研究發(fā)現，視覺空間學習障礙比思維障礙更常見

研究發(fā)現，視覺空間學習障礙比思維障礙更常見

Nonverbal learning disability (NVLD), a poorly understood and often-overlooked disorder that causes problems with visual-spatial processing, may affect nearly 3 million children in the United States, making it one of the most common learning disorders, according to a new study by led by Columbia University Irving Medical Center.

哥倫比亞大學歐文醫(yī)學中心(Columbia University Irving Medical Center)領導的一項新研究顯示，非語言學習障礙(NVLD)是一種理解力差、常被忽視的導致視覺空間處理問題的障礙，可能影響美國近300萬兒童，成為最常見的學習障礙之一。

The study, the first to estimate the prevalence of NVLD in the general population, was published online today in JAMA Network Open.

這項研究是首次估計NVLD的研究，今天在JAMA網公開發(fā)表。

"NVLD is a huge and hidden public health burden," said Jeffrey Lieberman, Chair of Psychiatry at the Columbia University Vagelos College of Physicians and Surgeons and Director of the New York State Psychiatric Institute. "This important work might never have come to light if not for the support of dedicated advocate and their philanthropic support. We hope that these findings raise awareness of the disorder and lead to an understanding of its neurobiology and better treatments."

“NVLD是一個巨大而隱蔽的公共衛(wèi)生負擔，”哥倫比亞大學瓦杰洛斯醫(yī)師和外科醫(yī)生學院精神病學系主任、紐約州精神病研究所所長杰弗里·利伯曼說，“這項重要的工作如果沒有熱心的倡導者的支持和他們的慈善支持，可能永遠不會曝光。我們希望這些發(fā)現能提高人們對這種疾病的認識，并有助于理解其神經生物學和更好的治療方法。”

The name of this neurodevelopmental disorder may be part of the problem: children with NVLD are not nonverbal, as the name suggests, and have no difficulty reading. Instead, children with NVLD have difficulty processing visual-spatial sensory information, which can cause problems with math, executive function, and fine motor and social skills. "Children with this disorder might shy away from doing jigsaw puzzles or playing with Legos," says lead author Amy E. Margolis, PhD, assistant professor of medical psychology at Columbia University Vagelos College of Physicians and Surgeons. "They may have trouble tying their shoes, using scissors, or learning routes or schedules."

這種神經發(fā)育障礙的名字可能是問題的一部分：NVLD兒童并不像名字所暗示的那樣是非語言的，而且閱讀也沒有困難。相反，患有NVLD的兒童很難處理視覺空間感覺信息，這可能會導致數學、執(zhí)行功能、精細運動和社交技能方面的問題。“患有這種疾病的兒童，可能會回避做拼圖游戲或玩樂高玩具，”主要作者艾米E.馬戈利斯博士說，她是哥倫比亞大學瓦杰洛斯醫(yī)師和外科醫(yī)生學院醫(yī)學心理學助理教授，“他們可能在系鞋帶、使用剪刀、學習路線或日程安排方面遇到困難。”

NVLD was first described in 1967, but compared with other learning disorders it has received little attention. There's little consensus among physicians on how to diagnose the disorder, and it is not included in the current edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). The cause of NVLD is not known and there are no treatments.

NVLD于1967年首次被發(fā)現，但與其他學習障礙相比，它很少受到關注。在如何診斷這種疾病上，醫(yī)生們幾乎沒有達成共識，而且它也沒有被包括在美國精神病學協會(American Psychiatric Association)最新版的《精神疾病診斷與統計手冊》(Diagnostic and Statistical Manual of Mental Disorders, DSM)中。NVLD的病因尚不清楚，也沒有治療方法。

Few parents have heard of NVLD. "Most parents recognize that a child who isn't talking by age two should be evaluated for a learning disorder. But no one thinks twice about kids who have problems with visual-spatial tasks," says Margolis.

很少有家長聽說過NVLD。“大多數父母都認識到，兩歲前不會說話的孩子應該被評估為學習障礙。但是對于那些在視覺空間任務上有問題的孩子，沒有人會做更多的考慮。”

To see how common the disorder is, the researchers analyzed three independent samples of children (ages 6 to 19) in the U.S. and Canada, including a total of 2,596 individuals. Any child with a deficit in spatial reasoning and impairment in two of four domains (fine motor skills, math calculation, visual executive functioning, and social skills) was considered to have NLVD.

為了了解這種疾病的常見程度，研究人員分析了美國和加拿大三個獨立的兒童樣本(6至19歲)，其中包括2596名個體。任何在四個領域(精細運動技能、數學計算、視覺執(zhí)行功能和社交技能)中有兩個領域的空間推理缺陷和障礙的兒童，都被認為患有NLVD。

The researchers found that 3 to 4 percent of children in each sample met the criteria for NLVD. "When applied to the U.S. population under 18, this translates to approximately 2.2 to 2.9 million children having NVLD," says co-author Katherine Keyes, PhD, MPH, associate professor of epidemiology at the Columbia Mailman School of Public Health.

研究人員發(fā)現，每個樣本中有3%到4%的兒童符合NLVD標準。研究報告的合著者、哥倫比亞郵差公共衛(wèi)生學院(Columbia Mailman School of Public Health)流行病學副教授凱瑟琳•凱斯(Katherine Keyes)博士說:“如果將這一結論應用到美國18歲以下的人口中，大約有220萬至290萬兒童患有NVLD。”

Many of the children in the study who were identified as having NVLD had been diagnosed with attention-deficit hyperactivity disorder (ADHD) or anxiety disorder. "While there is some overlap in symptoms between the two disorders, it's important to distinguish between them so we can begin to develop interventions for NVLD," says Margolis.

在這項研究中，許多被確診為NVLD的兒童被診斷為注意力缺陷多動障礙(ADHD)或焦慮癥。馬戈利斯說:“雖然這兩種疾病的癥狀有些重疊，但重要的是要區(qū)分它們，這樣我們才能開始開發(fā)針對NVLD的干預措施。”