Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Dell Medical School, Department of Population Health, University of Texas at Austin, Austin, Texas, USA.
Dev Med Child Neurol. 2022 Sep;64(9):1096-1105. doi: 10.1111/dmcn.15198. Epub 2022 Mar 9.
To examine speech impairment severity classification over time in a longitudinal cohort of children with cerebral palsy (CP).
A total of 101 children (58 males, 43 females) between the ages of 4 and 10 years with CP participated in this longitudinal study. Speech severity was rated using the Viking Speech Scale (VSS), a four-level classification rating scale, at 4, 6, 8, and 10 years (age 4 years: mean = 52 months [3 SD]; age 6 years: mean = 75 months [2 SD]; age 8 years: mean = 100 months [4 SD]; age 10 years: mean = 125 months [5 SD]). We used Bayesian mixed-effects ordinal logistic regression to model (1) the extent to which speech severity changed over time and (2) patterns of change across age groups and classification rating group levels.
VSS ratings decreased (speech severity became less severe) between 4 and 10 years of age. Children who were first classified in VSS levels I, II, or III at age 4 years had a high probability of staying at, or improving to, VSS level I by 10 years. Children who were first classified in VSS level IV at 4 years had a high probability of remaining in VSS level IV at 10 years.
Early speech performance is highly predictive of later childhood speech abilities. Children with any level of speech impairment at age 4 years should be receiving speech therapy. Those with more severe speech impairments should be introduced to augmentative and alternative communication as soon as possible.
Children with early Viking Speech Scale (VSS) ratings below level IV have a good prognosis for speech improvement. Children with early VSS level IV ratings are likely to remain at VSS level IV over time. Children did not show worsening of VSS level between the ages of 4 and 10 years.
在脑瘫（CP）儿童的纵向队列中，随时间推移检查言语障碍严重程度的分类。
共有 101 名年龄在 4 至 10 岁的 CP 儿童（男 58 名，女 43 名）参加了这项纵向研究。使用 Viking 语音量表（VSS）对语音严重程度进行分级，VSS 是一个四级分类评定量表，分别在 4、6、8 和 10 岁（4 岁年龄：平均=52 个月[3 个标准差]；6 岁年龄：平均=75 个月[2 个标准差]；8 岁年龄：平均=100 个月[4 个标准差]；10 岁年龄：平均=125 个月[5 个标准差]）进行评估。我们使用贝叶斯混合效应有序逻辑回归模型来模拟（1）言语严重程度随时间的变化程度，以及（2）各年龄组和分类评级组水平的变化模式。
VSS 评分在 4 至 10 岁之间下降（言语严重程度变轻）。在 4 岁时被首次分类为 VSS 水平 I、II 或 III 的儿童，在 10 岁时保持或改善到 VSS 水平 I 的可能性较高。在 4 岁时被首次分类为 VSS 水平 IV 的儿童，在 10 岁时保持在 VSS 水平 IV 的可能性较高。
早期言语表现高度预测儿童后期的言语能力。4 岁时存在任何程度言语障碍的儿童都应接受言语治疗。那些言语障碍程度较重的儿童应尽快引入辅助和替代沟通。
在早期具有 Viking 语音量表（VSS）评分低于 IV 级的儿童，其言语改善的预后良好。在早期 VSS 评分达到 IV 级的儿童，随着时间的推移，他们很可能仍保持在 VSS 四级。在 4 至 10 岁之间，儿童的 VSS 评分没有恶化。
