Department of Experimental Psychology, University of Oxford, Oxford, UK.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
J Child Psychol Psychiatry. 2017 Oct;58(10):1068-1080. doi: 10.1111/jcpp.12721. Epub 2017 Mar 30.
Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology.
The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members. On this basis they can either revise their views or make a case for their position. The statements are then revised based on panel feedback, and again rated by and commented on by the panel. In this study, feedback from a second round was used to prepare a final set of statements in narrative form. The panel included 57 individuals representing a range of professions and nationalities.
We achieved at least 78% agreement for 19 of 21 statements within two rounds of ratings. These were collapsed into 12 statements for the final consensus reported here. The term 'Language Disorder' is recommended to refer to a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis. The term, 'Developmental Language Disorder' (DLD) was endorsed for use when the language disorder was not associated with a known biomedical aetiology. It was also agreed that (a) presence of risk factors (neurobiological or environmental) does not preclude a diagnosis of DLD, (b) DLD can co-occur with other neurodevelopmental disorders (e.g. ADHD) and (c) DLD does not require a mismatch between verbal and nonverbal ability.
This Delphi exercise highlights reasons for disagreements about terminology for language disorders and proposes standard definitions and nomenclature.
儿童语言问题的标准和术语缺乏共识,这不仅影响了服务的提供,也阻碍了研究和实践。我们报告了一项使用在线德尔菲法解决这些问题的研究的第二阶段。在第一阶段,我们专注于语言障碍的标准。在这里,我们考虑术语。
德尔菲法是一种迭代过程,其中一组初始陈述由专家组进行评估,然后专家组有机会查看其他小组成员的匿名评分。在此基础上,他们可以修改他们的观点,或为他们的立场辩护。然后根据专家组的反馈修改陈述,并由专家组再次进行评分和评论。在这项研究中,第二轮的反馈用于准备最终的陈述。该小组包括 57 名代表不同专业和国籍的个人。
我们在两轮评分中至少达成了 78%的共识,其中有 21 项中的 19 项。这些在两轮评分中达成了至少 78%的共识,并在两轮评分中进行了整合,最终形成了 12 项共识陈述。推荐使用术语“语言障碍”来指代一种导致日常生活功能障碍且预后不良的困难模式。当语言障碍与已知的生物医学病因无关时,推荐使用术语“发育性语言障碍”(DLD)。同时还达成了以下共识:(a)存在风险因素(神经生物学或环境)并不排除 DLD 的诊断,(b)DLD 可能与其他神经发育障碍(如 ADHD)同时发生,(c)DLD 不需要言语和非言语能力之间存在不匹配。
这项德尔菲法研究强调了术语在语言障碍方面存在分歧的原因,并提出了标准的定义和命名法。