The impact of nonverbal ability on prevalence and clinical presentation of language disorder: evidence from a population study
The impact of nonverbal ability on prevalence and clinical presentation of language disorder: evidence from a population study
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DOI：
10.1111/jcpp.12573
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发表时间：
2016-11-01
影响因子：
7.6
通讯作者：
Pickles, Andrew
中科院分区：
文献类型：
--
作者：
Norbury, Courtenay Frazier;Gooch, Debbie;Pickles, Andrew
背景传统上，诊断特定的语言障碍需要非语言智商在正常范围内，这往往导致NVIQ较低的儿童获得临床服务的机会受到限制。DSM-5语言障碍标准的变更删除了NVIQ要求。本研究旨在描述英国首项入学语言障碍人口研究中不同NVIQ标准对语言障碍患病率、临床表现和功能影响的影响。方法使用基于人口的调查设计和样本加权程序来估计人口患病率。我们调查了英格兰萨里郡的国家维护的接待教室（n=161或符合条件的学校的61%）。在12，398名儿童（4- 5岁）中，有7，267名（59%）接受了筛查。一个分层的子样本（n=529）接受全面评估的语言，NVIQ，社会，情绪和行为问题，和academic.ResultsThe语言障碍的总人口患病率估计为9.92%（95%CI 7.38，13.20）。未知原因的语言障碍的患病率估计为7.58%（95% CI 5.33，10.66），而与智力残疾和/或现有医学诊断相关的语言障碍的患病率为2.34%（95% CI 1.40，3.91）。与同龄人相比，语言障碍儿童的社交、情绪和行为问题症状升高，F（1，466）=7.88，p= 0.05，88%的儿童没有取得预期的学业进步。在语言缺陷、社会、情绪和行为问题或教育程度的严重程度方面，平均NVIQ得分和低平均NVIQ得分的人之间没有差异。相比之下，与已知的医疗诊断和/或智力残疾的语言障碍的儿童表现出更严重的赤字在多个measurements.ConclusionsAt学校入学，大约有两个孩子在每个班的30名学生会遇到语言障碍严重到足以阻碍学业进步。获得专科临床服务不应取决于NVIQ。
BackgroundDiagnosis of specific' language impairment traditionally required nonverbal IQ to be within normal limits, often resulting in restricted access to clinical services for children with lower NVIQ. Changes to DSM-5 criteria for language disorder removed this NVIQ requirement. This study sought to delineate the impact of varying NVIQ criteria on prevalence, clinical presentation and functional impact of language disorder in the first UK population study of language impairment at school entry.MethodsA population-based survey design with sample weighting procedures was used to estimate population prevalence. We surveyed state-maintained reception classrooms (n=161 or 61% of eligible schools) in Surrey, England. From a total population of 12,398 children (ages 4-5years), 7,267 (59%) were screened. A stratified subsample (n=529) received comprehensive assessment of language, NVIQ, social, emotional and behavioural problems, and academic attainment.ResultsThe total population prevalence estimate of language disorder was 9.92% (95% CI 7.38, 13.20). The prevalence of language disorder of unknown origin was estimated to be 7.58% (95% CI 5.33, 10.66), while the prevalence of language impairment associated with intellectual disability and/or existing medical diagnosis was 2.34% (95% CI 1.40, 3.91). Children with language disorder displayed elevated symptoms of social, emotional and behavioural problems relative to peers, F(1, 466)=7.88, p=.05, and 88% did not make expected academic progress. There were no differences between those with average and low-average NVIQ scores in severity of language deficit, social, emotional and behavioural problems, or educational attainment. In contrast, children with language impairments associated with known medical diagnosis and/or intellectual disability displayed more severe deficits on multiple measures.ConclusionsAt school entry, approximately two children in every class of 30 pupils will experience language disorder severeenough to hinder academic progress. Access to specialist clinical services should not depend on NVIQ.