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Discrimination of Mentally Retarded Infants among Low Birthweight Infants Assessed by the Brazelton Neonatal Behavioral Assessment Scale

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タイトル: Discrimination of Mentally Retarded Infants among Low Birthweight Infants Assessed by the Brazelton Neonatal Behavioral Assessment Scale
その他のタイトル: 低出生体重児を対象としたブラゼルトン新生児行動評価による精神発達遅滞児の判別
著者: Ogi, Shohei / Iwanaga, Ryuichiro / Goto, Yoshiko / Akiyama, Tomitaro
著者(別表記) : 大城, 昌平 / 岩永, 竜一郎 / 後藤, ヨシ子 / 穐山, 富太郎
発行日: 1998年 3月25日
引用: 長崎大学医療技術短期大学部紀要 = Bulletin of the School of Allied Medical Sciences, Nagasaki University. 1998, 11, p.17-23
抄録: ブラゼルトン新生児行動評価法(Neonatal Behavioral Assessment Scale;NBAS)による精神発達遅滞児の鑑別診断の有効性を確認するため,追跡調査の結果を用いた判別分析による検討を行った.対象は新生児期にNBASを行い,3才までの発達経過を確認した低出生体重児86例である.これらの対象児を修正3才時のマッカーシー知能発達検査の結果から,境界値を含む一般知能指数90未満の17例(遅滞群)と,一般知能指数90以上の69例(正常群)の2群に分類し,この2群が胎齢44週時のNBASの結果から既知のグループに正しく区別されるかどうかについて,フィッシャーの線型判別式を用いた判別分析を行った.その結果,胎齢44週時のNBASの結果から正常群では69例中61例(88.5%)が,遅滞群では17例中12例(70.6%)が既知のグループに正しく分類され,その全体に対する割合は84.9%であった.また,一般知能指数と判別結果では指数70~79の遅滞域の4例中1例(25.0%),指数80~89の境界域の9例中4例(44.4%),指数90~120未満の正常域の69例中8例(13.0%)が誤判別であった.次に,関数値と各変数値とのグループ内相関を算出した結果,NBASのクラスターのうち「意識状態の幅」,「運動の調整」,「補足項目値」,「意識状態の調整」,「方位反応」のクラスターが順に統計的に影響力が強く,新生児期の行動評価の必要性を示した.以上より,胎齢44週時のNBASから低体重出生の精神発達遅滞児の判別は高い精度で可能で,早期診断と介入,療育の適応決定に有効であると考えられた.また,より長期的なフォローの必要性も示唆した. / The results of a follow-up study were reviewed by discriminant analysis to verify the effectiveness of differential diagnosis for mentally retarded infants by the Brazelton Neonatal Behavioral Assessment Scale (NBAS). The subjects were 86 low birthweight infants for whom the NBAS was performed in the neonatal period and whose developmental progress through age 3 years was confirmed. These infants were divided into 2 groups according to the results of the McCarthy Scales at revised age 3 years, i.e., 17 cases of intelligence quotient (IQ) of less than 90 including borderline area (retarded group) and 69 cases of IS 90 or more (normal group). Fisher's linear discriminant analysis was performed to see if these 2 groups are properly distinguished to the known groups in reference to the results of the NBAS at gestational age 44 weeks. As the result, 61 of the 69 cases in the normal group (88.5%) and 12 of the 17 cases in the retarded group (70.6%) were found to be properly classified in the known groups. The overall rate of proper classification was 84.9%. False discrimination was found in 1 of the 4 cases (25.0%) in the retarded area of IQ 70-79, in 4 of the 9 cases (44.4%) in the borderline area of IQ 80-89, and in 8 of the 69 cases (13.0%) in the normal area of IQ 90-<120. Then, the pooled within-groups correlations between discriminating variables and canonical discriminant functions were calculated. The results showed statistical influences by such NBAS clusters as state range, motor performance, supplemental items, state regulation and orientation, in descending order, indicating the necessity of behavioral assessment in the neonatal period. From the above, it was considered that discrimination of mental retardation in low birthweight infants in reference to the NBAS at gestational age 44 weeks is available at a high accuracy, and that the NBAS is effective on early diagnosis and on determining the application of early intervention and care. It was also indicated that follow-up for a longer period is necessary.
キーワード: Brazelton Neonatal Behavioral Assessment Scale (NBAS) / low birthweight infants / mental retardation / Fisher's linear discriminant analysis
URI: http://hdl.handle.net/10069/18264
ISSN: 09160841
資料タイプ: Departmental Bulletin Paper
原稿種類: publisher

引用URI : http://hdl.handle.net/10069/18264



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