Billard C, Fluss J, Ducot B, Bricout L, Richard G, Ecalle J, Magnan A, Warszawski J, Ziegler J
Unité de rééducation neurologique pédiatrie, centre de référence sur les troubles des apprentissages, hôpital Bicêtre, Le Kremlin-Bicêtre, France.
Rev Epidemiol Sante Publique. 2009 Jun;57(3):191-203. doi: 10.1016/j.respe.2009.02.205. Epub 2009 Apr 24.
Reading impairment is the major learning disability in children. While research on illiteracy has mainly been conducted from a sociological perspective, research on dyslexia has typically been studied from a cognitive-linguistic perspective. Studies that jointly investigate sociological, behavioral and cognitive factors in predicting reading outcome are rare and limited to English-speaking populations. The goal of the present study was to screen second grade children with reading impairment in French urban elementary schools and to pin down the factors that explain the various facets of reading failure and success.
A total of 1062 children from 20 different schools in the city of Paris participated in the study. Different aspects of reading were assessed individually for children with a suspected impairment in reading acquisition. Subsequently, 131 poor readers and 50 typically developing readers were matched for sex, age, and school. For these children, medical, cognitive, behavioral and individual socioeconomic data were obtained. Group differences were examined and multiple regression analyses were conducted to examine how much variance in reading was explained by the various variables.
The prevalence of poor reading skills in grade 2 was highly influenced by neighborhood socioeconomic status (SES) (ranging from 3.3% in high SES to 20.5% in low SES areas). Among the SES variables, employment of the father was a significant predictor of poor reading. Among the cognitive variables, phonological awareness and rapid naming were the most significant factors, much more than verbal or nonverbal intelligence. Among the behavioral variables, attention was an important factor but not externalized symptoms. Multiple regression analyses showed that reading outcome was best predicted by phonological awareness skills and attention deficits.
The majority of children with reading disability come from low SES areas. As in the English literature, the most robust predictor for reading impairment is phonological awareness, even when SES is taken into account. In addition, attention deficits seemed to aggravate reading impairments for children with weak phonological awareness skills. Successful early prevention should focus on reinforcing phonological awareness, recoding and attention skills.
阅读障碍是儿童主要的学习障碍。虽然关于文盲的研究主要是从社会学角度进行的，但关于诵读困难的研究通常是从认知语言学角度展开的。联合调查社会学、行为学和认知因素以预测阅读结果的研究很少，且仅限于英语国家人群。本研究的目的是筛查法国城市小学二年级有阅读障碍的儿童，并确定解释阅读失败和成功的各个方面的因素。
来自巴黎市20所不同学校的1062名儿童参与了本研究。对疑似阅读习得障碍的儿童分别评估阅读的不同方面。随后，131名阅读能力差的读者和50名发育正常的读者在性别、年龄和学校方面进行了匹配。收集了这些儿童的医学、认知、行为和个人社会经济数据。检验了组间差异，并进行了多元回归分析，以检验各种变量对阅读差异的解释程度。
二年级阅读能力差的患病率受社区社会经济地位（SES）的影响很大（高SES地区为3.3%，低SES地区为20.5%）。在SES变量中，父亲的就业情况是阅读能力差的一个重要预测因素。在认知变量中，语音意识和快速命名是最重要的因素，远比语言或非语言智力重要。在行为变量中，注意力是一个重要因素，但不是外化症状。多元回归分析表明，语音意识技能和注意力缺陷最能预测阅读结果。
大多数有阅读障碍的儿童来自低SES地区。与英语文献一样，即使考虑到SES，阅读障碍最有力的预测因素也是语音意识。此外，注意力缺陷似乎会加重语音意识技能较弱儿童的阅读障碍。成功的早期预防应侧重于强化语音意识、编码和注意力技能。
