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儿童构音障碍:典型言语运动发育背景下的听觉感知特征。

Childhood Dysarthria: Auditory-Perceptual Profiles Against the Background of Typical Speech Motor Development.

机构信息

Clinical Neuropsychology Research Group, Institute of Phonetics and Speech Processing, Ludwig Maximilian University of Munich, Germany.

出版信息

J Speech Lang Hear Res. 2022 Jun 8;65(6):2114-2127. doi: 10.1044/2022_JSLHR-21-00608. Epub 2022 May 10.

Abstract

PURPOSE

The purpose of this study was to describe childhood dysarthria by means of auditory-perceptual analyses covering all speech subsystems. We aimed to identify the most seriously affected auditory-perceptual dimensions in the observed dysarthria profiles and to detect specific markers of childhood dysarthria against the backdrop of typical speech development. Moreover, the relationship between the speech disorder and other relevant aspects of multiple disability was investigated.

METHOD

Thirty-one children with neurologic conditions were assessed with Bogenhausen Dysarthria Scales for Childhood Dysarthria, a German tool for the auditory-perceptual analysis of dysarthria in children. Nine relevant speech dimensions (, e.g., voice quality [VOQ]) and 29 individual symptoms (, e.g., breathy) were evaluated. Moreover, we documented motor, communicative, and cognitive-linguistic measures (i.e., Gross Motor Function Classification System [GMFCS], Communication Function Classification System [CFCS], Test for Reception of Grammar [TROG-D], and memory span). Recently published data from typically developing children were used for the purpose of age normalization.

RESULTS

Dysarthria severity was moderately correlated with GMFCS and CFCS but not with TROG-D and memory span. At the group level, respiration, articulation, and prosodic modulation were most severely affected, whereas voice function was only mildly affected or even spared in the majority of children. Four features were identified as most relevant markers of childhood dysarthria: conspicuous rhythm/stress pattern, hypernasality, strained-strangled voice, and reduced articulatory precision.

CONCLUSIONS

Childhood dysarthria is part of a complex multiple disability, but speech motor skills may still dissociate from gross-motor and cognitive-linguistic functions. Auditory-perceptual analyses incorporating age norms allow for a comprehensive description and identification of childhood dysarthria.

摘要

目的

本研究旨在通过涵盖所有言语子系统的听觉感知分析来描述儿童构音障碍。我们旨在确定观察到的构音障碍谱中受影响最严重的听觉感知维度,并在典型言语发展的背景下发现儿童构音障碍的特定标志物。此外,还研究了言语障碍与多种残疾相关方面之间的关系。

方法

对 31 名患有神经疾病的儿童进行了博根豪森儿童构音障碍评估量表的评估,这是一种用于儿童构音障碍听觉感知分析的德语工具。评估了九个相关的言语维度(例如,语音质量[VOQ])和 29 个个体症状(例如,呼吸声)。此外,我们还记录了运动、交际和认知语言方面的措施(即粗大运动功能分类系统[GMFCS]、交际功能分类系统[CFCS]、语法接受测试[TROG-D]和记忆广度)。为了进行年龄标准化,使用了来自正常发育儿童的最新发表数据。

结果

构音障碍严重程度与 GMFCS 和 CFCS 中度相关,但与 TROG-D 和记忆广度无关。在组水平上,呼吸、发音和韵律调制受到的影响最大,而在大多数儿童中,语音功能仅受到轻度影响甚至不受影响。有四个特征被确定为儿童构音障碍的最相关标志物:明显的节奏/重音模式、鼻音过重、紧张性窒息声和发音准确性降低。

结论

儿童构音障碍是复杂的多重残疾的一部分,但言语运动技能可能仍然与粗大运动和认知语言功能分离。结合年龄规范的听觉感知分析允许对儿童构音障碍进行全面描述和识别。

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