周歲前睡眠節律變化與兩歲語言成長速度之關連性

ASSOCIATION BETWEEN CHANGES IN CIRCADIAN RHYTHM BEFORE FIRST BIRTHDAY AND LANGUAGE DEVELOPMENT AT 2 YEARS OF AGE

10.6151/CERQ.202203_30(1).0005

呂信慧(Hsin-Hui Lu)；曹峰銘(Feng-Ming Tsao)；劉惠美(Hue-Mei Liu)

嬰兒睡眠節律 ； 語言發展 ； 發展級聯 ； 成長曲線 ； circadian rhythm ； language development ； developmental cascade ； growth curve

當代教育研究季刊

30卷1期（2022 / 03 / 31）

149 - 184

繁體中文

研究目的：本研究旨在探討嬰兒周歲前睡眠節律發展，能否預測他們兩歲的語言成長速度。具體問題有三，嬰兒周歲前睡眠節律出現年紀的個別差異型態？穩定的睡眠節律有助於嬰兒語言能力發展？越早出現睡眠節律的嬰兒，在兩歲的語言成長速度是否也越快？研究設計／方法／取徑：本研究採用臺灣幼兒發展調查資料庫「3月齡組」的3、6、12、18和24個月五波次調查資料，最後分析納入3563位嬰兒。採用多層次線性模型建構成長曲線，12、18及24個月的語言成長速度為依變項，將3、6及12個月睡眠節律動態分成「3個月前固定」、「3－6個月固定」、「6－12個月固定」、「周歲前有變動」四類為獨變項，並控制影響語言發展的其他個人與環境因素。研究發現或結論：本研究發現嬰兒滿周歲睡眠節律大致穩固，但發展時程呈個別差異性，約六成3個月大嬰兒已出現睡眠節律，但其中有8%到周歲前睡眠節律又出現不固定，到6個月大有八成五嬰兒出現睡眠節律。比較「3個月前固定」、「3-6個月固定」、「6-12個月固定」、「周歲前有變動」四類嬰兒兩歲語言成長速度，結果發現3個月前睡眠節律固定嬰兒，在第二年的語言成長速度皆顯著快於另外三類嬰兒。研究原創性／價值：過去研究多探討嬰兒睡眠品質與語言發展的關連性，且對語言能力預測多僅採單一時間點量測，本研究延伸發現嬰兒周歲前睡眠節律動態變化與第二年語言成長速度具關連性。此結果揭示嬰兒早期行為系統發展領域（即睡眠節律），會跨越原領域範疇，與後續另一心智系統（即語言學習）發展呈關聯性。證實睡眠與語言跨領域範疇的「發展級聯」效應在生命早期已出現。教育政策建議或實務意涵：本研究應用意涵：（1）嬰兒睡眠節律發展大致在周歲前完成，而且他們在周歲前的睡眠節律發展時程呈現明顯個別差異性（2）嬰兒周歲前的睡眠特徵，可考慮納為兒童語言發展評估時的風險因子之一。

Purpose: This study investigated whether infants' circadian rhythm before 1 year of age would predict their language development between 12 and 24 months of age. Specifically, this study addressed three topics: circadian rhythm development in early infancy, whether the development of the circadian rhythm before 1 year of age would benefit language development at 2 years of age, and whether the language development of newborns with a developed circadian rhythm by 3 months of age would be faster during the second year of life than would that of other newborns. Design/methodology/approach: This study used five-wave data from the Kids in Taiwan: National Longitudinal Study of Child Development and Care Project. Sleep and language data were collected from infants aged 3, 6, 12, 18, and 24 months. A total of 3,563 participants were included in the final analysis. Multilevel linear models were used to explore the association between the development of the circadian rhythm before 1 year of age and language development at 2 years of age, with demographic factors and language learning environment controlled for. In these models, circadian rhythm development at 3, 6, and 12 months of age was classified as four categories, ＂development before 3 months of age＂, ＂development at 3-6 months of age＂, ＂development at 6-12 months of age＂, and ＂change at 1 year of age＂ to serve as the independent variables. The slope of language development at 12, 18, and 24 months of age was the dependent variable. Findings/results: Approximately 60% of the participants developed a circadian rhythm by 3 months of age; however, 8% exhibited irregular rhythms at 12 months of age. Those who developed a circadian rhythm by 3 months of age exhibited stronger language skills and faster language development from 12 to 24 months of age than did those who either exhibited an irregular circadian rhythm between 3 and 12 months of age or developed a circadian rhythm at 6 months of age. Originality/value: This cohort study is one of few to explore the longitudinal associations between the development of the circadian rhythm at 3-12 months of age and language skills at 12-24 months of age, when infants begin to rapidly learn their native language. We discovered that the development of the circadian rhythm before 1 year of age was associated with language development at 2 years of age. The findings indicate a cross-domain developmental cascade between sleep and language during the first 2 years of life. Suggestions/implications: The circadian rhythm is stable before infants' first birthdays, and individual variation in circadian rhythm development occurs during the first year. The development of the circadian rhythm could be considered a risk factor in assessments of early language development.

