コミュニケーション障害児の早期発見のために4か月乳幼児健診を活用する目的で4か月健診時の発達評価項目試案を作成して調査した。評価項目は従来から用いられていた23項目に新たに27項を追加した50項目から構成された。この試案を4か月健診を受診した,第1子の母親68名,第2子以上の母親97名に実施した。評定方法は「はい,時々,まだ(いいえ)」の3段階で行った。項目の妥当性の検討は「はい」と回答した項目の通過率で行った。通過率は60%以上とし,60%以下については40%以上～60%未満,40%未満として検討した。結果は以下の通りであった。1試案に用いた50項目の通過率は,60%以上は29項目,40%以上～60%未満は11項目,40%未満は10項目であった。2第1子の母親と第2子以上の母親の評価項目の通過率による比較では,全体で7項目に有意差があり,第2子以上の母親の方が通過率が高かった。3従来の項目と追加した項目の通過率による比較では,前者には60%以上の通過率の項目が多く,後者には40%以上～60%未満に該当する項目の割合が多かった。以上の結果から,今回調査した試案の中から35項目を抽出して4か月健診時の発達評価項目改訂版を作成した。今後は,実施追跡例を増やすとともに,コミュニケーション障害の疑われる乳幼児についての経過追跡調査も検討する予定である。

A developmental assessment form (tentative plan) for the standard four-month medical checkup was created in order to better utilize the infant medical checkup sessions to aid in the early detection of communication disorders. This proposal contained a total of 50 items, consisting of 27 newly chosen items and 23 items from an earlier questionnaire, which the mother fills out at the time of the infant medical checkup. This tentative plan was carried out for 68 mothers who had their first child and for 97 mothers who had their second child or more, and who came for a four-month medical checkup. They were asked to answer "always, sometimes, or not yet" for each of the 50 items. The number of times "always" (NTA) was used as an answer was divided into three parts: High (more than 60%), Middle (from 40% to 60%), and Low (less than 40%). We evaluated the validity of the contents of an item from the NTA of the item. The results are as follows. 1 For the NTA for all of the 50 items, 29 items were classified as High, 11 as Middle, 10 as Low. 2 For the comparison of the NTA for each evaluation criteria between the mothers who had their first child and the mothers who had their second child or more: the latter mothers had a NTA significantly high for seven items. 3 For the comparison of the NTA between the conventional items and the newly chosen items: many items in the middle range were the newly chosen items. 4 We developed our final proposal for a four-month infant medical checkup developmental assessment from the 35 items, out of the 50 original items. In conclusion, although it is thought that this tentative plan is appropriate as a tool for infants at their four-month medical checkup, it is necessary to increase the number of trial cases and to continue further study, which may help in the early detection of communication disorders.

原著

Original Article

国立情報学研究所で電子化