Zhang Feng-hua, Jin Xing-ming, Zhang Yi-wen, Wu Hong, Jiang Fan, Shen Xiao-ming
Department of Child Health Care, Shanghai Children's Medical Center, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.
Zhonghua Er Ke Za Zhi. 2006 Mar;44(3):210-3.
To explore the clinical characteristics and speech therapy of 62 children with lingua-apical articulation disorder.
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 auxiliary 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.
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%.
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.
探讨62例舌尖音发音障碍儿童的临床特点及言语治疗方法。
对62例3至8岁舌尖音发音障碍儿童进行皮博迪图片词汇测验（PPVT）、格塞尔发育量表（Gesell）、韦氏学龄前儿童智力量表（WPPSI）及言语测试。PPVT用于测量接受性词汇技能。GESELL和WPPSI用于代表认知和非言语能力。采用言语测试评估言语发育情况。患儿每周接受1至2次言语治疗及辅助口腔运动功能训练。首先根据言语发育里程碑确定目标音，然后采用言语定位法明确正确的发音部位和方式。对存在口腔运动功能障碍的患儿，需改变食物性状并进行口腔运动功能训练。
62例舌尖音发音障碍患儿分为4组。发音障碍的组合形式最为常见（40例，64.5%），其次是舌尖-齿音障碍（15例，24.2%）。第三是腭音障碍（4例，6.5%），最后是舌-齿龈音障碍（3例，4.8%）。软腭音的替代错误最为常见（95.2%），其次是遗漏错误（30.6%），最后是送气缺失（12.9%）。部分患儿存在口腔运动功能障碍，如舌和头部关节运动紊乱、下颌不稳定、舌肌力量弱及舌运动协调性差等问题。部分患儿存在喂养问题，如偏好进食软食、口中含食、进食慢及咀嚼差等。经过5至18次治疗后，言语治疗有效率达82.3%。
舌尖音发音障碍可分为4组。发音错误的组合形式最为常见。多数舌尖音被软腭音替代。言语定位法在舌尖音发音障碍治疗中非常有用。对于存在喂养问题和口腔运动功能障碍的患儿，需改善食物质地并进行口腔运动技能训练。