1. 張鑑如, C. J.,謝淑惠, S. H.,周麗端, L. T.,廖鳳瑞, F. R.(2017)。幼兒發展調查資料庫建置計畫簡介。中國統計學報，55(1)，42-62。
   連結：
2. 劉惠美, H. M.,陳柏熹, P. H.,黃秀琦, S. C.,陳雅雯, Y. W.,張鑑如, C. J.(2018)。零至六歲嬰幼兒語言發展家長問卷。測驗學刊，65(1)，95-123。
   連結：
3. Belgin, P.,Abraham, B,Baburaj, S.,Mohandas, M.(2017).Environmental and biological risk factors associated with the prevalence of language delay in children upto 6 years of age from rural South India.Journal of Clinical & Diagnostic Research,11(12),11-14.
4. Binu, A.,Sunil, R.,Baburaj, S.,Mohandas, M. K.(2014).Sociodemographic profile of speech and language delay up to six years of age in Indian children.International Journal of Medical Research & Health Sciences,3(1),98-103.
5. Bornstein, M. H.,Hahn, C. S.,Putnick, D. L.,Pearson, R. M.(2018).Stability of core language skill from infancy to adolescence in typical and atypical development.Science Advances,4(11),eaat7422.
6. Brooks, E.,Canal, M. M.(2013).Development of circadian rhythms: Role of postnatal light environment.Neuroscience & Biobehavioral Reviews,37(4),551-560.
7. Bruer, J. T.,Greenough, W. T.(2001).The subtle science of how experience affects the brain.Critical thinking about critical
8. Bruni, O.,Baumgartner, E.,Sette, S.,Ancona, M.,Caso, G.,Di Cosimo, M. E.,Ulliana, A.(2014).Longitudinal study of sleep behavior in normal infants during the first year of life.Journal of Clinical Sleep Medicine,10(10),1119-1127.
9. Buhr, E. D.,Takahashi, J. S.(2013).Molecular components of the Mammalian circadian clock.Circadian Clocks
10. Burnham, M. M.,Goodlin-Jones, B. L.,Gaylor, E. E.,Anders, T. F.(2002).Nighttime sleep-wake patterns and self-soothing from birth to one year of age: A longitudinal intervention study.Journal of Child Psychology and Psychiatry,43(6),713-725.
11. Carpenter, J. S.,Robillard, R.,Hickie, I. B.(2015).Variations in the sleep–wake cycle from childhood to adulthood: Chronobiological perspectives.ChronoPhysiology and Therapy,5,37-49.
12. Coons, S.,Guilleminault, C.(1984).Development of consolidated sleep and wakeful periods in relation to the dav/night cycle in infancy.Developmental Medicine & Child Neurology,26(2),169-176.
13. Dagla, M.,Dagla, C.,Mrvoljak-Theodoropoulou, I.,Kavakou, A. T.,Rigoutsou, E.,Antoniou, E.(2021).Infant sleep difficulties at the 6th week and the 12th month postpartum: What Is their relationship with maternal mental health and other perinatal factors?.Materia Socio-Medica,33(1),21.
14. Dehaene-Lambertz, G.,Spelke, E. S.(2015).The infancy of the human brain.Neuron,88(1),93-109.
15. Dionne, G.,Touchette, E.,Forget-Dubois, N.,Petit, D.,Tremblay, R. E.,Montplaisir, J. Y.,Boivin, M.(2011).Associations between sleep-wake consolidation and language development in early childhood: A longitudinal twin study.Sleep,34(8),987-995.
16. Duch, H.,Fisher, E. M.,Ensari, I.,Harrington, A.(2013).Screen time use in children under 3 years old: A systematic review of correlates.International Journal of Behavioral Nutrition and Physical Activity,10(1),1-10.
17. Galland, B. C.,Taylor, B. J.,Elder, D. E.,Herbison, P.(2012).Normal sleep patterns in infants and children: A systematic review of observational studies.Sleep Medicine Reviews,16(3),213-222.
18. Gómez, R. L.,Edgin, J. O.(2015).Sleep as a window into early neural development: Shifts in sleep-dependent learning effects across early childhood.Child Development Perspectives,9(3),183-189.
19. Henderson, J. M.,France, K. G.,Blampied, N. M.(2011).The consolidation of infants’nocturnal sleep across the first year of life.Sleep Medicine Reviews,15(4),211-220.
