Karolinska Institutet, CLINTEC, Division of Speech-language pathology, Stockholm, Sweden; Autismcenter små barn (the Autism center for small children), Rosenlund Hospital, Tideliusgatan 12, Stockholm, 11869 Sweden.
Karolinska Institutet, CLINTEC, Division of Speech-language pathology, Stockholm, Sweden; Logopedbyrån Dynamica, Hammarby Allé 91, Stockholm, 120 63 Sweden.
J Commun Disord. 2022 Sep-Oct;99:106250. doi: 10.1016/j.jcomdis.2022.106250. Epub 2022 Aug 5.
In the early 20 century a link between infection and speech disfluency was discussed. Recent reports indicate that PANS (Pediatric Acute-onset Neuropsychiatric Syndrome), and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) may be associated with a high incidence of speech disfluency. The present study specifically investigates disfluency and other speech symptoms following onset of PANS and PANDAS. Prevalence of previously reported speech related symptoms vocal tics, selective mutism and "baby talk" is included. The present study also aims to explore possible changes in articulation and intelligibility, distress due to speech impairment, and effect of PANS or PANDAS medication on speech symptoms.
A questionnaire was distributed to caregivers of children with diagnosed or suspected PANS or PANDAS. In total 55 individuals in Sweden were included.
Onset of speech disfluency in association with PANS or PANDAS was reported by 54.5% of the caregivers. Most frequent disfluency symptoms were higher speech rate, superfluous verbal behavior, verbal blocks and associated motor symptoms. Previous findings of vocal tics, baby talk and mutistic behavior are supported. The present study also exposed previously unreported symptoms such as impaired articulation, reduced intelligibility, reduced speech production and language impairment. Eleven caregivers reported that medical treatment had a positive effect on speech fluency.
A connection between PANS and PANDAS and speech disfluency is supported, and a possible link between infection and disfluency is reactualized. Reported disfluency shares several characteristics with stuttering and cluttering, but the caregivers did not consistently associate it with stuttering. The present study also sheds new light on how symptoms of "baby talk", selective mutism and vocal tics might be viewed in this population. In all, the results indicate a substantial impact on speech fluency, speech and language in affected children, reducing quality of life.
在 20 世纪早期，人们就讨论过感染与言语不流畅之间的联系。最近的报告表明，PANS（儿童急性神经精神发作综合征）和 PANDAS（与链球菌感染相关的儿童自身免疫性神经精神障碍）可能与言语不流畅的高发率有关。本研究专门调查了 PANS 和 PANDAS 发病后的言语不流畅和其他言语症状。包括之前报道的与言语相关的症状，如发声抽动、选择性缄默和“儿语”。本研究还旨在探索发音和可理解度的可能变化、言语障碍引起的痛苦，以及 PANS 或 PANDAS 药物治疗对言语症状的影响。
向瑞典确诊或疑似 PANS 或 PANDAS 儿童的照顾者分发了一份问卷。共有 55 人参与了本研究。
54.5%的照顾者报告称，儿童的言语不流畅与 PANS 或 PANDAS 同时出现。最常见的言语不流畅症状包括言语速度加快、多余的言语行为、言语阻塞和相关的运动症状。之前关于发声抽动、儿语和缄默行为的发现得到了支持。本研究还揭示了以前未报告的症状，如发音障碍、言语清晰度降低、言语生成减少和语言障碍。11 位照顾者报告称，药物治疗对言语流畅度有积极影响。
本研究支持 PANS 和 PANDAS 与言语不流畅之间的联系，并重新引发了感染与不流畅之间的联系。报告的不流畅与口吃和口吃障碍有一些共同特征，但照顾者并不总是将其与口吃联系起来。本研究还揭示了在这一人群中，“儿语”、选择性缄默和发声抽动的症状可能会如何表现。总之，研究结果表明，受影响儿童的言语流畅性、言语和语言受到了重大影响，降低了生活质量。
