Speech Disorders In Children Research Articles

Distribution of Specialties Providing Surgical Management of Cleft-Related Speech Disorders in Children 3 years of Age and Older: 2004 to 2021.

Given the overlap in specialties performing secondary correction of velopharyngeal incompetence (VPI), the present study investigated the specialty distribution for surgical providers of cleft care from 2004 to 2021. Data were obtained from 45 hospitals from 2004 to 2021 through the Pediatric Health Information System database. Cases of secondary surgical management of VPI were retrieved, identifying the year of surgery and specialty of the providing surgeon. A total of 7090 procedures were included in this study, of which 36.0% were secondary palatoplasty/lengthening, 34.1% were sphincter pharyngoplasty, and 29.8% were pharyngeal flap. Secondary management of VPI was performed by plastic surgeons (67%), otolaryngologists (31%), and oral and maxillofacial surgeons (OMFS, 12%). Palatal revision and/or lengthening procedures were the most common secondary procedure performed by plastic surgeons (42%) and OMFS (64%), whereas sphincter pharyngoplasty was the most common procedure performed by otolaryngologists (55%; P<0.001). The proportion of sphincter pharyngoplasty performed by plastic surgeons significantly decreased from 2017-2021 (P<0.05). Plastic surgeons performed most procedures for secondary management of VPI from 2004 to 2021, followed by otolaryngologists and OMFS. The type of procedure selected for secondary management of VPI differed significantly between the provider's specialty, with otolaryngologists more likely to perform sphincter pharyngoplasty.

Mothers of Children with Stuttering and Their Daily Concerns: A Qualitative Study

Background: Stuttering is one of the most important speech disorders in children, which causes anxiety and worry in parents, especially mothers. The present study sought to investigate and identify the types of anxiety experienced by mothers of children with stuttering. Methods: This qualitative study adopted reflexive thematic analysis (Brown &amp; Clark) to investigate the anxiety and concerns experienced by mothers of children with stuttering. The participants were 15 mothers of children with stuttering who visited speech therapy centers in Isfahan and were selected through homogenous purposive sampling. The data were collected through interviews with the participants for 45 days and analyzed by the thematic analysis method. Results: Data analysis revealed two core categories, four organizing themes, and nineteen subthemes. The two core categories identified in this study were mother-centered anxiety (anxiety about public judgments on the mother and anxiety about the appropriateness of the mother’s behavior with the child who stutters) and child-centered anxiety (concerns about public reactions to the child’s stuttering and the concerns about the child’s future life and treatment). Conclusion: The findings indicated that the mothers of children with stuttering were mostly concerned about public reactions to the stuttering child and their judgments about the mother. Thus, promoting a sense of self-worth in these mothers can reduce such concerns. Moreover, raising public awareness about how to treat children with stuttering and their parents can make social life easier for such children and their mothers.

Correction of Grammatical Structure Disorders in Older Preschoolers with Severe Speech Disorders Using Children’s Fiction

Introduction. Currently, one of the most urgent problems of special education is the development of effective approaches to the correction of violations of grammatical structure of speech in older preschool children with severe speech disorders. The leading activity of this age period is play. It allows the formation of all important mental neo-formations. Thisnecessitates the use of game methods in the process of corrective-developmental activities for older preschool children. Objective. To select a set of correctional techniques, including the use of reading children’s fiction, for the correction of grammatical structure disorders in older preschoolers with severe speech disorders. Materials and Methods. To assess the formation of grammatical skills in older preschoolers, we used an adapted “Methodology of Psycholinguistic Research of Oral Speech Disorders in Children” by R. I. Lalaeva and “Comprehensive Educational Program of Preschool Education for Children with Severe Speech Disorders” by N. V. Nishcheva. Results. The experimental study was conducted with the involvement of 10 children (6 boys and 4 girls) of preschool age with the speech therapy conclusion “erased dysarthria” at the age of 5.5 to 6 years, attending kindergarten No. 52 in Taganrog. The results of the study showed that the use of the developed methods and techniques of speech therapy allowed to develop concentration of attention, diligence in classes and to correct the revealed violations of the grammatical structure of speech, which were manifested at the beginning of the work. Discussion. It was revealed that the use of a large number of visual teaching aids, taking into account individual and age-specific features of older preschool children with severe speech disorders allowed to bring the level of development of children’s speech skills closer to the age norm: they built their answers consistently and logically, and also learned to operate independent speech.

