本研究では,超低出生体重児の早期の発達的特徴を明らかにすることを目的とした。対象は,聖マリア病院新生児科の医療対象になった超低出生体重児53人(男29人,女24人)である。まず,超低出生体重児の発達については,3歳までの発達曲線を遠城寺式・乳幼児分析的発達検査の検診年齢別で明らかにした。さらに,5歳〜6歳で施行する乳幼児精神発達検査(3〜7歳)の質問項目を健常児で標準化された数値と検討した。有意に低い質問項目を検討したのちにこの検査からは,超低出生体重児の発達的特徴を検討した。遠城寺式・乳幼児分析的発達検査では,1歳から2歳までの発達は平均を下回っている。2歳6月で発語と言語理解を除いて,年齢相応の発達がみられる。3歳では発語のみが,平均を下回っている。また,乳幼児精神発達検査(3〜7歳)の5歳6月時と6歳時の通過率をそれぞれ健常児と比較した結果をK-J法でみると,その結果は,知識やコミュニケーションなど言語領域に問題がみられた。したがって,心理学的発達援助を行うときに2歳6月からは,とくに言語の発達に注目する必要があることがわかった。これらのことは,これまでの臨床経験で持ってきた超低出生体重児の発達の印象を,客観的な指標でとらえたことになる。これによって発達援助をより具体的に行うことが可能になると思う。発達援助を行う際は,このほかに超低出生体重児であるという事のために生じるかもしれない親の養育態度などの児への影響について検討する必要もあろう。また,超低出生体重児には,おちつきのなさや不器用さがみられることがある。児の中に学習障害児などがいる可能性の検討も含めて,今後はこのような発達援助を学童期まで続けることが必要と考える。

The study objective was to identify the early developmental characteristics of extremely low birth weight (ELBW) infants. The subjects were fifty-three ELBW infants (29 male and 24 female) who needed medical support at department of neonatology at St. Mary's hospital. For the development of ELBW infants, Enjoji's analytical development test of infants was used to identify their developments at different check-up periods, until the age of three. Furthermore, the items from Tsumori's mental development tests for infants and children done between the age of five and six were compared with the standardized figures. After examining the items that were significantly lower than the norm, the characteristics of ELBW infants were sought. The results showed that at the age of one to two, the developments of ELBW infants were below the average standards by Enjoji's analytical development test of infants. At two and a half years of age, the age equivalent developments were seen, except for the product of words and verbal comprehension. At three years of age, only the product of words was below the average. The rates of passing Tsumori's mental development tests for infants and children at five and a half and six years of age were compared with the norm. The items which had differences with the norm were considered using the KJ method. The results highlighted the problems in the knowledge and the verbal areas, such as communications. This indicated the need of careful observations of verbal development from the age of two and a half when giving a psycho-developmental support for the ELBW infants. The results gave an objective index to the developmental images of the ELBW infants that had been held through clinical settings. With the index, more specific developmental supports would be possible. When giving supports, the influence of other child-rearing factors which may be produced by having an ELBW infant should be considered. In addition, the children of ELBW often show hyperactivity and clumsiness. With the possibilities of these children developing learning disorders, the developmental support should be continued until the school ages.