Hendren Robert L, Haft Stephanie L, Black Jessica M, White Nancy Cushen, Hoeft Fumiko
Division of Child and Adolescent Psychiatry, Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States.
Dyslexia Center, University of California San Francisco, San Francisco, CA, United States.
Front Psychiatry. 2018 Mar 27;9:101. doi: 10.3389/fpsyt.2018.00101. eCollection 2018.
Reading disorder (RD), a specific learning disorder (SLD) of reading that includes impairment in word reading, reading fluency, and/or reading comprehension, is common in the general population but often is not comprehensively understood or assessed in mental health settings. In education settings, comorbid mental and associated disorders may be inadequately integrated into intervention plans. Assessment and intervention for RD may be delayed or absent in children with frequently co-occurring mental disorders not fully responding to treatment in both school and mental health settings. To address this oversight, this review summarizes current knowledge regarding RDs and common comorbid or co-occurring disorders that are important for mental health and school settings. We chose to highlight RD because it is the most common SLD, and connections to other often comorbid disorders have been more thoroughly described in the literature. Much of the literature we describe is on decoding-based RD (or developmental dyslexia) as it is the most common form of RD. In addition to risk for academic struggle and social, emotional, and behavioral problems, those with RD often show early evidence of combined or intertwined childhood disorders. These include attention deficit hyperactivity disorder, anxiety and depression, disruptive, impulse-control, and conduct disorders, autism spectrum disorders, and other SLDs. The present review highlights issues and areas of controversy within these comorbidities, as well as directions for future research. An interdisciplinary, integrated approach between mental health professionals and educators can lead to comprehensive and targeted treatments encompassing both academic and mental health interventions. Such targeted treatments may contribute to improved educational and health-related outcomes in vulnerable youth. While there is a growing research literature on this association, more studies are needed of when to intervene and of the early and long-term benefits of comprehensive intervention.
阅读障碍（RD）是一种特定的阅读学习障碍（SLD），包括单词阅读、阅读流畅性和/或阅读理解方面的损伤，在普通人群中很常见，但在心理健康环境中往往没有得到全面的理解或评估。在教育环境中，共病的精神和相关障碍可能没有充分纳入干预计划。对于在学校和心理健康环境中对治疗反应不完全的经常共病精神障碍的儿童，RD的评估和干预可能会延迟或缺失。为了解决这一疏忽，本综述总结了关于RD以及对心理健康和学校环境很重要的常见共病或并发障碍的现有知识。我们选择突出RD，因为它是最常见的SLD，并且与其他经常共病的障碍的联系在文献中已有更全面的描述。我们所描述的许多文献是关于基于解码的RD（或发育性阅读障碍），因为它是RD最常见的形式。除了学业困难以及社交、情感和行为问题的风险外，患有RD的人往往早期就表现出童年期多种或相互交织的障碍迹象。这些障碍包括注意力缺陷多动障碍、焦虑和抑郁、破坏性行为、冲动控制和品行障碍、自闭症谱系障碍以及其他SLD。本综述突出了这些共病中的问题和争议领域，以及未来研究的方向。心理健康专业人员和教育工作者之间的跨学科综合方法可以带来涵盖学业和心理健康干预的全面且有针对性的治疗。这种有针对性的治疗可能有助于改善弱势青少年的教育和健康相关结果。虽然关于这种关联的研究文献越来越多，但仍需要更多关于何时进行干预以及全面干预的早期和长期益处的研究。
