Boyer Julie, Flamant Cyril, Boussicault Gerald, Berlie Isabelle, Gascoin Géraldine, Branger Bernard, N'Guyen The Tich Sylvie, Rozé Jean-Christophe
Department of Otolaryngology (ENT), Nantes University Hospital, France; Centre d'Investigation Clinique INSERM CIC004, University Hospital of Nantes, France.
Centre d'Investigation Clinique INSERM CIC004, University Hospital of Nantes, France; Nantes University, Department of Neonatal Medicine, University Hospital of Nantes, France; "Loire Infant Follow-up Team" (LIFT) Network, Pays de Loire, France.
Early Hum Dev. 2014 Jun;90(6):281-6. doi: 10.1016/j.earlhumdev.2014.03.005. Epub 2014 Apr 13.
The optimal age for assessing language difficulties in premature children remains unclear.
To determine the most predictive and earliest screening tool for later language difficulties on children born preterm.
A prospective population-based study in the Loire Infant Follow-up Team LIFT SUBJECTS: All children born <35weeks of gestation between 2003 and 2005 were assessed at corrected ages by four screening tools: the Ages & Stages Questionnaire (ASQ) communication scale at 18 and 24months, the language items of Brunet Lezine test at 24months, and the "Epreuves de Repérage des Troubles du Langage" (ERTL) at 4years.
After 5years, the kindergarten teacher evaluated the vocabulary, grammar and pronunciation capacities of the child in comparison with the classroom performances.
Among 1957 infants enrolled at discharge, 947 were assessed by their teacher with 12.2% (n=116) of language difficulties. Full data at all time points were available for 426 infants. The area under curve of the receiver operator characteristic curve obtained for the ASQ communication scale at 18months was significantly lower (0.65±0.09) than that obtained at 24months (0.77±0.08) and the languages items of Brunet Lezine test at 24months (0.77±0.08), and the ERTL at 4years (0.76±0.09). The optimal cut-off value for ASQ communication at 24months is ≤45 [sensitivity of 0.79 (95%CI: 0.70-0.86); specificity of 0.63 (95%CI: 0.59-0.66)].
The Ages & Stages Questionnaire communication scale at 24 corrected months appears as an acceptable test at an early time point to identify preterm children at risk of later language difficulties.
评估早产儿语言困难的最佳年龄仍不明确。
确定对早产儿童后期语言困难最具预测性且最早的筛查工具。
在卢瓦尔河婴儿随访团队（LIFT）进行的一项基于人群的前瞻性研究。
2003年至2005年出生时孕周小于35周的所有儿童，在矫正年龄时通过四种筛查工具进行评估：18个月和24个月时的《年龄与阶段问卷》（ASQ）沟通量表、24个月时的布鲁内特·勒津测试语言项目以及4岁时的“语言障碍筛查测试”（ERTL）。
5年后，幼儿园教师根据课堂表现评估儿童的词汇、语法和发音能力。
在出院时登记的1957名婴儿中，947名由教师进行了评估，其中12.2%（n = 116）存在语言困难。426名婴儿在所有时间点的完整数据可用。18个月时ASQ沟通量表的受试者工作特征曲线下面积显著低于24个月时（0.65±0.09）、24个月时布鲁内特·勒津测试语言项目（0.77±0.08）以及4岁时ERTL（0.76±0.09）。24个月时ASQ沟通量表的最佳截断值为≤45[敏感度为0.79（95%CI：0.70 - 0.86）；特异度为0.63（95%CI：0.59 - 0.66）]。
矫正24个月时的《年龄与阶段问卷》沟通量表似乎是在早期识别有后期语言困难风险的早产儿童的可接受测试。
