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共病口吃与语音障碍的治疗证据:临床病例系列

Evidence for the treatment of co-occurring stuttering and speech sound disorder: A clinical case series.

作者信息

Unicomb Rachael, Hewat Sally, Spencer Elizabeth, Harrison Elisabeth

机构信息

a Speech Pathology Department, Faculty of Education and Arts , The University of Newcastle , Newcastle , Australia and.

b Linguistics Department, Faculty of Human Sciences, Macquarie University , Sydney , Australia.

出版信息

Int J Speech Lang Pathol. 2017 Jun;19(3):251-264. doi: 10.1080/17549507.2017.1293735. Epub 2017 Mar 14.

Abstract

PURPOSE

There is a paucity of evidence to guide treatment for children with co-occurring stuttering and speech sound disorder. Some guidelines suggest treating the two disorders simultaneously using indirect treatment approaches; however, the research supporting these recommendations is over 20 years old. In this clinical case series, we investigate whether these co-occurring disorders could be treated concurrently using direct treatment approaches supported by up-to-date, high-level evidence, and whether this could be done in an efficacious, safe and efficient manner.

METHOD

Five pre-school-aged participants received individual concurrent, direct intervention for both stuttering and speech sound disorder. All participants used the Lidcombe Program, as manualised. Direct treatment for speech sound disorder was individualised based on analysis of each child's sound system.

RESULT

At 12 months post commencement of treatment, all except one participant had completed the Lidcombe Program, and were less than 1.0% syllables stuttered on samples gathered within and beyond the clinic. These four participants completed Stage 1 of the Lidcombe Program in between 14 and 22 clinic visits, consistent with current benchmark data for this programme. At the same assessment point, all five participants exhibited significant increases in percentage of consonants correct and were in alignment with age-expected estimates of this measure. Further, they were treated in an average number of clinic visits that compares favourably with other research on treatment for speech sound disorder.

CONCLUSION

These preliminary results indicate that young children with co-occurring stuttering and speech sound disorder may be treated concurrently using direct treatment approaches. This method of service delivery may have implications for cost and time efficiency and may also address the crucial need for early intervention in both disorders. These positive findings highlight the need for further research in the area and contribute to the limited evidence base.

摘要

目的

缺乏指导同时患有口吃和语音障碍儿童治疗的证据。一些指南建议使用间接治疗方法同时治疗这两种障碍;然而,支持这些建议的研究已有20多年历史。在这个临床病例系列中,我们调查是否可以使用最新的、高水平证据支持的直接治疗方法同时治疗这些共病障碍,以及是否可以以有效、安全和高效的方式进行。

方法

五名学龄前参与者接受了针对口吃和语音障碍的个体同时直接干预。所有参与者都按照手册使用了利德康姆计划。基于对每个孩子语音系统的分析,对语音障碍进行个体化直接治疗。

结果

在治疗开始后的12个月,除一名参与者外,所有参与者都完成了利德康姆计划,并且在诊所内外收集的样本中,口吃音节的比例低于1.0%。这四名参与者在14至22次诊所就诊期间完成了利德康姆计划的第一阶段,与该计划目前的基准数据一致。在同一评估点,所有五名参与者的正确辅音百分比均显著增加,并且与该指标的年龄预期估计相符。此外,他们接受治疗的平均就诊次数与其他关于语音障碍治疗的研究相比具有优势。

结论

这些初步结果表明,同时患有口吃和语音障碍的幼儿可以使用直接治疗方法同时进行治疗。这种服务提供方式可能对成本和时间效率有影响,也可能满足对这两种障碍进行早期干预的关键需求。这些积极发现凸显了该领域进一步研究的必要性,并为有限的证据基础做出了贡献。

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