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美国儿童学习障碍的终生患病率。

Lifetime prevalence of learning disability among US children.

作者信息

Altarac Maja, Saroha Ekta

机构信息

Department of Maternal and Child Health, School of Public Health, University of Alabama, RPHB 320, 1530 Third Ave South, Birmingham, AL 35294-0022, USA.

出版信息

Pediatrics. 2007 Feb;119 Suppl 1:S77-83. doi: 10.1542/peds.2006-2089L.

Abstract

OBJECTIVE

Our goal was to examine the lifetime prevalence of learning disability by sociodemographic and family-functioning characteristics in US children, with particular attention paid to the children with special health care needs.

METHODS

By using data from the National Survey of Children's Health, we calculated lifetime prevalence of learning disability using a question that asked whether a doctor or other health care or school professional ever told the survey respondent that the child had a learning disability. Children with and those without special health care needs were classified on the basis of how many of 5 definitional criteria for children with special health care needs they met (0-5). Bivariate and multivariate statistical methods were used to assess independent associations of selected sociodemographic and family variables with learning disability.

RESULTS

The lifetime prevalence of learning disability in US children is 9.7%. Although prevalence of learning disability is lower among average developing children (5.4%), it still affected 2.7 million children compared with 3.3 million (27.8%) children with special health care needs. As the number of definitional criteria children with special health care needs met increased from 1 to 5, so did the prevalence of learning disability (15.0%, 27.1%, 41.6%, 69.3%, and 87.8%, respectively). In the adjusted logistic regression model, in addition to the number of definitional criteria the children met, variables associated with the increased odd ratios of learning disability were lower education, all categories of poverty <300% of the federal poverty level, being male, increasing age, having a 2-parent stepfamily or other family structure, being adopted, presence of a smoker, respondent's higher responses on aggravation in parenting scale, sharing ideas with the child less than very well, and never, rarely, or sometimes discussing serious disagreements calmly.

CONCLUSIONS

Although more than half of lifetime prevalence of learning disability occurred in children with special health care needs, it is a significant morbidity in average-developing children as well. Learning disabilities represent important comorbidities among children with special health care needs.

摘要

目的

我们的目标是根据社会人口统计学和家庭功能特征,研究美国儿童学习障碍的终生患病率,尤其关注有特殊医疗需求的儿童。

方法

利用全国儿童健康调查的数据,我们通过一个问题来计算学习障碍的终生患病率,该问题询问医生或其他医疗保健或学校专业人员是否曾告诉调查对象其孩子有学习障碍。有特殊医疗需求和无特殊医疗需求的儿童是根据他们符合特殊医疗需求儿童的5条定义标准中的几条来分类的(0 - 5条)。采用双变量和多变量统计方法来评估选定的社会人口统计学和家庭变量与学习障碍之间的独立关联。

结果

美国儿童学习障碍的终生患病率为9.7%。虽然发育正常儿童中学习障碍的患病率较低(5.4%),但仍影响了270万儿童,相比之下,有特殊医疗需求的儿童有330万(27.8%)。随着特殊医疗需求儿童符合的定义标准数量从1条增加到5条,学习障碍的患病率也随之增加(分别为15.0%、27.1%、41.6%、69.3%和87.8%)。在调整后的逻辑回归模型中,除了儿童符合的定义标准数量外,与学习障碍比值比增加相关的变量包括较低的教育程度、所有贫困类别(低于联邦贫困水平的300%)、男性、年龄增长、有双亲继家庭或其他家庭结构、被收养、有吸烟者、调查对象在育儿量表上对加重情况的较高回答、与孩子分享想法不太好以及从不、很少或有时平静地讨论严重分歧。

结论

虽然学习障碍终生患病率的一半以上发生在有特殊医疗需求的儿童中,但在发育正常儿童中也是一种显著的疾病。学习障碍是有特殊医疗需求儿童中的重要共病情况。

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