研究發(fā)現(xiàn)，視覺(jué)空間學(xué)習(xí)障礙比思維障礙更常見(jiàn)

研究發(fā)現(xiàn)，視覺(jué)空間學(xué)習(xí)障礙比思維障礙更常見(jiàn)

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(xué)歐文醫(yī)學(xué)中心(Columbia University Irving Medical Center)領(lǐng)導(dǎo)的一項(xiàng)新研究顯示，非語(yǔ)言學(xué)習(xí)障礙(NVLD)是一種理解力差、常被忽視的導(dǎo)致視覺(jué)空間處理問(wèn)題的障礙，可能影響美國(guó)近300萬(wàn)兒童，成為最常見(jiàn)的學(xué)習(xí)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(xiàng)研究是首次估計(jì)NVLD的研究，今天在JAMA網(wǎng)公開(kāi)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(gè)巨大而隱蔽的公共衛(wèi)生負(fù)擔(dān)，”哥倫比亞大學(xué)瓦杰洛斯醫(yī)師和外科醫(yī)生學(xué)院精神病學(xué)系主任、紐約州精神病研究所所長(zhǎng)杰弗里·利伯曼說(shuō)，“這項(xiàng)重要的工作如果沒(méi)有熱心的倡導(dǎo)者的支持和他們的慈善支持，可能永遠(yuǎn)不會(huì)曝光。我們希望這些發(fā)現(xiàn)能提高人們對(duì)這種疾病的認(rèn)識(shí)，并有助于理解其神經(jīng)生物學(xué)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(jīng)發(fā)育障礙的名字可能是問(wèn)題的一部分：NVLD兒童并不像名字所暗示的那樣是非語(yǔ)言的，而且閱讀也沒(méi)有困難。相反，患有NVLD的兒童很難處理視覺(jué)空間感覺(jué)信息，這可能會(huì)導(dǎo)致數(shù)學(xué)、執(zhí)行功能、精細(xì)運(yùn)動(dòng)和社交技能方面的問(wèn)題。“患有這種疾病的兒童，可能會(huì)回避做拼圖游戲或玩樂(lè)高玩具，”主要作者艾米E.馬戈利斯博士說(shuō)，她是哥倫比亞大學(xué)瓦杰洛斯醫(yī)師和外科醫(yī)生學(xué)院醫(yī)學(xué)心理學(xué)助理教授，“他們可能在系鞋帶、使用剪刀、學(xué)習(xí)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(xiàn)，但與其他學(xué)習(xí)障礙相比，它很少受到關(guān)注。在如何診斷這種疾病上，醫(yī)生們幾乎沒(méi)有達(dá)成共識(shí)，而且它也沒(méi)有被包括在美國(guó)精神病學(xué)協(xié)會(huì)(American Psychiatric Association)最新版的《精神疾病診斷與統(tǒng)計(jì)手冊(cè)》(Diagnostic and Statistical Manual of Mental Disorders, DSM)中。NVLD的病因尚不清楚，也沒(méi)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(zhǎng)聽(tīng)說(shuō)過(guò)NVLD。“大多數(shù)父母都認(rèn)識(shí)到，兩歲前不會(huì)說(shuō)話的孩子應(yīng)該被評(píng)估為學(xué)習(xí)障礙。但是對(duì)于那些在視覺(jué)空間任務(wù)上有問(wèn)題的孩子，沒(méi)有人會(huì)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(jiàn)程度，研究人員分析了美國(guó)和加拿大三個(gè)獨(dú)立的兒童樣本(6至19歲)，其中包括2596名個(gè)體。任何在四個(gè)領(lǐng)域(精細(xì)運(yùn)動(dòng)技能、數(shù)學(xué)計(jì)算、視覺(jué)執(zhí)行功能和社交技能)中有兩個(gè)領(lǐng)域的空間推理缺陷和障礙的兒童，都被認(rèn)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(xiàn)，每個(gè)樣本中有3%到4%的兒童符合NLVD標(biāo)準(zhǔn)。研究報(bào)告的合著者、哥倫比亞郵差公共衛(wèi)生學(xué)院(Columbia Mailman School of Public Health)流行病學(xué)副教授凱瑟琳•凱斯(Katherine Keyes)博士說(shuō):“如果將這一結(jié)論應(yīng)用到美國(guó)18歲以下的人口中，大約有220萬(wàn)至290萬(wàn)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(xiàng)研究中，許多被確診為NVLD的兒童被診斷為注意力缺陷多動(dòng)障礙(ADHD)或焦慮癥。馬戈利斯說(shuō):“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(kāi)始開(kāi)發(fā)針對(duì)NVLD的干預(yù)措施。”