Verdolini Abbott Katherine
Communication Science and Disorders, Otolaryngology, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA.
Semin Speech Lang. 2013 May;34(2):80-93. doi: 10.1055/s-0033-1342979. Epub 2013 Apr 30.
Voice disorders are the most common communication disorder across the life span, affecting more than five million school-aged children annually in the United States alone. Although such disorders are commonly associated with benign pathology, medically malicious conditions cannot be ruled out without proper medical examination by an otolaryngologist. Many children with voice disorders are otherwise healthy. However, some are not. Moreover, children with voice problems of any origin often experience distinctly negative consequences in quality of life and academic participation as a result of them. Regrettably, this population is badly underserved by speech-language pathology. In this article, possible reasons are suggested, among them the relative unattractiveness of traditional therapy that emphasizes voice conservation using a Skinnerian paradigm. Alternatives are presented in terms of foundational principles of biomechanics, biology, and learning and factors affecting children's compliance with health care directives, which may help to shape the next generation of pediatric voice therapies. The article concludes with discussion of challenges surrounding voice therapy in the school setting and possible solutions.
嗓音障碍是一生中最常见的交流障碍，仅在美国，每年就有超过500万学龄儿童受其影响。虽然此类障碍通常与良性病变相关，但未经耳鼻喉科医生进行适当医学检查，不能排除存在恶性病变的可能。许多有嗓音障碍的儿童在其他方面是健康的。然而，有些并非如此。此外，任何原因导致嗓音问题的儿童，其生活质量和学业参与度往往会因此受到明显负面影响。遗憾的是，言语病理学对这一群体的服务严重不足。本文提出了一些可能的原因，其中包括传统疗法相对缺乏吸引力，传统疗法采用斯金纳范式强调嗓音保护。从生物力学、生物学、学习的基本原理以及影响儿童遵守医疗保健指令的因素等方面提出了替代方案，这些可能有助于塑造下一代儿科嗓音治疗方法。文章最后讨论了学校环境中嗓音治疗面临的挑战及可能的解决方案。