20. Henderson, J. M.,France, K. G.,Owens, J. L.,Blampied, N. M.(2010).Sleeping through the night: The consolidation of self-regulated sleep across the first year of life.Pediatrics,126(5),e1081-e1087.
21. Horváth, K.,Myers, K.,Foster, R.,Plunkett, K.(2015).Napping facilitates word learning in early lexical development.Journal of Sleep Research,24(5),503-509.
22. Hox, J. J.,Moerbeek, M.,Van de Schoot, R.(2017).Multilevel analysis: Techniques and applications.Routledge.
23. Hupbach, A.,Gomez, R. L.,Bootzin, R. R.,Nadel, L.(2009).Nap-dependent learning in infants.Developmental Science,12(6),1007-1012.
24. Iglowstein, I.,Jenni, O. G.,Molinari, L.,Largo, R. H.(2003).Sleep duration from infancy to adolescence: Reference values and generational trends.Pediatrics,111(2),302-307.
25. Iverson, J. M.(2021).Developmental variability and developmental cascades: Lessons from motor and language development in infancy.Current Direc-tions in Psychological Science,30(3),228-235.
26. Kalsbeek, A.,Scheer, F. A.,Perreau-Lenz, S.,La Fleur, S. E.,Yi, C. X.,Fliers, E.,Buijs, R. M.(2011).Circadian disruption and SCN control of energy metabolism.FEBS Letters,585(10),1412-1426.
27. Korotchikova, I.,Stevenson, N. J.,Livingstone, V.,Ryan, C. A.,Boylan, G. B.(2016).Sleep–wake cycle of the healthy term newborn infant in the immediate postnatal period.Clinical Neurophysiology,127(4),2095-2101.
28. Law, J.,Roy, P.(2008).Parental report of infant language skills: A review of the development and application of the Communicative Development Inventories.Child and Adolescent Mental Health,13(4),198-206.
29. Madigan, S.,McArthur, B. A.,Anhorn, C.,Eirich, R.,Christakis, D. A.(2020).Associations between screen use and child language skills: A systematic review and meta-analysis.JAMA Pediatrics,174(7),665-675.
30. Masten, A. S.,Cicchetti, D.(2010).Developmental cascades.Development and Psychopathology,22(3),491-495.
31. McQuillan, M. E.,Bates, J. E.,Staples, A. D.,Hoyniak, C. P.,Rudasill, K. M.,Molfese, V. J.(2021).Sustained attention across toddlerhood: The roles of language and sleep.Developmental psychol-ogy,57(7),1042-1057.
32. Mirmiran, M.,Baldwin, R. B.,Ariagno, R. L.(2003).Circadian and sleep development in preterm infants occurs independently from the influences of environmental lighting.Pediatric Research,53(6),933-938.
33. Mistlberger, R. E.,Skene, D. J.(2005).Nonphotic entrainment in humans?.Journal of Biological Rhythms,20(4),339-352.
34. Mondal, N.,Bhat, B. V.,Plakkal, N.,Thulasingam, M.,Ajayan, P.,Poorna, D. R.(2016).Prevalence and risk factors of speech and language delay in children less than three years of age.Journal of Comprehensive Pediatrics,7(2),e33173.
35. Morales-Munoz, I.,Nolvi, S.,Virta, M.,Karlsson, H.,Paavonen, E. J.,Karlsson, L.(2020).The longitudinal associations between temperament and sleep during the first year of life.Infant Behavior and Development,61,101485.
36. Paavonen, E. J.,Saarenpää-Heikkilä, O.,Morales-Munoz, I.,Virta, M.,Häkälä, N.,Pölkki, P.,Karlsson, L.(2020).Normal sleep development in infants: Findings from two large birth cohorts.Sleep Medicine,69,145-154.
37. Paulson, J. F.,Keefe, H. A.,Leiferman, J. A.(2009).Early parental depression and child language development.Journal of Child Psychology and Psychiatry,50(3),254-262.
38. Peirano, P.,Algarın, C.,Uauy, R.(2003).Sleep-wake states and their regulatory mechanisms throughout early human development.The Journal of Pediatrics,143(4),70-79.
39. Pennestri, M. H.,Burdayron, R.,Kenny, S.,Béliveau, M. J.,Dubois-Comtois, K.(2020).Sleeping through the night or through the nights?.Sleep Medicine,76,98-103.
