伴隨語言發展異常與單純學前語音異常兒童之構音錯誤類型與嚴重度

Abstract

臨床觀察發現，語言能力的差異似乎會影響語音異常兒童的語音表現與錯誤情形。不少國外研究顯示，伴隨有語言困難的語音異常兒童，其語音異常嚴重度比起單純語音異常兒童有較為嚴重的現象。本研究的目的在於探討單純語音異常兒童和同時伴隨有語言發展異常兒童的構音錯誤類型與嚴重度之差異，並檢視語言能力和構音錯誤類型和語音異常嚴重度的相關性。研究對象為20名學前單純語音異常兒童（平均66.15月）和16名伴隨語言發展異常之語音異常兒童（平均66.81月），採準實驗研究法，施以一套自編情境詞語測驗蒐集所有參與兒童的語音樣本，分析與比較兩組受試者在構音錯誤類型及語音異常嚴重度之表現。結果發現，兩組兒童在構音錯誤類型的表現皆是以替代類型為主，其中伴隨語言發展異常組的替代類型出現次數顯著高於單純語音異常組。就音韻歷程的出現次數來看，亦是語言異常組顯著高於單純語音異常組。在語音異常嚴重度部份，單純語音異常組平均為輕-中度，伴隨語言異常組則平均為中-重度，兩組之間達顯著差異。進一步以相關和回歸分析檢驗語言能力和語音表現的關聯性，發現語言理解和口語表達與語音替代次數、音韻歷程次數及語音異常嚴重度之間皆有顯著相關性，其中以口語表達能力具有顯著預測力。研究結果支持伴隨有語言發展異常的語音異常兒童，其構音問題較單純語音異常兒童嚴重的論述，同時也顯示兒童語言能力的差異對語音錯誤與嚴重度會有一定的影響。建議在臨床上對於語音異常兒童，亦應瞭解其語言能力狀況，方能擬定更完整的療育方針。

Based on the clinical observation, it has been found that the differences of language ability may affect the articulation performance in children with speech sound disorder (SSD). The severity of speech sound disorder in children with language delay is more than the one with SSD only. The purpose of this study was to explore the types of articulation errors and severity of articulation difficultiesin preschool children with speech sound disorder with or without language development delay, and to examine the correlation between language abilities and speech production errors. 36 preschool children with SSD are selected as participants of this study. The SSD group contained 20 children (Age: M=66.15, SD=5.575) with SSD only. The SSD+LD group contained 16 children (Age: M=66.81, SD=4.902) with co-occurring SSD and language development delay. Based on Quasi-experimental method, standardlized tests were used to exmine children’s nonverbal IQ and language comprehension and production abilities. The self-invented Mandarin Speech Production Test was used to collect and assess individual child’s speech production abilities, including articularion error types and the severity of speech sound disorder. Apart from this, one way ANOVA was used to investigate the significant differences between two groups. The correlations between language comprehension ability, language production ability, speech error types, and speech error severity were also examined. Results demonstrated that the substitution error was the most frequent type of articulation errors in the two groups of children. Among this, SSD+LD group exhibited higher frequency of substitution errors than SSD group. For the group comparsion of phonological processes, SSD+LD group exhinited significantly higher frequency than SSD group. For the severity of speech sound disorder, the average level is from mild to moderate in children with SSD only, while the SSD+LD group exhibited the speech sound disorder from the moderate to severe level. Using Pearson product-moment correlation coefficient to examine the correlation between language abilitis and speech production abilities, the results show that the both language comprehension and expression abilities are significantly correlated with their substitution errors, phonological processes and speech sound disorder severities. In conclusion, the results of the present study support that children with speech sound disorder and language problems are more severe in the speech production than the ones with SSD only. The differences of children’s language ability have some effects on their speech sound production errors and the severity. It is suggested that in order to convey a complete speech and language treatment plan, clinicans should pay more attention to language difficulties of children with speech sound disorders.