PDF(Pubmed)
Abstract：
UNASSIGNED: The underdiagnosis of developmental language disorder (DLD) in children is a serious problem in developing countries with limited resources. It has long been noted that the concerns parents have about their children\'s health and development are richly informative, and if this information can be used for diagnosis, it may provide a means to address the problem of underdiagnosis of DLD. This study aimed to quantify the utility of parental linguistic concern questions (PLCQ) on the identification of language disorders in monolingual Spanish-speaking children in Mexico. It also explored whether a combination of biological and environmental conditions questions (BECQ) might improve the performance of a screening test to identify DLD.
UNASSIGNED: A total of 680 monolingual Mexican Spanish-speaking children and their parents from urban areas in Mexico participated in the study. The distribution of responses to questions about DLD concerns was compared between 185 children diagnosed with DLD and 495 control subjects, and multiple logistic regression analysis was performed to select questions with high predictivity, based on the Akaike information criterion. The diagnostic utility of the questions was assessed by receiver operating characteristic (ROC) curves, stratum-specific likelihood ratios (SSLRs), and changes in pretest and post-test probabilities of DLD. A similar procedure was used to explore whether adding BECQ would improve the diagnostic utility of questions about DLD concerns using data of 128 children.
UNASSIGNED: Four questions regarding parental linguistic concerns were found to be useful in identifying children with DLD. When all four concerns were present, the SSLR was 8.79, while it was only 0.27 when there were no concerns at all. The estimates of DLD probability increased from 0.12 to 0.55 at pretest and post-test. On the other hand, the BECQ did not perform as well as the PLCQ in identifying DLD, and the improvement in diagnostic performance it provided was limited to one question.
UNASSIGNED: The parental questionnaire can be used as a screening tool to help in identifying children with DLD. The data presented in this study underscore the importance of considering linguistic parental concerns as part of the screening process. This is a realistic option to provide a solution to the current problem of underdiagnosis of DLD in Mexico.
UNASSIGNED: A total of 680 monolingual Mexican Spanish-speaking children and their parents from urban areas in Mexico participated in the study. The distribution of responses to questions about DLD concerns was compared between 185 children diagnosed with DLD and 495 control subjects, and multiple logistic regression analysis was performed to select questions with high predictivity, based on the Akaike information criterion. The diagnostic utility of the questions was assessed by receiver operating characteristic (ROC) curves, stratum-specific likelihood ratios (SSLRs), and changes in pretest and post-test probabilities of DLD. A similar procedure was used to explore whether adding BECQ would improve the diagnostic utility of questions about DLD concerns using data of 128 children.
UNASSIGNED: Four questions regarding parental linguistic concerns were found to be useful in identifying children with DLD. When all four concerns were present, the SSLR was 8.79, while it was only 0.27 when there were no concerns at all. The estimates of DLD probability increased from 0.12 to 0.55 at pretest and post-test. On the other hand, the BECQ did not perform as well as the PLCQ in identifying DLD, and the improvement in diagnostic performance it provided was limited to one question.
UNASSIGNED: The parental questionnaire can be used as a screening tool to help in identifying children with DLD. The data presented in this study underscore the importance of considering linguistic parental concerns as part of the screening process. This is a realistic option to provide a solution to the current problem of underdiagnosis of DLD in Mexico.
摘要：
■在资源有限的发展中国家，儿童发育性语言障碍（DLD）的诊断不足是一个严重的问题。长期以来，人们一直注意到，父母对孩子的健康和发育的关注是丰富的信息，如果这些信息可以用于诊断，它可以提供一种方法来解决DLD的诊断不足的问题。这项研究旨在量化父母语言关注问题（PLCQ）对墨西哥单语西班牙语儿童语言障碍识别的效用。它还探讨了生物和环境条件问题（BECQ）的结合是否可以提高筛选测试的性能，以确定DLD。
■共有680名来自墨西哥城市地区的单语墨西哥西班牙语儿童和他们的父母参加了这项研究。比较了185名诊断为DLD的儿童和495名对照受试者对DLD关注问题的回答分布。并进行多元logistic回归分析，以选择具有高预测性的问题，基于Akaike信息标准。通过受试者工作特征(ROC)曲线评估问题的诊断效用，特定层似然比(SSLR)，以及DLD的前测和后测概率的变化。使用128名儿童的数据，使用类似的程序来探索添加BECQ是否会提高有关DLD问题的诊断实用性。
■发现关于父母语言问题的四个问题对于识别患有DLD的儿童很有用。当所有四个问题都存在时，SSLR为8.79，而在根本没有问题时只有0.27。在测试前和测试后，DLD概率的估计值从0.12增加到0.55。另一方面,BECQ在识别DLD方面的表现不如PLCQ好，它提供的诊断性能的改进仅限于一个问题。
■父母问卷可以用作筛查工具，以帮助识别患有DLD的儿童。这项研究中提供的数据强调了将父母的语言问题作为筛查过程的一部分的重要性。这是一个现实的选择，可以为墨西哥目前的DLD诊断不足问题提供解决方案。
■共有680名来自墨西哥城市地区的单语墨西哥西班牙语儿童和他们的父母参加了这项研究。比较了185名诊断为DLD的儿童和495名对照受试者对DLD关注问题的回答分布。并进行多元logistic回归分析，以选择具有高预测性的问题，基于Akaike信息标准。通过受试者工作特征(ROC)曲线评估问题的诊断效用，特定层似然比(SSLR)，以及DLD的前测和后测概率的变化。使用128名儿童的数据，使用类似的程序来探索添加BECQ是否会提高有关DLD问题的诊断实用性。
■发现关于父母语言问题的四个问题对于识别患有DLD的儿童很有用。当所有四个问题都存在时，SSLR为8.79，而在根本没有问题时只有0.27。在测试前和测试后，DLD概率的估计值从0.12增加到0.55。另一方面,BECQ在识别DLD方面的表现不如PLCQ好，它提供的诊断性能的改进仅限于一个问题。
■父母问卷可以用作筛查工具，以帮助识别患有DLD的儿童。这项研究中提供的数据强调了将父母的语言问题作为筛查过程的一部分的重要性。这是一个现实的选择，可以为墨西哥目前的DLD诊断不足问题提供解决方案。