40. Rączaszek-Leonardi, J.,Nomikou, I.,Rohlfing, K. J.,Deacon, T. W.(2018).Language development from an ecological perspective: Ecologically valid ways to abstract symbols.Ecological Psychology,30(1),39-73.
41. Rights, J. D.,Sterba, S. K.(2020).New recommendations on the Use of R-squared differences in multilevel model comparisons.Multivariate Behavioral Research,55(4),568-599.
42. Rivkees, S. A.(2003).Developing circadian rhythmicity in infants.Pediatrics,112(2),373-381.
43. Rose, S. A.,Feldman, J. F.,Jankowski, J. J.(2009).A cognitive approach to the development of early language.Child Development,80(1),134-150.
44. Rothbart, M. K.,Sheese, B. E.,Rueda, M. R.,Posner, M. I.(2011).Developing mechanisms of self-regulation in early life.Emotion Review,3(2),207-213.
45. Sadeh, A.(2011).The role and validity of actigraphy in sleep medicine: An update.Sleep Medicine Reviews,15(4),259-267.
46. Sadeh, A. V. I.,Mindell, J. A.,Luedtke, K.,Wiegand, B.(2009).Sleep and sleep ecology in the first 3 years: A web-based study.Journal of Sleep Research,18(1),60-73.
47. Scher, A.(2005).Infant sleep at 10 months of age as a window to cognitive development.Early Human Development,81(3),289-292.
48. Seehagen, S.,Konrad, C.,Herbert, J. S.,Schneider, S.(2015).Timely sleep facilitates declarative memory consolidation in infants.Proceedings of the National Academy of Sciences,112(5),1625-1629.
49. Smithson, L.,Baird, T.,Tamana, S. K.,Lau, A.,Mariasine, J.,Chikuma, J.,Turvey, S. E.(2018).Shorter sleep duration is associated with reduced cognitive development at two years of age.Sleep Medicine,48,131-139.
50. Sohr-Preston, S. L.,Scaramella, L. V.(2006).Implications of timing of maternal depressive symptoms for early cognitive and language development.Clinical Child and Family Psychology Review,9(1),65-83.
51. Sorondo, B. M.,Reeb-Sutherland, B. C.(2015).Associations between infant temperament, maternal stress, and infants’ sleep across the first year of life.Infant Behavior and Development,39,131-135.
52. Tham, E. K.,Schneider, N.,Broekman, B. F.(2017).Infant sleep and its relation with cognition and growth: A narrative review.Nature and Science of Sleep,9,135.
53. Thomas, K. A.,Burr, R. L.,Spieker, S.(2015).Maternal and infant activity: Analytic approaches for the study of circadian rhythm.Infant Behavior and Development,41,80-87.
54. Thomas, K. A.,Burr, R. L.,Spieker, S.,Lee, J.,Chen, J.(2014).Mother–infant circadian rhythm: Development of individual patterns and dyadic synchrony.Early Human Development,90(12),885-890.
55. Thomas, M. S.,Annaz, D.,Ansari, D.,Scerif, G.,Jarrold, C.,Karmiloff-Smith, A.(2009).Using developmental trajectories to understand develop-mental disorders.Journal of Speech, Language, and Hearing Research,52(2),336-358.
56. Topping, K.,Dekhinet, R.,Zeedyk, S.(2013).Parent–infant interaction and children’s language development.Educational Psychology,33(4),391-426.
57. Tsai, S.Y.,Barnard, K. E.,Lentz, M. J.,Thomas, K. A.(2011).Mother-infant activity synchrony as a correlate of the emergence of circadian rhythm.Biological Research for Nursing,13(1),80-88.
58. Wang, N. R.,Ye, Y.(2016).A prospective study of the development of nocturnal sleep patterns in infants.Zhongguo Dang Dai Er Ke Za Zhi Chinese Journal of Contemporary Pediatrics)),18(4),350-354.
59. Zauche, L. H.,Thul, T. A.,Mahoney, A. E. D.,Stapel-Wax, J. L.(2016).Influence of language nutrition on children’s language and cognitive development: An integrated review.Early Childhood Research Quarterly,36,318-333.
60. 劉惠美, H. M.,曹峰銘, F. M.(2010).華語嬰幼兒溝發展量表指導手冊.心理=Psy-chological Publishing.

1. 謝珮玲,許文施,施雅羚(2023)。團體人際心理治療對嬰幼兒母親適應狀況之影響研究。教育心理學報，54(4)，891-915。