Boys Town National Research Hospital, Omaha, NE.
The University of Manchester, United Kingdom.
Lang Speech Hear Serv Sch. 2023 Jul 5;54(3):927-951. doi: 10.1044/2023_LSHSS-22-00070. Epub 2023 May 2.
The aim of this study was to situate developmental language disorder (DLD) within the impairment and disability framework of the International Classification of Functioning, Disability, and Health (ICF); describe the functional strengths and weaknesses of a cohort of first-grade children with DLD and their peers; and explore the ways that language-related disabilities relate to language impairment, developmental risk, and receipt of language services.
We queried the caregivers of 35 children with DLD and 44 peers with typical language development about their children's language-related functions, developmental risks, and language services using mixed quantitative and qualitative methods.
The children with DLD presented with weaknesses in domains that are highly dependent upon language skill, including communication, community function, interpersonal relationships, and academics. They presented with strengths in domestic and personal aspects of daily living, play and coping aspects of socialization, and gross motor function. Caregivers of children with DLD expressed pride in their children's agentive and prosocial qualities. Consistent with the ICF, what distinguished children with DLD who had functional weaknesses and disabilities from those who had healthy function was not the severity of language impairment as measured by decontextualized tests of language skill, but the presence of cumulative developmental risks. Compared to those with healthy function, a larger portion of children with weaknesses and disabilities were receiving language services; however, two girls who had disabilities despite mild levels of impairment were without services.
Children with DLD present with predictable strengths and weaknesses in everyday language-related functioning. For some children, the weaknesses are mild, but for others, they limit function to a greater extent and should be considered disabilities. The severity of language impairment is not a strong indicator of language-related function and, therefore, is not a good metric for determining service qualification.
本研究旨在将发育性语言障碍（DLD）置于国际功能、残疾和健康分类（ICF）的损伤和残疾框架内；描述一组一年级 DLD 儿童及其同龄人的功能优势和劣势；并探讨与语言相关的残疾与语言障碍、发育风险和语言服务的关系。
我们使用混合定量和定性方法，向 35 名 DLD 儿童和 44 名语言发育正常的儿童的照顾者询问他们孩子的语言相关功能、发育风险和语言服务情况。
DLD 儿童在高度依赖语言技能的领域存在劣势，包括沟通、社区功能、人际关系和学业。他们在日常生活中的家庭和个人方面、社交中的游戏和应对方面以及大运动功能方面表现出优势。DLD 儿童的照顾者对他们孩子的主动性和亲社会品质感到自豪。与 ICF 一致的是，区分具有功能劣势和残疾的 DLD 儿童与具有健康功能的儿童的不是语言障碍的严重程度，而是累积发育风险的存在。与具有健康功能的儿童相比，更多具有劣势和残疾的儿童正在接受语言服务；然而，尽管有轻度损伤，但仍有两名残疾女孩没有接受服务。
DLD 儿童在日常语言相关功能方面表现出可预测的优势和劣势。对于一些儿童来说，劣势是轻微的，但对于其他儿童来说，它们在更大程度上限制了功能，应该被视为残疾。语言障碍的严重程度不是语言相关功能的有力指标，因此不是确定服务资格的良好指标。
