特征驱动的分类揭示了儿童言语失用症中潜在的合并症亚型,BMC Pediatrics

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特征驱动的分类揭示了儿童言语失用症中潜在的合并症亚型
BMC Pediatrics ( IF 2.0 ) Pub Date : 2020-11-13 , DOI: 10.1186/s12887-020-02421-1
Catherine M. Stein , Penelope Benchek , Gabrielle Miller , Noémi B. Hall , Dhanya Menon , Lisa Freebairn , Jessica Tag , Jennell Vick , H. Gerry Taylor , Barbara A. Lewis , Sudha K. Iyengar

儿童言语失用症（CAS）是一种神经发育障碍，具有异质沟通和其他合并症表现。尽管先前的研究已将与CAS相关的言语缺陷描述为特征，但很少有研究检查了阅读，语言和/或其他发育合并症的变异性。我们试图在CAS内鉴定出可能具有临床相关性和遗传独特性的合并症亚组。在一组31名具有CAS的儿童和8名对照的儿童中，我们使用发音，词汇和阅读量度进行了层次聚类分析。我们还对CAS患儿进行了图表审查，以检查这些患儿的其他临床特征以及他们与亚组成员的关系。我们确定了严重程度不同的CAS中的3个合并症亚组。与轻度严重组相比，高严重度组的特征是阅读和词汇不佳，中度严重度组的特征是阅读和非单词重复但平均词汇量差。就语音声音的产生（CAS的标志）而言，亚组是无法区分的，所有这些都表明发音不清。最严重的亚组中的儿童更容易出现早期喂养问题（p = 0.036）。患有CAS的儿童可能会根据词汇和阅读量的表现而分为合并症组，从而进一步了解CAS内的异质性，从而对教育干预产生影响。与轻度严重程度亚组相比。就语音声音的产生（CAS的标志）而言，亚组是无法区分的，所有这些都表明发音不清。最严重的亚组中的儿童更容易出现早期喂养问题（p = 0.036）。患有CAS的儿童可能会根据词汇和阅读量的表现而分为合并症组，从而进一步了解CAS内的异质性，从而对教育干预产生影响。与轻度严重程度亚组相比。就语音声音的产生（CAS的标志）而言，亚组是无法区分的，所有这些都表明发音不清。最严重的亚组中的儿童更容易出现早期喂养问题（p = 0.036）。患有CAS的儿童可能会根据词汇和阅读量的表现而分为合并症组，从而进一步了解CAS内的异质性，从而对教育干预产生影响。

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Feature-driven classification reveals potential comorbid subtypes within childhood apraxia of speech

Childhood apraxia of speech (CAS) is a neurodevelopmental disorder with heterogeneous communication and other comorbid manifestations. While previous studies have characterized speech deficits associated with CAS, few studies have examined variability in reading and language and/or other developmental comorbidities. We sought to identify comorbid subgroups within CAS that could be clinically relevant as well as genetically distinctive. In a group of 31 children with CAS and 8 controls, we performed hierarchical cluster analysis utilizing measures of articulation, vocabulary, and reading. We also conducted a chart review of the children with CAS to examine other clinical characteristics in these children and their association with subgroup membership. We identified 3 comorbid subgroups within CAS of varying severity. The high severity subgroup was characterized by poor reading and vocabulary, and the moderate severity subgroup by poor reading and non-word repetition but average vocabulary, compared to the mild severity subgroup. Subgroups were indistinguishable with respect to speech sound production, the hallmark of CAS, all demonstrating poor articulation. Children in the most severe subgroup were more likely to have early problems feeding (p = 0.036). Children with CAS may potentially be classified into comorbidity groups based on performance on vocabulary and reading measures, providing additional insight into the heterogeneity within CAS with implications for educational interventions.

更新日期：2020-11-13

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