注意缺陷多动障碍儿童语言发育特征及影响因素分析

Analysis of language development characteristics and influencing factors in children with attention deficit hyperactivity disorder

目的:探讨并分析注意缺陷多动障碍儿童的语言发育特征及影响因素。方法:采用病例对照研究,选取2021年5月至2023年8月在首都儿科研究所附属儿童医院儿童保健中心心理卫生门诊初次就诊并确诊为注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童272例及同期于儿童保健中心体检的健康儿童117名,采用《梦想普通话听力理解和表达能力标准化评估》(DREAM-C)进行语言能力测查,采用独立样本 t检验比较两组儿童的整体语言、听力理解、语言表达、语义、句法的发育水平;通过 χ^(2)检验、多因素logistic回归分析ADHD组儿童发生语言能力落后的影响因素。 结果:ADHD儿童272例,其中男206例,女66例,年龄范围6~8(7.29±1.17)岁;健康儿童117名,其中男91名,女26名,年龄范围6~8(7.02±0.82)岁。ADHD儿童整体语言、语言表达、句法得分均值低于健康儿童[(92.73±12.47/96.36±11.04)分, t=-2.857, P<0.05;(84.49±13.24/87.78±15.25)分, t=-2.029, P<0.05;(87.93±10.26/90.27±11.05)分, t=-2.022, P<0.05]。 χ^(2)检验显示,家庭关系不和谐( χ^(2)=4.183, P<0.05)、主要抚养人为非父母( χ^(2)=9.121, P<0.05)、过早屏幕暴露( χ^(2)=3.889, P<0.05)、有ADHD家族史( χ^(2)=5.423, P<0.05)是ADHD儿童发生语言发育落后的影响因素。多因素logistic回归模型分析结果显示,剖宫产( OR=2.137,95% CI:1.078~4.379, P=0.030)、家庭关系不和谐( OR=2.659,95% CI:1.178~5.999, P=0.019)、过早屏幕暴露( OR=3.556,95% CI:1.127~11.213, P=0.030)、有ADHD家族史( OR=1.959,95% CI:1.058~3.630, P=0.033)为ADHD儿童共病语言发育落后的危险因素。 结论:ADHD儿童整体语言能力、语言表达、句法得分均落后于健康儿童;ADHD儿童发生语言发育落后与分娩方式、家庭关系、主要带养人、过早屏幕暴露、ADHD家族史等因素有关。

ObjectiveTo explore and analyze the characteristics and influencing factors of language development in children with attention deficit hyperactivity disorder(ADHD).MethodsA case-control study was used,from May 2021 to August 2023,patients diagnosed with attention deficit hyperactivity disorder(ADHD)were enrolled in the mental health clinic of the Children′s Hospital Affiliated to the Capital Institute of Pediatrics.The language ability of 272 children with ADHD and 117 healthy children who underwent physical examination in children′s health center during the same period were tested by Diagnostic Receptive and Expressive Assessment of Mandarin-Comprehensive(DREAM-C),and the development levels of total language,receptive,expressive,semantics and syntax of the two groups were compared by independent sample t-test.The influential factors of language lag in children with ADHD were analyzed by univariate χ^(2) analysis and multiple logistic regression.ResultsThere were 272 children with ADHD,including 206 males and 66 females,with an age range of 6-8(7.29±1.17)years.While in the control group,there were 117 healthy children,including 91 males and 26 females,with an age range of 6-8(7.02±0.82)years.The average scores of total language,expressive and syntax of ADHD children were lower than those of healthy children[(92.73±12.47/96.36±11.04),t=-2.857,P<0.05;(84.49±13.24/87.78±15.25),t=-2.029,P<0.05;(87.93±10.26/90.27±11.05),t=2.022,P<0.05].Univariate χ^(2) analysis showed that disharmonious family relationship(χ^(2)=4.183,P<0.05),the main caregivers were non-parents(χ^(2)=9.121,P<0.05),early screen exposure(χ^(2)=3.889,P<0.05),ADHD family history(χ^(2)=5.423,P<0.05)were influential factors of language development lag in ADHD children.The results of multivariate logistic regression model analysis showed that cesarean section(OR=2.137,95%CI:1.078-4.379,P=0.030),disharmonious family relationship(OR=2.659,95%CI:1.178-5.999,P=0.019),early screen exposure(OR=3.556,95%CI:1.127-11.213,P=0.030),ADHD family history(OR=1.959,95%CI:1.058-3.630,P=0.033)were risk factors for comorbidities of language development in children with ADHD.ConclusionThe total language ability,expressive and syntax scores of ADHD children lag behind those of healthy children.The delayed language development of ADHD children is related to delivery mode,family relationship,the main caregivers,early screen exposure,family history of ADHD.