智力与发展性残疾儿童言语与语言障碍康复的系统综述

doi:10.3969/j.issn.1006-9771.2024.08.004

Abstract

Abstract:

Objective To systematically evaluate the effect of speech and language therapies and educational interventions on children with intellectual and developmental disabilities (IDD).

Methods A systematic review was conducted by searching relevant literature in PubMed, PsycINFO, ERIC, Cochrane Library and Web of Science databases, ranging from January, 2018 to May, 2024.

Results A total of eight English articles were included, from six countries including the United States, France, Italy, Norway, Poland and New Zealand, involving 610 children with IDD, from journals about speech language pathology, Down syndrome research and speech language hearing research. The publication time was mainly from 2018 to 2023. The age of the subjects was two to twelve years, and the main health conditions included intellectual disability, autism and Down syndrome. The intervention methods included routine speech therapy (individualized therapy and group therapy), augmentative and alternative communication (device-assisted and sign language and picture cards), family-involved language training programs (parent training and family interaction), computer-assisted language learning (language learning software and telehealth), and play-based interventions (interactive games and structured games); 15 to 150 minutes a time, one to ten times a week, for ten to 144 weeks. The outcomes were reflected in five aspects: increasing the vocabulary in speaking; improving the language comprehension, symbol recognition and vocabulary comprehension; improving both expressive and receptive language skills; improving participation in game diversity and game participation levels, communication, social interaction and interaction skills; and improving overall language and non-verbal communication skills.

Conclusions Combining a variety of methods, such as individualized therapy, family participation, technologic assistance and interactive games, speech and language therapies and education are effective on spoken language production, language comprehension, speech production, social interaction and communication skills for children with IDD.

Key words: intellectual and developmental disabilities, children, speech and language rehabilitation, systematic review

CLC Number:

R749.93

ZHOU Jing, ZHANG Xiaoxiao, DING Zhongbing, CHEN Jianchao, WEI Xingxing, LIN Shuqi. Effect of speech and language rehabilitation on children with intellectual and developmental disabilities: a systematic review[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(8): 894-902.

Figures/Tables 4

Table 1

Figure 1

Table 2

Table 3

Basic characteristics of included literatures"

纳入文献	国家	样本特征	健康状况	干预场所	干预类型	干预方案	比较	结局
Kasari等^[16](2023)	美国	n = 164 年龄2~5岁	智力发育迟缓 ASD	幼儿园	游戏干预结合言语治疗传统言语治疗	JASPER、DTT(模仿、游戏、匹配、请求、理解、学习准备和标记)；每次60 min，每周5次，共72周	与传统言语治疗比较	口语生成未提及语言理解语言理解能力改善言语生成表达性语言评分改善接受性语言评分改善社会交往游戏多样性和游戏参与水平改善交流能力未提及
Saint-Georges等^[17](2020)	法国	n = 72 年龄5~9岁	ASD	特殊教育学校	传统言语治疗	语言治疗、作业治疗、社交技能小组活动；每次150 min，每周4次，共144周	与未接受干预比较	口语生成未提及语言理解词汇理解得分提高言语生成未提及社会交往社会交往与互动能力改善交流能力沟通交流能力改善
Parsons等^[18](2019)	意大利	n = 71 6~10岁	ASD	康复机构	基于游戏的干预	治疗师主导的视频反馈、儿童主导游戏、治疗师与家长讨论干预目标和策略；每次55 min，每周1次，共10周	与未接受干预比较干预前后比较	口语生成未提及语言理解未提及言语生成表达性语言评分改善接受性语言评分改善社会交往未提及交流能力言语交际能力中等程度改善
Thiemann-Bourque等^[19](2018)	美国	n = 45 2~11岁	ASD	特殊教育学校	计算机辅助语言学习治疗	配备iPad (包含教师根据儿童的能力和个别化教育计划设计的词汇)并安装了语音输出应用程序；每次30~120 min，每周3次，共24周	与未接受干预比较	口语生成未提及语言理解未提及言语生成未提及社会交往同伴沟通率提高交流能力沟通出现了更为平衡的反应和启动
Gengoux等^[20](2019)	美国	n = 48 2~5岁	ASD	特殊教育学校	家庭参与的语言训练计划	关键反应治疗：父母每周接受培训课程(教材和录像) 60 min，儿童接受临床医生的上门治疗；每次60 min，每周5~10次，共24周	与未接受干预比较	口语生成总话语数增加单词使用改善语言理解未提及言语生成未提及社会交往社交状况显著改善交流能力非言语(如手势、面部表情、肢体语言)交流能力得到改善
Næss等^[21](2022)	挪威	n = 103 6~8岁	唐氏综合征	特殊教育学校	计算机辅助语言学习治疗	安装了应用程序的iPad (包括图片卡、玩具和游戏)，通过图画书共享进行对话互动；每次15 min，每周5次，共15周	与未接受干预比较	口语生成口语表达中的词汇量增加语言理解词汇理解能力提高言语生成未提及社会交往未提及交流能力未提及
Quinn等^[22](2020)	波兰	n = 9 3~4岁	唐氏综合征	特殊教育学校	增强和替代沟通	词汇探究、对话阅读和主题游戏玩法；每次60 min，每周5次，共24周	与未接受干预比较	口语生成单词量由单一转向多个语言理解符号识别与词汇理解能力增强言语生成未提及社会交往未提及交流能力同伴导向谈话能力提高
Dekker等^[23](2021)	新西兰	n = 98 9~12岁	ASD	康复机构	传统言语治疗家庭参与的语言训练计划	学生干预(新话题、练习和角色扮演、新作业和游戏)；家长干预(支持孩子社交的技能，包括指导、行为练习和角色扮演)；每次90 min，每周1次，共18周	与传统言语治疗比较	口语生成未提及语言理解未提及言语生成言语生成能力提高社会交往未提及交流能力沟通技能感知困难降低

Table 3

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纳入文献	资格标准	随机分配	分配隐藏	基线相似	被试施盲	治疗师施盲	评估者施盲	被试流失率≤ 15%	意向治疗分析	组间统计比较	报告点测量和变异量值	总分
Kasari等^[16](2023)	√	√	√	√			√	√		√	√	7
Saint-Georges等^[17](2020)	√	√		√		√		√	√	√		6
Parsons等^[18](2019)	√	√		√	√	√		√	√	√		7
Thiemann-Bourque等^[19](2018)	√	√	√				√	√		√	√	6
Gengoux等^[20](2019)	√	√	√	√		√	√	√	√		√	8
Næss等^[21](2022)	√	√		√	√			√	√		√	6
Quinn 等^[22](2020)	√	√	√	√		√	√	√		√	√	8
Dekker等^[23](2021)	√	√		√	√	√		√	√	√		7

Effect of speech and language rehabilitation on children with intellectual and developmental disabilities: a systematic review

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