Galuschka Katharina, Schulte-Körne Gerd
Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwig-Maximilians-Universität München.
Dtsch Arztebl Int. 2016 Apr 22;113(16):279-86. doi: 10.3238/arztebl.2016.0279.
3-11% of children and adolescents suffer from a reading andor spelling disorder. Their poor written-language skills markedly impair their scholastic performance and are often associated with other mental disorders. A great deal of uncertainty still surrounds the question of the appropriate methods of diagnosis and treatment.
We systematically searched for pertinent publications in databases and literature reference lists, summarized the evidence in six tables, and examined some of it in a meta-analysis. Recommendations were developed in a consensus conference.
A reading and/or spelling disorder should only be diagnosed if performance in these areas is below average. It should be determined whether an attention deficit-hyperactivity disorder, anxiety disorder, or disorder of arithmetical skills is also present. Reading and spelling performance should be reinforced with systematic instruction about letter-sound and sound-letter correspondences, letter-syllable-morpheme synthesis, and sound-syllablemorpheme analysis (g' = 0.32) (recommendation grade A). Spelling ability responds best to spelling-rule training (recommendation grade A). Irlen lenses, visual and/or auditory perceptual training, hemispheric stimulation, piracetam, and prism spectacles should not be used (recommendation grade A).
Evidence- and consensus-based guidelines for the diagnosis and treatment of reading and/or spelling disorders in children and adolescents are now available for the first time. Reading and spelling abilities should be systematically and comprehensively reinforced, and potential comorbid disorders should be sought and treated appropriately. The efficacy of many treatments now in use has not been documented; if they are to be used in the future, they must be tested in randomized, controlled trials. For adult sufferers, adequate diagnostic instruments and therapeutic methods are not yet available.
3%至11%的儿童和青少年患有阅读和/或拼写障碍。他们较差的书面语言能力显著损害其学业成绩，且常与其他精神障碍相关。关于合适的诊断和治疗方法问题仍存在大量不确定性。
我们系统检索了数据库和文献参考文献列表中的相关出版物，在六个表格中总结了证据，并在一项荟萃分析中对其中一些证据进行了审查。在一次共识会议上制定了建议。
仅当这些领域的表现低于平均水平时，才应诊断为阅读和/或拼写障碍。应确定是否还存在注意力缺陷多动障碍、焦虑症或算术技能障碍。应通过关于字母-发音和发音-字母对应、字母-音节-语素合成以及发音-音节-语素分析的系统教学来强化阅读和拼写表现（g' = 0.32）（推荐等级A）。拼写能力对拼写规则训练反应最佳（推荐等级A）。不应使用爱尔伦镜片、视觉和/或听觉感知训练、半球刺激、吡拉西坦和棱镜眼镜（推荐等级A）。
首次有了基于证据和共识的儿童及青少年阅读和/或拼写障碍诊断与治疗指南。应系统且全面地强化阅读和拼写能力，并寻找并适当治疗潜在的共病障碍。目前许多正在使用的治疗方法的疗效尚未得到证实；如果未来要使用这些方法，必须在随机对照试验中进行测试。对于成年患者，尚无足够的诊断工具和治疗方法。
