貝萊氏嬰幼兒發展量表第二版應用於台灣正常足月兒的跨文化研究

Abstract

目的：本研究共有三個目的：（一）應用貝萊氏嬰幼兒發展量表第二版長期追蹤台灣正常足月兒於年齡6、12、18及24個月時的發展表現，並比較台灣足月兒的心智與動作發展分數與美國常模間的差異；（二）探討周產期與家庭人口學因素對於台灣正常足月兒於年齡6至24個月間之貝萊氏嬰幼兒心智與動作分數的影響；以及（三）探討台灣正常足月兒於心智與動作發展的變化趨勢，並且了解心智與動作遲緩於各年齡間的穩定性及共病性。方法：本研究共有507位台灣正常足月兒參與發展追蹤，受試嬰兒來自台灣的北部、中部及南部地區，共有十二家醫療院所參與本研究之收案工作，嬰孩於年齡6、12、18及24個月時接受貝萊氏嬰幼兒發展量表第二版之評估。結果：台灣的正常足月兒於年齡6、12、18及24個月所測得之貝萊氏心智及動作發展分數皆顯著低於美國常模。與心智發展分數明顯相關的影響因素包括：年齡、出生體重、性別、地區及父親之教育程度與職業等級，與動作發展分數明顯相關的影響因素為年齡。發展趨勢分析的結果顯示，正常心智及動作發展之嬰孩呈現高度之穩定性，會於追蹤期間維持正常的表現；而心智及動作發展遲緩之嬰孩則呈現高比率會轉變為正常之表現。至於發展遲緩於心智及動作功能間，具有同年齡及年齡間顯著之共病現象。此外，單純與合併心智及動作發展遲緩於追蹤後期均呈現高度之穩定性，會維持其發展遲緩的型態。結論：台灣臨床人員使用貝萊氏嬰幼兒發展量表第二版以評估嬰孩之發展時，可能需要使用本研究所建立之發展資料當作參考之標準。台灣足月兒於年齡6至24月期間之心智與動作發展，呈現複雜之穩定與共病現象。

Purposes: This study was aimed for three purposes: (1) to assess full-term Taiwanese infants from 6 to 24 months of age using the Bayley Scales of Infant Development—Second Edition (BSID-II) and to compare the data of Taiwan with the normative data established in the United States (US); (2) to examine the potential influencing factors for mental and motor development in full-term Taiwanese infants; and (3) to explore the developmental trajectory of full-term Taiwanese infants during age period of 6 to 24 months. Methods: Five hundred and seven normal full-term infants born in various regions in Taiwan were prospectively examined the BSID-II at 6, 12, 18 and 24 months of age. Twelve hospitals located at the west side of the country participated in the study. Results: The Bayley Mental and Motor raw scores of the full-term Taiwanese infants were significantly lower than those of the US infants across ages. Significant influencing factors identified for infants’ mental development included age, gender, geographical region, and paternal education and occupation; while that for infants’ motor development was age only. Within the mental and motor development, normal performance showed high stability across ages; while delayed performance showed high probability of transition to normal performance during the follow-up. Mental delay was concurrently and consecutively associated with motor delay and vice versa. Furthermore, noncomorbid and comorbid mental and motor delay showed high degree of stability at later ages. Conclusion: Our results suggest that interpretation of the BSID-II results of Taiwanese infants may consider using the data of this study as the standard. Furthermore, full-term Taiwanese infants exhibit complexity in stability as well as comorbidity in mental and motor development during the age period of 6 to 24 months.