The Differences in Clinical Aspect Between Specific Language Impairment and Global Developmental Delay
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Objective To compare and analyze the clinical characteristics of children with delayed language acquisition due to two different diagnoses, which were specific language impairment (SLI, a primarily delayed language development) and global developmental delay (GDD, a language delay related to cognitive impairment). Methods Among 1,598 children who had visited the developmental delay clinic from March 2005 to February 2011, 467 children who were diagnosed with GDD and 183 children who were diagnosed with SLI were included in this study. All children were questioned about past, family, and developmental history, and their language competences and cognitive function were assessed. Some children got electroencephalography (EEG), in case of need. Results The presence of the perinatal risk factors showed no difference in two groups. In the children with GDD, they had more delayed acquisition of independent walking and more frequent EEG abnormalities compared with the children with SLI (p<0.01). The positive family history of delayed language development was more prevalent in children with SLI (p<0.01). In areas of language ability, the quotient of receptive language and expressive language did not show any meaningful statistical differences between the two groups. Analyzing in each group, the receptive language quotient was higher than expressive language quotient in both group (p<0.01). In the GDD group, the Bayley Scales of Infant Development II (BSIDII) showed a marked low mental and motor quotient while the Wechsler Intelligence Scale showed low verbal and nonverbal IQ. In the SLI group, the BSIDII and Wech sler Intelligence Scale showed low scores in mental area and verbal IQ but sparing motor area and nonverbal IQ. Conclusion The linguistic profiles of children with language delay could not differentiate between SLI and GDD. The clinicians needed to be aware of these developmental issues, and history taking and clinical evaluation, including cognitive assessment, could be helpful to diagnose adequately and set the treatment plan for each child.
Abstract
Objective To compare and analyze the clinical characteristics of children with delayed language acquisition due to two different diagnoses, which were specific language impairment (SLI, a primarily delayed language development) and global developmental delay (GDD, a language delay related to cognitive impairment). Methods Among 1,598 children who had visited the developmental delay clinic from March 2005 to February 2011, 467 children who were diagnosed with GDD and 183 children who were diagnosed with SLI were included in this study. All children were questioned about past, family, and developmental history, and their language competences and cognitive function were assessed. Some children got electroencephalography (EEG), in case of need. Results The presence of the perinatal risk factors showed no difference in two groups. In the children with GDD, they had more delayed acquisition of independent walking and more frequent EEG abnormalities compared with the children with SLI (p<0.01). The positive family history of delayed language development was more prevalent in children with SLI (p<0.01). In areas of language ability, the quotient of receptive language and expressive language did not show any meaningful statistical differences between the two groups. Analyzing in each group, the receptive language quotient was higher than expressive language quotient in both group (p<0.01). In the GDD group, the Bayley Scales of Infant Development II (BSIDII) showed a marked low mental and motor quotient while the Wechsler Intelligence Scale showed low verbal and nonverbal IQ. In the SLI group, the BSIDII and Wech sler Intelligence Scale showed low scores in mental area and verbal IQ but sparing motor area and nonverbal IQ. Conclusion The linguistic profiles of children with language delay could not differentiate between SLI and GDD. The clinicians needed to be aware of these developmental issues, and history taking and clinical evaluation, including cognitive assessment, could be helpful to diagnose adequately and set the treatment plan for each child.
참고문헌 (22)
- 김진경, "발달 지연아에서 K-ASQ(Korean-Ages & Stages Quest ionnaires) 발달 선별 검사와 베일리 영유아 발달 검사의 비교", 대한소아신경학회지, 18(1), pp.49~57 (2010), 대한소아신경학회
- 이정주, "여성의 첫 출산 연령이 저체중출생아의 출생률에 미치는 영향", Korean Journal of Pediatrics, 50(12), pp.1206~1211 (2007), 대한소아과학회
- Jolly M, "The risks associated with pregnancy in women aged 35years or older", Hum Reprod, 15, pp.2433~2437 (2000)
- 조성래, "말ㆍ언어 장애 아동에서 언어지수와 지능 및 사회지수의 관계", Annals of Rehabilitation Medicine, 32(2), pp.129~134 (2008), 대한재활의학회
- 권정이, "말 장애 및 언어 발달 지연을 주소로 내원한 아동들의 진단", Annals of Rehabilitation Medicine, 30(4), pp.309~314 (2006), 대한재활의학회
- Majnemer A, "Benefits of early intervention for children with developmental disabilities", Semin Pediatr Neurol, 5, pp.62~69 (1998)
- Park CI, "Early treatment effect in children with cerebral palsy and delayed development", J Korean Acad Rehabil Med, 23, pp.1127~1133 (1999)
- Shevell M, "Developmental and functional outcomes in children with global developmental delay or developmental language impairment", Dev Med Child Neurol, 47, pp.678~683 (2005)
- Majnemer A, "Diagnostic yield of the neurologic assessment of the developmentally delayed child", J Pediatr, 127, pp.193~199 (1995)
- Shevell MI, "Present conceptualization of early childhood neurodevelopmental disabilities", J Child Neurol, 25, pp.120~126 (2010)
- 김성우, "언어발달이 지연된 환아들의 진단과 이에 따른 임상양상", Annals of Rehabilitation Medicine, 29(6), pp.584~590 (2005), 대한재활의학회
- 김성우, "소아의 육아지도: 부모의 호소에 따른 올바른 발달 지도", 대한의사협회지, 52(3), pp.244~261 (2009), 대한의사협회
- Shevell M, "Practice parameter: evaluation of the child with global developmental delay: report of the Quality Standards Subcommittee of the American Academy of Neurology and The Practice Committee of the Child Neurology Society", Neurology, 60, pp.367~380 (2003)
- Council on Children With Disabilities, "Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening", Pediatrics, 118, pp.405~420 (2006)
- Riou EM, "Global developmental delay and its relationship to cognitive skills", Dev Med Child Neurol, 51, pp.600~606 (2009)
- Prelock PA, "Speech-language impairment: how to identify the most common and least diagnosed disability of childhood", Medscape J Med, 10, pp.136~ (2008)
- Seong Woo Kim, "Effects of Speech Therapy in Children with Specific Language Impairment and Mild Intellectual Disability", Annals of Rehabilitation Medicine, 35(1), pp.48~54 (2011), 대한재활의학회
- Shevell M, "Global developmental delay and mental retardation or intellectual disability: conceptualization, evaluation, and etiology", Pediatr Clin North Am, 55, pp.1071~1084 (2008)
- Bishop DV, "Parental phonological memory contributes to prediction of outcome of late talkers from 20 months to 4 years: a longitudinal study of precursors of specific language impairment", J Neurodev Disord, 4, pp.3~ (2012)
- Stromswold K, "Genetics of spoken language disorders", Hum Biol, 70, pp.297~324 (1998)
- Webster RI, "Neurobiology of specific language impairment", J Child Neurol, 19, pp.471~481 (2004)
- Bayley N, "Bayley Scales of Infant Development: manual" (1993), Psychological Corp
