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单侧脑瘫患者的吞咽和运动言语技能:一项初步横断面研究的新发现。

Swallowing and Motor Speech Skills in Unilateral Cerebral Palsy: Novel Findings From a Preliminary Cross-Sectional Study.

机构信息

Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN.

Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN.

出版信息

J Speech Lang Hear Res. 2022 Sep 12;65(9):3300-3315. doi: 10.1044/2022_JSLHR-22-00091. Epub 2022 Aug 11.

Abstract

PURPOSE

Our purpose was to start examining clinical swallowing and motor speech skills of school-age children with unilateral cerebral palsy (UCP) compared to typically developing children (TDC), how these skills relate to each other, and whether they are predicted by clinical/demographic data (age, birth history, lesion type, etc.).

METHOD

Seventeen children with UCP and 17 TDC (7-12 years old) participated in this cross-sectional study. Feeding/swallowing skills were evaluated using the Dysphagia Disorder Survey (DDS) and a normalized measure of mealtime efficiency (normalized mealtime duration, i.e., nMD). Motor speech was assessed via speech intelligibility and speech rate measures using the Test of Children's Speech Plus. Analyses included nonparametric bootstrapping, correlation analysis, and multiple regression.

RESULTS

Children with UCP exhibited more severe (higher) DDS scores ( = .0096, Part 1; = .0132, Part 2) and reduced speech rate than TDC ( = .0120). Furthermore, in children with UCP, total DDS scores were moderately negatively correlated with speech intelligibility (words: = -.6162, = .0086; sentences: = -.60792, = .0096). Expressive language scores were the only significant predictor of feeding and swallowing performance, and receptive language scores were the only significant predictor of motor speech skills.

CONCLUSIONS

Swallowing and motor speech skills can be affected in school-age children with UCP, with wide variability of performance also noted. Preliminary cross-system interactions between swallowing, speech, and language are observed and might support the complex relationships between these domains. Further understanding these relationships in this population could have prognostic and/or therapeutic value and warrants further study.

摘要

目的

本研究旨在比较单侧脑瘫(UCP)儿童与正常发育儿童(TDC)的临床吞咽和运动言语技能,以及这些技能之间的相关性,同时还研究了这些技能是否可由临床/人口统计学数据(年龄、出生史、病变类型等)预测。

方法

本横断面研究共纳入 17 名 UCP 儿童和 17 名 TDC(7-12 岁)。使用吞咽障碍问卷(DDS)和标准化餐时效率测量值(标准化用餐时间,即 nMD)评估喂养/吞咽技能。通过言语可懂度和言语速率测试(使用儿童言语测试加版)评估运动言语。分析包括非参数引导、相关分析和多元回归。

结果

UCP 儿童的 DDS 评分(第 1 部分为.0096,第 2 部分为.0132)更高,言语速率更慢(均 < 0.012),且 DDS 总评分与言语可懂度呈中度负相关(单词: = -.6162, =.0086;句子: = -.60792, =.0096)。在 UCP 儿童中,仅表达性语言评分是喂养和吞咽表现的唯一显著预测因素,而接受性语言评分是运动言语技能的唯一显著预测因素。

结论

UCP 儿童的吞咽和运动言语技能可能受到影响,且表现存在较大差异。观察到吞咽、言语和语言之间的初步交叉系统相互作用,这可能支持这些领域之间的复杂关系。进一步了解该人群中这些关系可能具有预后和/或治疗价值,值得进一步研究。

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本文引用的文献

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Living Conditions and Social Outcomes in Adults With Cerebral Palsy.脑瘫成人的生活状况与社会结局
Front Neurol. 2021 Oct 21;12:749389. doi: 10.3389/fneur.2021.749389. eCollection 2021.
9
Characteristics of Speech Rate in Children With Cerebral Palsy: A Longitudinal Study.脑瘫患儿语速特征:一项纵向研究
J Speech Lang Hear Res. 2018 Oct 26;61(10):2502-2515. doi: 10.1044/2018_JSLHR-S-17-0003.

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