Shaywitz S E, Shaywitz B A, Fletcher J M, Escobar M D
Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06510-8064.
JAMA. 1990;264(8):998-1002.
We hypothesized that results of previous investigations indicating an increased prevalence of reading disability in boys compared with girls reflected a bias in subject selection. In an epidemiologic sample of 215 girls and 199 boys, we identified two groups of reading-disabled children: research identified and school identified. Results indicated no significant differences in the prevalence of reading disability in research-identified boys compared with research-identified girls in either second (17[8.7%] of 196 boys; 15[6.9%] of 216 girls) or third grade (18[9.0%] of 199 boys; 13[6.0%] of 215 girls). In contrast, school identification resulted in the classification of 27 (13.6%) of 198 boys and seven (3.2%) of 216 girls in second grade and 20 (10.0%) of 199 boys and nine (4.2%) of 215 girls in third grade. Our data indicate that school-identified samples are almost unavoidably subject to a referral bias and that reports of an increased prevalence of reading disability in boys may reflect this bias in ascertainment. These findings caution against relying solely on schools for identification of reading-disabled children.
我们推测，先前调查结果显示男孩阅读障碍患病率高于女孩，这反映了受试者选择方面的偏差。在一个包含215名女孩和199名男孩的流行病学样本中，我们确定了两组阅读障碍儿童：研究确定的和学校确定的。结果表明，在二年级（196名男孩中的17名[8.7%]；216名女孩中的15名[6.9%]）或三年级（199名男孩中的18名[9.0%]；215名女孩中的13名[6.0%]），研究确定的男孩与研究确定的女孩在阅读障碍患病率上没有显著差异。相比之下，学校认定的结果是，二年级有27名（13.6%）198名男孩和7名（3.2%）216名女孩被归类为阅读障碍，三年级有20名（10.0%）199名男孩和9名（4.2%）215名女孩被归类为阅读障碍。我们的数据表明，学校认定的样本几乎不可避免地存在转诊偏差，男孩阅读障碍患病率增加的报告可能反映了这种确定过程中的偏差。这些发现提醒我们不要仅仅依赖学校来识别阅读障碍儿童。
