisabilities；Behavior；Factoranalysis,statistical；Comparativestudy；Child儿童发育性协调障碍(developmentalcoordinationdisorder,DCD)是一种儿童时期特殊的发育障碍性疾病，以运动技能障碍为特征，主要表现在运动时间安排、运动控制、计划和持久能力等方面的缺陷，同时可并发认知功能损害和焦虑、抑郁、社会适应能力不良等情绪问题。根据美国精神病联合学会(APA)流行病学调查显示，5〜11岁儿童DCD发病率可达5%〜6%,男性居多，且存在一定的地区差异［1］。DCD儿童以动作协调障碍为主要特点，导致儿童日常生活中功能性活动明显减少和多种心理-行为问题的出现，从而严重影响儿童的生长发育［1-2］。功能性行为［3［主要指神经肌肉耗能水平超过基础代谢的...