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儿童科利纳德朗格综合征(CdLS)的沟通、认知发展和行为:初步结果。

Communication, cognitive development and behavior in children with Cornelia de Lange Syndrome (CdLS): preliminary results.

机构信息

Unità Operativa Neuropsichiatria dell'Infanzia e dell'Adolescenza, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.

出版信息

Am J Med Genet B Neuropsychiatr Genet. 2014 Apr;165B(3):223-9. doi: 10.1002/ajmg.b.32224. Epub 2014 Feb 7.

Abstract

In this study, we present preliminary data on cognitive, behavioral and communication domains of individuals with Cornelia de Lange Syndrome (CdLS), collected through a specific protocol combining direct and indirect tools. Seventeen subjects with CdLS were assessed, 2.5- to 13.4-year-old. Cognitive level of the subjects differed from what previously described in literature, showing more patients with normal or borderline cognitive abilities. We found a relation between severe autistic behavior and comprehension impairments: all children with high CARS score have severe receptive language disability. A correlation was also found between CARS score and ID: high CARS score occurred only in patients with profound levels of ID. Results of this study support the need for a specific assessment protocol tailored for the characteristics of subjects with multiple disabilities, to be able to identify their strengths avoiding the avalanche effect of weaknesses. Most tests on neuropsychological functions have been developed and standardized for typically developing children, and require the integrity of other functions aside the one that is evaluated, determining an underestimation of the level of functioning. This study could be a starting point to develop new models applicable to other genetic syndromes and complex situations; new and wider studies are needed in order to allow a more complete and accurate assessment, thereby ensuring more efficient and family-centered treatment plans.

摘要

在这项研究中,我们通过结合直接和间接工具的特定方案,呈现了关于患有Cornelia de Lange 综合征(CdLS)个体的认知、行为和沟通领域的初步数据。我们评估了 17 名年龄在 2.5 岁至 13.4 岁的 CdLS 患者。与文献中之前描述的相比,患者的认知水平有所不同,表现出更多的认知能力正常或边缘的患者。我们发现严重的自闭症行为和理解障碍之间存在相关性:所有 CARS 评分较高的儿童均存在严重的接受性语言障碍。CARS 评分与 ID 之间也存在相关性:高 CARS 评分仅出现在 ID 程度较深的患者中。这项研究的结果支持需要针对多种残疾患者的特点制定特定的评估方案,以识别他们的优势,避免弱点的雪崩效应。大多数神经心理功能测试都是为正常发育的儿童开发和标准化的,除了评估的功能之外,还需要其他功能的完整性,从而导致对功能水平的低估。这项研究可以作为开发适用于其他遗传综合征和复杂情况的新模型的起点;需要进行更多的新的、更广泛的研究,以便能够进行更完整和准确的评估,从而确保更有效的、以家庭为中心的治疗计划。

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