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成人脑瘫的构音障碍:I. 可懂度与发音障碍

Dysarthria of adult cerebral palsy: I. Intelligibility and articulatory impairment.

作者信息

Platt L J, Andrews G, Young M, Quinn P T

出版信息

J Speech Hear Res. 1980 Mar;23(1):28-40. doi: 10.1044/jshr.2301.28.

DOI:10.1044/jshr.2301.28
PMID:7442182
Abstract

The speech intelligibility and articulatory impairment of 32 spastic and 18 athetoid males, aged 17-55, were examined. Selection was based on a definite diagnosis of cerebral palsy, and adequate intelligence, hearing, and ability to perform the required tasks. Two estimates of speech intelligibility were obtained from naive listeners: single words correctly recognized and prose intelligibility rating. Diadochokinetic (DDK) syllable rates and percent correct articulation of selected phonemes were employed as indices of articulatory impairment. The 50 subjects were, on average, judged to be 50% intelligible on both intelligibility estimates. Group mean DDK rate was 2.9 syllables per second and 78% of phonemes were transcribed as correctly articulated. :The mean scores of the spastic subjects were superior to the athetoids on all speech measures, significantly so for single-word intelligibility and DDK rate even when group inequalities for physical disability and I.Q. were adjusted. In this sample, spastics were less physically disabled and had lower I.Q.'s than athetoids. Specific phonemic features characteristic of the dysarthria in cerebral-palsied subjects were: (1) anterior lingual place inaccuracy; (2) reduced precision of fricative and affricate manners; and (3) inability to achieve the extreme positions in the vowel articulatory space. A comparison of these results with those reported for children with cerebral palsy suggests that the consonantal place and manner problems are fairly stable features of cerebral palsy dysarthria.

摘要

对32名年龄在17至55岁之间的痉挛型男性和18名徐动型男性的言语清晰度和构音障碍进行了检查。入选基于明确的脑瘫诊断以及足够的智力、听力和完成所需任务的能力。从普通听众那里获得了两种言语清晰度评估结果:正确识别的单个单词和散文清晰度评分。将重复运动(DDK)音节率和所选音素的正确发音百分比用作构音障碍的指标。这50名受试者在两种清晰度评估中的平均可理解度被判定为50%。组平均DDK率为每秒2.9个音节,78%的音素被转录为发音正确。痉挛型受试者在所有言语测量指标上的平均得分均高于徐动型受试者,即使在对身体残疾和智商的组间差异进行调整后,单字清晰度和DDK率仍有显著差异。在这个样本中,痉挛型患者的身体残疾程度较轻,智商也低于徐动型患者。脑瘫患者构音障碍的特定音素特征为:(1)舌前位置不准确;(2)摩擦音和塞擦音发音方式的精确度降低;(3)无法在元音发音空间中达到极端位置。将这些结果与报道的脑瘫儿童的结果进行比较表明,辅音位置和发音方式问题是脑瘫构音障碍相当稳定的特征。

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