不同听处理能力的学龄前儿童认知相关行为差异分析

周佳; 刘潘婷; 林欢喜; 肖正路; 孙钰英; 俞欣悦; 钱君; 池霞; 洪琴

doi:10.16766/j.cnki.issn.1674-4152.003801

不同听处理能力的学龄前儿童认知相关行为差异分析

doi: 10.16766/j.cnki.issn.1674-4152.003801

周佳^{1, 2},
刘潘婷¹,
林欢喜²,
肖正路³,
孙钰英²,
俞欣悦³,
钱君¹,
池霞^{1, 4},
洪琴^{1, 4, ,}

1.
南京医科大学附属妇产医院(南京市妇幼保健院)儿童保健科，江苏南京 210004
2.
南京医科大学护理学院，江苏南京 211166
3.
南京医科大学儿科学院，江苏南京 211166
4.
南京市发育行为医学重点实验室，江苏南京 210004

基金项目:

江苏省妇幼健康科研项目 F202112

江苏省卫生保健协会科研课题 FYX202340

南京市卫生科技发展专项基金 YKK21157

南京市卫生科技发展专项基金 YKK23152

南京医科大学科技发展基金项目 NMUB20220102

详细信息

通讯作者:
洪琴，E-mail：rambler_hq@163.com

中图分类号: R179 R764.5
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- 被引次数: 0
出版历程
- 收稿日期: 2024-06-10
- 网络出版日期: 2025-01-20

Analysis of cognitive-related behavior differences among preschool children with different auditory processing abilities

ZHOU Jia^{1, 2},
LIU Panting¹,
LIN Huanxi²,
XIAO Zhenglu³,
SUN Yuying²,
YU Xinyue³,
QIAN Jun¹,
CHI Xia^{1, 4},
HONG Qin^{1, 4
, ,}

1.
Department of Child Healthcare, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu 210004, China

摘要

摘要: 目的分析不同听处理能力的学龄前儿童认知相关行为差异，探究学龄前儿童听处理能力与认知相关行为的关系。方法对2021年8月参与学龄前儿童听处理评估量表南京地区常模研究、南京市妇幼保健院儿童保健科就诊的儿童以及南京市幼儿园的4~6岁学龄前儿童，利用学龄前儿童听处理评估量表筛选出听处理异常低风险组48例，高风险组48例，采用韦氏幼儿智力量表第4版(WPPSI-Ⅳ)、学龄前儿童持续注意力测试(K-CPT)和Conners父母用症状问卷(PSQ)分别评估学龄前儿童智力、注意力和行为问题，比较低风险组和高风险组认知相关行为的差异及其与听处理能力的关系。结果高风险组儿童言语理解合成分低于低风险组(Z=-2.484，P < 0.05)，K-CPT中误点数及刺激改变，PSQ中各行为问题因子得分均高于低风险组(P < 0.05)。相关性分析显示，WPPSI-Ⅳ中言语理解合成分与量表总分及除听觉注意外其他各维度得分，K-CPT中误点数与量表总分及各维度得分，刺激改变与量表总分及除听觉解码、沟通交流外其他各维度得分，PSQ中除焦虑外其他问题因子与量表总分及各维度得分均相关(P < 0.05)，焦虑与量表总分及除沟通交流、视觉注意外其他各维度得分均相关(P < 0.05)。多重线性回归分析显示，听处理量表中听觉解码得分对WPPSI-Ⅳ中言语理解合成分有显著影响(β=-0.601，P < 0.05)。结论不同听处理能力的学龄前儿童认知相关行为有差异，其听处理能力与认知相关行为有关
- 听处理能力 /
- 认知行为 /
- 学龄前儿童
Abstract: Objective To analyze the cognitive-related behaviors of preschool children with different auditory processing abilities, and to explore the relationship between auditory processing ability and cognitive-related behaviors of preschool children. Methods For the 48 children with low risk of auditory processing disorder and the 48 children with high risk of auditory processing disorder identified by the preschool auditory processing assessment scale in the normative study conducted in Nanjing for children aged 4-6 years old in August 2021, who were seen at the Pediatric Healthcare Department of Nanjing Maternal and Child Healthcare Hospital and the children in Nanjing kindergartens, respectively. The Wechsler preschool and primary intelligence scale-Ⅳ (WPPSI-Ⅳ), the kiddie continuous performance test (K-CPT), and the Conners parent symptom questionnaire (PSQ) were used to evaluate the children's intelligence, attention, and behavior problems, and the differences in behavioral performance between the low-risk group and high-risk group and the relationship between behavioral performance and auditory processing ability were compared. Results Compared with the low-risk group, the high-risk group had lower verbal comprehension composite scores on the WPPSI-kiddie continuous performance test (Z=-2.484, P < 0.05), more errors on the K-CPT, more stimulus changes, and higher scores on each behavior problem factor on the PSQ (P < 0.05). Pearson correlation analysis showed that verbal comprehension composite scores on the WPPSI-Ⅳ, total scores and scores on all dimensions except auditory attention on the K-CPT, and scores on all dimensions except communication, visual attention, and auditory processing on the PSQ were correlated with total scores and all dimensions (P < 0.05). Anxiety on the PSQ was correlated with total scores and all dimensions except communication and visual attention (P < 0.05). The results of the multiple linear regression showed that auditory processing scores on the K-CPT were significantly related to verbal comprehension composite scores on the WPPSI-Ⅳ (β=-0.601, P < 0.05). Conclusion The behavioral performance of preschool children with different auditory processing abilities is different, and their auditory processing abilities are related to their behavioral performance.
- Auditory processing ability /
- Cognitive behavior /
- Preschool children

