| ObjectiveAutism spectrum disorder(ASD)and developmental language disorder(DLD)are the most common diseases with poor language development in community child health care.In this study,the Chinese version of the parent-child interaction rating scale(IRS-C)was used to assess the parent-child interaction rating level of children with language developmental delay.The characteristics and influencing factors of parent-child interaction in children with ASD and DLD were analyzed to provide evidence for early identification and intervention of different diseases.MethodsThe selected subjects were children aged 21-72 months who complained of "poor language development" in the Children’s Health Care Clinic of Shandong University Cheeloo Hospital from January 2018 to March 2020.According to the diagnostic criteria of DSM-5,30 children with ASD and DLD diagnosed by professional physicians were included in the case group after screening and exclusion.During the same period,30 cases of typical developmental children(TD)undergoing routine physical examination in the Children’s Health Care Clinic of Cheeloo Hospital and the Central Campus Hospital of Shandong University were selected as the control group.Using the Chinese version of parent-child interaction rating scale(IRS-C),video analysis was used to analyze the interactive behavior of the included children and their caregivers.At the same time with the method of questionnaire survey,through the family social economic level of the questionnaire and international standardized scale childcare environment index(Index of Child Care Environment,ICCE)background analysis of raising children and family life.All data were statistically analyzed using SPSS 26.0.First,the three groups were compared,and then the pairwise multiple comparison was conducted to analyze the differences in parent-child interaction among children in different groups.Results1.There were statistically significant differences in the total score of parent-child interaction among the three groups(P<0.05),and there were statistically significant differences in the score of child’s domain and caregiver’s domain(P<0.05).There were significant differences in the scores of "Autonomy","Responsiveness to caregiver","Empathy" and "Emotional regulation" in the child’s domain(P<0.05).There were statistically significant differences in the scores of "Sensitivity","Responsiveness to child","Respect for child’s autonomy","Social-emotional growth fostering" and "cognitive growth fostering" in the caregiver’s domain(P<0.05).2,Comparison of parent-child interaction between children with ASD and children with DLD:Compared with children with DLD,the total score of social scores of children with ASD and the total score of parenting level of parents were lower,the difference was statistically significant(P<0.05);In the children’s domain,the scores of "Autonomy","Responsiveness to caregiver","Empathy" and "Emotional regulation" were lower than those of the DLD group,and the difference was statistically significant(P<0.05).In the caregiver’s domain,scores of "Sensitivity","Responsiveness to child","Respect for child’s autonomy"and "Social-emotional growth fostering" were lower than those of the DLD group,and the difference was statistically significant(P<0.05).3.Characteristics of parent-child interaction in the ASD group:the score of the parent-child interaction scale in the ASD group was lower than that in the TD group.The scores of "Autonomy","Responsiveness to caregiver","Empathy" and "Emotional regulation" in child’s domain were significantly different from those in the TD group(P<0.05).The scores of "Sensitivity","Responsiveness to child","Respect for child’s autonomy"and "Cognitive growth fostering" in the caregiver’s domain were significantly different from those in the TD group(P<0.05).The higher the scores of "Empathy","Respect for child’s autonomy"and"Cognitive growth fostering" in parent-child interaction,the lower the risk of ASD(OR=0.174,0.103,0,159,P<0.05);Good family rearing environment and annual family income≥100,000 yuan were protective factors for ASD(OR=0.022,0.069,P<0.05),and daily video viewing time>1h were risk factors for ASD(OR=29,P<0.05).4.Characteristics of parent-child interaction in the DLD group:The score of the parent-child interaction scale of the DLD children was lower than that of the TD group.There were statistically significant differences in the scores of "Responsiveness to caregiver" and"Empathy" in the child’s domain with TD group(P<0.05).The scores of "Respect for child’s autonomy","Social-emotional growth fostering" and"Cognitive growth fostering" in the caregiver’s domain were statistically different from those in the TD group(P<0.05).The higher the scores of "Empathy","Respect for child’s autonomy" and "Cognitive growth fostering" in parent-child interaction,the lower the risk of DLD(OR=0.165,0.417,0.202,P<0.05);Mother’s education level,family rearing environment,annual income and daily screen time were the influencing factors of DLD(P<0.05).5.Correlation between parent-child interaction score and GDS energy range:In the child’s domain the four dimensions of "Autonomy","Responsiveness to caregiver","Empathy" and "Emotional regulation" were positively correlated with the DQ of the five functional areas of GDS,showing statistical significance(P<0.05),and the "Motor regulation" dimension was positively correlated with the DQ of the functional area of GDS,showing statistical significance(P<0.05).In the caregiver’s domain the four dimensions of"Sensitivity","Responsiveness to child","Respect for child’s autonomy" and "Cognitive growth fostering" were positively correlated with the DQ scores of the five ability areas of GDS,with statistical significance(P<0.05).6.Correlation between the total score of parent-child interaction and the parenting environment scale and the general situation of the family:Spearman rank correlation analysis results showed:The total score of parent-child interaction was positively correlated with ICCE scale level,mother’s education level,father’s education level and family annual income(rs=0.409,0.421,0.521,0.511,P<0.05),and negatively correlated with daily screen time(rs=-0.365,P<0.05).7.Influencing factors of parent-child interaction:The results of multiple linear regression analysis showed that the total score of parent-child interaction in the lower group of family rearing environment(ICCE total score of 11)was higher than that in the lower group of family rearing environment(ICCE total score of 10 or less)(B=5.575,P=0.04),and the total score of parent-child interaction in the extended family was lower than that in the nuclear family(B=-5.194,P=0.006).Conclusion1.The quality of parent-child interaction in ASD and DLD children was significantly lower than that in TD group;The quality of parent-child interaction was lower in children with ASD than in children with DLD.2.The quality of parent-child interaction,family rearing environment,family annual income and daily screen time are the influencing factors of ASD and DLD.3.Parent-child interaction score is positively correlated with the score of the five ability areas of GDS.The score of parent-child interaction is positively correlated with family rearing environment,parents’ education level and family annual income,while the score of children’s electronic video time is negatively correlated with parent-child interaction.4.The better the family rearing environment is,the higher the quality of parent-child interaction is,and the quality of parent-child interaction in nuclear families is higher than that in extended families.5.Parent-child interaction rating scale based on video acquisition has good application value in children with language development problems. |
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