children with dyslexia
Introduction
Introduction to pediatric dyslexia Dyslexia is a recognition function of words and an obvious developmental disorder of reading comprehension. This disorder cannot be explained by mental retardation, inadequate education, or the result of visual, auditory or neurological disorders. basic knowledge Sickness ratio: 0.05% Susceptible people: children Mode of infection: non-infectious Complications: ADHD
Cause
Causes of pediatric dyslexia
(1) Causes of the disease
The learning disorder of this disease is manifested in the process of information processing. There are perceptions of perception, representation, abstraction, etc., and the memory of both hearing and vision. Any obstacle can lead to reading problems.
Clinical observation and epidemiological studies have found that dyslexia has a family tendency, Sysvia et al found that the incidence of dyslexia is more than 45%; the study of twins also shows that the same incidence of identical twins is higher than that of fraternal twins. The ratio is 87%: 24%.
(two) pathogenesis
Gene linkage analysis suggested that there are gene loci that are inherited by autosomal display on the 15th pair of chromosomes; there are also reported gene loci on the sixth chromosome, and some scholars have adopted binaural listening techniques, electrophysiological methods, Cortical blood flow analysis, transversal half field of view and other methods to study brain function lateralization, found that: children with dyslexia have brain structure lateralization abnormalities, may lead to abnormal development of fetal blood testosterone levels, and some scholars believe that: such children In the process of writing the word system, there are abnormalities or defects; or the literacy pattern is abnormal or the language path is abnormal, and some are cognitive or spatial perception disorders, others are considered to be caused by vestibular dysfunction in the inner ear, parents and families. Negative life events can exacerbate such problems.
Prevention
Pediatric dyslexia prevention
Behavioral interventions basically use the principle of operational conditioning to increase or decrease the frequency of occurrence of targeted behavior by appropriate environmental control of events associated with a child's target behavior. The significance of controlling the environment is to provide opportunities for the generation of specific behaviors. When conducting behavioral interventions, it is first necessary to conduct a detailed analysis of the premise and consequences of behaviors, which are often based on direct observations. Second, in identifying those issues that may cause or reinforce what we are trying to overcome, the main attempt is to create A stable, structured intervention environment; again, the rules of intervention should be clear and consistent, appearing in a positive form as much as possible, rather than in a single form of prohibition. In addition, the requirements for children with dyslexia should be less and clear for a period of time, and guarantee feedback at any time.
Complication
Pediatric dyslexia complications Complications ADHD
School-aged can be accompanied by language skills barriers, phonics barriers, computational barriers, etc., poor language, poor answers to mathematics application questions, often accompanied by difficulty in spelling, and often accompanied by ADHD and behavioral problems, combined with immune and autoimmune diseases More than the normal population.
Symptom
Symptoms of dyslexia in children, common symptoms, cognitive dysfunction, loss of reading
1. General clinical manifestations
In the alphabet writing system, the early stages of dyslexia may appear as memorizing letters, saying the correct name of the letter, the segmentation of the word, the analysis or classification of the pronunciation, and the like, and then showing the lack of reading in the spoken language: missing words when reading aloud ( For example, "The rabbit turned into the hole under the fence" read "Bunny turned into the fence hole"), adding words (such as "I didn't expect her to go down the hole, she kept going down" read "I didn't expect her As soon as you enter the hole, you keep going to the ground.", read the wrong word (such as reading "6" as "9", or "d" as "b", and "" as " "Autumn", "goods" read as "goods", "wrestling" read as "doctor", "crossing the road" read "yellow crossing the road", "detailed" read as "sheep", etc., writing typo ( For example, Yes is written as Long Jing, Party is written as Tang), and the word is replaced (such as falling a squat and falling down), and the words in the sentence or the words in the words are reversed. ("na" reads "an", "f" reads "t"), reading is slow, long pauses are not correctly segmented, and reading comprehension is also There are defects, you can't recall what you read, you can't draw conclusions or reasoning from the materials you read, use general common sense to answer the questions in the special stories you read, and you can't use the information in the stories to read in the Chinese system. Obstacles are also manifested as: the tone is wrong, the sound of similar structure ("fox" read "orphan"), multi-phonetic reading wrong, reading a word composed of two words, can not distinguish homophones, reading comprehension It is also obviously impaired. Some children with dyslexia can also show certain language defects and cognitive dysfunction before school. For example, when copying pictures, they often cannot distinguish the relationship between the subject and the background, and cannot analyze the combination of graphics. Can not integrate the various parts of the graph into a whole, more left-handed, high positive rate of nervous system soft signs.
