不同年龄段儿童功能性构音障碍辅音错误特点及疗效分析.pdf

口腔疾病防治2023年12月第31卷第12期Journal of Prevention and Treatment for Stomatological Diseases,Dec.2023,Vol.31 No.12http:/【摘要】目的分析不同年龄段功能性构音障碍儿童辅音错误特点及语音训练效果，为临床治疗提供参考。方法本研究遵循医学伦理，并获得患者知情同意。对388例功能性构音障碍患者的语音资料进行回顾性研究，以6岁为界将其分为两组即学龄前组（46岁）226例、学龄组（613岁，含6岁）162例。从平均错误个数、发音部位、发音方式、错误类型4个方面分析其辅音发音错误特点，并对其进行一对一语音训练，训练频率1周1次，1次30 min；训练方法按照音素训练音节训练词汇训练句子训练短文、会话训练的顺序进行。比较2组语音训练效果的差异。结果按发音部位分析：两年龄组均为舌尖后音错误频率最高；而错误频率最低的学龄组为唇齿音，学龄前组为双唇音。按发音方式分析：两年龄组均为送气性塞擦音错误频率最高，鼻音错误频率最低。按错误类型分析：两年龄组均以置换、省略为主。相较于学龄前组，学龄组大部分辅音从发音部位、发音方式及错误类型三个方面均有好转的趋势。腭化和侧化两种错误类型则是学龄组错误频率高于学龄前组，但侧化学龄组升高趋势无统计学意义。学龄前组及学龄组通过6.7次和5.5次语音训练后，发音均能得到明显改善，学龄组治愈率为84.9%（118/139），学龄前组治愈率为77.1%（91/118），两组间治愈率差异无统计学意义。结论功能性构音障碍随着年龄增长会有所改善，但并不会完全自愈。不同年龄段患儿在经过科学合理的语音训练均能得到较好的治疗效果。【关键词】学龄前；学龄；儿童；功能性构音障碍；辅音；发音部位；发音方式；语音训练【中图分类号】R78【文献标志码】A【文章编号】20961456（2023）12087106【引用著录格式】吴晓璐,于国霞,陈仁吉,等.不同年龄段儿童功能性构音障碍辅音错误特点及疗效分析J.口腔疾病防治,2023,31(12):871876.doi:10.12016/j.issn.20961456.2023.12.005.Analysis of the characteristics and therapeutic effect of consonant errors in children with functional articulation disorders at different agesWU Xiaolu1,YU Guoxia1,CHEN Renji2,WANG Li1,HAO Jingping1.1.BeijingChildren s Hosipital,Capital Medical University,Beijing 100045,China;2.Beijing Stomatological Hospital Affiliatedto Capital Medical University，Beijing 100050,ChinaCorresponding author:CHEN Renji,Email:,Tel:861057099300【Abstract】ObjectiveAnalyzing the characteristics of consonant errors in children with functional dysarthria in different age groups and the effect of speech training provides a reference for clinical treatment.MethodsThis study followed medical ethics,and informed consent has been obtained from patients.Speech data from 388 patients with functional dysarthria were retrospectively studied.They were divided into two groups at the age of 6,namely,the preschoolgroup(46 years old)of 226 patients and the school age group(613 years old,including 6 years old)of 162 patients.The characteristics of consonant pronunciation errors from four aspects were analyzed:average number of errors,pronunciation location,pronunciation method,and error type.Oneonone speech training was conducted,with a training frequency of once a week and once for 30 minutes.The training method was carried out in the order of phoneme training,微信公众号【收稿日期】20230512；【修回日期】20230612【基金项目】北京市自然科学基金项目（7212047）【作者简介】吴晓璐，医师，硕士，Email：【通信作者】陈仁吉，教授，博士，Email：，Tel：861057099300DOI 10.12016/j.issn.20961456.2023.12.005临床研究不同年龄段儿童功能性构音障碍辅音错误特点及疗效分析吴晓璐1，于国霞1，陈仁吉2，王丽1，郝京萍11.首都医科大学附属北京儿童医院，北京（100045）；2.首都医科大学附属北京口腔医院，北京（100050）871口腔疾病防治2023年12月第31卷第12期Journal of Prevention and Treatment for Stomatological Diseases,Dec.2023,Vol.31 No.12http:/syllable training,vocabulary training,sentence training,and short text and conversation training.The effects of speechtraining in the two groups were compared.ResultsAnalysis by pronunciation location:both age groups had the highest frequency of errors in tongue tip posterior sounds;the school age group had the lowest error frequency for labiodental consonants,and the preschool group had the lowest error frequency for bilabial consonants.According to the analysisof pronunciation mode,both age groups had the highest error frequency of aspirated affricate and the lowest error frequency of nasal sound.Analysis by error type:both age groups are mainly characterized by substitution and omission.Compared with the preschool group,most consonants of patients in the school group tend to improve in terms of pronunciation location,pronunciation mode,and error types.Compared with the preschool group,the two types of errorspalatalization and lateralizationincreased in frequency in the school group,but the trend of increased lateralization was not statistically significant.After 6.7 and 5.5 sessions of speech training,the pronunciation of the preschool group and theschoolage group significantly improved;the cure rate of the schoolage group was 84.9%(118/139),and that of the preschool group was 77.1%(91/118).There was no statistically significant difference in the cure rate between the twogroups.ConclusionFunctional dysarthria may improve with age,but it may not completely selfheal.Children of different age groups can achieve good treatment results through scientific and reasonable speech training.【Key words】preschool age;school age;children;functional articulation disorders;consonant;pronunciation position;pronunciation method;speech trainingJ Prev Treat Stomatol Dis,2023,31(12):871876.【Competing interests】The authors declare no competing interests.This study was supported by the grants from National Natural Science Foundation of Beijing(No.7212047).功能性构音障碍（functional articulation disorders，FAD）指患者的构音器官无形态异常，听力、智力均在正常水平，但表现为发音不清，并且找不到明确病因的构音障碍，临床多见于儿童，特别是学龄前儿童13。国内研究发现其患病率为0.78%10%4。国外报道 FAD 的患病率为 3%10%57。本研究对388例FAD患者语音资料进行回顾性研究，分析不同年龄段功能性构音障碍儿童辅音错误特点及疗效，为临床治疗提供参考。1资料和方法1.1纳入和排除标准纳入标准：符合FAD的诊断标准1,5，即构音器官形态无异常，构音器官运动功能无异常，听力、智力无异常，年龄在 4 岁以上，构音错误成固定状态。排除标准：智力、听力障碍；存在腭裂、舌系带过短等构音器官形态异常者；语言发育迟缓等。1.2研究对象选取2018年5月至2021年5月就诊于首都