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发育性语言障碍:早期预测因素、诊断年龄及诊断工具。一项范围综述

Developmental Language Disorder: Early Predictors, Age for the Diagnosis, and Diagnostic Tools. A Scoping Review.

作者信息

Sansavini Alessandra, Favilla Maria Elena, Guasti Maria Teresa, Marini Andrea, Millepiedi Stefania, Di Martino Maria Valeria, Vecchi Simona, Battajon Nadia, Bertolo Laura, Capirci Olga, Carretti Barbara, Colatei Maria Paola, Frioni Cristina, Marotta Luigi, Massa Sara, Michelazzo Letizia, Pecini Chiara, Piazzalunga Silvia, Pieretti Manuela, Rinaldi Pasquale, Salvadorini Renata, Termine Cristiano, Zuccarini Mariagrazia, D'Amico Simonetta, De Cagno Anna Giulia, Levorato Maria Chiara, Rossetto Tiziana, Lorusso Maria Luisa

机构信息

Department of Psychology "Renzo Canestrari", University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy.

CLASTA-Communication & Language Acquisition Studies in Typical & Atypical Population, Piazza Epiro 12D, 00183 Roma, Italy.

出版信息

Brain Sci. 2021 May 17;11(5):654. doi: 10.3390/brainsci11050654.

Abstract

BACKGROUND

Developmental Language Disorder (DLD) is frequent in childhood and may have long-term sequelae. By employing an evidence-based approach, this scoping review aims at identifying (a) early predictors of DLD; (b) the optimal age range for the use of screening and diagnostic tools; (c) effective diagnostic tools in preschool children.

METHODS

We considered systematic reviews, meta-analyses, and primary observational studies with control groups on predictive, sensitivity and specificity values of screening and diagnostic tools and psycholinguistic measures for the assessment of DLD in preschool children. We identified 37 studies, consisting of 10 systematic reviews and 27 primary studies.

RESULTS

Delay in gesture production, receptive and/or expressive vocabulary, syntactic comprehension, or word combination up to 30 months emerged as early predictors of DLD, a family history of DLD appeared to be a major risk factor, and low socioeconomic status and environmental input were reported as risk factors with lower predictive power. Optimal time for screening is suggested between age 2 and 3, for diagnosis around age 4. Because of the high variability of sensitivity and specificity values, joint use of standardized and psycholinguistic measures is suggested to increase diagnostic accuracy.

CONCLUSIONS

Monitoring risk situations and employing caregivers' reports, clinical assessment and multiple linguistic measures are fundamental for an early identification of DLD and timely interventions.

摘要

背景

发育性语言障碍(DLD)在儿童期很常见,可能会产生长期后果。通过采用循证方法,本范围综述旨在确定(a)DLD的早期预测因素;(b)使用筛查和诊断工具的最佳年龄范围;(c)学龄前儿童有效的诊断工具。

方法

我们纳入了关于筛查和诊断工具的预测性、敏感性和特异性值以及用于评估学龄前儿童DLD的心理语言学测量方法的系统评价、荟萃分析和有对照组的原发性观察性研究。我们确定了37项研究,包括10项系统评价和27项原发性研究。

结果

在30个月之前,手势表达、接受性和/或表达性词汇、句法理解或单词组合方面的延迟是DLD的早期预测因素,DLD家族史似乎是一个主要风险因素,低社会经济地位和环境因素被报告为预测力较低的风险因素。建议在2至3岁之间进行筛查,在4岁左右进行诊断。由于敏感性和特异性值的高度变异性,建议联合使用标准化和心理语言学测量方法以提高诊断准确性。

结论

监测风险情况并采用照顾者报告、临床评估和多种语言测量方法对于早期识别DLD和及时干预至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d371/8156743/2e5fccb5d5a6/brainsci-11-00654-g001.jpg

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