功能性构音障碍儿童口部运动功能及其与辅音错误发音相关性

doi:10.11852/zgetbjzz2022-0959

摘要/Abstract

摘要： 目的探究功能性构音障碍(FAD)儿童口部感觉-运动功能及其与辅音发音错误相关性,为FAD干预提供依据和思路。方法选取2021年6月—2022年1月于青岛大学附属医院儿童保健科FAD儿童61例为病例组,正常健康儿童90例为对照组。对两组儿童进行构音障碍检查、构音器官、听力检查以及口部感觉-运动评估,比较辅音发音错误与口部感觉-运动功能相关性。结果病例组儿童的口部感觉-运动功能总分(0.85±0.08 vs.0.94±0.03)、口部感觉(0.96±0.08 vs.1.00±0.00)、下颌运动(0.80±0.15 vs.0.91±0.05)、唇运动(0.86±0.09 vs.0.93±0.04)、舌运动(0.82±0.12 vs.0.94±0.03)均值均低于对照组,差异具有统计学意义(t=10.307,4.471,6.595,5.865,9.626,P<0.001);双唇音、舌尖中音与下颌、舌部分运动之间有相关性(P<0.05),唇齿音与下颌、唇部分运动之间有相关性(P<0.05),舌面音与舌部分运动之间有相关性(P<0.05),舌尖前音、舌尖后音、舌根音与下颌、舌、唇部分运动之间有相关性(P<0.05)。结论 FAD儿童口部感觉-运动功能低下,且与辅音发音错误数量呈现不同程度的相关性。

关键词: 功能性构音障碍, 错误辅音, 口部感觉, 口部运动

Abstract: Objective To explore the oral sensory-motor function and its correlation with consonant pronunciation errors in children with functional articulation disorders (FAD), in order to provide basis and ideas for intervention in FAD children. Methods A total of 61 FAD children admitted to the Department of Child Health in Qingdao University Affiliated Hospital from June 2021 to January 2022 were selected as the case group, and 90 normal healthy children were enrolled into the control group. Speech disorder examination, articulatory organ, hearing examination and oral sensory-motor assessment were performed in children to analyze the correlation between consonant mispronunciation and oral sensory-motor function. Results Compared with those of control group, the total score of oral sensory-motor function (0.85±0.08 vs.0.94±0.03), oral sensation (0.96±0.08 vs.1.00±0.00), mandibular movement (0.80±0.15 vs.0.91±0.05), lip movement (0.86±0.09 vs.0.93±0.04) and tongue movement (0.82±0.12 vs.0.94±0.03) of children in the case group were significantly lower (t=10.307,4.471,6.595,5.865,9.626, P<0.001). There were correlations of bilabial and mid-lingual sounds with the movements of the tongue and jaw (P<0.05), and correlations between labiodental sounds and movements of jaw and lip part (P<0.05), between lingual and tongue part movements (P<0.05). Moreover, correlations ofprelingual, postlingual and lingual root sounds with jaw, tongue and lip part movements were significant (P<0.05). Conclusion Oral sensory-motor function in children with FAD is low, and is correlated with consonant mispronunciation to varying degrees.

Key words: functional articulation disorders, false consonants, oral sensation, oral movement

中图分类号:

R767.92

马良, 王艳霞, 冉霓, 单延春, 刘小梅, 刘媛媛, 衣明纪. 功能性构音障碍儿童口部运动功能及其与辅音错误发音相关性[J]. 中国儿童保健杂志, 2023, 31(2): 156-161.

MA Liang, WANG Yan-xia, RAN Ni, SHAN Yan-chun, LIU Xiao-mei, LIU Yuan-yuan, YI Ming-ji. Oral motor function and its correlation with consonant mispronunciation errors in children with functional articulation disorders[J]. Chinese Journal of Child Health Care, 2023, 31(2): 156-161.

