Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder.
Am J Speech Lang Pathol. 2021 Nov 4;30(6):2350-2367. doi: 10.1044/2021_AJSLP-20-00395. Epub 2021 Sep 7.
Purpose The current literature on pediatric autoimmune encephalitis (AE) focuses on medical identification/diagnosis and medical treatments. Data about the identification and treatment of communication disorders in these children are limited. This clinical focus article provides an example of the speech, language, and communication characteristics, intervention, and recovery of a single child with medical diagnoses of pediatric AE and pediatric acute-onset neuropsychiatric syndrome (PANS) and special education eligibility under the autism spectrum disorder category. Method This is an in-depth illustrative/descriptive case study. Medical, educational, and speech-language documentation of one child diagnosed with AE at age 7 years was reviewed. Methods included interviews with family members, teachers, and the school speech-language pathologist and reviews of documentation including evaluations, reports, and Individualized Education Programs. Results This child received special education and therapy services through his public school and a university speech-language clinic. He concurrently received medical treatment for AE and PANS. Comprehensive augmentative and alternative communication (AAC) intervention included the use of core words, modeling, parallel talk, self-talk, expansive recasts, shared book reading, family counseling, and collaboration with the parents and the school speech-language pathologist. The child made progress on all goals despite irregular attendance to therapy due to medical complications. Discussion Because experimental research including this population is currently limited, this descriptive case study provides valuable information to clinicians, educators, pediatricians, medical diagnosticians, and anyone providing services to a child with a complex neuropsychological disorder like AE. Future research is needed with more children who have AE, especially experimental investigations of the intervention methods utilized here. Additional research of more children with AE can provide information about the scope and severity of speech, language, and communication needs and the trajectory of recovery given AAC intervention.
目的 目前关于儿科自身免疫性脑炎 (AE) 的文献主要集中在医学鉴定/诊断和医学治疗上。关于这些儿童沟通障碍的识别和治疗的数据有限。本临床重点文章提供了一个单一儿童的言语、语言和沟通特征、干预和康复的例子,该儿童的医学诊断为儿科 AE 和儿科急性发作神经精神综合征 (PANS),并根据自闭症谱系障碍类别获得特殊教育资格。 方法 这是一个深入的说明/描述性案例研究。对一名 7 岁时被诊断为 AE 的儿童的医学、教育和言语语言记录进行了回顾。方法包括对家庭成员、教师和学校言语语言病理学家进行访谈,并对包括评估、报告和个别化教育计划在内的记录进行审查。 结果 该儿童通过他的公立学校和一所大学言语语言诊所接受特殊教育和治疗服务。他同时接受 AE 和 PANS 的医疗治疗。全面的辅助和替代沟通 (AAC) 干预包括使用核心词、模仿、平行谈话、自我对话、扩展重述、共享阅读、家庭咨询以及与父母和学校言语语言病理学家的合作。尽管由于医疗并发症导致治疗经常中断,但该儿童在所有目标上都取得了进步。 讨论 由于目前针对该人群的实验研究有限,本描述性案例研究为临床医生、教育工作者、儿科医生、医学诊断医生以及为患有 AE 等复杂神经心理障碍的儿童提供服务的任何人提供了有价值的信息。需要对更多患有 AE 的儿童进行未来研究,特别是对这里使用的干预方法进行实验研究。对更多患有 AE 的儿童进行更多研究可以提供有关言语、语言和沟通需求的范围和严重程度以及 AAC 干预后的康复轨迹的信息。