2. Course of disease
It usually starts in infancy or childhood, and is obvious in 6 to 7 years old (first and second grade). Sometimes, dyslexia can be compensated in the lower grades, and it is obviously serious after 9 years old (fourth grade) or later. After reading, the reading will gradually catch up, until the adult has no signs of dyslexia, and the patient is seriously ill. Although treated, many signs of the disorder will last for a lifetime.
Examine
Pediatric dyslexia examination
Generally no special findings, chromosomal gene linkage analysis can be abnormal.
Should do brain CT, EEG, binaural hearing technology, electrophysiological methods, cortical blood flow analysis, transilluminator half field of view and other methods, can be found in children with lateral brain structural abnormalities, EEG can be non-specific Abnormal changes.
EEG examination
About 50% of children with special learning disabilities have EEG abnormalities, mainly in frequency and amplitude abnormalities, but there is no characteristic EEG performance.
2. Evoked potential check
Since the 1970s, auditory and visual evoked potentials have been used in the study of such children. It has been found that the amplitude of visual evoked potentials in the left half of the brain of children with dyslexia changes, and the latency of visual and auditory evoked potentials is prolonged. The after event related electric potential has gradually attracted people's attention. It has been confirmed that the potential latency of the patient exceeds 300 ms. It is currently considered that these test methods cannot be an independent auxiliary test.
3. Neuroimaging
The development of neuroimaging technology has also made some new discoveries in the study of special learning insufficiency. Some studies have found that such children sometimes have a phenomenon of dislocation of the sacral plane. Under normal circumstances, the speech center of the temporal lobe is often located. On the left side of the brain, this area of children with dyslexia is often on the right side. A positron-stimulated X-ray tomography (PET) study found that children with dyslexia have regional and frontal cortical functionalities during reading. Changes, the recent study of single-photon excitation computer-controlled X-ray tomography (SPECT) found that cerebral blood flow in the forehead of children with dyslexia is considered to have a certain diagnostic value for special learning disabilities.
Diagnosis
Diagnosis and diagnosis of dyslexia in children
diagnosis
Standardized individual test
The reading scores obtained by standardized individual tests are significantly lower than the expected levels determined by their intelligence and education.
The key to the diagnosis of dyslexia is that the reading scores obtained by standardized individual tests compared to learning ability and intelligence (individually determined by IQ) are significantly lower than the expected levels determined by their intelligence and education; but the focus of the problem And it is very easy to make a difference: the level of difference between reading grades and expected grades is considered to be significantly different. In this regard, there are four methods of assessment:
(1) Reading is less than 2 years of the current grade.
(2) The reading age is significantly lower than the expected age (expected age = age of the actual age of the intellectual age, reading age / expected age <90, suggesting difficulty reading) or reading performance is significantly lower than the expected grade.
(3) Z-segment difference method.
(4) Regression difference method.
The first method does not consider the inconsistency between ability and performance, which is inconsistent with the current diagnostic criteria. The second method ignores the standard deviation of the expected age or grade distribution with age, making more older children diagnosed as Dyslexia does not take into account the incomplete correlation between reading scores and IQ. The third method does not take into account the incomplete correlation between reading scores and IQ. The fourth method overcomes the above basic shortcomings. In the fourth In the method, the regression equation between reading score and IQ is calculated, and the expected reading score is calculated by using the regression equation. If the actual score is significantly lower than the expected score, the diagnosis can be established, but the workload of the norm is large.
2. The reduction of reading ability affects daily life
Found for the first time in infants or childhood, the duration of the disease continues, and the decline in reading ability affects their daily lives.
3. Exclude other diseases
Exclude children with schizophrenia, childhood autism, mental retardation and other diseases, as well as obstacles due to visual or auditory defects or neurological diseases.
Differential diagnosis
1. Childhood schizophrenia
The first onset in infants and young children, with other mental disorders, the disease has relief and recurrence characteristics.
2. Child autism
It was also first discovered in infants and young children. Although there are language and dyslexia, children's autism is mainly a life-related, communication and limited repetitive behavior.
3. Mental retardation
The reading scores obtained by the standardized individual test for mental retardation are consistent with the expected levels determined by intelligence and education, and the reading scores and intelligence levels are lower than average.
