背景:据估计,9.9%的儿童患有发育性语言障碍(DLD),7.6%以限定的DLD形式出现,没有任何严重的伴随损害,2.3%有对语言有影响的合并症,如听力障碍。发育性语言障碍是更常治疗的儿童疾病之一;如果它们持续存在,它们往往会对以后的教育程度和社会地位产生不利影响。生命第三年的发育性语言延迟是发育性语言障碍的重要危险因素。
方法:本跨学科临床实践指南反映了对发育性语言延迟和障碍的循证干预措施的最新知识。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。
结果:本指南中的建议包括:表达发育性语言延迟,结构化父母培训(对冲=0.38-0.82);在接受成分或其他风险因素的情况下,语言治疗(科恩的d=-0.20-0.90);对于语音发音障碍,语音或综合治疗方法(科恩的d=0.89-1.04);语音障碍(在没有发育语言障碍的情况下),传统的运动方法;对于词汇语义和形态句法障碍,隐式和显式方法的组合(输入丰富,建模技术,启发方法,创造生产机会,元语言,可视化;科恩的d=0.89-1.04)。进一步的建议包括对语用交际发展语言障碍的干预措施,以及双/多语种儿童和听力受损儿童的发育性语言障碍,智力残疾,自闭症谱系障碍,选择性的mutism,以及与语言有关的综合症和多重残疾。在某些情况下,还建议住院语言康复。
结论:早期以父母和儿童为中心的干预措施与教学语言推广相结合,以及基于证据的治疗组件的使用,剂量频率和形式,和设置,可以帮助提高对发育性语言延迟和障碍的干预效果。
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.
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.
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.
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.