Population Health Sciences Institute, Newcastle University, Newcastle, UK.
Child and Adolescent Mental Health Services, Tees, Esk and Wear Valleys, NHS Foundation Trust, Durham, UK.
Dev Med Child Neurol. 2020 Oct;62(10):1161-1169. doi: 10.1111/dmcn.14635. Epub 2020 Jul 30.
To test the prediction of communication disorder severity at 5 years of age from characteristics at 2 years for children with cerebral palsy (CP) whose communication is giving cause for concern.
In this cohort study, 77 children (52 males; 25 females) with communication difficulties and CP were visited at home at 2 (mean 2y 4mo; SD 3mo) and 5 (mean 5y 5mo; SD 4mo) years of age. Information on the type and distribution of motor disorder, seizures, gross and fine motor function, hearing, and vision were collected from medical notes. Non-verbal cognition, language comprehension, language expression, spoken vocabulary, and methods of communication were assessed directly at age 2 years. At 5 years, communication and speech function were rated using the Communication Function Classification System (CFCS), Functional Communication Classification System (FCCS), and Viking Speech Scale (VSS).
In multivariable regression models, CP type, Gross Motor Function Classification System level, vision, the amount of speech understood by strangers, non-verbal cognition, and number of consonants produced at age 2 years predicted the CFCS level at age 5 years (R =0.54). CP type, Manual Ability Classification System level, amount of speech understood, vision, and number of consonants predicted the FCCS level (R =0.49). CP type, amount of speech understood by strangers, and number of consonants predicted the VSS level (R =0.50).
Characteristics at 2 years of age predict communication and speech performance at 5 years, and should inform referral to speech and language therapy.
测试对于有交流障碍的脑瘫（CP）儿童，2 岁时的特征是否可以预测其 5 岁时的交流障碍严重程度。
在这项队列研究中，77 名有交流困难和 CP 的儿童在 2 岁（平均 2 岁 4 个月；SD 3 个月）和 5 岁（平均 5 岁 5 个月；SD 4 个月）时在家中接受了访视。从病历中收集了运动障碍类型和分布、癫痫、粗大运动和精细运动功能、听力和视力的信息。在 2 岁时直接评估非语言认知、语言理解、语言表达、口语词汇量和交流方式。在 5 岁时，使用交流功能分类系统（CFCS）、功能性交流分类系统（FCCS）和 Viking 语音量表（VSS）评估交流和言语功能。
在多变量回归模型中，CP 类型、粗大运动功能分类系统级别、视力、陌生人理解的言语量、非语言认知和 2 岁时产生的辅音数量预测了 5 岁时的 CFCS 水平（R=0.54）。CP 类型、手动能力分类系统级别、理解言语量、视力和辅音数量预测了 FCCS 水平（R=0.49）。CP 类型、陌生人理解的言语量和辅音数量预测了 VSS 水平（R=0.50）。
2 岁时的特征可以预测 5 岁时的交流和言语表现，应告知转介言语和语言治疗。
