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发育性语言障碍的个体和累积风险因素:病例对照研究。

Individual and cumulative risk factors in developmental language disorder: A case-control study.

机构信息

Department of Psychology, 5622University of Montreal, Montreal, QC, Canada.

CIUSSS Nord-de-l'Ile-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montreal, QC, Canada.

出版信息

Clin Child Psychol Psychiatry. 2023 Jan;28(1):398-414. doi: 10.1177/13591045221113389. Epub 2022 Jul 7.

Abstract

Many mental disorders (MD) share common etiology, fuelling debates about the specificity of clinical categories and whether the presence of specific risk factors (RF) can distinguish among them. The study of developmental language disorder (DLD), more specifically, has been further hindered by a lack of consensus regarding its definition. These limitations increase the risk of under-detection and lifelong consequences for affected children. This paper aims (1) to document which individual RF allow differentiating DLD from other MD and (2) to compare the cumulative RF between children with DLD versus other MD. This case-control design study used medical records of a psychiatric sample of 795 preschoolers (mean age 4:11, 75% boys). A logistic regression measured the predictive value of potential RF on DLD. Later first sentences, maternal immigration and family history of language delay were identified as significant in explaining 30% of the variance for DLD diagnosis. An ANCOVA revealed that children with DLD were exposed to a significantly higher number of RF than were children with other MD. Public health policies informed with the knowledge of specific RF associated with DLD, and their cumulative impact, could improve early detection and reduce the cascade of negative consequences associated with DLD.

摘要

许多精神障碍(MD)具有共同的病因,这引发了关于临床类别特异性的争论,以及特定风险因素(RF)的存在是否可以将它们区分开来。更具体地说,发育性语言障碍(DLD)的研究由于其定义缺乏共识而进一步受阻。这些限制增加了受影响儿童漏诊和终生后果的风险。本文旨在(1)记录哪些个体 RF 可将 DLD 与其他 MD 区分开来,以及(2)比较 DLD 儿童与其他 MD 儿童之间的累积 RF。这项病例对照设计研究使用了一个精神科样本的 795 名学龄前儿童(平均年龄 4:11,75%为男孩)的医疗记录。逻辑回归测量了潜在 RF 对 DLD 的预测价值。后来发现,早期句子、母亲移民和语言延迟家族史在解释 DLD 诊断的 30%方差方面具有重要意义。ANCOVA 显示,与其他 MD 儿童相比,DLD 儿童接触到的 RF 数量明显更多。具有特定与 DLD 相关的 RF 及其累积影响的公共卫生政策,可以改善早期发现并减少与 DLD 相关的负面后果的连锁反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d18c/9893307/ca8bdf70f97e/10.1177_13591045221113389-fig1.jpg

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