Huang Ya-Fen, Chang Hsueh-Ling, Wu Yu-Yu, Huang Yu-Shu, Liang Hsin-Yi
Department of Child Psychiatry, Chang Gung Children's Hospital, Taipei, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Chang Gung Med J. 2007 Sep-Oct;30(5):423-9.
Clinical studies of children with learning disorders (LD) in Chinese-speaking society are still very limited. The aim of this study was to obtain the clinical picture of children with LD in Taiwan.
Medical records of diagnoses-validated subjects in a local children's hospital from 1998 through 2005 were reviewed in detail. Relevant data were collected and analyzed. The diagnoses were made based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for learning disorders.
Among the 27 subjects (23 boys and 4 girls) identified, the average age upon diagnosis was 9.6 +/- 2.0 years with school grade of 3.5 +/- 1.9. The percentages of subjects with reading disorders (RD), mathematics disorders (MD) and disorders of written expression (DWE) were 66.7%, 11.1% and 77.8%, respectively. Over half (55.6%) of the subjects had two subtypes concurrently, and the majority of which had both RD and DWE. The overall, psychiatric, and medical comorbid rates were 88.9%, 81.5% and 22.2%, respectively. Attention-deficit/hyperactivity disorder (ADHD) was the most common (66.7%) co-existing condition. Subtypes were slightly different in terms of demographic data, IQ profile and comorbid conditions.
Our LD sample was predominantly male with average levels of intelligence and highly comorbid with ADHD. Each subtype of LD seemed to have its own unique feature in terms of cognitive function, comorbid condition, sexual differences, and other aspects. Further research is eagerly warranted. When evaluating learning problems, clinicians should keep in mind that ADHD often exists. Treating concomitant ADHD and other co-existing problems should bring more favorable outcomes. Due to the heterogeneity of LD, evaluation of each suggested case should be carefully monitored and individually tailored.
在说中文的社会中，针对学习障碍（LD）儿童的临床研究仍然非常有限。本研究的目的是了解台湾学习障碍儿童的临床情况。
详细回顾了一家当地儿童医院1998年至2005年确诊病例的病历。收集并分析了相关数据。诊断依据《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）中学习障碍的标准。
在确定的27名受试者（23名男孩和4名女孩）中，诊断时的平均年龄为9.6±2.0岁，年级为3.5±1.9。阅读障碍（RD）、数学障碍（MD）和书面表达障碍（DWE）受试者的比例分别为66.7%、11.1%和77.8%。超过一半（55.6%）的受试者同时患有两种亚型，其中大多数同时患有RD和DWE。总体共病率、精神共病率和医学共病率分别为88.9%、81.5%和22.2%。注意力缺陷多动障碍（ADHD）是最常见的共病情况（66.7%）。不同亚型在人口统计学数据、智商特征和共病情况方面略有不同。
我们的学习障碍样本以男性为主，智力水平中等，且与ADHD高度共病。学习障碍的每种亚型在认知功能、共病情况、性别差异和其他方面似乎都有其独特的特征。迫切需要进一步的研究。在评估学习问题时，临床医生应牢记ADHD经常存在。治疗伴随的ADHD和其他共存问题可能会带来更有利的结果。由于学习障碍的异质性，对每个疑似病例的评估应仔细监测并进行个体化调整。
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