语音障碍儿童神经心理发育特征及影响因素分析  

Analysis of neuropsychological development characteristics and influencing factors in children with speech sound disorder

作　　者：刘晓莉 王建红[1] 许琪 王蕾 周波 张丽丽[1] 王琳 Liu Xiaoli;Wang Jianhong;Xu Qi;Wang Lei;Zhou Bo;Zhang Lili;Wang Lin(Department of Child Healthcare,Children′s Hospital,Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院保健科,北京100020

出　　处：《中华预防医学杂志》2023年第3期356-361,共6页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金面上项目(82273645);北京市医院管理中心“登峰”计划专项经费资助(DFL20221103);首都卫生发展科研专项(2020-2-2104);北京市属医学科研院所公益发展改革试点项目(京医研2019-11,京医研2021-03);北京市属医院科研培育项目(PX2022053);首都儿科研究所所级基金(QN-2020-08,CXYJ-2021-08,LCPY-2021-11,LCPY-2021-22,LCPY-2021-27)。

摘　　要：目的探讨语音障碍儿童的神经心理发育特征及影响因素。方法采用病例对照研究,选取2019年1月至2021年9月在首都儿科研究所附属儿童医院保健科语言-言语门诊初次就诊并诊断为语音障碍的395例儿童作为语音障碍(SSD)组,并选取同期于保健科体检的1179名健康儿童作为对照组,均进行《儿童神经心理行为检查量表2016版》(儿心量表2016版)检查,采用独立样本t检验比较两组儿童的总发育商、大运动、精细动作、适应能力、语言和社会行为能力的发育水平;采用单因素χ2分析、多因素logistic回归分析儿童语音障碍的影响因素。结果SSD儿童395例,其中男296例,女99例,年龄≥4岁及≤6岁,(4.71±0.76)岁;对照组儿童1179例,其中男864例,女315例,年龄≥4岁及≤6岁,(4.64±0.78)岁。SSD组总发育商均值低于对照组[(86.45±11.57)分/(91.24±8.00)分,t=-7.78,P<0.01],并且SSD组男童和女童总发育商的均值均低于对照组[(86.00±11.40)分/(90.78±7.86)分,t=-6.70,P<0.01;(87.82±12.03)分/(92.87±8.49)分,t=-3.88,P<0.01]。各能区发育商比较,SSD组大运动、精细动作、适应能力、语言能力、社会行为均值均低于对照组[(89.76±12.47)分/(92.01±10.69)分,t=-3.21,P<0.01;(80.62±13.64)分/(84.49±11.55)分,t=-5.06,P<0.01;(87.92±15.25)分/(92.98±12.06)分,t=-6.00,P<0.01;(86.48±16.30)分/(94.55±12.08)分,t=-9.04,P<0.01;(87.02±15.18)分/(92.63±12.57)分,t=-6.62,P<0.01];SSD组内比较,男童的精细动作均值低于女童[(79.80±13.42)分/(83.08±14.05)分,t=-2.08,P<0.05]。自主进餐时间>2岁(OR=1.527,95%CI:1.180~1.977,P=0.001)、辅食添加时间延迟(OR=1.510,95%CI:1.123~2.029,P=0.006)、家庭语言环境存在方言(OR=1.351,95%CI:1.060~1.723,P=0.015)为儿童语音障碍的危险因素。结论儿童语音障碍以男童多见,SSD儿童整体发育水平落后于正常儿童,且SSD男童精细动作落后于女童;儿童语音障碍发生与辅食添加时间、自主进餐时间以及家庭�Objective Exploring the neuropsychological developmental characteristics and influencing factors of children with speech disorder.Methods A case-control study was conducted.A total of 395 children diagnosed with speech disorders were selected as speech sound disorder(SSD)group from January 2019 to September 2021 in the speech-speech outpatient department of the Children′s Hospital Affiliated to Capital Institute of Pediatrics,and 1179 healthy children who underwent physical examination in the health department during the same period were selected as the control group.All the children were examined by the"Children′s Neuropsychological Behavior Scale 2016 Edition"(Children′s Mind Scale 2016 edition).Independent sample t test was used to compare the developmental levels of the two groups of children,including total developmental quotient,gross motor,fine motor,adaptive ability,language and social behavior ability.The influential factors of children′s speech disorders were analyzed by univariate Chi-square analysis and multivariate logistic regression.Results There were 395 SSD children,including 296 males and 99 females,4≤age≤6,(4.71±0.76)years.There were 1179 children in the control group,including 864 males and 315 females,4≤age≤6,(4.64±0.78)years.The mean value of total developmental factors in SSD group was lower than that in control group[(86.45±11.57)/(91.24±8.0),t=-7.78,P<0.01],and the mean values of total developmental markers in both boys and girls in SSD group were lower than those in control group[(86.00±11.40)/(90.78±7.86),t=-6.70,P<0.01;(87.82±12.03)/(92.87±8.49),t=-3.88,P<0.01].The mean values of gross motor,fine motor,adaptive ability,language ability and social behavior in SSD group were lower than those in control group[(89.76±12.47)/(92.01±10.69),t=-3.21,P<0.01;(80.62±13.64)/(84.49±11.55),t=-5.06,P<0.01;(87.92±15.25)/(92.98±12.06),t=-6.00,P<0.01;(86.48±16.30)/(94.55±12.08),t=-9.04,P<0.01;(87.02±15.18)/(92.63±12.57),t=-6.62,P<0.01];The mean value of fine motor in bo

关 键 词：儿童 语音障碍 神经心理发育 病例对照研究 

分 类 号：R749.94[医药卫生—神经病学与精神病学]