Rudolph Johanna M
University of Texas at Dallas.
Am J Speech Lang Pathol. 2017 Aug 15;26(3):991-1010. doi: 10.1044/2016_AJSLP-15-0181.
Research suggests that the best approach to early identification of children with specific language impairment (SLI) should include assessment of risk factors. However, previous attempts to develop a list for this purpose have been unsuccessful. In this study, systematic review and meta-analytic procedures were used to determine whether any case history factors can be used to identify toddlers at risk of developing SLI.
Epidemiological studies that examined the association between risk factors and SLI were identified. Results across studies were aggregated to determine more precisely the strength of association between each risk factor and the development of SLI. The clinical significance of these factors was established via comparison to late talker status.
Eleven risk factors were found to be statistically significant predictors of SLI. Among these, maternal education level, 5-min Apgar score, birth order, and biological sex met criteria for clinical significance.
At least 4 case history factors are as predictive as late talker status in the context of early identification of toddlers at risk for SLI. The findings of this review highlight the importance of taking a child's genetic and environmental context into consideration when deciding whether further evaluation and early intervention services are warranted.
研究表明，早期识别特定语言障碍（SLI）儿童的最佳方法应包括对风险因素的评估。然而，此前为此制定清单的尝试均未成功。在本研究中，采用系统评价和荟萃分析程序来确定是否有任何病史因素可用于识别有发展为SLI风险的幼儿。
确定了检验风险因素与SLI之间关联的流行病学研究。汇总各项研究的结果，以更精确地确定每个风险因素与SLI发展之间关联的强度。通过与说话晚的状况进行比较，确定这些因素的临床意义。
发现11个风险因素是SLI的统计学显著预测指标。其中，母亲教育水平、5分钟阿氏评分、出生顺序和生物学性别符合临床意义标准。
在早期识别有SLI风险的幼儿时，至少有4个病史因素与说话晚的状况具有同样的预测性。本综述的结果突出了在决定是否需要进一步评估和早期干预服务时考虑儿童遗传和环境背景的重要性。
