[北京语言障碍儿童的语言及影响因素分析]。

J. Wang, Q. Xu, H. F. Duan, L. Wang, B. Zhou, L. Zhang, X. Wang, L. J. Zhou, X. M. Liu
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All children experienced a standardized evaluation of language with diagnostic receptive and expressive assessment of mandarin-comprehensive(DREAM-C) and questionnaire, One-way ANOVA and LSD test were conducted to compare the differences in overall language, receptive language, expressive language, semantics, and syntax scores among 3 groups of children. According to the results of DREAM-C, the children with speech disorder were divided into language normal group and language delay group. Chi-square test and multivariate Logistic regression were implemented to analyze the association between the linguistic development of children with speech disorder and potential influential factors. Results: There were 145 children in the speech sound disorder group, including 110 males and 35 females respectively, with an age of (5.9±1.0) years; 117 children in the stuttering group, including 91 males and 26 females, with an age of (5.8±1.0) years; 100 children in the healthy group, including 75 males and 25 females, with an age of (5.7±1.2) years. The variations in overall language, expressive language, and syntax scores among 3 groups of children were statistically significant (92±18 vs.96±11 vs. 98±11, 81±18 vs. 84±14 vs. 88±13, 87±16 vs. 89±11 vs. 91±10, F=5.46, 4.69, 3.68, all P<0.05). Pairwise comparison revealed that the speech sound disorder group had lower scores in overall language, expressive language, and syntactic compared to the healthy group, and the differences were statistically significant (all P<0.01) and the overall language score was lower than that of children with stuttering (P<0.05). In terms of overall language and expressive language, there was a statistically significant difference in the incidence of language delay among the three groups of children (15.9% (23/145) vs. 20.5% (24/117) vs. 7.0% (7/100), 46.2% (67/145) vs. 39.3% (46/117) vs. 26.0% (26/100); χ2=7.93, 10.28; both P<0.05). In terms of overall language, the stuttering group took up the highest proportion. In terms of expressive language, the speech sound disorder group accounted for the highest amount. The incidence of language delay in children with speech disorder was 44.3% (116/262). Non-parent-child reading, daily screen time ≥1 hour and screen exposure before 1.5 years of age are risk factors for the development of language in children with speech disorder (OR=1.87, 2.18, 2.01; 95%CI 1.07-3.27, 1.23-3.86, 1.17-3.45; all P<0.01). Negative family history are protective factors for the progress of language ability (OR=0.37, 95%CI 0.17-0.81, P<0.05). 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引用次数: 0