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表 1 2组学龄前儿童一般情况比较

Table 1. Comparison of general conditions between the two groups of preschool children

项目	低风险组(n=48)	高风险组(n=48)	统计量	P值
性别[例(%)]			2.671^a	0.102
男性	27(56.25)	19(39.58)
女性	21(43.75)	29(60.42)
年龄(x±s, 月)	61.30±7.86	60.74±5.27	0.675^b	0.745
母亲怀孕时年龄(x±s, 岁)	29.61±3.79	30.21±5.12	0.242^b	0.673
孕周[例(%)]			1.377^a	0.502
< 37周	1(2.08)	3(6.25)
≥37	47(97.92)	45(93.75)
生产方式[例(%)]			0.066^a	0.798
顺产	39(81.25)	38(79.17)
剖宫产	9(18.75)	10(20.83)
家庭月收入[例(%)]			-0.378^c	0.706
< 5 000元	1(2.08)	1(2.08)
5 000~10 000元	1(2.08)	4(8.33)
10 000~30 000元	30(62.50)	23(47.92)
>30 000元	16(33.33)	20(41.67)
母亲教育程度[例(%)]			-0.220^c	0.826
初中及以下	1(2.08)	1(2.08)
高中	4(8.33)	2(4.17)
中专或大专	6(12.50)	8(16.67)
本科	26(54.17)	28(58.33)
硕士及以上	11(22.92)	9(18.75)
父亲教育程度[例(%)]			-0.028^c	0.978
初中及以下	2(4.17)	3(6.25)
高中	5(10.42)	4(8.33)
中专或大专	5(10.42)	5(10.42)
本科	24(50.00)	24(50.00)
硕士及以上	12(25.00)	12(25.00)
WPPSI-Ⅳ总分(x±s, 分)	114.25±7.01	111.48±11.58	1.418^b	0.160
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组学龄前儿童WPPSI-Ⅳ得分比较(分)

Table 2. Comparison of WPPSI-Ⅳ scores between the two groups of preschool children (points)

