口吃病的心理和行为治疗

目的通过对口吃患者心理治疗和言语矫治来消除心理障碍、改变错误的发音习惯，最大程度的提高或改善语言表达能力，达到流畅说话的目的。方法①心理激励；②细听倾诉；③说明与指导；④心理分析；⑤心理治疗；⑥口吃行为矫治和改变认知评价系统，从根本上解决引起当前口吃的心理原因；⑦治疗前后分别采用心理问卷以60道测试题从“对现实的感知性”、“情绪的稳定性”、“人际关系和谐性”、“心理适应性”等方面的心理变化和动态进行测试和评价比较；并对患者矫治前后的讲话进行录音，观察其初阻、中阻、拖音、字重复、句重复、附加字、附加词、附加动作，记录其出现次数和时间进行评价比较。通过心理治疗、语言行为治疗、以新的语言模式替代旧的语言习惯以及巩固和周期性调整语言模式的方法来综合矫治方法。结果心理问卷中四个部分矫治前平均分分别为16．6、129．5、31．8和25．1；矫治后平均分分别为8．9、55．9、19．1和14．6。矫治后得分比矫治前均有不同程度下降。治疗前后录音显示口吃及相关行为明显减少。     

口吃患者心理问题调查报告

本文对口吃患者发病年龄，性别，就诊年龄，性格，气质类型，心理表现，发病诱因及声带检查情况进行了调查分析。结果表明：10－20岁男性发病率高，性格内向或偏内向型显著高于外向或偏外向型者；而发病诱因多为模仿（68％）。本文患者全部表现有不同程度的心理障碍，而检查发声器官无器质性病变，口吃的产生和病情加重其主要原因为患者心理纠缠过重，而矫治的方法应以解脱患者心理障碍为关键，而后辅以良好的发音技巧训练。     

HZZ-1型口吃治疗仪对46例口吃患者综合治疗的临床观察

目的总结46例口吃病例综合治疗的效果，进一步探讨口吃的治疗方法。方法采用DAF口吃治疗仪．心理辅导．语言训练相结合的治疗方法，对患者治疗前后的口吃严重程度进行比较（采用t检验），并统计治疗的有效率。结果治疗前后口吃严重程度构成有显著性差异（p〈0．01），总有效率达到98％。结论根据观察，综合治疗对于口吃患者的康复具有比较确切的疗效。     

思比易(SpeechEasy)口吃矫正器矫治口吃临床观察

目的观察思比易(SpeechEasy)口吃矫正器对口吃矫治的疗效。方法为5名口吃患者验配口吃矫正器,记录受试者治疗前后正常语速下每100个音节中出现口吃的音节数,并统计结果。结果经使用口吃矫正器,受试者口吃音节百分比均下降,有效率达77.1%(P<0.01)。结论思比易(SpeechEasy)口吃矫正器能有效矫治口吃。     

痉挛性言语神经官能症（口吃）的矫治

痉挛性言语神经官能症（口吃）的矫治张向红１李宝树１董丽娟２痉挛性言语神经官能症，俗称“口吃”、“结巴”，为常见的言语障碍。声病门诊中虽有不少此类患者求治，因种种原因，能坚持治疗者甚少，现报告具有完整资料的病例６例，并对其发病特点及诊治方法进行了讨论，...     

患者心理因素对嗓音疾病发声矫治的影响

目的 探讨嗓音疾病的发声矫治中心理因素对发声矫治效果的影响.方法 对功能性失音患者15例、嗓音误用引起的声带器质性病变患者326例、青春期后持续性假声7例进行发声矫治.结果 矫治困难16例、矫治失败4例,原因均为患者从心理上不相信医生的诊断,治疗过程中不配合,从而导致治疗失败.结论 心理因素一定程度影响嗓音疾病的发声矫治患者的矫治疗效.     

经泪前隐窝入路鼻内镜下上颌窦手术相关应激心理障碍的术前心理护理干预效果分析

目的观察术前护理干预对经泪前隐窝入路鼻内镜上颌窦手术相关应激心理障碍的影响。方法本院接受经泪前隐窝入路鼻内镜上颌窦手术患者36例纳入研究,采用随机数字表法分成观察组和对照组各18例。对照组术前进行常规健康教育,观察组则在此基础上再联合应用心理护理干预,以SAI评分和VAS评分对应急心理障碍程度进行评估,比较分析术前护理干预对患者术后激心理障碍的影响。结果观察组患者术后SAI及VAS分值明显低于对照组(t=2.799~5.290,P0.0);手术医生对患者术中配合状况的满意度明显高于对照组(χ2=4.909,P0.05)。结论经泪前隐窝入路鼻内镜上颌窦手术患者都会存在不同程度的应激心理障碍,术前心理护理干预有助于缓解其焦虑状态,减轻疼痛程度,提高手术配合程度。     

