儿童保健门诊中语音障碍患儿的初诊情况及监护人自觉状况分析

Analysis of initial diagnosis of speech sound disorder and guardian’s self-awareness in child healthcare clinic

目的调查儿童保健门诊中语言障碍患儿的初诊情况及监护人自觉状况,为临床诊治提供依据和建议。方法以2018年1月—2020年12月在深圳市盐田区妇幼保健院儿科初诊为语言障碍(speech sound disorders,SSD)的儿童患者480例为研究对象,收集患者的性别、年龄、听力、语音及行为等临床资料,检查患者口腔结构及对声源的反应,分析其语音障碍情况与监护人自觉状况。结果所有研究对象的口唇等构音器官均未发现畸形等结构异常。对SSD儿童病史中对听力及声源反应的描述分析结果显示,监护人自觉听力正常儿童的神经发育疾病发生率(21.15%)低于自觉听力异常的儿童(72.22%),差异有统计学意义(P<0.05);对声源反应正常儿童的神经发育疾病的发生率(25.90%)低于声源反应异常的儿童(47.37%),差异有统计学意义(P<0.05)。结论 SSD儿童可并发神经发育性疾病,听力损失比例也较高,初诊时应关注其心理发育和行为认知等方面的表现,重视诊断性听力测试,同时关注监护人的相关描述,结合发育行为评估,促进SSD儿童的临床诊治。

Objective To investigate initial diagnosis of children with Speech Sound Disorder(SSD) and their guardian’ s selfawareness in child healthcare clinic, in order to provide evidence and suggestions for clinical diagnosis and treatment.Methods Totally 480 children with initial diagnosis of SSD in our hospital from January 2018 to December 2020 were recruited as research subjects. Their clinical data of gender, age, hearing, sound and speech, and behavior were collected. Their oral structure and response to the sound stimulation were examined. Their current status of SSD and guardian’s self-awareness were analyzed.Results Articulator abnormality was not found among all subjects. Descriptive analysis to children’s medical history of hearing and response to sound stimulation showed that the incidence of neurodevelopmental diseases(21. 15%) of the children with normal hearing was lower than that of children with conscious hearing abnormality(78. 85%), and the difference was statistically significant(P< 0. 05);The incidence of neurodevelopmental diseases in children with normal response to sound stimulation(25. 90%) was lower than that of children with abnormal sound response(47. 37%), and the difference was statistically significant(P< 0. 05).Conclusion SSD is frequently comorbid with neurodevelopmental disorders in children. The proportion of hearing loss in SSD children is also relatively high. Attention should be paid to their psychological development and behavioral cognition at the initial diagnosis. In addition,diagnostic hearing test and relevant description of guardians should be valued, developmental behavior evaluation should be combined,so as to promote clinical diagnosis and treatment for SSD children.