汉语发育性阅读障碍儿童多种认知加工缺陷初探

目的 对汉语发育性阅读障碍(DD)儿童8种认知加工能力进行研究,初步探索主要的认知加工缺陷及其与DD的因果关系。方法 2017年以28名DD儿童为实验组,以28名阅读能力(RL)匹配和28名年龄(CA)匹配的正常儿童为对照,采用儿童汉语阅读障碍量表(DCCC)对三组儿童的认知加工特征进行比较。结果 汉语DD儿童DCCC总T分(F=8.05)、书面表达障碍(F=12.20)、不良阅读习惯(F=4.14)、注意力障碍(F=4.57)、视知觉障碍(F=12.29)、书写障碍(F=7.26)、听知觉障碍(F=5.56)、意义理解障碍(F=4.79)的T分显著高于两组正常儿童,差异有统计学意义(P<0.05),而口语障碍T分(F=1.55)三组差异无统计学意义(P>0.05);多元Logistic回归分析表明,与RL比,视知觉障碍(OR=0.915,95%CI:0.838～0.999)是汉语DD儿童的主要缺陷;与CA比,视知觉障碍(OR=0.908,95%CI:0.828～0.996)和书面表达障碍(OR=0.818,95%CI:0.695～0.963)是汉语DD儿童的主要缺陷。结论 汉语DD儿童是一种多维度认知加工缺陷类疾病;视知觉障碍和书面表达障碍是汉语DD的核心缺陷,视知觉障碍可能是汉语DD的病因,而书面表达障碍是DD的结果。

Preliminary study on multiple cognitive processing characteristics in Chinese children with developmental dyslexia

Objective To study eight cognitive processing abilities in Chinese children with developmental dyslexia (DD),and to initially explore the main characteristics of cognitive processing defects and its causal relationship with DD. Methods A total of 28 DD children were enrolled in case group,and 28 normal children with matched reading-level (RL) and 28 normal children with equivalent chronological age(CA) were selected as control group.The Dyslexia Checklist for Chinese Children (DCCC) was used to compare the multiple of cognitive processing characteristics in children of three groups. Results The T scores of DCCC(F=8.05),written expression disorder(F=12.20),unhealthy reading habits(F=4.14),attention deficits(F=4.57),visual perception deficits(F=12.29),writing disorder(F=7.26),auditory perceptual deficits(F=5.56)and meaning comprehension disorder(F=4.79)in DD children were significantly higher than those of the controls (P<0.05).But the scores of spoken language barriers(F=1.55)among three groups were not significantly different (P>0.05).Logistic regression analysis showed that compared with reading level,visual impairment (OR=0.915,95%CI:0.838~0.999) was the main defect in Chinese DD children;Compared with chronological age,visual impairment (OR=0.908,95%CI:0.828~0.996) and written expression disorder (OR=0.818,95%CI:0.695~0.963) were the main defects of Chinese DD children. Conclusions Multiple cognitive deficits exist in Chinese DD children.The core defect of Chinese DD is visual impairment,and written expression disorder may be greatly influenced by reading level.