Iuzzini-Seigel Jenya, Delaney Amy L, Kent Ray D
Department of Speech Pathology and Audiology, Marquette University, Milwaukee, WI.
Waisman Center, University of Wisconsin-Madison.
Perspect ASHA Spec Interest Groups. 2022 Feb;7(1):45-55. doi: 10.1044/2021_persp-20-00283. Epub 2022 Jan 27.
This study sought to determine if children with childhood apraxia of speech (CAS) plus another major diagnosis (CAS+) are equivalent in communication and motor profiles to those with a primary diagnosis of CAS and no indication or report of any other diagnosis (CAS-Primary).
This retrospective case-control study included a chart review of 143 children who were suspected of having CAS at Children's Hospital-Wisconsin between 1998 and 2004. Participants were between 30 and 127 months old and included 107 males. Participants were assigned to the suspected CAS-Primary group ( = 114) if they had characteristics of CAS but no other major diagnosis (e.g., galactosemia) and to the CAS+ group ( = 29) if a comorbid diagnosis was present. Groups were compared across demographic, communication, and motor characteristics.
Children with CAS+ evidenced more severe motor profiles than those with CAS-Primary, χ = (1, = 122) = 4.952, = .026, and a small-to-medium effect size (Φ = .201). On average, communication profiles also tended to be more severe among those with CAS+ wherein receptive language was poorer and phonemic inventories were smaller than those with CAS-Primary.
These retrospective data suggest that comorbid diagnosis may play an important role in communication and motor development in children with suspected CAS. These exploratory findings should motivate future prospective studies that consider the role of concomitant diagnoses in symptom profile and response to treatment in children with CAS.
本研究旨在确定患有言语失用症(CAS)并伴有另一主要诊断(CAS+)的儿童在沟通和运动方面的特征是否与仅以CAS为主要诊断且无任何其他诊断迹象或报告的儿童(原发性CAS)相当。
这项回顾性病例对照研究包括对1998年至2004年间在威斯康星儿童医院疑似患有CAS的143名儿童的病历进行审查。参与者年龄在30至127个月之间,其中包括107名男性。如果参与者具有CAS的特征但无其他主要诊断(如半乳糖血症),则被分配到疑似原发性CAS组(n = 114);如果存在共病诊断,则被分配到CAS+组(n = 29)。对两组在人口统计学、沟通和运动特征方面进行比较。
CAS+组儿童的运动特征比原发性CAS组儿童更为严重,χ²(1, n = 122) = 4.952,p = .026,效应量为小到中等(Φ = .201)。平均而言,CAS+组儿童的沟通特征也往往更为严重,其接受性语言较差,音素库存比原发性CAS组儿童更小。
这些回顾性数据表明,共病诊断可能在疑似CAS儿童的沟通和运动发育中起重要作用。这些探索性发现应促使未来开展前瞻性研究,考虑共病诊断在CAS儿童症状特征和治疗反应中的作用。