功能性构音障碍患者舌尖后音异常的语音特点及康复训练
|
摘要
目的探讨功能性构音障碍(functional articulation disorders,FAD)患者舌尖后音异常的语音特点和康复训练的效果。方法分析107例FAD患者(年龄4～28岁,平均7.04±4.79岁)舌尖后音异常的语音特点,对其中90例舌尖后音异常的患者进行针对性康复训练;对舌尖后音异常和年龄的关系进行关联性分析和简单线性回归分析。结果学龄前FAD患儿(4～6岁,74例)舌尖后音异常的比例最高,为69.16%(74/107);/zh/、/ch/、/sh/、/r/均涉及的错误方式为舌前音化、构音扭曲、辅音脱落、侧化构音;其中/zh/音主要发生扭曲、脱落及被置换为/d/、/z/;/ch/音主要发生扭曲、脱落及被置换为/d/、/t/、/c/、/z/;/sh/音主要发生扭曲、侧化构音及被置换为/s/、/z/;/r/音主要表现为扭曲、脱落及置换为/y/。舌尖后音与不同的韵母组合,构音错误方式不同;90例患者经过1～2个疗程的康复训练,发音错误字数由训练前的47.37±15.32个明显减少到训练后的7.33±4.08个,差异有统计学意义(Z=-8.240,P<0.001);FAD患者舌尖后音错误字数与年龄呈负相关(r=-0.588,P<0.001),年龄对舌尖后音异常的决定系数为0.410(R~2=0.410)。结论 FAD患者舌尖后音构音错误方式主要为舌前音化、辅音脱落、构音扭曲;舌尖后音与不同韵母相拼时,错误方式不同;针对性康复训练的疗效确切;年龄是影响舌尖后音异常预后的重要因素。
Objective To explore the phonological characteristics and rehabilitation training of abnormal blade-palatal in patients with functional articulation disorders(FAD).Methods A total of 107 patients with FAD were studied for the phonological characteristics of blade-palatal. Among these 107 patients, 90 patients with abnormal blade-palatal received targeted rehabilitation training. The correlation and simple linear regression analysis were carried out on abnormal blade-palatal articulation and age.Results The highest proportion of abnormal blade-palatal lied in preschool children with FAD was 69.16%(74/107).The common erroneous patterns of/zh/,/ch/,/sh/and/r/were replacement by apical consonants, distortion,omission and lateral misarticulation./zh/mainly showed distortion, omission and replacement by/d/and/z/;/ch/mainly showed distortion, omission and replacement by/d/,/t/,/c/and/z/;/sh/mainly showed distortion, lateral misarticulation and replacement by/d/and/t/;/r/mainly showed distortion, omission and replacement by/y/.The erroneous patterns varied with the combination of blade-palatal and vowels. After 1 to 2 courses of speech training, the number of erroneous words decreased to 7.33±4.08 from 47.37±15.32 before the speech training. The difference was statistically significant(Z=-8.240, P<0.001).The number of erroneous words was negatively correlated with age(r=-0.588,P<0.001). The results of simple linear regression analysis showed that the determination coefficient was 0.410.Conclusion The articulation disorder of blade-palatal mainly showed replacement by apical consonants, omission and distortion varying with vowels. The targeted rehabilitation training hereby established is significantly effective. Age plays an important role in the outcome of blade-palatal.
Objective To explore the phonological characteristics and rehabilitation training of abnormal blade-palatal in patients with functional articulation disorders(FAD).Methods A total of 107 patients with FAD were studied for the phonological characteristics of blade-palatal. Among these 107 patients, 90 patients with abnormal blade-palatal received targeted rehabilitation training. The correlation and simple linear regression analysis were carried out on abnormal blade-palatal articulation and age.Results The highest proportion of abnormal blade-palatal lied in preschool children with FAD was 69.16%(74/107).The common erroneous patterns of/zh/,/ch/,/sh/and/r/were replacement by apical consonants, distortion,omission and lateral misarticulation./zh/mainly showed distortion, omission and replacement by/d/and/z/;/ch/mainly showed distortion, omission and replacement by/d/,/t/,/c/and/z/;/sh/mainly showed distortion, lateral misarticulation and replacement by/d/and/t/;/r/mainly showed distortion, omission and replacement by/y/.The erroneous patterns varied with the combination of blade-palatal and vowels. After 1 to 2 courses of speech training, the number of erroneous words decreased to 7.33±4.08 from 47.37±15.32 before the speech training. The difference was statistically significant(Z=-8.240, P<0.001).The number of erroneous words was negatively correlated with age(r=-0.588,P<0.001). The results of simple linear regression analysis showed that the determination coefficient was 0.410.Conclusion The articulation disorder of blade-palatal mainly showed replacement by apical consonants, omission and distortion varying with vowels. The targeted rehabilitation training hereby established is significantly effective. Age plays an important role in the outcome of blade-palatal.
引文
1 李胜利.语言治疗学[M].第2版.北京:人民卫生出版社,2013.138～139.
2 王慧,鲍毓,徐琳,等.儿童功能性构音障碍的临床分析及言语治疗[J].中华物理医学与康复杂志,2011,33:835.
3 吴萍,李丽华.65例功能性构音障碍儿童训练效果分析[J].中国康复理论与实践,2011,17:688.
4 高楠,李峰,徐丽娜,等.舌尖音构音障碍的临床特点及语音训练[J].中华物理医学与康复杂志,2015,37:813.
5 张风华,金星明,章依文,等.舌尖音发音缺陷的临床特征和语音治疗[J].中华儿科杂志,2006,44:210.
6 王国民,杨育生.唇腭裂序列治疗学[M].杭州:浙江科学技术出版社,2014.235～235.
