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[儿童言语不清。儿童言语失用症]

[Incomprehensible speech in children. Childhood apraxia of speech].

作者信息

Meyer S, Kühn D, Ptok M

机构信息

Klinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover.

出版信息

HNO. 2012 May;60(5):410-5. doi: 10.1007/s00106-011-2446-1.

Abstract

BACKGROUND

Some children referred to ENT physicians suffer from severe and seemingly therapy-resistant impairment of the articulation of speech. Apart from classical symptoms of specific language impairment (SLI), such as a delay in the acquisition of syntax or poor lexical competence, these children's speech is sometimes practically incomprehensible. Describing the disorder as SLI although not correct would nevertheless be inappropriate. The term childhood apraxia of speech (CAS) has been coined for such impairment. In this article the background, symptoms, diagnostics and therapy of CAS are reviewed.

METHOD

For this systematic review a selective literature search in PubMed was conducted.

RESULTS

The etiology of CAS is not well known and genetic factors, neurological diseases and metabolic imbalances are assumed. Symptoms differ significantly among individuals as well as intraindividually. CAS is defined as impairment in planning and controlling articulatory movements, which has a severe impact on the sound production.

DISCUSSION

For ENT specialists it is important to be aware that CAS symptoms may lead to a severe impediment of verbal communication and subsequently also interfere with the normal socio-emotional development of an affected child. Thus, an intensive therapy regimen is mandatory. Studies with a high level of evidence concerning the sensitivity and specificity of diagnostic tools, as well as studies regarding the effectiveness and efficiency of therapeutic approaches are needed.

摘要

背景

一些被转诊至耳鼻喉科医生处的儿童存在严重且似乎对治疗有抵抗性的言语清晰度受损问题。除了特定语言障碍(SLI)的典型症状,如句法习得延迟或词汇能力差之外,这些儿童的言语有时几乎难以理解。将这种障碍描述为SLI虽然不正确,但也是不恰当的。“儿童言语失用症(CAS)”这一术语已被用于描述此类损伤。本文对CAS的背景、症状、诊断和治疗进行了综述。

方法

为进行这项系统综述,在PubMed上进行了选择性文献检索。

结果

CAS的病因尚不明确,推测与遗传因素、神经系统疾病和代谢失衡有关。症状在个体之间以及个体内部都有显著差异。CAS被定义为计划和控制发音动作的损伤,这对语音产生有严重影响。

讨论

对于耳鼻喉科专家来说,重要的是要意识到CAS症状可能会严重阻碍言语交流,进而也会干扰受影响儿童的正常社会情感发展。因此,强化治疗方案是必不可少的。需要有关于诊断工具的敏感性和特异性的高证据水平研究,以及关于治疗方法的有效性和效率的研究。

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