Ahmmed Ansar Uddin
Lancashire Teaching Hospitals NHS Foundation Trust, Paediatric Audiology Service, Fulwood Clinic, 4 Lytham Road, Fulwood, Preston, PR2 8JB, UK.
Int J Pediatr Otorhinolaryngol. 2020 Aug;135:110117. doi: 10.1016/j.ijporl.2020.110117. Epub 2020 May 13.
To evaluate the prevalence of sleep disturbance and its relationship with auditory processing (AP) and co-morbidities in children diagnosed with auditory processing disorder (APD).
Data from 109 children (Males = 59, Females = 50) with mean non-verbal intelligence quotient (NVIQ) of 89.44 (SD:18.16), aged between 6 and 16 years (mean: 10 years 7 months; SD: 2 years 9 months) with a diagnosis of APD were analysed. Participants performed ≤1.33 SD below the mean in two or more out of five SCAN-3 diagnostic APD tests that included 'Filtered Words' (FW), 'Auditory Figure Ground 0 dB' (AFG0), 'Competing Words-Directed Ear' (CW-DE), 'Competing Sentences' (CS) and 'Time Compressed Sentences' (TCS). Concern about sleep in addition to other symptoms and medical history were documented from structured parental history sheet which forms part of the routine APD assessment. Language impairment (LI), attention-deficit-hyperactivity-disorder (ADHD) and oppositional defiant disorder (ODD), and anxiety were evaluated using the 'Children's Communication Checklist-2' (CCC-2), 'Swanson Nolan and Pelham rating scale' (SNAP-IV) and 'Anxiety Scale for Children-Autism Spectrum Disorder' (ASC-ASD) respectively.
Sixty children had sleep disturbance, a prevalence of 55% (95% CI 45.2%-64.6%). The two groups of APD children, with (n = 49) and without sleep (n = 60) disturbance, did not vary in their auditory processing abilities. The sleep disturbed group had significant issues with pragmatic language impairment, hyperactivity/impulsivity, oppositional defiant symptoms and anxiety compared to the group without sleep disturbance when they were analysed separately. After the variables were considered in step wise fashion in binary logistic regression analyses, only pragmatic language impairment and anxiety predicted sleep disturbance (p < .01).
In APD the prevalence of sleep disturbance is high, justifying screening within a transdisciplinary APD assessment protocol. Sleep disturbance in APD is predicted by pragmatic language impairment and anxiety, but not by ADHD symptoms or ODD.
评估被诊断为听觉处理障碍（APD）的儿童睡眠障碍的患病率及其与听觉处理（AP）和共病的关系。
分析了109名儿童（男59名，女50名）的数据，这些儿童平均非言语智商（NVIQ）为89.44（标准差：18.16），年龄在6至16岁之间（平均：10岁7个月；标准差：2岁9个月），被诊断为APD。参与者在五项SCAN - 3诊断性APD测试中的两项或更多项中表现低于平均值1.33个标准差，这些测试包括“过滤词”（FW）、“听觉图形背景0分贝”（AFG0）、"竞争词 - 定向耳"（CW - DE）、"竞争句子"（CS）和"时间压缩句子"（TCS）。除其他症状和病史外，有关睡眠的问题是从结构化的家长病史表中记录的，该表是常规APD评估的一部分。分别使用“儿童沟通检查表 - 2”（CCC - 2）、“斯旺森·诺兰和佩勒姆评定量表”（SNAP - IV）和“儿童自闭症谱系障碍焦虑量表（ASC - ASD）”评估语言障碍（LI）、注意力缺陷多动障碍（ADHD）和对立违抗障碍（ODD）以及焦虑。
60名儿童存在睡眠障碍，患病率为55%（95%置信区间45.2% - 64.6%）。两组APD儿童，即有睡眠障碍（n = 49）和无睡眠障碍（n = 60）的儿童，在听觉处理能力上没有差异。与无睡眠障碍组相比，睡眠障碍组在语用语言障碍、多动/冲动、对立违抗症状和焦虑方面存在显著问题，对其进行单独分析时发现如此。在二元逻辑回归分析中逐步考虑这些变量后，只有语用语言障碍和焦虑可预测睡眠障碍（p <.01）。
在APD中，睡眠障碍的患病率很高，这证明在跨学科APD评估方案中进行筛查是合理的。APD中的睡眠障碍可由语用语言障碍和焦虑预测，但不能由ADHD症状或ODD预测。
