Conrad Amy L, Crilly Bellucci Claudia, Heppner Celia E, Albert Meredith, Crerand Canice E, Woodard Suzanne, Sheikh Farah, Kapp-Simon Kathleen A
The Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Cleft-Craniofacial Clinic, Department of Psychology, Shriners Hospitals for Children-Chicago, Chicago, IL, USA.
Cleft Palate Craniofac J. 2024 Jan;61(1):68-78. doi: 10.1177/10556656221116008. Epub 2022 Jul 26.
This study evaluated the effectiveness of academic screening measures in relation to parent-reported diagnoses. Multicenter, retrospective cohort study including structured interviews, questionnaires, and chart reviews. Six North American cleft centers. Children (n = 391) with cleft lip and/or palate, ages 8 to 10 years of age (192 male) and their guardians were recruited during regular clinic visits. Parent and child ratings on the Pediatric Quality of Life Inventory (PedsQL) School Scale, child report on CleftQ School Scale, parent report on the Adaptive Behavior Assessment System-Third Edition Functional Academics (ABAS-FA) Scale and Child Behavior Checklist (CBCL) School Competency Scale, parent interview, and medical chart review. Risk for concerns ranged from 12% to 41%, with higher risk reflected on the CBCL-SC compared to other measures. Males with cleft palate were consistently at the highest risk. Only 9% of the sample had a parent-reported diagnosis of a learning or language disability. Ratings from the ABAS-FA and CBCL-SC had the highest utility in identifying those with language and/or learning concerns. As cleft teams work to develop standardized batteries for screening and monitoring of patients, it is important to evaluate the effectiveness of measures in identifying those at highest risk. When screening for language and learning disorders, questions related to potential academic struggles, such as increased school effort or increased school distress, are most useful. Referrals for follow-up evaluation are recommended for those identified at high risk.
本研究评估了学术筛查措施与家长报告的诊断之间的有效性。多中心回顾性队列研究，包括结构化访谈、问卷调查和病历审查。六个北美腭裂中心。招募了年龄在8至10岁（192名男性）的唇裂和/或腭裂患儿（n = 391）及其监护人，在定期门诊就诊期间进行研究。家长和孩子对儿童生活质量量表（PedsQL）学校版的评分、孩子对腭裂问卷（CleftQ）学校版的报告、家长对适应性行为评估系统第三版功能学术（ABAS-FA）量表和儿童行为清单（CBCL）学校能力量表的报告、家长访谈以及病历审查。存在问题的风险范围为12%至41%，与其他测量方法相比，CBCL-SC反映出的风险更高。腭裂男性始终处于最高风险。样本中只有9%的家长报告孩子有学习或语言障碍的诊断。ABAS-FA和CBCL-SC的评分在识别有语言和/或学习问题的儿童方面效用最高。由于腭裂治疗团队致力于开发标准化的筛查和监测患者的成套工具，评估这些措施在识别高风险患者方面的有效性非常重要。在筛查语言和学习障碍时，与潜在学业困难相关的问题，如学习努力增加或学校困扰增加，最为有用。建议对那些被确定为高风险的儿童进行后续评估转诊。
