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目的探讨注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)对功能性构音障碍(functional articulation disorders,FAD)语音治疗效果的影响。方法选择在郑州大学第一附属医院语音治疗科就诊的110例FAD患儿为研究对象,依据DSM-ⅣADHD诊断标准,将同时患有ADHD的FAD患儿分为:注意障碍为主型(predominantly inattentive,I)、多动/冲动为主型(predominantly hyperactive-impulsive,HI)、混合型(combined type,C),比较FAD-I组、FAD-HI组和FAD-C组与单纯FAD组患儿语音治疗前后语音清晰度(PI)的差别。结果语音治疗前,各组间PI值的差异没有统计学意义(F=1.046,P=0.375);语音治疗后,各组间PI值的差异有统计学意义(F=73.726,P<0.001)。进一步Q检验结果显示,FAD-I组、FAD-C组PI值低于单纯FAD组,差异有统计学意义(P<0.05),单纯FAD组和FADHI组差异无统计学意义(P>0.05);FAD-HI组PI值高于FAD-I组和FAD-C组,差异有统计学意义(P<0.05)。结论ADHD的I和C亚型可能会降低FAD的语音治疗效果,或许需要在进行语音治疗的同时采取针对ADHD的相关治疗。
Objective To investigate the effect of attention deficit hyperactivity disorder (ADHD) on speech therapy of functional articulation disorders (FAD). Methods A total of 110 FAD patients treated in the Department of Speech Therapy, the First Affiliated Hospital of Zhengzhou University were enrolled. According to DSM-ⅣADHD diagnostic criteria, FAD children with ADHD were divided into two groups: predominantly inattentive , I), predominantly hyperactive-impulsive (HI), combined type (C), FAD-I group, FAD-HI group and FAD-C group Differences in speech intelligibility (PI) before and after speech therapy. Results There was no significant difference in PI between groups before and after phonotherapy (F = 1.046, P = 0.375). After phonological therapy, the difference of PI between groups was statistically significant (F = 73.726, P <0.001) . Further Q test showed that the PI value of FAD-I group and FAD-C group was lower than that of FAD group (P <0.05), there was no significant difference between FAD group and FADHI group (P> 0.05) ; PI in FAD-HI group was higher than that in FAD-I group and FAD-C group, the difference was statistically significant (P <0.05). Conclusion Subtypes I and C of ADHD may reduce the speech therapy effect of FAD and may require the treatment of ADHD-related therapies while performing speech therapy.