摘要

目的研究各类语言障碍儿童的语言特点和影响因素。方法:进行病例对照研究:对2021年1月至2023年11月在首都儿科研究所附属儿童医院儿童保健中心语言-言语门诊确诊的262名言语障碍儿童进行病例对照研究,将言语发音障碍儿童作为言语发音障碍组,将发育性口吃儿童作为口吃组。同期在保健中心进行体检的100名发育正常儿童为健康组。所有儿童都接受了普通话接受和表达能力综合诊断评估(DREAM-C)和问卷调查的标准化语言评估,并进行了单因素方差分析和LSD检验,以比较三组儿童在总体语言、接受语言、表达语言、语义和句法得分方面的差异。根据 DREAM-C 的结果,将语言障碍儿童分为语言正常组和语言延迟组。采用卡方检验和多元 Logistic 回归分析言语障碍儿童的语言发展与潜在影响因素之间的关联。结果语音障碍组145名儿童,其中男110名,女35名,年龄(5.9±1.0)岁;口吃组117名儿童,其中男91名,女26名,年龄(5.8±1.0)岁;健康组100名儿童,其中男75名,女25名,年龄(5.7±1.2)岁。3组儿童的语言总分、语言表达能力和句法得分差异有统计学意义(92±18 vs.96±11 vs.98±11, 81±18 vs.84±14 vs.88±13, 87±16 vs.89±11 vs.91±10, F=5.46, 4.69, 3.68, 均P<0.05)。配对比较显示,与健康组相比,言语发声障碍组在语言总分、语言表达能力和句法方面得分较低,差异有统计学意义(均P<0.01),且语言总分低于口吃儿童(P<0.05)。在总体语言和表达性语言方面,三组儿童的语言延迟发生率差异有统计学意义(15.9%(23/145)vs 20.5%(24/117)vs 7.0%(7/100),46.2%(67/145)vs 39.3%(46/117)vs 26.0%(26/100);χ2=7.93,10.28;均P<0.05)。就总体语言而言,口吃组所占比例最高。在语言表达方面,语音障碍组所占比例最高。语言障碍儿童的语言延迟发生率为 44.3%(116/262)。非亲子阅读、每天屏幕时间≥1小时和1.5岁前接触屏幕是言语障碍儿童语言发展的风险因素(OR=1.87、2.18、2.01;95%CI 1.07-3.27、1.23-3.86、1.17-3.45;均P<0.01)。阴性家族史是语言能力进步的保护因素(OR=0.37,95%CI 0.17-0.81,P<0.05)。结论有语言障碍的儿童往往容易出现语言发育迟缓,尤其是在语言表达和句法方面。语言障碍儿童语言发育迟缓的发生与家庭病史、亲子阅读、屏幕时间等因素密切相关。应关注语言障碍儿童的语言发展。
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[Analysis of language and influencing factors of children with speech disorder in Beijing].
Objective: To investigate the features and influencing factors of language in children with various types of speech disorders. Methods: A case-control study was carried out, 262 children with speech disorder had been diagnosed at the language-speech clinic of the Center of Children's Healthcare, Children's Hospital, Capital Institute of Pediatrics from January 2021 to November 2023, the children with speech sound disorder as the speech sound disorder group, the children with developmental stuttering as the stuttering group. There were 100 typically-developed children who underwent physical checkups at the Center of Healthcare during the same period as the healthy group. All children experienced a standardized evaluation of language with diagnostic receptive and expressive assessment of mandarin-comprehensive(DREAM-C) and questionnaire, One-way ANOVA and LSD test were conducted to compare the differences in overall language, receptive language, expressive language, semantics, and syntax scores among 3 groups of children. According to the results of DREAM-C, the children with speech disorder were divided into language normal group and language delay group. Chi-square test and multivariate Logistic regression were implemented to analyze the association between the linguistic development of children with speech disorder and potential influential factors. Results: There were 145 children in the speech sound disorder group, including 110 males and 35 females respectively, with an age of (5.9±1.0) years; 117 children in the stuttering group, including 91 males and 26 females, with an age of (5.8±1.0) years; 100 children in the healthy group, including 75 males and 25 females, with an age of (5.7±1.2) years. The variations in overall language, expressive language, and syntax scores among 3 groups of children were statistically significant (92±18 vs.96±11 vs. 98±11, 81±18 vs. 84±14 vs. 88±13, 87±16 vs. 89±11 vs. 91±10, F=5.46, 4.69, 3.68, all P<0.05). Pairwise comparison revealed that the speech sound disorder group had lower scores in overall language, expressive language, and syntactic compared to the healthy group, and the differences were statistically significant (all P<0.01) and the overall language score was lower than that of children with stuttering (P<0.05). In terms of overall language and expressive language, there was a statistically significant difference in the incidence of language delay among the three groups of children (15.9% (23/145) vs. 20.5% (24/117) vs. 7.0% (7/100), 46.2% (67/145) vs. 39.3% (46/117) vs. 26.0% (26/100); χ2=7.93, 10.28; both P<0.05). In terms of overall language, the stuttering group took up the highest proportion. In terms of expressive language, the speech sound disorder group accounted for the highest amount. The incidence of language delay in children with speech disorder was 44.3% (116/262). Non-parent-child reading, daily screen time ≥1 hour and screen exposure before 1.5 years of age are risk factors for the development of language in children with speech disorder (OR=1.87, 2.18, 2.01; 95%CI 1.07-3.27, 1.23-3.86, 1.17-3.45; all P<0.01). Negative family history are protective factors for the progress of language ability (OR=0.37, 95%CI 0.17-0.81, P<0.05). Conclusions: Children with speech disorder tend to have easy access to language delay, especially in expressive language and syntax. The occurrence of language delay in children with speech disorder is tightly connected with factors such as the family medical history, parent-child reading, screen time, etc. Attention should be paid to the development of language in children who suffer from speech disorder.
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