背景:在20世纪初,人们讨论了感染与言语不流利之间的联系。最近的报道表明,PANS(小儿急性发作神经精神综合征),和PANDAS(儿童自身免疫性神经精神障碍与链球菌感染相关)可能与言语障碍的高发生率相关。本研究专门研究了PANS和PANDAS发作后的流畅性和其他言语症状。先前报告的语音相关症状的患病率,包括选择性的mutism和“婴儿谈话”。本研究还旨在探索清晰度和清晰度的可能变化,由于语言障碍造成的痛苦,以及PANS或PANDAS药物对言语症状的影响。
方法:向被诊断或怀疑为PANS或PANDAS的儿童的照顾者发放问卷。瑞典共有55个人被包括在内。
结果:54.5%的护理人员报告了与PANS或PANDAS相关的言语不流畅的发作。最常见的不流利症状是言语率较高,多余的言语行为,言语障碍和相关的运动症状。以前对声乐抽搐的发现,支持婴儿说话和多语性行为。本研究还暴露了以前未报告的症状,如关节受损,清晰度降低,减少言语产生和语言障碍。11名护理人员报告说,药物治疗对言语流畅性有积极影响。
结论:支持PANS和PANDAS之间的连接以及语音不流畅,感染和不流畅之间可能的联系被重新实现。报告的不流畅具有口吃和杂乱的几个特征,但是护理人员并不总是将它与口吃联系起来。本研究还为“婴儿说话”的症状提供了新的思路在这个人群中可能会看到选择性的mutism和声乐抽动。总之,结果表明,对言语流畅性有重大影响,受影响儿童的言语和语言,降低生活质量。
BACKGROUND: In the early 20th century a link between infection and speech disfluency was discussed. Recent reports indicate that PANS (Pediatric Acute-onset Neuropsychiatric Syndrome), and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) may be associated with a high incidence of speech disfluency. The present study specifically investigates disfluency and other speech symptoms following onset of PANS and PANDAS. Prevalence of previously reported speech related symptoms vocal tics, selective mutism and \"baby talk\" is included. The present study also aims to explore possible changes in articulation and intelligibility, distress due to speech impairment, and effect of PANS or PANDAS medication on speech symptoms.
METHODS: A questionnaire was distributed to caregivers of children with diagnosed or suspected PANS or PANDAS. In total 55 individuals in Sweden were included.
RESULTS: Onset of speech disfluency in association with PANS or PANDAS was reported by 54.5% of the caregivers. Most frequent disfluency symptoms were higher speech rate, superfluous verbal behavior, verbal blocks and associated motor symptoms. Previous findings of vocal tics, baby talk and mutistic behavior are supported. The present study also exposed previously unreported symptoms such as impaired articulation, reduced intelligibility, reduced speech production and language impairment. Eleven caregivers reported that medical treatment had a positive effect on speech fluency.
CONCLUSIONS: A connection between PANS and PANDAS and speech disfluency is supported, and a possible link between infection and disfluency is reactualized. Reported disfluency shares several characteristics with stuttering and cluttering, but the caregivers did not consistently associate it with stuttering. The present study also sheds new light on how symptoms of \"baby talk\", selective mutism and vocal tics might be viewed in this population. In all, the results indicate a substantial impact on speech fluency, speech and language in affected children, reducing quality of life.