发育性口吃儿童神经心理发育特征分析

Characteristics of neuropsychological development in children with developmental stuttering

目的探讨发育性口吃儿童的神经心理发育特征及各能区发育的差异。方法选取2016年1月至2018年12月首都儿科研究所附属儿童医院保健科语言-言语门诊诊断为发育性口吃的儿童168例及同期于保健科体检的健康儿童411例进行《儿童神经心理行为检查量表2016版》(儿心量表2016版)检查,比较两组儿童的总发育商、大运动、精细动作、适应能力、语言和社会行为能力的发育水平。结果口吃组总发育商均值低于对照组[(89.59±11.22)分比(91.21±9.00)分],但差异无统计学意义(P=0.096),其中口吃组男童总发育商的均值低于对照组男童[(87.31±11.06)分比(90.26±8.44)分,P<0.05]。各能区发育商比较,口吃组精细动作、适应能力均值低于对照组[(79.88±15.20)分比(84.35±13.55)分,(89.20±15.41)分比(94.38±13.17)分,P<0.01],其中口吃组男童精细动作、适应能力均值明显低于对照组男童[(77.22±14.96)分比(81.79±12.22)分,(86.77±14.84)分比(93.40±12.81)分,P<0.01];口吃组女童大运动均值高于对照组女童[(96.15±12.30)分比(90.19±13.05)分,P<0.01],精细动作均值低于对照组女童[(84.44±14.62)分比(90.25±14.64)分,P<0.05]。口吃组内比较,男童总发育商、大运动、精细动作、适应能力及社会行为发育商均值低于女童[(87.31±11.06)分比(93.48±10.48)分,(90.33±12.84)分比(96.15±12.30)分,(77.22±14.96)分比(84.44±14.62)分,(86.77±14.84)分比(93.34±15.62)分,(91.25±13.92)分比(96.85±16.69)分,P<0.05]。结论儿童发育性口吃以男童多见,发育性口吃儿童的各能区发育不平衡,精细动作、适应能力发育不成熟,男童为著。因此,对发育性口吃儿童进行全面神经心理发育评估是必要的,尤其是男童的精细动作、适应能力的发育需要引起重视,应针对其发育特点进行个体化和综合性干预指导,促进其康复及全面发展。

Objective To summarize the neuropsychological development characteristics of children with developmental stuttering and the differences between different dimensions.Methods A total of 168 cases of children diagnosed with developmental stuttering in the language-speech clinic of children health care department in Children’s Hospital Affiliated to Capital Institute of Pediatrics and 411 healthy children under physical examination in the health care department were examined by children neuropsychological and behavioral scale(CNBS-R2016)from January 2016 to December 2018.The total developmental quotient and the dimensions of gross motor,fine motor,adaptability,language and social behavior of the two groups were compared with each other.Results The mean of the total developmental quotient of the stuttering group was lower than that of the control group[(89.59±11.22)vs.(91.21±9.00)],but there was no statistical difference(P=0.096);the total developmental quotient of the boys in the stuttering group was lower than that of the boys in the control group[(87.31±11.06)vs.(90.26±8.44),P<0.05].In different dimensions,the mean value of the developmental quotient of fine motor and adaptability in stuttering group was lower than that of the control group[(79.88±15.20)vs.(84.35±13.55),(89.20±15.41)vs.(94.38±13.17),P<0.01];among them,the fine motor and adaptability of the boys in the stuttering group were significantly lower than those of the boys in the control group[(77.22±14.96)vs.(81.79±12.22),(86.77±14.84)vs.(93.40±12.81),P<0.01];while the gross motor of the girls in the stuttering group was higher than that of the girls in the control group[(96.15±12.30)vs.(90.19±13.05),P<0.01],the fine motor was lower than that of the girls in the control group[(84.44±14.62)vs.(90.25±14.64),P<0.05].In the stuttering group,the mean value of the total developmental quotient,gross motor,fine motor,adaptability and social behavior of the boys were lower than those of girls[(87.31±11.06)vs.(93.48±10.48),(90.33±12.84)vs.(96.15±12.30),(77.22±14.96)vs.(84.44±14.62),(86.77±14.84)vs.(93.34±15.62),(91.25±13.92)vs.(96.85±16.69),P<0.05].Conclusions There are more boys than girls with developmental stuttering.The development of the dimensions of the children with developmental stuttering is unbalanced,the development of fine motor and adaptability is immature,especially the boys.Therefore,it is necessary to evaluate the neuropsychological development of children with developmental stuttering,and pay attention to the development of the boys on fine motor and adaptability.Individualized and comprehensive intervention and guidance according to their developmental characteristics is necessary,so as to promote their rehabilitation and overall development.