学龄前发育性语言障碍儿童听处理与行为问题的关联研究

董婷, 刘潘婷, 孙钰英, 俞欣悦, 周佳, 李婷钰, 陈忆晴, 钱君, 池霞, 洪琴

中国当代儿科杂志 ›› 2026, Vol. 28 ›› Issue (7) : 848-855.

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中国当代儿科杂志 ›› 2026, Vol. 28 ›› Issue (7) : 848-855. DOI: 10.7499/j.issn.1008-8830.2512004
论著·临床研究

学龄前发育性语言障碍儿童听处理与行为问题的关联研究

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Association between auditory processing and behavioral problems in preschool children with developmental language disorder

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摘要

目的 探讨学龄前发育性语言障碍(developmental language disorder, DLD)儿童听处理 (auditory processing, AP)、工作记忆与语言功能的关联,分析工作记忆的中介作用。 方法 采用前瞻性横断面设计,选取42例DLD儿童(设为DLD组)及45例正常儿童(设为正常对照组)为研究对象,采用梦想普通话听力理解和表达能力标准化评估(Diagnostic Receptive and Expressive Assessment of Mandarin‑Comprehensive, DREAM‑C)、学龄前儿童听处理评估量表(Preschool Auditory Processing Assessment Scale, PAPAS)、韦氏智力量表第4版及Conners父母用症状问卷(Conners Parent Symptom Questionnaire, PSQ)对所有儿童进行评估,分析量表间相关性,并分析听觉解码、工作记忆与整体语言的关系及工作记忆的中介效应。 结果 DLD组PAPAS各维度得分及AP异常风险比例高于正常对照组(P0.001)。所有儿童DREAM‑C各维度得分与PAPAS各维度得分呈负相关(P0.05)。DLD组工作记忆得分与PAPAS总分、听觉解码、听觉注意、沟通交流维度得分呈负相关(P0.05);PSQ品行问题、学习问题和多动指数得分与PAPAS总分、听觉解码、听觉注意、沟通交流、多动-冲动维度得分呈正相关(P0.05),冲动-多动得分与PAPAS总分、听觉注意、多动冲动维度得分呈正相关(P0.05),焦虑得分仅与沟通交流维度得分呈正相关(P0.05)。控制混杂因素后,听觉解码得分(b'=-0.431,P=0.009)、工作记忆得分(b'=0.437,P0.001)与DREAM‑C整体语言维度得分独立相关。工作记忆在听觉解码与整体语言间起部分中介作用,效应占比40%。 结论 学龄前DLD儿童AP与语言、认知及行为问题密切相关;听觉解码不仅直接影响语言功能,还通过工作记忆发挥间接效应。PAPAS可作为简便筛查工具在临床中推广应用。

Abstract

Objective To investigate associations among auditory processing (AP), working memory, and language function in preschool children with developmental language disorder (DLD), and to analyze the mediating role of working memory. Methods A prospective cross-sectional design was adopted. Forty-two children with DLD (DLD group) and 45 typically developing children (normal control group) were enrolled. The Diagnostic Receptive and Expressive Assessment of Mandarin-Comprehensive (DREAM-C), Preschool Auditory Processing Assessment Scale (PAPAS), Wechsler Intelligence Scales (Fourth Edition), and Conners Parent Symptom Questionnaire (PSQ) were used for evaluation. Correlations among scales were analyzed. The relationships among auditory decoding, working memory, and overall language function, as well as the mediating effect of working memory, were examined. Results Scores on all PAPAS dimensions and the proportion of children at risk for AP abnormalities were significantly higher in the DLD group than in the control group (P0.001). In all children, DREAM-C dimension scores were negatively correlated with PAPAS dimension scores (P0.05). In the DLD group, working memory was negatively correlated with total PAPAS score and scores for auditory decoding, auditory attention, and communication (P0.05). PSQ scores for conduct problems, learning problems, and hyperactivity index were positively correlated with total PAPAS score and scores for auditory decoding, auditory attention, communication, and hyperactivity-impulsivity (P0.05). The impulsivity-hyperactivity score was positively correlated with total PAPAS score and scores for auditory attention and hyperactivity-impulsivity (P0.05). The anxiety score was positively correlated only with the communication score (P0.05). After controlling for confounders, the auditory decoding score (b'=-0.431, P=0.009) and the working memory score (b'=0.437, P0.001) were independently associated with the DREAM-C overall language score. Working memory partially mediated the association between auditory decoding and overall language ability, accounting for 40% of the total effect. Conclusions Auditory processing in preschool children with DLD is closely associated with language, cognitive, and behavioral problems. Auditory decoding directly affects language function and indirectly influences it through working memory. PAPAS may serve as a convenient screening tool for clinical use.