7 林焘,王理嘉.语音学教程[M].第2版.北京:北京大学出版社,2013.202～203.
8 江茹,赵生全,张铁松,等.功能性构音障碍儿童言语异常及矫治效果研究[J].听力学及言语疾病杂志,2011,19:260.
9 张文婧,陈仁吉.173例功能性构音障碍患者辅音错误特点分析[J].北京口腔医学,2016,24:29.
10 徐亚琴,梁沂,胡小沙,等.儿童功能性构音障碍21个词首辅音的临床特征分析[J].中国儿童保健杂志,2015,23:472.
11 徐丽娜,李峰,胡明芳,等.功能性构音障碍患者侧化构音的语音特点及康复训练[J].中国康复理论与实践,2016,22:581.
12 Mcleod S,Baker E.Speech-language pathologists' practices regarding assessment,analysis,target selection,intervention and service delivery for children with speech sound disorders[J].Clin Linguist Phon,2014,28:508.
13 卢红云,黄昭鸣.口部运动治疗学[M].上海:华东师范大学出版社,2010.6～7.
14 Lee AS,Gibbon FE.Non-speech oral motor treatment for children with developmental speech sound disorders[J].Cochrane Database Syst Rev,2015,25:CD009383.
15 段林茹,郑洁皎,陈秀恩,等.构音障碍治疗的研究进展[J].中国康复,2015,30:229.
16 Clark HM.The role of strength training in speech sound disorders[J].Semin Speech Lang,2008,29:276.
17 蒋莉萍,王国民.咽成形术后语音治疗效果的CSL评定[J].中国口腔颌面外科杂志,2010,8:509.
18 Sugden E,Baker E,Munro N,et al.Involvement of parents in intervention for childhood speech sound disorders:a review of the evidence[J].Int J Lang Commun Disord,2016,51:597.
19 刘晓.儿童功能性构音障碍错误辅音临床特征分析[J].重庆医学,2012,41:254.
20 杜志宏,毛丽珈,彭炳蔚,等.不同年龄段功能性构音障碍儿童错误辅音分析[J].中国康复,2014,29:328.
21 金星明.语音和语言障碍临床解析[J].中国实用儿科杂志,2014,29:496.
22 徐丽娜,李峰,高楠,等.成年功能性构音障碍患者的语音训练及临床特点分析[J].中华物理医学与康复杂志,2017,25:175.
23 徐丽娜,李峰,吕自愿,等.成年功能性构音障碍患者辅音错误类型及方式分析[J].听力学及言语疾病杂志,2017,25:149.
2 王慧,鲍毓,徐琳,等.儿童功能性构音障碍的临床分析及言语治疗[J].中华物理医学与康复杂志,2011,33:835.
3 吴萍,李丽华.65例功能性构音障碍儿童训练效果分析[J].中国康复理论与实践,2011,17:688.
4 高楠,李峰,徐丽娜,等.舌尖音构音障碍的临床特点及语音训练[J].中华物理医学与康复杂志,2015,37:813.
5 张风华,金星明,章依文,等.舌尖音发音缺陷的临床特征和语音治疗[J].中华儿科杂志,2006,44:210.
6 王国民,杨育生.唇腭裂序列治疗学[M].杭州:浙江科学技术出版社,2014.235～235.
7 林焘,王理嘉.语音学教程[M].第2版.北京:北京大学出版社,2013.202～203.
8 江茹,赵生全,张铁松,等.功能性构音障碍儿童言语异常及矫治效果研究[J].听力学及言语疾病杂志,2011,19:260.
9 张文婧,陈仁吉.173例功能性构音障碍患者辅音错误特点分析[J].北京口腔医学,2016,24:29.
10 徐亚琴,梁沂,胡小沙,等.儿童功能性构音障碍21个词首辅音的临床特征分析[J].中国儿童保健杂志,2015,23:472.
11 徐丽娜,李峰,胡明芳,等.功能性构音障碍患者侧化构音的语音特点及康复训练[J].中国康复理论与实践,2016,22:581.
12 Mcleod S,Baker E.Speech-language pathologists' practices regarding assessment,analysis,target selection,intervention and service delivery for children with speech sound disorders[J].Clin Linguist Phon,2014,28:508.
13 卢红云,黄昭鸣.口部运动治疗学[M].上海:华东师范大学出版社,2010.6～7.
14 Lee AS,Gibbon FE.Non-speech oral motor treatment for children with developmental speech sound disorders[J].Cochrane Database Syst Rev,2015,25:CD009383.
15 段林茹,郑洁皎,陈秀恩,等.构音障碍治疗的研究进展[J].中国康复,2015,30:229.
16 Clark HM.The role of strength training in speech sound disorders[J].Semin Speech Lang,2008,29:276.
17 蒋莉萍,王国民.咽成形术后语音治疗效果的CSL评定[J].中国口腔颌面外科杂志,2010,8:509.
18 Sugden E,Baker E,Munro N,et al.Involvement of parents in intervention for childhood speech sound disorders:a review of the evidence[J].Int J Lang Commun Disord,2016,51:597.
19 刘晓.儿童功能性构音障碍错误辅音临床特征分析[J].重庆医学,2012,41:254.
20 杜志宏,毛丽珈,彭炳蔚,等.不同年龄段功能性构音障碍儿童错误辅音分析[J].中国康复,2014,29:328.
21 金星明.语音和语言障碍临床解析[J].中国实用儿科杂志,2014,29:496.
22 徐丽娜,李峰,高楠,等.成年功能性构音障碍患者的语音训练及临床特点分析[J].中华物理医学与康复杂志,2017,25:175.
23 徐丽娜,李峰,吕自愿,等.成年功能性构音障碍患者辅音错误类型及方式分析[J].听力学及言语疾病杂志,2017,25:149.