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神经发育障碍儿童在诊断内部和诊断之间形态词汇发展的差异。

Variation in morpho-lexical development within and between diagnoses in children with neurodevelopmental disorders.

作者信息

Foster-Cohen Susan, Macrae Toby, Newbury Jayne

机构信息

Department of Linguistics, University of Canterbury, Christchurch, New Zealand.

New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand.

出版信息

Front Psychol. 2023 Jan 12;13:968408. doi: 10.3389/fpsyg.2022.968408. eCollection 2022.

Abstract

While primary diagnosis is only one aspect of the presentation of a child with neurodevelopmental delay/disorder, the degree to which early expressive language reflects diagnostic divisions must be understood in order to reduce the risk of obscuring clinically important differences and similarities across diagnoses. We present original data from the New Zealand MacArthur-Bates Communicative Development Inventory (NZCDI) from 88 English-speaking children aged 2;6 to 5;6 years receiving multidisciplinary intervention within a single family-centered program. The children had one of six pediatrician-assigned genetic or behaviorally determined diagnoses: Down syndrome (DS); motor disorders (cerebral palsy and developmental coordination disorder); global development delay; disorders of relating and communicating (R&C); other genetically defined diagnoses; or language delay due to premature (PREM) birth. Morphological and lexical development were compared within and across diagnostic groups, using both data visualization and mixed-effects modeling. Groups varied in the amount of variation within and between them, but only prematurity reached significance, in interaction with age, as a predictor of morpho-lexical scores. Further analysis of longitudinal data available from a subset of the sample ( = 62) suggested that individual trajectories of vocabulary growth could not be reliably predicted by diagnosis. Moreover, the distribution of word types (nouns, predicates, etc.) only distinguished PREM children with language delay from those with DS and those in the R&C group. There were strong similarities in early morpho-lexical development across these clinical populations, with some differences. These findings align with research and clinical approaches which accommodate individual variation within diagnosis, and broad similarities across diagnostic groups.

摘要

虽然初步诊断只是患有神经发育迟缓/障碍儿童临床表现的一个方面,但必须了解早期表达性语言反映诊断分类的程度,以降低模糊不同诊断之间临床重要差异和相似性的风险。我们展示了来自新西兰麦克阿瑟-贝茨交流发展量表(NZCDI)的原始数据,这些数据来自88名年龄在2;6至5;6岁之间、在一个以家庭为中心的单一项目中接受多学科干预的英语儿童。这些儿童有六种由儿科医生指定的基因或行为诊断之一:唐氏综合征(DS);运动障碍(脑瘫和发育协调障碍);全面发育迟缓;社交和交流障碍(R&C);其他基因定义的诊断;或早产(PREM)导致的语言迟缓。使用数据可视化和混合效应模型,对诊断组内和组间的形态和词汇发展进行了比较。各诊断组内部和之间的变异量各不相同,但只有早产与年龄相互作用时,作为形态-词汇得分的预测指标具有统计学意义。对样本子集(n = 62)可得的纵向数据进行的进一步分析表明,词汇增长的个体轨迹无法通过诊断可靠预测。此外,词类(名词、谓语等)的分布仅区分了有语言迟缓的早产儿童与唐氏综合征儿童以及R&C组儿童。这些临床群体在早期形态-词汇发展方面有很强的相似性,也存在一些差异。这些发现与适应诊断内个体差异以及诊断组间广泛相似性的研究和临床方法一致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ef3/9878158/eb453d909171/fpsyg-13-968408-g001.jpg

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