组别	例数	言语理解合成分 [M(P₂₅, P₇₅)]	视觉空间合成分 [M(P₂₅, P₇₅)]	流体推理合成分 [M(P₂₅, P₇₅)]	工作记忆合成分 [M(P₂₅, P₇₅)]	加工速度合成分 (x±s)
低风险组	48	120.00(108.50, 132.00)	112.00(103.00, 118.00)	114.00(105.00, 120.00)	103.00(94.00, 110.00)	103.25±9.13
高风险组	48	111.00(102.00, 123.00)	110.50(97.00, 120.30)	108.00(97.80, 120.00)	100.00(94.00, 115.30)	103.56±8.29
统计量		-2.484^a	-0.526^a	-0.847^a	-0.280^a	0.176^b
P值		0.013	0.599	0.397	0.780	0.861
注：^a为Z值，^b为t值。

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表 3 2组学龄前儿童K-CPT情况比较(分数)

Table 3. Comparison of K-CPT between the two groups of preschool children (points)

组别	例数	识别力(x±s)	漏点数[M(P₂₅, P₇₅)]	错点数[M(P₂₅, P₇₅)]	误点数[M(P₂₅, P₇₅)]	反应速度[M(P₂₅, P₇₅)]
低风险组	48	49.44±11.00	48.00(43.30, 54.00)	43.00(40.0, 53.00)	52.00(47.0, 67.0)	51.00(47.0, 58.0)
高风险组	48	53.25±12.57	52.00(44.30, 60.00)	47.00(40.30, 58.00)	67.00(49.50, 83.50)	51.00(45.50, 60.00)
统计量		1.581^a	-1.336^b	-1.456^b	-2.321^b	-0.070^b
P值		0.117	0.182	0.145	0.020	0.944

组别	例数	反应标准差[M(P₂₅, P₇₅)]		模块改变[M(P₂₅, P₇₅)]	刺激改变(x±s)	变异性[M(P₂₅, P₇₅)]
低风险组	48	51.00(44.0, 56.8)		52.50(43.00, 55.00)	44.13±16.13	49.00(43.30, 58.00)
高风险组	48	51.00(47.00, 61.00)		49.50(42.30, 54.80)	52.75±12.35	51.50(45.30, 65.00)
统计量		-1.402^b		-0.473^b	2.941^a	-1.871^b
P值		0.161		0.636	0.004	0.061
注：^a为t值，^b为Z值。

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表 4 2组学龄前儿童PSQ得分比较[M(P₂₅, P₇₅), 分]

Table 4. Comparison of PSQ scores between the two groups of preschool children [M(P₂₅, P₇₅), points]

组别	例数	品行问题	学习问题	心身障碍	多动冲动	焦虑	多动指数
低风险组	48	0.25(0.10, 0.40)	0.50(0.30, 0.90)	0.00(0.00, 0.00)	0.25(0.00, 0.80)	0.25(0.00, 0.50)	0.30(0.10, 0.70)
高风险组	48	0.75(0.40, 1.00)	1.20(0.80, 1.80)	0.00(0.00, 0.40)	1.00(0.60, 2.00)	0.50(0.10, 0.80)	1.00(0.70, 1.50)
Z值		-5.973	-5.908	-3.914	-5.040	-2.018	-6.183
P值		＜0.001	＜0.001	＜0.001	＜0.001	0.044	＜0.001

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表 5 学龄前儿童听处理评估量表总分及各维度得分与行为表现的相关性分析(r值)

Table 5. Correlation between the total score and the scores of each dimension of the preschool children auditory processing assessment scale and behavioral performance (r value)