关键词

发育性语言障碍 / 听处理 / 学龄前儿童听处理评估量表 / 筛查 / 工作记忆 / 儿童

Key words

Developmental language disorder / Auditory processing / Preschool auditory processing assessment scale / Screening / Working memory / Child

引用本文

导出引用
董婷, 刘潘婷, 孙钰英, . 学龄前发育性语言障碍儿童听处理与行为问题的关联研究[J]. 中国当代儿科杂志. 2026, 28(7): 848-855 https://doi.org/10.7499/j.issn.1008-8830.2512004
Ting DONG, Pan-Ting LIU, Yu-Ying SUN, et al. Association between auditory processing and behavioral problems in preschool children with developmental language disorder[J]. Chinese Journal of Contemporary Pediatrics. 2026, 28(7): 848-855 https://doi.org/10.7499/j.issn.1008-8830.2512004

参考文献

[1]
Ullman MT, Clark GM, Pullman MY, et al. The neuroanatomy of developmental language disorder: a systematic review and meta-analysis[J]. Nat Hum Behav, 2024, 8(5): 962-975. DOI: 10.1038/s41562-024-01843-6 .
[2]
Wu S, Zhao J, de Villiers J, et al. Prevalence, co-occurring difficulties, and risk factors of developmental language disorder: first evidence for Mandarin-speaking children in a population-based study[J]. Lancet Reg Health West Pac, 2023, 34: 100713. PMCID: PMC10240373. DOI: 10.1016/j.lanwpc.2023.100713 .
[3]
Delage H, Frauenfelder UH. Relationship between working memory and complex syntax in children with developmental language disorder[J]. J Child Lang, 2020, 47(3): 600-632. DOI: 10.1017/S0305000919000722 .
[4]
Asadi IA, Khateb A, Mansour-Adwan J, et al. When developmental language disorder meets diglossia: a cross-sectional investigation of listening comprehension among native Arabic-speaking preschoolers[J]. J Psycholinguist Res, 2022, 51(5): 1083-1099. DOI: 10.1007/s10936-022-09885-5 .
[5]
ASHA. Central auditory processing disorder[EB/OL]. [2025-02-01].
[6]
Sun Y, Zhou J, Zhu H, et al. Characteristics of speech auditory brainstem response in preschool children with attention-deficit/hyperactivity disorder[J]. J Speech Lang Hear Res, 2024, 67(9): 3163-3177. DOI: 10.1044/2024_JSLHR-23-00454 .
[7]
Edwards B. A model of auditory-cognitive processing and relevance to clinical applicability[J]. Ear Hear, 2016, 37 : 85S-91S. DOI: 10.1097/AUD.0000000000000308 .
Suppl 1
[8]
Asuncion RMD, Al Khalili Y. Short-Term Memory Impairment[M]//StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2025.
[9]
Sanhueza S, Urrutia M, Marrero H. Finding the mole and choosing the apple: executive function challenges in children with developmental language disorder (DLD)[J]. Children (Basel), 2024, 11(12): 1519. PMCID: PMC11674595. DOI: 10.3390/children11121519 .
[10]
Jones SD, Westermann G. Under-resourced or overloaded? Rethinking working memory deficits in developmental language disorder[J]. Psychol Rev, 2022, 129(6): 1358-1372. PMCID: PMC9899422. DOI: 10.1037/rev0000338 .
[11]
Chinn LK, Zhukova MA, Kroeger RJ, et al. Auditory brainstem response deficits in learning disorders and developmental language disorder: a systematic review and meta-analysis[J]. Sci Rep, 2022, 12(1): 20124. PMCID: PMC9684495. DOI: 10.1038/s41598-022-20438-7 .
[12]
Elmahallawi TH, Gabr TA, Darwish ME, et al. Children with developmental language disorder: a frequency following response in the noise study[J]. Braz J Otorhinolaryngol, 2022, 88(6): 954-961. PMCID: PMC9615520. DOI: 10.1016/j.bjorl.2021.01.008 .
[13]
American Academy of Audiology. Clinical practice guidelines: diagnosis, treatment, and management of children and adults with central auditory processing disorder[EB/OL]. [2025-10-15].
[14]
Liu P, Lin H, Xiao Z, et al. The development, validity, reliability, and norm of a preschool auditory processing assessment scale in China[J]. Res Dev Disabil, 2022, 128: 104272. DOI: 10.1016/j.ridd.2022.104272 .
[15]
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5[M]. 5th ed. Washington, DC, USA: American Psychiatric Association, 2013: 55-57.
[16]
Valade F, Béliveau MJ, Breault C, et al. Individual and cumulative risk factors in developmental language disorder: a case-control study[J]. Clin Child Psychol Psychiatry, 2023, 28(1): 398-414. PMCID: PMC9893307. DOI: 10.1177/13591045221113389 .