Forming inflection and word-formation operations in preschoolers with mental retardation

Introduction. At the present stage of societal development, great attention is paid to issues affecting the psychological and pedagogical support in the educational process of children with disabilities. One general pattern of dysontogenetic development is violation of speech mediation. The most important areas of assistance to children with special educational needs are: identifying speech defect specifics and creating additional special conditions that will facilitate assimilation of educational programs and the social development of each student’s personality. The study aims to develop and test a program for forming inflection and word-formation operations in preschoolers with mental retardation. Materials and methods. The study involved 92 preschoolers aged 6-7 with mental retardation. The research methods were: Methodology of psycholinguistic study of oral speech disorders in children by R.I. Lalaeva, Diagnostics of oral speech of children aged 4-7 by N.V. Nishcheva; mathematical statistics: χ2-Pearson criterion. Results. The ascertaining experiment showed that preschoolers with mental retardation are characterized by predominantly low level of formation of inflection and word-formation operations. Specific difficulties were identified: omission or incorrect use of prepositions in speech; errors in changing nouns in indirect cases; deficiencies in the agreement of an adjective with a noun in the neuter gender; lexical substitutions of nouns, verbs when forming new words using suffixes and prefixes; replacement and incorrect use of suffixes while forming relative and possessive adjectives, etc. After the formative experiment, significant shifts occurred both in the level of noun inflection operations (χ2 = 19.739; p ≤ 0.05) where the number of children at a low level decreased from 64% to 32%, and in the level of verb word-formation operations (χ2 = 30.61; p ≤ 0.05) where the number of children at an average level increased from 39% to 58%. Conclusion. Preschoolers with mental retardation experience difficulties in grammatically designing speech utterances. The data obtained in the experiment show that speech difficulties are due to the delayed development of inflection and word-formation operations and the qualitative peculiarity of the manifestation of the defect. Studying grammatical operations in young children with mental retardation and the specifics of the manifestation of this disorder in written speech is a promising further direction.

Features of speech disorders in children with epileptic encephalopathies

Introduction. Speech disorders are a common problem in childhood. Speech disorders of various types are, in particular, the most common complications of epilepsy.&#x0D; Objective. The clinical manifestations of speech disorders in children with epileptic encephalopathies were studied.&#x0D; Materials and methods. The study included eighty nine children with epileptic encephalopathies. All patients underwent a detailed study of the anamnesis of life and disease, assessment of neurological and somatic, analysis of the semiotics of seizures, assessment of the therapy received, articulatory praxis, phonemic perception, game activity, expressive speech, impressive speech.&#x0D; Results. Speech in the examined patients had the character of a gross violation after the stage of normal development (37.1%), speech development delay was noted in 38.2% of patients from birth. Phonemic perception was impaired in 73 (82.0%) patients, a violation of articulatory praxis was detected in 63 (70.8%) patients, coherent speech was not formed in 78 (87.6%) patients, play activity did not correspond to the age of the child in 50 ( 56.2%) cases, violation of the account was detected in 69 (77.5%) patients, violation of sound pronunciation was observed in 30 (33.7%) patients. &#x0D; Conclusion. Articulatory apraxia and motor alalia are the most common types of speech disorders in children with epileptic encephalopathies.

Psoriasis and atopic dermatitis in terms of psychosomatic effects

The aim of this paper is to present the review of research into the psychological functioning of children and adults suffering from chronic diseases, with particular emphasis on psoriasis and atopic dermatitis. We have reviewed the scientific articles available in research databases on the topic: psoriasis and atopic dermatitis in terms of psychosomatic effects. It was found that psoriasis and atopic dermatitis interfere with patients’ most vital processes and negatively affect their immediate vicinity. They cause changes in the somatic, mental and social functioning of the patient. Frequently, they also cause a change in behaviour and negatively affect the quality of patients’ lives. Patients with severe psoriasis have an increased risk of death due to circulatory system diseases, cancer, chronic diseases of the lower respiratory tract, diabetes, dementia, infections and kidney diseases. Atopic dermatitis is correlated and may predispose to an increased risk of other atopic disorders, including asthma, hay fever, food allergies, and eosinophilic oesophagitis. It seems that patients with atopic dermatitis are more susceptible to infections and cardiovascular diseases and numerous neuropsychiatric disorders, including depression, attention deficit hyperactivity disorder, speech disorders in childhood, headaches and seizures. There is also a multifactor correlation between AD and osteoporosis, injuries, and fractures. Psoriasis is not only associated with anxiety disorders, depressive disorders and suicidal ideation, but also with significant cognitive functions impairment. In the case of atopic dermatitis, many authors emphasize the association between the occurrence of this skin disease and cognitive impairment, including reduced attention, visual and verbal memory, executive functions and abstract thinking.

