Developmental dyslexia: predicting individual risk.
Developmental dyslexia: predicting individual risk.
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DOI：
10.1111/jcpp.12412
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Snowling MJ
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文献类型：
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作者：
Thompson PA;Hulme C;Nash HM;Gooch D;Hayiou-Thomas E;Snowling MJ
阅读障碍的因果理论认为它是一种遗传性障碍，是多种危险因素共同作用的结果。然而，早期筛查阅读障碍是否可行尚不清楚。该研究跟踪了从学龄前到小学早期的阅读障碍高危儿童，从3岁零6个月（T1）开始，大约每年一次评估他们的认知、语言和执行运动技能。儿童被招募到三个组：儿童在家庭风险的阅读障碍，儿童与关注有关的讲话，和语言发展在3; 06年和控制被认为是典型的发展。在8岁时，儿童被归类为“阅读障碍”或没有。Logistic回归模型被用来预测阅读障碍的个体风险，并调查风险因素如何积累来预测识字率低的结果。家庭风险状况是一个更强的预测阅读障碍在8岁比低语言在学前。在学龄前的其他预测因素包括字母知识，语音意识，快速自动化命名，和执行技能。在入学时，语言技能成为重要的预测因素，运动技能增加了一个小但显着的预测概率增加。我们目前的分类精度使用不同的概率截断逻辑回归模型和ROC曲线，以突出在个人水平上的风险因素的积累。阅读障碍是多种风险因素的结果，入学时有语言困难的儿童风险很高。阅读障碍家族史是学龄前识字结果的预测因子。然而，筛查没有达到可接受的临床水平，直到接近入学时，字母知识，语音意识，RAN，而不是家庭风险，一起提供良好的灵敏度和特异性作为一个筛选电池。
Causal theories of dyslexia suggest that it is a heritable disorder, which is the outcome of multiple risk factors. However, whether early screening for dyslexia is viable is not yet known. The study followed children at high risk of dyslexia from preschool through the early primary years assessing them from age 3 years and 6 months (T1) at approximately annual intervals on tasks tapping cognitive, language, and executive-motor skills. The children were recruited to three groups: children at family risk of dyslexia, children with concerns regarding speech, and language development at 3;06 years and controls considered to be typically developing. At 8 years, children were classified as ‘dyslexic’ or not. Logistic regression models were used to predict the individual risk of dyslexia and to investigate how risk factors accumulate to predict poor literacy outcomes. Family-risk status was a stronger predictor of dyslexia at 8 years than low language in preschool. Additional predictors in the preschool years include letter knowledge, phonological awareness, rapid automatized naming, and executive skills. At the time of school entry, language skills become significant predictors, and motor skills add a small but significant increase to the prediction probability. We present classification accuracy using different probability cutoffs for logistic regression models and ROC curves to highlight the accumulation of risk factors at the individual level. Dyslexia is the outcome of multiple risk factors and children with language difficulties at school entry are at high risk. Family history of dyslexia is a predictor of literacy outcome from the preschool years. However, screening does not reach an acceptable clinical level until close to school entry when letter knowledge, phonological awareness, and RAN, rather than family risk, together provide good sensitivity and specificity as a screening battery.