[17]
Liu XL, de Villiers J, Ning C, et al. Research to establish the validity, reliability, and clinical utility of a comprehensive language assessment of Mandarin[J]. J Speech Lang Hear Res, 2017, 60(3): 592-606. DOI: 10.1044/2016_JSLHR-L-15-0334 .
[18]
Korpinen E, Slama S, Rosenqvist J, et al. WPPSI-IV and NEPSY-II performance in mono- and bilingual 5-6-year-old children: findings from the FinSwed study[J]. Scand J Psychol, 2023, 64(4): 409-420. DOI: 10.1111/sjop.12895 .
[19]
Wanderer S, Roessner V, Strobel A, et al. WISC-IV performance of children with chronic tic disorder, obsessive-compulsive disorder and attention-deficit/hyperactivity disorder: results from a German clinical study[J]. Child Adolesc Psychiatry Ment Health, 2021, 15(1): 44. PMCID: PMC8408972. DOI: 10.1186/s13034-021-00392-4 .
[20]
Fumeaux P, Mercier C, Roche S, et al. Validation of the French version of Conners' Parent Rating Scale-Revised, Short Form in ADHD-diagnosed children and comparison with control children[J]. J Atten Disord, 2021, 25(1): 124-133. DOI: 10.1177/1087054718763908 .
[21]
Chen L, Durrleman S. Comprehension of Mandarin aspect markers by preschool children with and without developmental language disorder[J]. Front Psychol, 2022, 13: 839951. PMCID: PMC9097452. DOI: 10.3389/fpsyg.2022.839951 .
[22]
Coughler C, Hamel EM, Cardy JO, et al. Compensation to altered auditory feedback in children with developmental language disorder and typical development[J]. J Speech Lang Hear Res, 2021, 64(6S): 2363-2376. DOI: 10.1044/2020_JSLHR-20-00374 .
[23]
Sheng L, Yu J, Su PL, et al. Developmental language disorder in Chinese children: a systematic review of research from 1997 to 2022[J]. Brain Lang, 2023, 241: 105268. DOI: 10.1016/j.bandl.2023.105268 .
[24]
Przybylski L, Bedoin N, Krifi-Papoz S, et al. Rhythmic auditory stimulation influences syntactic processing in children with developmental language disorders[J]. Neuropsychology, 2013, 27(1): 121-131. DOI: 10.1037/a0031277 .
[25]
Jones SD, Stewart HJ, Westermann G. A maturational frequency discrimination deficit may explain developmental language disorder[J]. Psychol Rev, 2024, 131(3): 695-715. PMCID: PMC11115354. DOI: 10.1037/rev0000436 .
[26]
Khavarghazalani B, Dastgerdi ZH, Hamidi Nahrani M, et al. A review of the importance of top-down processing assessment in auditory processing disorder[J]. Int J Pediatr Otorhinolaryngol, 2024, 186: 112128. DOI: 10.1016/j.ijporl.2024.112128 .
[27]
Hancock AS, Warren CM, Barrett TS, et al. Functional near-infrared spectroscopy measures of neural activity in children with and without developmental language disorder during a working memory task[J]. Brain Behav, 2023, 13(2): e2895. PMCID: PMC9927862. DOI: 10.1002/brb3.2895 .
[28]
de Wit E, van Dijk P, Hanekamp S, et al. Same or different: the overlap between children with auditory processing disorders and children with other developmental disorders: a systematic review[J]. Ear Hear, 2018, 39(1): 1-19. PMCID: PMC7654752. DOI: 10.1097/AUD.0000000000000479 .
[29]
Dos Santos JCC, Arruda MA, Masruha MR. Auditory processing disorder in childhood: a critical appraisal of diagnostic validity, functional assessment, and interdisciplinary practice[J]. Front Hum Neurosci, 2026, 20: 1715787. PMCID: PMC13099855. DOI: 10.3389/fnhum.2026.1715787 .
[30]
Burnley A, St Clair M, Bedford R, et al. Understanding the prevalence and manifestation of anxiety and other socio-emotional and behavioural difficulties in children with developmental language disorder[J]. J Neurodev Disord, 2023, 15(1): 17. PMCID: PMC10268478. DOI: 10.1186/s11689-023-09486-w .

脚注

所有作者声明无利益冲突。

基金

江苏省科技计划专项基金(重点研发计划社会发展)(BE2023666)
南京市国际/港澳台科技合作计划项目(202401037)
南京市卫生科技发展项目(YKK23152)
南京医科大学科技发展基金(NMUB20220102)
江苏省妇幼保健协会科研项目(FYX202338)

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