Methods of Overcoming Speech Disorders in Children (Study of the Experience of Prophet Moses in the Quran)

&lt;p&gt;&lt;em&gt;The Qur'an gives instructions to everyone, including various goats. In Islam, a, -l-Quran as a holy book that has medicinal powers (Shifa), especially in everyone who reads and listens to it with confidence. This paper aims to explore and analyze children who have difficulty speaking. Qualitative methods were used in subjects of several children aged 3 to 6 years, data were collected through interviews, observation and documentation of the author's intersubjectivity. Furthermore, interactive model techniques are carried out, namely data collection, data reduction, data presentation and conclusions. The findings explain that speech difficulties have actually been practiced since the time of Prophet Moses who asserted that when Prophet Moses asked Allah for prayers against him, this practice in the Qur'an illustrates that, in practice with methods and beliefs in the Quran has a good influence in overcoming speech difficulties in children&lt;/em&gt;&lt;/p&gt;

The value of genomic testing in severe childhood speech disorders.

With increasing gene discoveries for severe speech disorders, genomic testing can alter the diagnostic and clinical paradigms, enabling better life outcomes for children and their families. However, evidence on the value of the outcomes generated is lacking, impeding optimal translation into health care. This study aims to estimate the value and uptake of genomic testing for severe childhood speech disorders. A discrete choice experiment was undertaken to elicit preferences for genomic testing from the perspective of the Australian public (n = 951) and parents of children experiencing severe speech disorder (n = 56). Choice attributes associated with genomic testing were identified through focus groups. A Bayesian D-efficient design was used to develop choice scenarios and choice data were analyzed using a panel error component mixed logit model and a latent class model. Statistically significant preferences were identified across all seven attributes. The mean monetary value of the benefits of genomic testing relative to standard diagnostic care in Australia was estimated at AU$7489 (US$5021) and AU$4452 (US$2985) from the perspectives of the Australian public and families with lived experience of severe speech disorders, with a corresponding test uptake of 94.2% and 99.6%. To ensure fair prioritization of genomics, decision-makers need to consider the wide range of risks and benefits associated with genomic information.

Genetic Aspects of Speech Disorders in Children

Genetic Aspects of Speech Disorders in Children

Поиск причин речевых нарушений у детей (перинатальные аспекты)

Speech disorders in children are a current issue of modern times, primarily because speech is a central cognitive function, without which the development of other mental processes, including thinking, is impossible. Speech development disorders in children can lead to difficulties in various areas in the future. This underscores the relevance of studying the causes of speech disorders in children and analyzing the factors influencing their occurrence. The aim of the research was to study the gender differences in the causes of speech disorders in children. A review and analysis of the literature on the problem were conducted. It was found that researchers consider perinatal factors among the significant causes of speech disorders. A retrospective analysis of the medical and educational documentation of children (n = 300) with disabilities, including severe speech disorders, was carried out. As a result, potential risk factors of the perinatal period influencing the occurrence of speech disorders in children were identified, and a gender analysis of these causes was conducted. Taking into account the identified risk factors, along with the early detection of deviations in a child’s psychomotor and speech development, will allow for the timely initiation of medication therapy and corrective work.

ДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА РЕЧЕВЫХ НАРУШЕНИЙ У ДЕТЕЙ С АУТИЗМОМ И СПЕЦИФИЧЕСКИМИ РАССТРОЙСТВАМИ РЕЧИ И ЯЗЫКА

A wide range of speech disorders causes the complex structure of the defect, which results in a disharmonious clinical and psychological characteristic of autism. The expediency of using the method of speech disorders in children with infantile autism is justified by the results of diagnostic efficiency analysis from the standpoint of evidence-based medicine. A wide range of speech disorders causes the complex structure of the defect, which results in a disharmonious clinical and psychological characteristic of autism. Objectivization of speech pathologies with the help of scientifically grounded diagnostic method of speech disorders in children with infantile autism gives an opportunity to create a speech profile of the child, which helps to determine the principles of their correction. The expediency of using the method is justified by the results of diagnostic efficiency analysis from the standpoint of evidence-based medicine.

