Katrin Neumann, Christina Kauschke, Annette Fox-Boyer, Carina Lüke, Stephan Sallat, Christiane Kiese-Himmel
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引用次数: 0
Abstract
Background: Approximately 9.9 % of children present with difficulties in language development (DLD), 7.6 % without serious additional impairments and 2.3 % associated with languagerelevant comorbidities, e.g., hearing loss. Notably, in a consensus statement by experts in German-speaking countries, in the guideline presented here, and further in this article, all of these disorders are referred to as "developmental language disorders" (DLD), whereas the international consortium CATALISE only refers to those without comorbidities as DLD. DLDs are among the most commonly treated childhood disorders and, if persistent, often reduce educational and socio-economic outcome. Children in their third year of life with developmental language delay (late talkers, LT) are at risk of a later DLD.
Methods: This German interdisciplinary clinical practice guideline reflects current knowledge regarding evidence-based interventions for developmental language delay and disorders. A systematic literature review was conducted on the effectiveness of interventions for DLD.
Results: The guideline recommends parent training (Hedges g = 0.38 to 0.82) for LTs with expressive language delay, language therapy (Cohen's d = -0.20 to 0.90) for LTs with additional receptive language delay or further DLD risk factors, phonological or integrated phonological treatment methods (Cohen's d = 0.89 to 1.04) for phonological speech sound disorders (SSDs), a motor approach for isolated phonetic SSDs (non-DLD), and for lexical-semantic and morpho-syntactic impairments combinations of implicit and explicit intervention approaches (including input enrichment, modeling techniques, elicitation methods, creation of production opportunities, metalinguistic- approaches, visualizations; Cohen's d = 0.89-1.04). Recom mendations were also made for DLD associated with pragmatic-communicative impairment, bi-/ multilingualism, hearing loss, intellectual disability, autism-spectrum disorders, selective mutism, language- relevant syndromes or multiple disabilities, and for intensive inpatient language rehabilitation.
Conclusion: Early parent- and child-centered speech and language intervention implementing evidence-based intervention approaches, frequency, and settings, combined with educational language support, can improve the effectiveness of management of developmental language delay and disorders.
背景:据估计,9.9%的儿童患有发育性语言障碍(DLD),7.6%的儿童患有无任何严重伴随障碍的局限性发育性语言障碍,2.3%的儿童患有对语言有影响的并发症,如听力障碍。发育性语言障碍是较常治疗的儿童疾病之一;如果这些疾病持续存在,往往会对日后的教育成就和社会地位产生不利影响。出生后第三年的语言发育迟缓是导致语言发育障碍的重要风险因素:本跨学科临床实践指南反映了当前对语言发育迟缓和语言障碍的循证干预知识。方法:这一跨学科临床实践指南反映了目前对发育性语言延迟和障碍的循证干预措施的认识,并对各种干预措施对发育性语言障碍的疗效进行了系统的文献综述:该指南中的建议包括:对于表达性语言发育迟缓,采用结构化家长培训(Hedges' g = 0.38-0.82);对于接受性语言发育迟缓或存在其他风险因素,采用语言疗法(Cohen's d = -0.20-0.90);对于语音发音障碍,采用语音或综合治疗方法(Cohen's d = 0.89-1.04);对于语音障碍(在没有发育性语言障碍的情况下),采用传统的运动疗法;对于词汇-语义和形态-句法障碍,采用隐性和显性相结合的方法(丰富输入、建模技术、诱导方法、创造生产机会、金属语言、可视化;Cohen's d = 0.89-1.04)。进一步的建议包括针对实用-交流发育性语言障碍、双语/多语儿童发育性语言障碍、听力受损儿童、智障儿童、自闭症谱系障碍儿童、选择性缄默症儿童以及对语言有影响的综合症和多重残疾儿童的干预措施。在某些情况下,还建议进行住院语言康复治疗:结论:以家长和儿童为中心的早期干预与教学语言促进相结合,并使用循证治疗成分、剂量频率和形式以及环境,有助于提高语言发育迟缓和语言障碍的干预效果。
期刊介绍:
Deutsches Ärzteblatt International is a bilingual (German and English) weekly online journal that focuses on clinical medicine and public health. It serves as the official publication for both the German Medical Association and the National Association of Statutory Health Insurance Physicians. The journal is dedicated to publishing independent, peer-reviewed articles that cover a wide range of clinical medicine disciplines. It also features editorials and a dedicated section for scientific discussion, known as correspondence.
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