基于世界卫生组织国际分类家族构建儿童交流障碍诊断与干预理论架构与方法

目的 基于《国际疾病分类》第11次修订本(ICD-11)、《国际功能、残疾和健康分类(儿童和青少年版)》(ICF-CY)和《国际健康干预分类》(ICHI),探讨儿童交流障碍相关核心术语、疾病诊断标准、功能诊断标准和整体康复方案。 方法 运用ICD-11、美国言语治疗师协会(ASHA)和《精神疾病诊断与统计手册》第5版(DSM-Ⅴ)的相关标准,分析儿童交流障碍的核心术语。运用ICD-11分析儿童交流障碍的疾病诊断标准。运用ICF-CY分析儿童交流障碍功能诊断标准。依据ICF-CY和ICHI构建儿童交流障碍整体化与结构化康复方案。 结果和结论 儿童交流障碍相关的核心术语有“发育性语言障碍主要伴语用语言损伤”“交流”“交流-生成”“交流-接收”等。儿童交流障碍是以社会交流受限为典型特征的障碍,是儿童发育迟缓的典型障碍表现,疾病诊断命名为“发育性语言障碍主要伴语用语言损伤”(6A01.22),属发育性语言障碍(6A01)的一个亚型。儿童交流障碍相关功能涉及与言语-听觉相关的身体结构、身体功能以及交流活动,交流活动涉及交流-接收(d310-d329)、交流-生成(d330-d349)、交流和使用交流设备与技术(d350-d369),个人因素涉及儿童健康相关行为。结构化的儿童交流障碍综合康复解决方案涉及身体功能和结构、活动和参与、环境因素和个人因素4个层面,干预方法可分为评估类、训练类、教育与咨询类以及社会心理支持类。

Framework and Approach of Diagnosis and Rehabilitation Intervention for Children with Communication Disorders Using WHO Family International Classifications

Objective To explore the definition and core terminology of communication disorders for children,establish the diagnostic criteria and functional assessment criteria of communication disorder,and develop a holistic rehabilitation solution for it based on International Classification of Diseases 11th Revision(ICD-11),International Classification of Functioning,Disability and Health(Children and Youth version)(ICF-CY)and International Classification of Health Interventions(ICHI).Methods Core definition and terminology of communication disorder were analysed with ICD-11,American Speech-Language-Hearing Association(ASHA)and Diagnostic and Statistical Manual of Mental Disorders-V(DSM-V).The diagnostical criteria of communication disorders for children were analyzed using the ICD-11.The functioning diagnostical criteria of communication disorders for children were explored using ICF-CY.A holistic rehabilitation solution was developed based on ICF-CY and ICHI.Results and Conclusion The core diagnostical terms of communication disorder for children include Primary Pragmatic Language Impairment of Developmental Language Disorder,Communication,Communicating-Receiving,and Communicating-Production,etc.Communication disorder is a typical disorder of limited social interaction and a typical manifestation of developmental retardation for children,named Developmental Language Disorder Main Companion Pragmatic Language Impairment(6A01.22),subclass of Developmental Language Disorder(6A01).Communication disorders involve in speech-related body structures and functions,activity and participation,environmental factors and personal factors;such as communication(d3),including communicating-receiving(d310-d329),communicating-production(d330-d349),conversation and use of communication devices and techniques(d350-d369),and health-related behaviors.The structured framework of rehabilitation intervention involves in body function and structure,activity and participation,environmental factors and personal factors;includes assessment,training and treatment,educational counseling,and psychological and social support.