大龄功能性构音障碍患者的构音特点分析
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摘要
目的探讨年龄≥7岁功能性构音障碍(functional articulation disorders,FAD)患者的构音特点,为大龄FAD患者的临床语音训练提供参考。方法对228例年龄≥7岁FAD患者进行语音评估,其中7～12岁组125例、13～17岁组54例、18～26岁组49例,分析各年龄段大龄FAD患者主要构音错误类型及形式等语音特点。结果 228大龄FAD患者异常辅音均以舌尖后音错误比例最高,均以双唇音错误比例最低。辅音错误类型主要为置换、脱落、扭曲及侧化,置换及脱落以7～12岁组比例最高,分别为90.4%(113/125)和58.4%(73/125),扭曲及侧化以18～26岁组比例最高,分别为55.1%(27/49)和32.7%(16/49)。各组所占比例最高的构音错误形式依次为/l/音脱落48.8%(61/125)、舌尖前音扭曲40.7%(22/54)和舌尖后音扭曲32.7%(16/49)。结论大龄FAD患者的构音特点主要表现为舌尖音异常;辅音错误类型主要为扭曲、置换、脱落及侧化构音;不同年龄段大龄FAD患者各有其特异性表现,年龄越大,辅音矫正难度越大。
Objective To study the articulation characteristics of older patients with FAD and provide reference for clinical speech treatment of older patients with FAD. Methods Speech assessments were carried out on 228 older patients with functional articulation disorders whose clinical characteristics were analyzed, and the articulation characteristics of different developmental stages were compared with each other. There were 125 cases aged 7 to 12 years old,54 cases aged 13 to 17 years old and 49 cases of adults among the 228 patients with FAD.Results The error ratio of retroflex was the highest, and that of bilabial was the lowest. The error types of articulation were distortion, substitution, omission and lateral misarticulation.The highest ratio of substitution and omission lay in patients aged 7 to 12,which were 90.4%(113/125) and 58.4%(73/125) respectively. The lowest ratio of distortion and lateral misarticulation was in the adult group as 55.1%(27/49) and 32.7%(16/49),respectively.The error forms of articulation disorders with highest error rate were omission of/l/,distortion of dental and retroflex among three groups, the proportions of which were 48.8%(61/125),40.7%(22/54) and 32.7%(16/49), respectively. Conclusion The articulation characteristics of abnormal consonants of older patients with functional articulation disorders mainly show apical articulation disorders. The error types of articulation are distortion,substitution,omission and lateral misarticulation.Specific performance lies in patients with different stages of development.
Objective To study the articulation characteristics of older patients with FAD and provide reference for clinical speech treatment of older patients with FAD. Methods Speech assessments were carried out on 228 older patients with functional articulation disorders whose clinical characteristics were analyzed, and the articulation characteristics of different developmental stages were compared with each other. There were 125 cases aged 7 to 12 years old,54 cases aged 13 to 17 years old and 49 cases of adults among the 228 patients with FAD.Results The error ratio of retroflex was the highest, and that of bilabial was the lowest. The error types of articulation were distortion, substitution, omission and lateral misarticulation.The highest ratio of substitution and omission lay in patients aged 7 to 12,which were 90.4%(113/125) and 58.4%(73/125) respectively. The lowest ratio of distortion and lateral misarticulation was in the adult group as 55.1%(27/49) and 32.7%(16/49),respectively.The error forms of articulation disorders with highest error rate were omission of/l/,distortion of dental and retroflex among three groups, the proportions of which were 48.8%(61/125),40.7%(22/54) and 32.7%(16/49), respectively. Conclusion The articulation characteristics of abnormal consonants of older patients with functional articulation disorders mainly show apical articulation disorders. The error types of articulation are distortion,substitution,omission and lateral misarticulation.Specific performance lies in patients with different stages of development.
引文
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14 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.
15 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.
16 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.
17 徐丽娜,李峰,高楠,等.功能性构音障碍患者舌尖中音异常的语音特点及康复训练[J].听力学及言语疾病杂志,2016,24:321.
18 宋志明.舌边音构音障碍的临床特点及康复训练[J].中国康复理论与实践,2015,21:1311.
19 Preston JL,Hull M,Edwards ML.Preschool speech error patterns predict articulation and phonological awareness outcomes in children with histories of speech sound disorders[J].Am J Speech Lang Pathol,2013,22:173.
20 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.
21 刘晓.儿童功能性构音障碍的错误辅音临床特征分析[J].重庆医学,2012,41:254.
22 王国民,蒋丽萍,吴忆来,等.成年腭裂患者语音治疗的特点和方法探讨[J].上海口腔医学,2003,12:81.
23 吕自愿,李峰,徐丽娜,等.年龄对功能性构音障碍预后的影响[J].中国儿童保健杂志,2015,23:536.
24 Wren Y,McLeod S,White P,et al.Speech characteristics of 8-year-old children:findings from a prospective population study[J].J Commun Disord,2013,46:53.
25 丘卫红,窦祖林,张百祥,等.功能性构音障碍语言评价及训练效果的分析[J].中华物理医学与康复杂志,2003,25:39.
2 李胜利.语言治疗学[M].第2版.北京:人民卫生出版社,2013.138～139.
3 Müürsepp I,Aibast H,Gapeyeva H,et al.Motor skills,haptic perception and social abilities in children with mild speech disorders[J].Brain Dev,2012,34:128.
4 高延,洪琦.儿童功能性构音障碍的研究进展[J].中国儿童保健杂志,2010,18:580.
5 于萍.儿童言语和语言障碍的研究现状[J].中华耳科学杂志,2013,11:408.
6 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.
7 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.
8 尹恒,郭春丽,石冰,等.大龄腭裂患者术前辅音构音特点的初步研究[J].华西口腔医学杂志,2013,31:182.
9 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,2014.235～239.
10 徐丽娜,李峰,张艳云,等.功能性构音障碍患儿舌根音异常的语音特点和康复训练[J].华西口腔医学杂志,2016,34:594.
11 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.
12 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.
13 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.
14 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.
15 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.
16 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.
17 徐丽娜,李峰,高楠,等.功能性构音障碍患者舌尖中音异常的语音特点及康复训练[J].听力学及言语疾病杂志,2016,24:321.
18 宋志明.舌边音构音障碍的临床特点及康复训练[J].中国康复理论与实践,2015,21:1311.
19 Preston JL,Hull M,Edwards ML.Preschool speech error patterns predict articulation and phonological awareness outcomes in children with histories of speech sound disorders[J].Am J Speech Lang Pathol,2013,22:173.
20 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.
21 刘晓.儿童功能性构音障碍的错误辅音临床特征分析[J].重庆医学,2012,41:254.
22 王国民,蒋丽萍,吴忆来,等.成年腭裂患者语音治疗的特点和方法探讨[J].上海口腔医学,2003,12:81.
23 吕自愿,李峰,徐丽娜,等.年龄对功能性构音障碍预后的影响[J].中国儿童保健杂志,2015,23:536.
24 Wren Y,McLeod S,White P,et al.Speech characteristics of 8-year-old children:findings from a prospective population study[J].J Commun Disord,2013,46:53.
25 丘卫红,窦祖林,张百祥,等.功能性构音障碍语言评价及训练效果的分析[J].中华物理医学与康复杂志,2003,25:39.