项目	量表总分	听觉解码	听觉注意	沟通交流	多动冲动	视觉注意
WPPSI-Ⅳ
言语理解合成分	-0.277^a	-0.311^a	-0.152	-0.221^b	-0.274^a	-0.238^b
K-CPT
误点数	0.310^a	0.280^a	0.319^a	0.246^b	0.235^b	0.221^b
刺激改变	0.264^a	0.195	0.201^b	0.124	0.284^a	0.241^b
PSQ
品行问题	0.588^a	0.492^a	0.534^a	0.475^a	0.614^a	0.564^a
学习问题	0.602^a	0.471^a	0.543^a	0.550^a	0.563^a	0.561^a
心身障碍	0.378^a	0.317^a	0.393^a	0.370^a	0.325^a	0.256^b
冲动多动	0.505^a	0.397^a	0.497^a	0.408^a	0.494^a	0.535^a
焦虑	0.226^b	0.278^a	0.223^b	0.135	0.311^a	0.117
多动指数	0.616^a	0.501^a	0.606^a	0.540^a	0.607^a	0.606^a
注：^aP < 0.01，^bP < 0.05。

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表 6 言语理解合成分影响因素的多重线性回归分析

Table 6. Verbal comprehension and composition factors of multiple linear regression

变量	非标准化系数		β	t值	P值	共线性统计
变量	B	SE	β	t值	P值	VIF	容忍度
常数	125.712	3.932		31.973	< 0.001
听处理量表总分	0.489	0.329	0.841	1.483	0.141	32.937	0.030
听觉解码	-0.827	0.414	-0.601	-1.996	0.049	9.302	0.108
沟通交流	-0.577	0.635	-0.169	-0.910	0.366	3.519	0.284
多动冲动	-1.173	0.791	-0.312	-1.483	0.142	4.548	0.220
视觉注意	-0.691	0.734	-0.190	-0.941	0.349	4.167	0.240
注：各变量均以实际值赋值。采用步进法，调整后R²=0.073。

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参考文献(21)