Clinical study on the efficacy of Kalyanaka Leha Churna (Poly-herbal Ayurveda Powder) and Yapana Basti (Medicated Enema) in Language and Communication Disorders secondary to Autism Spectrum Disorder (ASD)– Study Protocol

Background: Autism Spectrum Disorder (ASD), in children is characterised by neuro-developmental challenges, which lack pharmaceutical solutions, making behavioural interventions the primary treatment in the contemporary system. Ayurveda offers a holistic approach to treating the condition with a combination of herbs-mineral medicines and Panchakarma therapies. This clinical study investigates the efficacy of Ayurveda interventions, specifically Kalyanaka Leha Churna, a poly-herbal powder commonly used in speech disorders of children and Yapana Basti, a poly-herbal decoction enema in addressing language and communication disorders secondary to ASD. Objectives of the Study: The primary objectives include assessing the effectiveness of Ayurveda intervention with the standard control therapies on the clinical features of ASD concerning speech. Materials and methods: The present trial has been approved by the IEC (JSSAMC/1106/2022-23) and duly registered in the clinical trial registry of India (CTRI/2023/07/055877). Twenty subjects in each group, aged 3-6 years, diagnosed with language and communication disorders secondary to ASD, will be recruited from various centres in and around Mysuru, Karnataka. Assessments will utilise the Indian Scale for Assessment of Autism (ISAA), Receptive and Expressive Emergent Language Scale (REELS), and Communication Deall Developmental (COMDEALL). Statistical analyses, including the Wilcoxon sign rank test, will be employed to evaluate the results. Conclusion: Language and Communication Disorders secondary to ASD are not an uncommon condition in children in the current day. Ayurveda classifies such a clinical condition under the ambit of ‘Unmada’. The difficulty to communicate has many negative consequences in children including poor academic performance, quality of life and behavioural problems. A significant result of therapy can be just supplementing speech as such or by any other means. This study aims to provide insights into the potential role of Ayurveda in this condition which will help in enhancing the quality of life for children with ASD and their families, presenting a holistic approach.

Peculiarities of educational work in the territorial community regarding the provision of speech therapy services

The proposed article highlights the peculiarities of educational work in the territorial community regarding the provision of speech therapy services. Based on the theoretical analysis of scientific and methodical literature, the historical development, peculiarities and formation of the provision of speech therapy services and speech therapy as a science as a whole are studied. It was determined that the speech therapist can carry out corrective, diagnostic, preventive and educational work, but a special emphasis in this process is determined on the importance of the speech therapist's work in the territorial community regarding educational activities, cooperation with parents and raising the level of their pedagogical culture. In order to study the awareness of residents of territorial communities (adults who have children), a survey was conducted regarding the provision of speech therapy services. The obtained results of the study proved that many parents have a certain understanding of the peculiarities of the child's speech development. Most of the answers indicate that parents understand when the child should begin to express the first phrases and communicate. A general trend is the desire of parents to be educated and informed about the speech development of their children. It is important to support this motivation of parents and ensure their access to reliable and trustworthy information resources. Informed parents can be more successful in addressing the issues of their children's speech development and contribute to their success in this area. Prevention of speech disorders in children is important to ensure their successful development, so parents should have such information. Improving a child's speech is an extremely important process and plays a key role in communication, expression of thoughts, development of thinking and social skills. The study emphasized the importance of informational work with parents aimed at spreading knowledge about the role of a speech therapist and the availability of speech therapy services for children in the community.

ПСИХОЛОГО-ПЕДАГОГИЧЕСКИЕ ПРИЕМЫ РАЗВИТИЯ МОТИВАЦИИ К ИСПРАВЛЕНИЮ НАРУШЕНИЙ РЕЧИ НА ЛОГОПЕДИЧЕСКИХ ЗАНЯТИЯХ

The article deals with the problem of finding psychological and pedagogical techniques for developing and maintaining motivation to correct speech disorders in children. The article presents an analysis of the effectiveness of speech therapy work to overcome violations of sound reproduction in preschoolers with FFN using the technique of creating a situation of success. The methods of developing motivation to correct speech disorders are considered.

