摘要
目的回顾性分析62例舌尖音发音缺陷患儿的临床资料，为此类发音缺陷疾病的评估和治疗提供参考。方法对62例3．0～8．0岁舌尖音发音缺陷儿童，采用图片词汇测试评估其语言理解能力；采用发育或智能测试评估其非言语智商（发育商）和认知发育水平；采用普通话语音测试评估其语音状况。给予患儿语音治疗，每周1～2次，每次约60min。治疗时，根据发育进程确立目标语音，采用语音定位法让儿童对正确的发音部位和方式有清晰的认识。对存在口腔运动功能障碍的儿童，改变食物的质地并分别给予口腔功能训练。结果按发音部位分类，舌尖音发音缺陷分为四种类别，以混合性发音异常最为常见，共40例（64．5％）；其他依次为舌尖中音异常15例（24．2％）；舌尖后音4例（6．5％）和舌尖前音3例（4．8％）。发音错误形式分为三类，舌后音化59例（95．2％）；省略音化19例（30．6％）；不送气音化8例（12．9％）。临床上部分患儿存在口腔运动功能障碍；部分患儿存在进食问题，如食物偏软、常含在口中、进食慢、咀嚼不充分。经5～18次治疗，82．3％患儿有显著疗效。结论舌尖音发音缺陷分为四种表型，以混合性发音异常最为常见。发音错误形式分为三类，以舌后音化最多见。治疗宜采用语音定位法让儿童认识正确的发音部位和方式。对存在进食问题和口腔运动功能障碍的儿童，需改变食物的质地并进行必要的口腔功能训练。
Objective To explore the clinical characteristics and speech therapy of 62 children with lingua-apical articulation disorder. Methods Peabody Picture Vocabulary Test （PPVT）, Gesell development scales （Gesell）, Wechsler Intelligence Scale for Preschool Children （WPPSI） and speech test were performed for 62 children at the ages of 3 to 8 years with lingua-apical articulation disorder. PPVT was used to measure receptive vocabulary skills. GESELL and WPPSI were utilized to represent cognitive and non-verbal ability. The speech test was adopted to assess the speech development. The children received speech therapy and auxilary oral-motor functional training once or twice a week. Firstly the target sound was identified according to the speech development milestone, then the method of speech localization was used to clarify the correct articulation placement and manner. It was needed to change food character and administer oral-motor functional training for children with oral motor dysfunction. Results The 62 cases with the apical articulation disorder were classified into four groups. The combined pattern of the articulation disorder was the most common （40 cases, 64. 5% ）, the next was apico-dental disorder （ 15 cases, 24. 2% ）. The third was palatal disorder （4 cases, 6.5% ） and the last one was the linguo-alveolar disorder （3 cases, 4. 8% ）. The substitution errors of velar were the most common （95.2%）, the next was omission errors （30. 6% ） and the last was absence of aspiration （12.9%）. Oral motor dysfunction was found in some children with problems such as disordered joint movement of tongue and head, unstable jaw, weak tongue strength and poor coordination of tongue movement. Some children had feeding problems such as preference of eating soft food, keeping food in mouths, eating slowly, and poor chewing. After 5 to 18 times of therapy, the effective rate of speech therapy reached 82. 3%. Conclusion The lingua-apical articulation disorders can be classified into four groups. The combined pattern of the articulation errors is the most common one. Most of the apical sounds are replaced by velar sounds. The speech localization method is very useful in the therapy of apical articulation disorder. For children with feeding problems and oral motor dysfunction, it is needed to improve food texture and administer oral motor skill training.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2006年第3期210-213,共4页
Chinese Journal of Pediatrics
基金
上海市重点学科建设资助项目(T0204)
关键词
发音障碍
分类法
言语疗法
Articulation disorders
Classification
Speech therapy
