功能性构音障碍共病注意缺陷多动障碍儿童的语音治疗效果分析

Analysis of speech treatment effect in children with functional articulation disorder combined with attention deficit hyperactivity disorder

目的探讨注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)对功能性构音障碍(functional articulation disorders,FAD)语音治疗效果的影响。方法选择在郑州大学第一附属医院语音治疗科就诊的110例FAD患儿为研究对象,依据DSM-ⅣADHD诊断标准,将同时患有ADHD的FAD患儿分为:注意障碍为主型(predominantly inattentive,I)、多动/冲动为主型(predominantly hyperactive-impulsive,HI)、混合型(combined type,C),比较FAD-I组、FAD-HI组和FAD-C组与单纯FAD组患儿语音治疗前后语音清晰度(PI)的差别。结果语音治疗前,各组间PI值的差异没有统计学意义(F=1.046,P=0.375);语音治疗后,各组间PI值的差异有统计学意义(F=73.726,P<0.001)。进一步Q检验结果显示,FAD-I组、FAD-C组PI值低于单纯FAD组,差异有统计学意义(P<0.05),单纯FAD组和FADHI组差异无统计学意义(P>0.05);FAD-HI组PI值高于FAD-I组和FAD-C组,差异有统计学意义(P<0.05)。结论ADHD的I和C亚型可能会降低FAD的语音治疗效果,或许需要在进行语音治疗的同时采取针对ADHD的相关治疗。

Objective To compare the efficacy of speech therapy in children with functional articulation disorder （FAD） with or without attention deficit hyperactivity disorder （ADHD）. Methods A total of 110 children diagnosed with FAD were selected as research objects from department of Speech Therapy,the first affiliated hospital,Zhengzhou university. According to whether fulfilled ADHD criteria of DSM-Ⅳ, the children were further divided into 3 subtypes;predominant ly inattentive（I,18 cases）,predominantly hyperactive-impulsive （HI, 12 cases） and combined type （C, 22 cases）. Then the FAD-I group,the FAD-HI group,the FAD-C group and the non-ADHD group were given the same speech therapy. At last the phonetic intelligibility （PI） of the four groups was compared before and after speech therapy to explore the impact of ADHD on the effect of speech therapy. Results Before speech treatment, there was no statistical significance in differ ences of PI between groups （F= 1. 046, P= 0. 375）. After speech treatment, there was a statistical significance in differences of PI between groups （F=73. 726,P〈0. 001）. The results of Q test indicated that the PI of the FAD-I group and the FAD- C group were lower than the non-ADHD group,the differences were statistically significant （P〈0.05） ; There was no sta- tistical significance between the differences of the FAD-HI group and the FAD group （P〉0.05）. The PI of the FAD-HI group was lower than the FAD-I group and the FAD-C group, the differences were statistically significant （P〈0.05）. Conclusion The I and C subtype of ADHD may lower the speech therapy effect of the FAD patients obviously,but the HI subtype is not so obvious. Maybe when implementing the speech therapy,it also needs to take relevant treatment for ADHD at the same time.