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罗宾序列征言语障碍的强化治疗:一例报告

Intensive treatment of speech disorders in robin sequence: a case report.

作者信息

Pinto Maria Daniela Borro, Pegoraro-Krook Maria Inês, Andrade Laura Katarine Félix de, Correa Ana Paula Carvalho, Rosa-Lugo Linda Iris, Dutka Jeniffer de Cássia Rillo

机构信息

Universidade de São Paulo - USP - Bauru (SP), Brazil.

University of Central Florida - UFC - Orlando (FL), USA.

出版信息

Codas. 2017 Oct 23;29(5):e20160084. doi: 10.1590/2317-1782/20172016084.

Abstract

PURPOSE

To describe the speech of a patient with Pierre Robin Sequence (PRS) and severe speech disorders before and after participating in an Intensive Speech Therapy Program (ISTP).

METHODS

The ISTP consisted of two daily sessions of therapy over a 36-week period, resulting in a total of 360 therapy sessions. The sessions included the phases of establishment, generalization, and maintenance. A combination of strategies, such as modified contrast therapy and speech sound perception training, were used to elicit adequate place of articulation. The ISTP addressed correction of place of production of oral consonants and maximization of movement of the pharyngeal walls with a speech bulb reduction program. Therapy targets were addressed at the phonetic level with a gradual increase in the complexity of the productions hierarchically (e.g., syllables, words, phrases, conversation) while simultaneously addressing the velopharyngeal hypodynamism with speech bulb reductions.

RESULTS

Re-evaluation after the ISTP revealed normal speech resonance and articulation with the speech bulb. Nasoendoscopic assessment indicated consistent velopharyngeal closure for all oral sounds with the speech bulb in place.

CONCLUSION

Intensive speech therapy, combined with the use of the speech bulb, yielded positive outcomes in the rehabilitation of a clinical case with severe speech disorders associated with velopharyngeal dysfunction in Pierre Robin Sequence.

摘要

目的

描述一名患有皮埃尔·罗宾序列征(PRS)且存在严重言语障碍的患者在参加强化言语治疗项目(ISTP)前后的言语情况。

方法

ISTP为期36周,每天进行两节课的治疗,总共进行360节治疗课程。这些课程包括建立、泛化和维持阶段。采用多种策略组合,如改良对比疗法和语音感知训练,以引出适当的发音部位。ISTP通过减少语音球囊程序来解决口腔辅音发音部位的纠正以及咽壁运动最大化的问题。治疗目标在语音层面上进行,随着发音复杂性的逐步增加(例如音节、单词、短语、对话),同时通过减少语音球囊来解决腭咽功能不全的问题。

结果

ISTP后重新评估显示,使用语音球囊时言语共鸣和发音正常。鼻内镜评估表明,佩戴语音球囊时所有口腔音的腭咽闭合均一致。

结论

强化言语治疗结合语音球囊的使用,在皮埃尔·罗宾序列征中与腭咽功能障碍相关的严重言语障碍临床病例的康复中取得了积极成果。

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