目的 回顾性分析18~36月龄语言发育迟缓儿童神经发育特点,为后期评估、干预提供理论依据。方法 选取苏州大学附属儿童医院2018-2019年因语言问题首次就诊的18~36月龄婴幼儿,根据“0~6岁儿童神经心理发育量表”及“早期语言发育进程量表”结果分为单纯语言发育迟缓组与多能区发育迟缓组,比较两组儿童各能区发育、早期语言水平,以及孤独症筛查阳性检出率。结果 共有700例婴幼儿入选,两组间月龄(t=-1.73,P=0.09)、性别(χ2=2.06,P=0.15)差异无统计学意义;两组间年龄构成比存在差异(χ2=9.124 ,P=0.01)。多能区发育迟缓组在语言、大运动、精细运动、适应性及社交能区均更为落后(t=15.08,20.26,25.68,18.76,39.79,P＜0.001)。在早期语言水平方面,多能区发育迟缓组在总的早期语言发展水平、语音和语言表达、听觉感受理解、视觉相关语言方面较单纯语言发育迟缓组均更低(t=8.20,10.23,9.18,11.39,P＜0.001)。单纯语言迟缓组语言能区的落后与精细运动、适应性及社交DQ存在相关性(r=0.127,0.146,0.238,P＜0.001),而多能区发育迟缓组语言能区的落后与各能区DQ均存在相关性(r=0.154,0.392,0.390,0.435,P＜0.001);多能区发育迟缓组孤独症筛查阳性检出率更高(χ2=61.69,105.17,P＜0.05)。结论 早期语言发育迟缓儿童合并多能区落后时存在语言发育的显著落后,应进一步完善检查,注意识别神经发育障碍性疾病。
Abstract
Objective To retrospectively analyze the characteristics of neurodevelopment in children with language developmental delay aged 18 to 36 months, so as to provide theoretical evidence for further assessment and intervention. Methods Children with language problems aged 18 to 36 months from 2018 to 2019 were enrolled in this study from Children′s Hospital of Soochow University. Children′s neurodevelopment was assessed by Chinese Children Development Scale and Early Language Milestone Scale, which divided them into two groups according to the results: simple language delay and global developmental delay. The development quotients(DQ) of each dimension and early language development were compared within two groups. Positive detection rate of autism was analyzed. Results A total of 700 children were included. There were no significant differences in age(t＝-1.73,P=0.09) and gender(χ2=2.06,P=0.15)between the two groups. The development of language areas, gross motor, fine motor, adaptability and social interaction in global developmental delay group was significantly worse than that in simple language delay group(t=15.08, 20.26, 25.68, 18.76, 39.79,P＜0.001). In addition, early language development in general language development, language understanding, expression and auditory perception, and visual-related language decreased significantly in global developmental delay group compared with simple language delay group (t=8.20, 10.23, 9.18. 11.39,P<0.001). Language delay was related to the DQ of fine motor, adaptability and social interaction in simple developmental delay group (r=0.127, 0.146, 0.238, P<0.001), while it was associated with the DQ of each dimension in global developmental delay group(r=0.154, 0.392, 0.390, 0.435, P<0.001). The positive detection rate of autism screening in global developmental delay group was significantly higher (χ2=61.69, 105.17, P<0.05). Conclusion Children with early language delay combined with backwardness in multiple dimensions have a significant lag in language development and should be further examined to identify neurodevelopmental disorders.
关键词
语言发育迟缓 /
智能发育 /
儿童
Key words
language developmental delay /
neurodevelopment /
children
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基金
苏州市“科教兴卫”青年科技项目(KJXW2018020);苏州市民生科技项目(SYS2018066)
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