发育性语言障碍和神经多样性:揭示矛盾、紧张和未解之谜。

IF 1.5 3区 医学 Q2 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Hannah M Hobson, Umar Toseeb, Jenny L Gibson
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引用次数: 0

摘要

背景:有关自闭症研究和实践的神经多样性讨论日益增多。然而,有关发育性语言障碍(DLD)的神经发育状况和神经多样性运动的学术研究还很缺乏。虽然这一运动可能会为 DLD 社区带来机遇,但由于 DLD 和自闭症在公众和专业人士的认识和理解程度上存在很大差异,因此需要考虑将神经多样性的概念应用到 DLD 的研究和实践中。我们旨在批判将神经多样性原则(或假定原则)应用于 DLD 领域时可能产生的一些假设:本文是一篇讨论性论文,借鉴了作者团队的个人经历和思考:我们论证了为何应将 DLD 纳入有关神经变异的讨论,并概述了这样做的考虑因素,以及为何某些问题和应用可能是 DLD 所特有的。在我们对神经多样性的理解方面,我们概述了与自闭症的相似点和对比点。我们考虑了与诊断和术语有关的问题,并敦促从业人员继续使用当前商定的术语来诊断 DLD,以免破坏最近的宣传工作。我们注意到,以神经多样性为基础的观点要求我们在环境层面而不仅仅是个体层面提供干预措施。事实上,神经多样性提供了一个平台,可以为患有 DLD 的儿童和成人在精神健康环境、教育和工作中争取更好的权利和更具包容性的空间:应从神经多样性的角度来考虑 DLD 问题,我们希望这将导致神经多样性的实践,从而让公众和与他们一起工作的专业人员更好地理解患有 DLD 的年轻人。需要进一步开展工作,以便更好地支持患有 DLD 的儿童、青少年和成人在神经多样性运动中发表意见:有关该主题的已知信息 神经多样性方法正越来越多地被用于与自闭症有关的研究和实践中,这意味着我们对自闭症的理解以及如何为自闭症患者提供支持正越来越多地借鉴神经多样性原则。然而,自闭症并不是唯一的神经多样性人群。发育性语言障碍(DLD)是另一种神经发育性疾病;然而,与自闭症相比,发育性语言障碍在专业人士和公众中的认知度较低。目前还没有学术研究通过神经多样性的视角对 DLD 进行研究,或考虑将肯定神经多样性的方法应用于 DLD。本文对现有知识的补充 在本文中,我们探讨了神经多样性运动对 DLD 研究和实践的意义。特别是,我们考虑了自闭症领域的神经多样性可能给我们带来的启示,以及神经多样性在 DLD 领域的应用,并强调了我们认为这两种人群之间存在重要差异的地方。我们思考了神经多样性对于干预、诊断、术语和倡导无障碍需求(尤其是在心理健康支持、教育和就业方面)的意义。这项工作的潜在或实际临床意义是什么?神经多样性凸显了考虑在个人环境层面进行干预的必要性(例如,我们如何才能让这个空间更具包容性?我们对 "肯定神经多样性的方法意味着不对 DLD 进行诊断或改变 DLD 的术语 "这一观点提出质疑:我们认为这不符合最初的神经多样性运动的精神,而且对于一种公众认知度如此之低的疾病来说,这些行动对受 DLD 影响的家庭来说可能弊大于利。我们呼吁围绕神经多样性方法在 DLD 中的应用开展更深入的学术研究和讨论,并认为神经多 样性运动提供了一个重要的机会,可在多个领域提高人们对 DLD 的认识和理解,包括(但不限 于)心理健康、教育和就业领域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Developmental language disorder and neurodiversity: Surfacing contradictions, tensions and unanswered questions

Background

Neurodiversity is increasingly discussed in relation to autism research and practice. However, there is a lack of scholarship concerning the neurodevelopmental condition of Developmental Language Disorder (DLD) and the neurodiversity movement. While this movement may hold opportunities for the DLD community, the application of the concept of neurodiversity to DLD research and practice needs consideration, as DLD and autism have very different levels of public and professional awareness and understanding.

Aims

In this article, we discuss what the concept of neurodiversity and the associated neurodiversity movement could mean for DLD research and practice. We aim to critique some assumptions that may arise from the application of neurodiversity principles (or assumed principles) to the field of DLD.

Methods

This is a discussion paper, drawing on the personal experiences and reflections of the author team.

Main Contributions

We make the case for why DLD should be included in discussions about neurodivergence and outline considerations for doing so, and why some issues and applications may be particular to DLD. We outline points of similarity and contrast with autism in relation to our understanding of neurodiversity. We consider the issues around diagnosis and terminology and urge practitioners to continue to diagnose DLD using currently agreed terminology, so as not to undermine recent awareness efforts. We note that a neurodiversity-informed perspective challenges us to offer interventions that operate at the level of our environments, not just at the level of an individual. Indeed, neurodiversity offers a platform to argue for better rights and more inclusive spaces in mental health settings, education and work for children and adults with DLD.

Conclusions

DLD should be considered from a neurodiversity-informed perspective, and it is our hope that this will lead to neurodiversity-affirming practice that will afford young people with DLD better understanding from members of the public and the professionals who work with them. Further work is needed to better support children, young people and adults with DLD to have a voice in the neurodiversity movement.

WHAT THIS PAPER ADDS

What is already known on the subject

  • Neurodiversity approaches are increasingly being taken up in research and practice in relation to autism, meaning that our understanding of autism and how autistic people are supported is increasingly drawing on the principles of neurodiversity. However, autism is not the only neurodivergent population. Developmental Language Disorder (DLD) is another neurodevelopmental condition; however, relative to autism, DLD has lower awareness amongst professionals and the public. There has been no scholarship that has examined DLD through the lens of neurodiversity, or considered the application of neurodiversity-affirming approaches to DLD.

What this paper adds to existing knowledge

  • In this paper, we examine what the neurodiversity movement means for DLD research and practice. In particular, we consider what neurodiversity in the field of autism might teach us about the application of neurodiversity in the field of DLD, and highlight where we believe there are important differences between the two populations. We reflect on what neurodiversity means for intervention, diagnosis, terminology and championing the need for accessibility, especially with regard to mental health support, education and employment.

What are the potential or actual clinical implications of this work?

  • Neurodiversity highlights the need to consider interventions at the level of an individual's environment (e.g., how can we make this space more inclusive?) as well as interventions operating at the level of the individual themselves (e.g., interventions focusing on an individual's language skills). We challenge the notion that neurodiversity-affirming approaches mean not diagnosing DLD or changing DLD's terminology: we argue that this is not in the spirit of the original neurodiversity movement, but also that for a condition with such low public awareness, these actions could do more harm than good for families affected by DLD. We call for more in-depth scholarship and discussion around the application of neurodiversity approaches to DLD and argue that the neurodiversity movement offers an important opportunity to raise better awareness and understanding of DLD in multiple sectors, including (but not limited to) mental health, education and employment.
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来源期刊
International Journal of Language & Communication Disorders
International Journal of Language & Communication Disorders AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION
CiteScore
3.30
自引率
12.50%
发文量
116
审稿时长
6-12 weeks
期刊介绍: The International Journal of Language & Communication Disorders (IJLCD) is the official journal of the Royal College of Speech & Language Therapists. The Journal welcomes submissions on all aspects of speech, language, communication disorders and speech and language therapy. It provides a forum for the exchange of information and discussion of issues of clinical or theoretical relevance in the above areas.
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