日本未熟児新生児学会雑誌　第18巻　第2号　29～34頁（2006年）

日本未熟児新生児学会雑誌　18(2)：219-224；2006　

受付日：平成16．11．01

受理日：平成17．06．30

広汎性発達障害と考えられる極低出生体重児（2） ―長期的支援の必要性―

Pervasive Developmental Disorders in very-low-birthweight infants（2） ―A proposal for their long-term developmental support―

＊1名古屋第二赤十字病院　小児科，＊2川崎医科大学　新生児科学教室，＊3子どもクリニック

＊1 Department of Pediatrics, Nagoya Daini Red Cross Hospital，＊2 Department of Neonatology, Kawasaki Medical School，＊3 Kodomo Clinic

永田雅子（臨床心理士）＊1・永井幸代＊1・側島久典＊2・岸　真司＊1・斎藤久子＊3・安藤恒三郎＊1

Masako NAGATA＊1，Yukiyo NAGAI＊1，Hisanori SOBAJIMA＊2， Shinji KISHI＊1，Hisako SAITO＊3，Tsunesaburo ANDO＊1

Key Words：very-low-birthweight infant，Pervasive Developmental Disorders（PDD），long-term follow-up study

　名古屋第二赤十字病院では，NICU入院児の両親に出生前後より臨床心理士および小児精神科医が関わり，NICU退院後は未熟児フォローアップ外来時に並行して心理面接を行うことで，育児支援および発達援助を継続して行っている。これまでのフォローアップで，極低出生体重児の中に広汎性発達障害と考えられる症例を10年間に15例経験した。今回そうした症例の発達支援について検討を加えた。早期からの介入により，本人の発達特徴を捉え，援助を行っていくことができ，適応に改善が認められた。極低出生体重児のフォローアップを行う際，社会性の問題にも焦点をあてながら，長期にわたる発達支援が必要だと考えられた。

　Learning and behavioral disorders on developing very low birth weight infants（VLBWIs）without neurological disorders are focused in recent time through the long-term follow up studies. Clinical psychologists and pediatric psychiatrists in Nagoya Daini Red Cross Hospital has been guided parents with VLBWIs for many worries of unexpected pregnancy and delivery until perinatal period in these ten years. Continuous developmental support on child rearing was provided through psychological interviews to the parents at the same time of follow-up out patient department for VLBWIs.
　We found that there is some VLBWIs probably diagnosed pervasive developmental disorders. There are 15 children with the diagnosis of pervasive developmental disorders in 163 VLBWIs followed up more than 3 years in our out patient clinical department for 10 years.
　We recognized a good improvement in social adaptation in these children with pervasive developmental disorder by early interventions including expanded approach to the parents in their perinatal period. We conclude that long-term developmental support focused on social interactions is necessary in follow up of VLBWIs.