Nicola K, Watter P
Physiotherapy, The University of Queensland, Brisbane, QLD, Australia.
Child Care Health Dev. 2016 Sep;42(5):742-9. doi: 10.1111/cch.12365. Epub 2016 Jun 12.
This study investigated (1) the visual-motor integration (VMI) performance of children with severe specific language impairment (SLI), and any effect of age, gender, socio-economic status and concomitant speech impairment; and (2) the relationship between language and VMI performance. It is hypothesized that children with severe SLI would present with VMI problems irrespective of gender and socio-economic status; however, VMI deficits will be more pronounced in younger children and those with concomitant speech impairment. Furthermore, it is hypothesized that there will be a relationship between VMI and language performance, particularly in receptive scores.
Children enrolled between 2000 and 2008 in a school dedicated to children with severe speech-language impairments were included, if they met the criteria for severe SLI with or without concomitant speech impairment which was verified by a government organization. Results from all initial standardized language and VMI assessments found during a retrospective review of chart files were included.
The final study group included 100 children (males = 76), from 4 to 14 years of age with mean language scores at least 2SD below the mean. For VMI performance, 52% of the children scored below -1SD, with 25% of the total group scoring more than 1.5SD below the mean. Age, gender and the addition of a speech impairment did not impact on VMI performance; however, children living in disadvantaged suburbs scored significantly better than children residing in advantaged suburbs. Receptive language scores of the Clinical Evaluation of Language Fundamentals was the only score associated with and able to predict VMI performance.
A small subgroup of children with severe SLI will also have poor VMI skills. The best predictor of poor VMI is receptive language scores on the Clinical Evaluation of Language Fundamentals. Children with poor receptive language performance may benefit from VMI assessment and multidisciplinary management.
本研究调查了(1)患有严重特定语言障碍(SLI)儿童的视动整合(VMI)表现,以及年龄、性别、社会经济地位和伴随的言语障碍的任何影响;(2)语言与VMI表现之间的关系。研究假设,患有严重SLI的儿童无论性别和社会经济地位如何都会出现VMI问题;然而,VMI缺陷在年幼儿童和伴有言语障碍的儿童中会更加明显。此外,研究假设VMI与语言表现之间存在关系,特别是在接受性分数方面。
纳入2000年至2008年在一所专门为严重言语-语言障碍儿童设立的学校就读的儿童,前提是他们符合严重SLI的标准,无论是否伴有言语障碍,这由一个政府组织进行了核实。回顾性查阅病历档案时发现的所有初始标准化语言和VMI评估结果均被纳入。
最终研究组包括100名儿童(男性76名),年龄在4至14岁之间,平均语言分数至少比平均分低2个标准差。对于VMI表现,52%的儿童得分低于-1个标准差,整个组中有25%的儿童得分比平均分低1.5个标准差以上。年龄、性别和是否伴有言语障碍对VMI表现没有影响;然而,生活在弱势郊区的儿童得分明显高于生活在优势郊区的儿童。语言基本能力临床评估的接受性语言分数是唯一与VMI表现相关且能够预测VMI表现的分数。
一小部分患有严重SLI的儿童也会有较差的VMI技能。VMI较差的最佳预测指标是语言基本能力临床评估的接受性语言分数。接受性语言表现较差的儿童可能会从VMI评估和多学科管理中受益。