Jocelyn L J, Penko M A, Rode H L
Department of Pediatrics, University of Manitoba, Winnipeg, Canada.
Pediatrics. 1996 Apr;97(4):529-34.
To compare a group of children with cleft lip and palate (CLP) with a group of noncleft, matched control children on measures of cognitive development, speech and language abilities, and audiologic status at 12 and 24 months of age.
Using a prospective, longitudinal study design, a group of 16 children with CLP and a group of 16 noncleft control children matched for race, sex, birth order, and socioeconomic status were compared using the Bayley Scales of Infant Development, the Receptive-Expressive Emergent Language Scale, the Sequenced Inventory of Communication Development-Revised (SICD-R), the Preschool Language Scale-Revised (PLS-R), the mean length of utterance, audiometric evaluation, and impedance screening at 12 and 24 months of age. All were free of other congenital abnormalities or known causes of neurodevelopmental dysfunction.
Children with CLP had lower mental developmental index (MDI) and psychomotor developmental index scores than control children. They had lower language comprehension scores on the SICD-R and PLS-R and lower expressive language scores on the Receptive-Expressive Emergent Language Scale, SICD-R, and PLS-R than control children. The group with CLP had a significantly higher number of children with abnormal tympanogram results or ventilation tubes at 12 and 24 months. There was a positive correlation between language test scores at 24 months and MDI scores at 24 months (r = .73 to .85). Seventy-five percent of children with CLP who had hearing loss at 12 months had MDI scores more than 1 SD below the mean versus 0% of children with normal hearing. There was a relationship between hearing status at 12 months and comprehension and expressive language scores at 24 months.
Children with CLP had significantly lower scores on tests of cognition, comprehension, and expressive language abilities than matched control children at 12 and 24 months of age. They also had a higher frequency of middle-ear disease and ventilation tubes than control children, although no significant difference in hearing sensitivity was found between groups. Early identification and treatment of these delays may reduce subsequent verbal deficits, hearing loss, and academic difficulties.
比较一组唇腭裂（CLP）儿童与一组非唇腭裂的匹配对照儿童在12个月和24个月大时的认知发展、言语和语言能力以及听力状况指标。
采用前瞻性纵向研究设计，使用贝利婴儿发展量表、接受表达性语言发展量表、修订版沟通发展顺序量表（SICD-R）、修订版学前语言量表（PLS-R）、平均语句长度、听力评估以及12个月和24个月大时的阻抗筛查，对16名唇腭裂儿童和16名在种族、性别、出生顺序和社会经济地位方面相匹配的非唇腭裂对照儿童进行比较。所有儿童均无其他先天性异常或已知的神经发育功能障碍原因。
唇腭裂儿童的心理发展指数（MDI）和精神运动发展指数得分低于对照儿童。他们在SICD-R和PLS-R上的语言理解得分较低，在接受表达性语言发展量表、SICD-R和PLS-R上的表达性语言得分低于对照儿童。唇腭裂组在12个月和24个月大时，鼓膜图结果异常或有通气管的儿童数量显著更多。24个月时的语言测试得分与24个月时的MDI得分之间存在正相关（r = 0.73至0.85）。12个月时有听力损失的唇腭裂儿童中，75%的MDI得分比平均水平低1个标准差以上，而听力正常的儿童这一比例为0%。12个月时的听力状况与24个月时的理解和表达性语言得分之间存在关联。
在12个月和24个月大时，唇腭裂儿童在认知、理解和表达性语言能力测试中的得分显著低于匹配的对照儿童。他们中耳疾病和通气管的发生率也高于对照儿童，尽管两组之间在听力敏感度方面未发现显著差异。对这些发育迟缓进行早期识别和治疗可能会减少随后的语言缺陷听力损失和学业困难。