The use of information computer technologies in the independent consolidation of knowledge in younger schoolchildren in the correction of dysgraphy

The relevance of studying the formation of independent consolidation of knowledge in children with disabilities is presented in a reasoned manner. Information and communication technologies are proposed by the authors as a tool for self-consolidation of knowledge. The authors consider such categories as independence, skills formation and children with disabilities, students with disabilities. Three directions in the theory of independent activity of P.I. Pidkasisty are revealed. The following authors made a great contribution to the study of self-consolidation of knowledge in children with disabilities: A. I. Herzen, V. G.Belinsky, N. A. Dobrolyubov, N. G. Chernyshevsky, D. I. Pisarev, E.Ya. Golant, Ushinsky K.D., Kaptereva P.F., Vakhterova V.P. In the study, the authors selected subcategories of children with disabilities, especially children with oral and written speech violation. L.S. Volkova’s classification of written speech is revealed. The group of 40 primary school students (second grades) took part in the study. The analyzed speech disorders in children of primary school age revealed the importance of independent consolidation skills of knowledge at all stages of remedial work. The results of studies revealing the peculiarity of using information and communication technologies (ICT) in the process of forming of independent consolidation skills of knowledge in children are considered. Special attention is paid to the consideration of the speech therapy program for the correction of written speech in primary schoolchildren with developmental language disorder (DLD) and using of computer technology, and the peculiarity of consolidating new knowledge at each stage of the study. The possibilities of using ICT as an effective resource for the formation of the of self-consolidation skills of knowledge in children with speech disorders are shown.

Interdisciplinary approach to the diagnosis of dentofacial deformities and speech disorders in preschoolers

Relevance. Maxillofacial deformities and speech disorders are common types of oral pathology detected in children under seven years. Comprehensive rehabilitation of patients with a combination of these forms of pathology is a difficult task since there is no situational analysis of their prevalence; motivated specialists work in different institutions (education, healthcare) and have different guidelines for the treatment (correction) of existing diseases (disorders), which complicates planning and administering treatment, and predicting results.Material and methods. To identify the nature of the relationship between various forms of orthodontic and speech disorders in children, we conducted a comprehensive clinical dental examination of 80 children aged 4-6 years in a preschool educational institution, where children with speech disorders receive speech therapy assistance.Results. Maxillofacial deformities appeared to be in 56.25% of children with some speech sound disorder. Children with identified speech sound disorders combined with dentofacial deformities showed not only skeletal but also soft tissue defects: shifted midline (86.67 ± 0.10%), distal occlusion (42.22 ± 0.30%), deep overbite (46.68%), as well as tongue and upper lip ties in 51.10% and 22.20% of cases, respectively. On examination, 44.45% of patients demonstrated clinical signs of mouth breathing, 32.5% – reverse swallowing, and 53.33% – inefficient chewing.Conclusion. Analysis of the results of a comprehensive speech pathology assessment and dental examination allowed us to conclude that there is a need to rethink the methodology of diagnosis, prevention and treatment of combined speech and dental disorders due to the high frequency of their comorbidity in preschool children.

Speech disorders in genetically determined forms of epilepsy in children. Clinical observations

BACKGROUND: Speech disorders in children are one of the pressing problems of child neurology. In recent years, much attention has been paid to studying the genetic aspects of the development of speech disorders in children with epilepsy. Speech function in childhood is vulnerable, and its violation has a number of significant consequences. Specialists from different disciplines focus on specific aspects of speech disorders. Speech therapists consider speech disorders based on linguistic criteria, psychologists evaluate the psychological characteristics of children with speech disorders. The rapid development of genetic research, the availability of many molecular genetic tests, especially such a method as next generation sequencing, allowed us to pay more attention to the study of genetic aspects of the development of speech disorders in children with epilepsy.&#x0D; AIM: to present options for speech disorders in genetically determined forms of epilepsy in children based on clinical examples.&#x0D; RESULTS: The article analyzes 3 clinical cases of epilepsy in children, combined with speech pathology (2 boys and 1 girl aged 2 to 5 years). The data of anamnesis of life and disease, neurological examination with assessment of speech function, results of genetic research, electroencephalographic examination and magnetic resonance imaging are presented.&#x0D; CONCLUSION: All patients are united by a combination of speech disorders, epileptic seizures, and the presence of genetic pathologies that are responsible for speech function. These clinical observations demonstrate the need for a comprehensive, multidisciplinary approach both at the stage of early diagnosis of speech impairment in children with epileptic seizures and at the stage of further treatment of such patients.

