Waisman Center, University of Wisconsin-Madison.
Ebling Library for the Health Sciences, University of Wisconsin-Madison.
J Speech Lang Hear Res. 2023 Nov 9;66(11):4432-4460. doi: 10.1044/2023_JSLHR-23-00336. Epub 2023 Oct 18.
The purpose of this scoping review was to (a) summarize methodological characteristics of studies examining vocal characteristics of infants at high risk for neurological speech motor involvement and (b) report the state of the high-quality evidence on vocal characteristic trends of infants diagnosed or at high risk for cerebral palsy (CP).
The PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) extension for scoping reviews was followed for reporting our review. Studies measured prelinguistic vocal characteristics of infants under 24 months with birth risk or genetic conditions known to commonly present with speech motor involvement. Fifty-five studies met criteria for Part 1. Eleven studies met criteria for synthesis in Part 2.
A smaller percentage of studies examined infants with or at risk for CP compared to studies examining genetic conditions such as Down syndrome. The median year of publication was 1999, with a median sample size of nine participants. Most studies were conducted in laboratory settings and used human coding of vocalizations produced during caregiver-child interactions. Substantial methodological differences were noted across all studies. A small number of high-quality studies of infants with or at risk for CP revealed high rates of marginal babbling, low rates of canonical babbling, and limited consonant diversity under 24 months. Mixed findings were noted across studies of general birth risk factors.
There is limited evidence available to support the early detection of speech motor involvement. Large methodological differences currently impact the ability to synthesize findings across studies. There is a critical need to conduct longitudinal research with larger sample sizes and advanced, modern technologies to detect vocal precursors of speech impairment to support the accurate diagnosis and prognosis of speech development in infants with CP and other clinical populations.
本范围综述的目的是:(a) 总结研究婴儿神经言语运动障碍高风险的嗓音特征的方法学特点;(b) 报告关于脑瘫(CP)诊断或高风险婴儿嗓音特征趋势的高质量证据现状。
我们的综述报告遵循了 PRISMA(系统评价和荟萃分析的首选报告项目)扩展用于范围综述的报告标准。研究测量了 24 个月以下具有已知与言语运动障碍相关的出生风险或遗传条件的婴儿的前言语嗓音特征。55 项研究符合第一部分的标准。11 项研究符合第二部分综合的标准。
与研究遗传条件(如唐氏综合征)相比,研究 CP 或具有 CP 风险的婴儿的研究比例较小。发表的中位数年份为 1999 年,中位数样本量为 9 名参与者。大多数研究是在实验室环境中进行的,使用人类对在照顾者-儿童互动中产生的嗓音进行编码。所有研究都注意到了方法学上的显著差异。少数高质量研究显示,CP 或具有 CP 风险的婴儿在 24 个月以下出现边缘性咿呀学语的比例较高,出现典型性咿呀学语的比例较低,辅音多样性有限。一般出生风险因素的研究结果不一。
目前,支持言语运动障碍早期检测的证据有限。目前,方法学上的巨大差异影响了对研究结果进行综合的能力。迫切需要开展具有更大样本量和先进现代技术的纵向研究,以检测言语障碍的嗓音前兆,从而为 CP 和其他临床人群的婴儿言语发育的准确诊断和预后提供支持。