参考文献

[1] 王涛, 徐丽娜, 李峰.功能性构音障碍患者侧化构音特点分析及语音训练疗效观察[J].中华物理医学与康复杂志, 2020, 42(1):40-43.
Wang T, Xu L, Li F. Analysis of lateralization articulation characteristics and observation of speech training effect in patients with functional dysarthria[J].Chin J Phys Med Rehabil, 2020, 42 (1):40-43.
[2] Muursepp 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(2):128-132.
[3] Nakeva V MC. Phonemic discrimination and reproduction in 4-5-year-old children:Relations to hearing[J].Int J Pediatr Otorhinolaryngol, 2020, 1(133):109981-109981.
[4] 陈雯聪,熊丽梅,高黎,等.儿童保健门诊语音障碍儿童初诊现状分析[J].中国当代儿科杂志,2020,22(5):499-504
Chen WC,Xiong LM, Gao L, et al. Current status of initial diagnosis of speech sound disorder in a child healthcare clinic[J].Clin J Contemp Pediatr, 2020, 22(5):499-504.
[5] Nakeva V MC. Audiometric profiles in children with speech sound disorder:Subclinical hearing loss as a potential factor[J].Clinical Linguistics & Phonetics, 2021, 35(9):847-873.
[6] Yi A, Li B, Li S. Perception of the/t/-/k/contrast by Mandarin-speaking children with speech sound disorders[J].Clinical Linguistics & Phonetics,2021, 11(36):1029-1044.
[7] Brignell A, St John M, Boys A, et al. Characterization of speech and language phenotype in children withNRXN1 deletions[J].American Journal of Medical Genetics Part B:Neuropsychiatric Genetics, 2018, 177(8):700-708.
[8] 周浩, 熊才运, 刘烨, 等.515例言语语言障碍患儿病因分析[J].听力学及言语疾病杂志, 2019, 27(5):477-481.
Zhou H,Xiong YC, Liu Y, et al. Etiological analysis of 515 children with speech and language disorders[J]. Journal of Audiology and Speech Pathology, 2019, 27(5):477-481.
[9] 刘开宇, 熊才运, 刘烨, 等.功能性构音障碍儿童口部运动评估分析[J].听力学及言语疾病杂志, 2022, 30(6):623-626.
Liu KY,Xiong CY, Liu Y, et al. Analysis of the oral motor assessment in children with functional articulation disorders[J].Journal of Audiology and Speech Pathology, 2022, 30(6):623-626.
[10] 缪丽丽, 顾秋燕, 孙利华, 等.观察口部肌肉训练联合语音训练对功能性构音障碍患儿言语发育的影响[J].当代医学, 2021, 27(10):61-63.
Miao LL, Gu QY, Sun LH, et al. Observe the effect of oral muscle training combined with speech training on speech development in children with functional articulation disorder[J].Contemporary Medicine, 2021, 27(10):61-63.
[11] Siemons-Lühring DI, Euler HA, Mathmann P,, et al. The effectiveness of an integrated treatment for functional speech sound disorders-a randomized controlled trial[J].Children, 2021, 8(12):1-24.
[12] Zcebe E, Noyan Erbas A, Bacik Tirank S, et al. Turkish stimulability treatment program for children with speech sound disorders:A preliminary study[J].Logopedics, Phoniatrics, Vocology, 2021, 46(2):63-69.
[13] 高铁英, 赵婵娟, 郝淑红.功能性构音障碍儿童智力结构分析[J].中国儿童保健杂志, 2019, 27(4):451-453.
Gao TY, Zhao CJ, Hao SHY, et al. Analysis of intellectual structure in children with functional articulationdisorder[J].Chin J Child Health Care, 2019, 27(4):451-453.
[14] 潘雪珂.口部感觉-运动评估表的编制及其在脑瘫儿童中的应用[D]. 上海:华东师范大学, 2017.
Pan XK. The preparation of oral sensory-motor assessment andit′s application in children with cerebral palsy[D].Shanghai:East china normal university, 2017.
[15] 卢红云. 构音运动障碍评估与治疗的理论、方法及临床应用研究[D]. 上海:华东师范大学言语听觉科学, 2008.
Lu HY. Theory, method and clinical application of assessment and treatment of dysarthria[D]. Shanghai:East China normal University,2008.
[16] 黄昭鸣.言语障碍的评估与矫治[M]. 上海:华东师范大学出版社, 2006.
Huang ZHM. Evaluation and correction of speech disorder[M].Shanghai:East China Normal University, 2006.
[17] 戴晓阳, 龚耀先.长沙-韦氏幼儿智力量表(C-WYCSI)的编制[J].心理科学, 1986, 1(4):364-376.
Dai XY,Geng YX. Development of Changsha Wechsler Preschool Intelligence Scale (C-WYCSI)[J].Psychological Science, 1986, 1(4):364-376.
[18] 张厚粲.韦氏儿童智力量表第四版(WISC-Ⅳ)中文版的修订[J].心理科学, 2009, 32(5):1177-1179.
Zhang HC. Revision of the Chinese version of WISC-Ⅳ[J].Psychological Science, 2009, 32(5):1177-1179.
[19] 王建红, 王琳, 许琪, 等.语音障碍患儿辅音的特点[J].中华儿科杂志, 2021, 59(6):478-483.
Wang JH, Wang L, Xu Q, et al. Characteristics of consonant among children with speech sounddisorder[J].Chin J Pediatr, 2021, 59(6):478-483.
[20] 夏琼, 胡继红, 阳伟红, 等.探究功能性构音障碍患儿舌尖中音异常的语音特点和语言训练疗效观察[J].当代护士(下旬刊), 2019, 26(11):72-74.
Xia Q, Hu JH, Yang WH, et al. To explore the phonetic characteristics of abnormal tongue tip middle tone in children with functional dysarthria and observe the effect of language training[J].Contemporary Nurses (Later Edition),2019, 26(11):72-74.
[21] 袁惠芳, 方政, 赵军方, 等.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[J].听力学及言语疾病杂志, 2019, 27(3):270-275.
Yuan HF, Fang ZH, Zhao FJ, et al. Phonological characteristics and rehabilitation training of abnormal blade-palatal in children with functional articulationdisorders[J].Journal of Audiology and Speech Pathology, 2019, 27(3):270-275.
[22] 孙莉. 下颌运动受限评估与矫治的个案研究[J]. 中国听力语言康复科学杂志, 2017,15(4):311-313.
Sun L. A case study of evaluation and correction of mandibular motion restriction[J]. Chinese Scientific Journal of Hearing and Speech Rehabilitation 2017,15(4):311-313.
[23] 卢红云, 黄昭鸣.口部运动治疗概述及其作用(一)[J].现代特殊教育, 2009, 1(1):37-38.
Lv HY, Huang ZHM. Overview of oral motor therapy and its role(Ⅰ)[J].Modern Special Education, 2009, 1(1):37-38.
[24] 刘媛媛, 马良, 衣明纪, 等.功能性构音障碍儿童口部感觉-运动功能特征分析[J].中国康复理论与实践, 2022, 2022, 28(8):903-908.
Liu YY, Ma L, Yi MJ,et al. Characteristics of oral sensory-motor function in children with functional articulation disorders[J].Chin J Rchabil Theory Pract, 2022, 28(8):903-908.