Guiding Mothers About Early Detection and Addressing Speech Delay and Disorders Among Children in a Rural Setup.

Introduction Speech is one of the most important milestones to be achieved by a growing child. The significance of being informed about different pediatric speech abnormalities, especially to mothers, allows them to help their children in cases of irregularities in the maturation in this domain. Aim and objectives The study aimed to assess and educate mothers on the important milestones of speech delay in children and make them address the issue and be aware of various corrective measures to treat the underlying conditions of speech disorders in children.The objectives of the study includeunderstanding the pre-acquired knowledge of the mothers regarding the delay in speech in children, imparting knowledge regarding different speech disorders and their management, spreading awareness on how to seek help for various underlying causes of speech irregularities or delay, and to train the mothers into approaching the challenges in an orderly manner. Methods A study was conducted to guide rural mothers visiting the Obstetrics and Gynecology and Pediatric out-patient departments and Neonatal wards in a rural tertiary care hospital situated in the Sawangi Meghe village of Wardha City, Maharashtra, India, about the detection and treatment of children with disabilities of speech as early as possible. The mothers' knowledge was assessed before and after the study with the help of questionnaires, and basic understandable information on different types, causes, symptomatology, and management of speech delay and disorders among children was explained with the help of group discussions and posters. Results The motive behind this study was to be aware of facts known by the rural mothers, their actions on coming across such presentations by their children, cues that they would pick up, and the need to ask for help at the appropriate time were assessed and elaborated if not known by them. The Relative Learning Gain and Normalized Gain were calculated to be 76.43% and 0.74 (high gain), respectively, and out of the total subjects, 97.16% of mothers voted that this study proved helpful, and six mothers (4.23%) benefited with the intervention and were referred to experts for evaluation of their children. Conclusion Awareness in this field is necessary to manage children's development, especially by their mothers. Knowing the prevalence of knowledge in mothers may build an association with the prevalence of the recognized cases of speech disorders in children. Evaluation at different community levels may be conducted to gauge the need to impart required knowledge about speech disabilities in children to the maternal population. Future research and the impartation of knowledge to caregivers are vital to promote vigilant and systematic action to be taken regarding the proper growth of their children.

SPECIFICITY OF LOGOPEDICAL ASSISTANCE FOR CHILDREN IN THE HEALTH CARE SYSTEM

The state of speech disorders in children at the present stage and the network of institutions and facilities providing speech therapy are highlighted. The peculiarities of providing speech therapy in health care institutions of Ukraine are identified and

Cognitive speech disorders in children with congenital heart defects aged 5–7 years

Purpose. To found out expressive speech disorders as a sign of neurocognitive development delay in children with congenital heart defects before and after surgery. Material and methods: 216 children with congenital heart defects were divided into groups according to the presence (group 1, n = 71) and absence (group 2, n = 145) of family history confounding factors, and studied before surgery and in 1 and 2 years after definitive repair under cardiopulmonary bypass. The anamnesis, clinical and hemodynamic aspects were studied before and after surgery, mental status and expressive speech diagnostics were also performed. Results. The predictors of neurocognitive impairment in children with congenital heart defects before surgery were identified: the level of heart failure, comorbidity, burdened family history. 76.3 % of children had «average» level of neurocognitive development (more in group 2) in a year after surgical correction, while 23.6 % had «low» and «very low» level (more in group 1); there were general expressive speech disorders in 68 % children in group 1 and in 55 % in group 2 among all children. «High» level of neurocognitive development was recorded in 2 years (13.8 % among all children), while the number of children with general expressive speech disorders was approximately the same despite of positive dynamic of clinical and hemodynamic aspects. Conclusion. There are «low» levels of neurocognitive development and expressive speech disorders in children with congenital heart defects in long term postoperative period despite of clinical and hemodynamic normalization. It can predict significant risks and poor quality of life in the absence of timely correction.