由于COVID-19大流行的中断和限制，5岁及以下的婴儿和儿童在发育里程碑上只经历了“适度”延迟, a study led by Johns Hopkins Children’s Center finds.

In a report on the study published April 22 in JAMA Pediatrics, 研究人员评估了与大流行相关的日常生活中断与发育里程碑筛查评分变化之间的可能联系. 数据来自综合健康与决策信息系统(CHADIS)。, 一种基于网络的筛查平台，看护者用来完成关于他们孩子发展的调查. It is used by more than 5,000 pediatric practices in 48 U.S. states.

Using the Ages and Stages Questionnaire-3 (ASQ-3), 作为儿科护理的一部分，照例收集的由照顾者完成的儿童发育测量, researchers say they found only small decreases in communication, problem-solving, and personal-social skills, and no changes in fine or gross motor skills among children in the study.

“We found, overall, that while there are some changes, the sky is not falling, and that is a really important and reassuring finding,” says Sara Johnson, Ph.D., M.P.H., corresponding author of the study, director of the Rales Center for the Integration of Health and Education 约翰·霍普金斯儿童中心的教授，也是毯子堡基金会的儿科教授 the Johns Hopkins University School of Medicine.

Numerous studies, the researchers say, 发现COVID-19大流行和相关的封锁限制扰乱了许多人的生活, including families with young children. Everyday life and daily routines were upended, as schools and child care centers closed, many people began working from home and social contacts diminished. Many experienced increased stress, 由于这些变化和活动取消而导致的焦虑和社会孤立.

研究还表明，大流行与儿童健康状况较差有关 quality of life, increased mental health concerns, decreased sleep and increased risk of obesity. 然而，大流行对美国幼儿发展里程碑的影响.S. remained unclear, 部分原因是针对这些问题的研究是在美国以外进行的, or in small samples. In the new study, 儿童中心的研究人员观察了50岁儿童的发育里程碑状态,205 children, ages 0 to 5 years, 从50多万儿童的样本中抽取，这些儿童的父母或照顾者完成了ASQ-3. ASQ-3评估儿童在五个技能领域的发展里程碑:沟通, gross motor, fine motor, problem-solving and personal-social.

研究人员比较了2018年至2022年大流行之前和期间的儿童，发现ASQ-3得分在交流中下降了约3%。, problem-solving (about 2%) and personal-social (about 2%) skill domains. They found no changes in fine or gross motor skill domains. When looking specifically at infants 0–12 months old, similarly modest effects were observed, 只有在沟通领域(约3%)和解决问题领域(约2%)有所下降。.

“我们认为婴儿可能比大一点的孩子受到的影响更小, 考虑到许多看护人可能会花更多的时间在家陪伴他们年幼的孩子,” says Johnson. “但我们在婴儿身上看到的情况与在大一点的孩子身上看到的情况大致相同.”

Also, given an increase in parent and caregiver worry and stress, 研究人员调查了父母和照顾者在大流行期间是否报告了更多对孩子的担忧, regardless of milestone achievement, 他们发现，在疫情期间，对孩子的担忧只是略有增加, compared to before the pandemic.

While the researchers say the findings are reassuring, 他们补充说，这对儿童长期发展的影响尚不清楚.

“对我们来说，继续关注各个年龄段孩子的发育情况非常重要, 因此，我们可以了解这些变化是否会对儿童产生长期影响，或者随着儿童年龄的增长，是否会出现新的挑战,” says Johnson.

约翰逊和她的研究小组相信，他们的研究结果将有助于为未来的公共卫生危机制定计划, 也证明了支持美国负担过重的卫生系统的临床基础设施的重要性.S., particularly developmental behavioral pediatricians, who are specially trained to evaluate and treat developmental concerns. 这些资源对于满足儿童现在和将来的发展需要是必不可少的.

研究人员提醒说，这项研究没有考虑到一些可能改变研究结果的变量, such as prenatal substance abuse and other health conditions. In addition, infants born preterm were excluded from the study, which may underestimate developmental impacts for this subgroup. 研究人员也不能排除参与CHADIS的卫生保健提供者的“选择偏差”, 没有没有接触到COVID-19大流行限制的儿童的对照组.

Along with Johnson, the study authors from Johns Hopkins include Molly Kuehn, Jennifer Lambert, Lauren Klein, Barbara Howard (also with CHADIS Inc.), Raymond Sturner(也是通过初级保健促进儿童发展中心的工作人员)和Eliana Perrin. J. Paul Spin from EVERSANA was also an author.

该研究由约翰霍普金斯人口中心及其基础设施资助(P2CHD042854)，由国家儿童健康与人类发展研究所(NICHD)资助。.

霍华德和斯特纳是通过初级保健促进儿童发展中心的董事会成员, and are paid employees or consultants at both the center and CHADIS, Inc. 隶属于约翰霍普金斯大学的作者没有根据约翰霍普金斯大学的政策宣布任何利益冲突.

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