[1]	ASHA. Central auditory processing disorder[EB/OL]. (2023-01-28)[2023-02-01]. https://www.asha.org/Practice-Portal/Clinical-Topics/Central-Auditory-Processing-Disorder/.
[2]	CHOI S M R, KEI J, WILSON W J. Hearing and auditory processing abilities in primary school children with learning difficulties[J]. Ear Hear, 2019, 40(3): 700-709. doi: 10.1097/AUD.0000000000000652
[3]	GOKULA R, SHARMA M, CUPPLES L, et al. Comorbidity of auditory processing, attention, and memory in children with word reading difficulties[J]. Front Psychol, 2019, 10: 2383. DOI: 10.3389/fpsyg.2019.02383.
[4]	CHINN L K, ZHUKOVA M A, KROEGER R J, 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. DOI: 10.1038/s41598-022-20438-7.
[5]	GUZEK A, IWANICKA-PRONICKA K. Analysis of the auditory processing skills in 1 012 children aged 6-9 confirms the adequacy of APD testing in 6-year-olds[J]. PLoS One, 2022, 17(8): e0272723. DOI: 10.1371/journal.pone.0272723.
[6]	American Academy of Audiology. Clinical practice guidelines: diagnosis, treatment, and management of children and adults with central auditory processing disorder[EB/OL]. (2010-08-10)[2023-02-01]. https://www.audiology.org/practice-guideline/clinical-practice-guidelines-diagnosis-treatment-and-management-of-children-and-adults-with-central-auditory-processing-disorder/.
[7]	British Society of Audiology. Position statement and practice guidance auditory processing disorder (APD)[EB/OL]. (2022-10-17)[2023-02-01]. https://www.thebsa.org.uk/resources/position-statementpractice-guidance-auditory-processing-disorder-apd/.
[8]	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.
[9]	陈敏, 张蕾, 胡耀芳, 等. 学龄前注意缺陷多动障碍73例儿童韦氏智力量表结果特征分析[J]. 中华全科医学, 2020, 18(7): 1147-1149, 1164. doi: 10.16766/j.cnki.issn.1674-4152.001451 CHEN M, ZHANG L, HU Y F, et al. Characteristics analysis of wechsler intelligence scale in 73 preschool children with attention deficit hyperactivity disorder[J]. Chinese Journal of General Practice, 2020, 18(7): 1147-1149, 1164. doi: 10.16766/j.cnki.issn.1674-4152.001451
[10]	孙钰英, 祝慧琴, 刘潘婷, 等. 学龄前儿童听处理评估量表在注意缺陷多动障碍儿童中的应用研究[J]. 中国当代儿科杂志, 2023, 25(8): 824-830. SUN Y Y, ZHU H Q, LIU P T, et al. Application of preschool auditory processing assessment scale in children with attention deficit hyperactivity disorder[J]. Chinese Journal of Contemporary Pediatrics, 2023, 25(8): 824-830.
[11]	张勋, 孙玉燕, 康娟, 等. 感觉统合训练对注意缺陷多动障碍儿童干预效果分析[J]. 中华全科医学, 2022, 20(1): 95-98. doi: 10.16766/j.cnki.issn.1674-4152.002286 ZHANG X, SUN Y Y, KANG J, et al. Analysis of the effect of sensory integration training on children with attention deficit hyperactivity disorder[J]. Chinese Journal of General Practice, 2022, 20(1): 95-98. doi: 10.16766/j.cnki.issn.1674-4152.002286
[12]	林海, 常佳, 刘晓红, 等. 哮喘儿童气质类型及行为问题的研究[J]. 中国临床医生杂志, 2020, 48(5): 611-614. LIN H, CHANG J, LIU X H, et al. Study on temperament types and behavior problems in asthmatic children[J]. Chinese Journal for Clinicians, 2020, 48(5): 611-614.
[13]	MAGIMAIRAJ B M, NAGARAJ N K, CHAMPLIN C A, et al. Speech perception in noise predicts oral narrative comprehension in children with developmental language disorder[J]. Front Psychol, 2021, 12: 735026. DOI: 10.3389/fpsyg.2021.735026.
[14]	MARI G, PICCIOTTI P M, MARTINA B M, et al. Speech perception in noise in children with dyslexia: does speech sound disorder matter?[J]. Dyslexia, 2022, 28(2): 202-211. doi: 10.1002/dys.1710
[15]	KALNAK N, NAKEVA VON MENTZER C. Listening and processing skills in young school children with a history of developmental phonological disorder[J]. Healthcare(Basel), 2024, 12(3): 359. DOI: 10.3390/healthcare12030359.
[16]	DROSOS K, PAPANICOLAOU A, VONIATI L, et al. Auditory processing and speech-sound disorders[J]. Brain Sci, 2024, 14(3): 291. DOI: 10.3390/brainsci14030291.
[17]	CUNHA P, SILVA I M C, NEIVA E R, et al. Auditory processing disorder evaluations and cognitive profiles of children with specific learning disorder[J]. Clin Neurophysiol Pract, 2019, 4: 119-127. doi: 10.1016/j.cnp.2019.05.001
[18]	CAMPOS A, TUOMAINEN J, TUOMAINEN O. Mismatch responses to speech contrasts in preschoolers with and without developmental language disorder[J]. Brain Sci, 2023, 14(1): 42. DOI: 10.3390/brainsci14010042.
[19]	TIEN Y M, CHEN V C, LO T S, et al. Deficits in auditory sensory discrimination among children with attention-deficit/hyperactivity disorder[J]. Eur Child Adolesc Psychiatry, 2019, 28(5): 645-653. doi: 10.1007/s00787-018-1228-7
[20]	林欢喜, 刘潘婷, 孙钰英, 等. 听处理与学龄前儿童问题行为的关系: 执行功能的中介作用[J]. 中国当代儿科杂志, 2024, 26(2): 174-180. LIN H X, LIU P T, SUN Y Y, et al. Association between auditory processing and problem behaviors in preschool children: the mediating role of executive function[J]. Chinese Journal of Contemporary Pediatrics, 2024, 26(2): 174-180.
[21]	AHMMED A U. Auditory processing, co-morbidities, and parental report of sleep disturbance in children with auditory processing disorder (APD)[J]. Int J Pediatr Otorhinolaryngol, 2020, 135: 110117. DOI: 10.1016/j.ijporl.2020.110117.