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[伴有丹迪-沃克变异型的脆性X综合征:口腔和书面交流表现的临床研究]

[Fragile X syndrome with Dandy-Walker variant: a clinical study of oral and written communicative manifestations].

作者信息

Lamônica Dionísia Aparecida Cusin, Ferraz Plínio Marcos Duarte Pinto, Ferreira Amanda Tragueta, Prado Lívia Maria do, Abramides Dagma Venturini Marquez, Gejão Mariana Germano

机构信息

Departamento de Fonoaudiologia da Faculdade de Odontologia de Bauru, Universidade de São Paulo – USP – Bauru (SP), Brasil.

出版信息

J Soc Bras Fonoaudiol. 2011;23(2):177-82. doi: 10.1590/s2179-64912011000200016.

Abstract

The Fragile X syndrome is the most frequent cause of inherited intellectual disability. The Dandy-Walker variant is a specific constellation of neuroradiological findings. The present study reports oral and written communication findings in a 15-year-old boy with clinical and molecular diagnosis of Fragile X syndrome and neuroimaging findings consistent with Dandy-Walker variant. The speech-language pathology and audiology evaluation was carried out using the Communicative Behavior Observation, the Phonology assessment of the ABFW - Child Language Test, the Phonological Abilities Profile, the Test of School Performance, and the Illinois Test of Psycholinguistic Abilities. Stomatognathic system and hearing assessments were also performed. It was observed: phonological, semantic, pragmatic and morphosyntactic deficits in oral language; deficits in psycholinguistic abilities (auditory reception, verbal expression, combination of sounds, auditory and visual sequential memory, auditory closure, auditory and visual association); and morphological and functional alterations in the stomatognathic system. Difficulties in decoding the graphical symbols were observed in reading. In writing, the subject presented omissions, agglutinations and multiple representations with the predominant use of vowels, besides difficulties in visuo-spatial organization. In mathematics, in spite of the numeric recognition, the participant didn't accomplish arithmetic operations. No alterations were observed in the peripheral hearing evaluation. The constellation of behavioral, cognitive, linguistic and perceptual symptoms described for Fragile X syndrome, in addition to the structural central nervous alterations observed in the Dandy-Walker variant, caused outstanding interferences in the development of communicative abilities, in reading and writing learning, and in the individual's social integration.

摘要

脆性X综合征是遗传性智力残疾最常见的病因。Dandy-Walker变异型是一组特定的神经影像学表现。本研究报告了一名15岁男孩的口语和书面交流情况,该男孩临床和分子诊断为脆性X综合征,神经影像学表现与Dandy-Walker变异型一致。使用交流行为观察、ABFW儿童语言测试的语音评估、语音能力概况、学校表现测试和伊利诺伊心理语言能力测试进行了言语病理学和听力学评估。还进行了口颌系统和听力评估。观察到:口语中的语音、语义、语用和形态句法缺陷;心理语言能力缺陷(听觉接收、言语表达、声音组合、听觉和视觉序列记忆、听觉闭合、听觉和视觉联想);以及口颌系统的形态和功能改变。阅读时观察到解码图形符号有困难。写作方面,除了视觉空间组织困难外,该受试者还存在遗漏、粘连和主要使用元音的多重表征。在数学方面,尽管能识别数字,但该参与者无法完成算术运算。外周听力评估未观察到异常。脆性X综合征所描述的行为、认知、语言和感知症状,以及Dandy-Walker变异型中观察到的结构性中枢神经系统改变,对交流能力的发展、读写学习和个体的社会融合产生了显著干扰。

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