Kaplan B, Crawford S, Cantell M, Kooistra L, Dewey D
Department of Pediatrics, University of Calgary, AB, Canada.
Child Care Health Dev. 2006 Nov;32(6):723-31. doi: 10.1111/j.1365-2214.2006.00689.x.
Comorbidity, co-occurrence and continuum are three terms used when referring to developmental problems such as Developmental Coordination Disorder (DCD), but they can be confusing and misleading. Further, the terms can be upsetting to parents, and are not always helpful in guiding the selection of clinical interventions.
The main purpose of this paper is to question some of the terminology we employ when referring to DCD and other developmental problems. A secondary purpose is to discuss some of the conceptual frameworks that have been proposed that attempt to address the issue of the interrelationships among developmental problems.
The terminology is examined by first referring to the basic dictionary definitions. Second, data we have published that relate to the issues of co-occurrence and continuum are reviewed in light of the terminology questions. Finally, we review some alternative conceptual frameworks which more accurately describe the relationships among developmental problems.
The term 'comorbidity' has limited relevance to developmental problems, and its use is questionable. In contrast, co-occurrence and continuum are more useful terms to use in regard to developmental problems. Concepts such as atypical brain development and minor neurological dysfunction provide some possible explanations for the increased levels of co-occurrence of developmental disorders in children who are more severely affected.
共病、并发和连续统是在提及诸如发育协调障碍（DCD）等发育问题时使用的三个术语，但它们可能令人困惑且具有误导性。此外，这些术语可能会让家长感到不安，并且在指导临床干预措施的选择方面并不总是有帮助。
本文的主要目的是质疑我们在提及DCD和其他发育问题时所使用的一些术语。次要目的是讨论一些已提出的概念框架，这些框架试图解决发育问题之间的相互关系问题。
首先参考基本的词典定义来审视这些术语。其次，根据术语问题，回顾我们已发表的与并发和连续统问题相关的数据。最后，我们回顾一些更准确描述发育问题之间关系的替代概念框架。
“共病”一词与发育问题的相关性有限，其使用存在疑问。相比之下，并发和连续统是在发育问题方面更有用的术语。非典型脑发育和轻度神经功能障碍等概念为受影响更严重的儿童中发育障碍并发水平增加提供了一些可能的解释。
