Miniscalco Carmela, Nygren Gudrun, Hagberg Bibbi, Kadesjö Björn, Gillberg Christopher
Department of Logopedics and Phoniatrics, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Dev Med Child Neurol. 2006 May;48(5):361-6. doi: 10.1017/S0012162206000788.
We present a prospective study at school age of neuropsychiatric and neurodevelopmental outcome of language delay suspected at child health screening around 30 months of age. In a community sample, 25 children (21 males, 4 females) screening positive and 80 children (38 males, 42 females) screening negative for speech and language problems at age 30 months were examined in detail for language disorders at age 6 years. The screen-positive children were then followed for another year and underwent in-depth neuropsychiatric examination by assessors blind to the results of previous testing. Detailed follow-up results at age 7 years were available for 21 children. Thirteen of these 21 children (62%) had a major neuropsychiatric diagnosis (autism, atypical autism, Asperger's syndrome, attention-deficit-hyperactivity disorder [ADHD]), or combinations of these. Two further children (10%) had borderline IQ with no other major diagnosis. We conclude that children in the general population who screen positive for speech and language problems before age 3 years appear to be at very high risk of autism spectrum disorders or ADHD, or both, at 7 years of age. Remaining language problems at age 6 years strongly predict the presence of neuropsychiatric or neurodevelopmental disorders at age 7 years.
我们开展了一项前瞻性研究,针对在30个月左右儿童健康筛查中疑似语言发育迟缓的学龄儿童的神经精神和神经发育结局进行研究。在一个社区样本中,对25名在30个月大时言语和语言问题筛查呈阳性的儿童(21名男性,4名女性)以及80名筛查呈阴性的儿童(38名男性,42名女性)在6岁时进行了详细的语言障碍检查。然后对筛查呈阳性的儿童再随访一年,并由对先前测试结果不知情的评估人员进行深入的神经精神检查。有21名儿童获得了7岁时的详细随访结果。这21名儿童中有13名(62%)患有主要的神经精神疾病诊断(自闭症、非典型自闭症、阿斯伯格综合征、注意力缺陷多动障碍[ADHD]),或这些疾病的组合。另有两名儿童(10%)智商处于临界水平,无其他主要诊断。我们得出结论,在3岁前言语和语言问题筛查呈阳性的普通人群中的儿童在7岁时似乎患自闭症谱系障碍或ADHD,或两者兼有的风险非常高。6岁时仍存在的语言问题强烈预示着7岁时存在神经精神或神经发育障碍。