声带小结患者发音矫治前后电声门图参数变化

目的 比较分析声带小结患者发音矫治前后电声门图参数变化，评价发音矫治对声带小结的疗效。方法 对48例声带小结（软性小结）患者发音矫治（3～6个月）前后分别进行电声门图检测，并对其主要参数进行比较分析。结果 发音矫治后平均基频、接触率较矫治前有显菩性升高（P〈0．05），基频微扰、振幅微扰、噪声能量较矫治前有显著性下降（P〈0．05）。结论 发音骄治前后电声门圈参数变化结果提示，发音矫治对声带小结具有一定的治疗效果。     

团体心理支持对成年非器质性口吃者负性情绪改善的研究

目的研究团体心理治疗及言语训练疗法联合治疗口吃的疗效。方法 78名非器质性病变的口吃人士接受团体心理治疗和/或言语训练治疗前后,采用焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)和交流恐惧自陈量表(personal report of communication apprehension,PRCA-24)对其情绪状态、社交回避程度等心理健康状况进行评估和比较。结果①SAS、SDS和PRCA-24评估结果显示,治疗前口吃人士的焦虑、抑郁情绪均高于常模(P<0.05),并存在明显的社交恐惧(P<0.05);②短期强化言语训练治疗后口吃人士的焦虑情绪(SAS评分)和人际交往过程中的恐惧感(PRCA-24评分)均显著降低(P<0.01);但抑郁情绪(SDS评分)没有明显改善(P>0.05);③团体心理治疗配合言语训练治疗后,口吃者的SAS、SDS、和PRCA-24评分均显著降低(P<0.05)。结论在口吃治疗中,以团体心理治疗配合言语训练疗法可弥补单纯言语训练疗法的不足,改善患者的抑郁程度,提高并巩固言语训练的疗效。     

言语及发声障碍患者矫治效果分析

目的探讨言语及发声障碍的矫治方法及效果。方法对116例言语或发声障碍病例进行言语及发声矫治,其中口吃31例,声带息肉25例,声带小结18例,功能性失声15例,青春期后假声11例,开放性鼻音16例。结果经3个月治疗后口吃患者治愈率68%,功能性失声治愈率100%,青春期后假声治愈率73%,开放性鼻音及声带息肉、声带小结经手术及术后训练,治愈率100%。结论对言语或发声障碍患者予分类诊断后,再作相应的言语或发声训练治疗,是行之有效的方法。     

Lexical priming in picture naming of young children who do and do not stutter.

The purpose of this investigation was to assess the influence of lexical/semantic priming on the speech reaction time of young children who do and do not stutter during a picture-naming task. Participants were 23 children who stutter, age-matched (+/-4 months) to 23 children who do not stutter, ranging in age from 3;0 (years;months) to 5;11. Procedures involved a computer-assisted picture-naming task, during which each participant was presented with the same set of 28 pictures in each of 3 different conditions: (a) no-prime condition, in which no auditory stimulus was presented before picture display; (b) related-prime condition, in which a word, semantically related to the target picture, was presented auditorily 700 ms before picture display; and (c) unrelated-prime condition, in which a semantically unrelated word was presented auditorily 700 ms before picture display. Results indicated that when compared with a no-prime condition, presentation of semantically related words before the picture-naming response led to shorter or faster speech reaction times for children who do not stutter, but for children who stutter, it led to longer or slower speech reaction times. Moreover, children who do not stutter and who had higher receptive vocabulary scores exhibited faster speech reaction times and a greater semantic priming effect, whereas no such relationships were found for children who stutter. Findings were taken to suggest that children who stutter may exhibit subtle difficulties with lexical encoding and that this difficulty with speech-language planning may be one variable that contributes to childhood stuttering.     

食管发音对无喉患者生存质量的影响

目的探讨无喉患者术后躯体康复对生存质量（qualjty of life）的影响。方法对49例喉全切除术后进行食管发音训练成功的患者，分别在训练前和食管发音后3个月，用头颈肿瘤行为状态量表（performance status scale for head and neck cancer patients，PSS—HN），癌症治疗功能评估调查问卷（functional assessment of cancer therapy-head and neck，FACT—H＆N）进行生存质量评估。结果喉全切除严重影响患者的生存质量，在食管发音训练前PSS—HN量表和FACT—H＆N问卷的评分为131．4和90．6分，均低于标准（分别300分和144分），差异有统计学意义（t值分别为53．673、67．44，P值均〈0．001）。在运用食管发音后PSS—HN量表、FACT—H＆N问卷的评分均比训练前提高，分别为240．4和103．7分，与训练前比较差异有统计学意义（t值分别为18．209、21．389，P值均〈0．001）。结论无喉患者可以通过术后躯体的康复及食管发音训练来提高其生存质量。     

The Five Factor Model of personality applied to adults who stutter

Previous research has not explored the Five Factor Model of personality among adults who stutter. Therefore, the present study investigated the five personality domains of Neuroticism, Extraversion, Openness, Agreeableness and Conscientiousness, as measured by the NEO Five Factor Inventory (NEO-FFI), in a sample of 93 adults seeking speech treatment for stuttering, and compared these scores with normative data from an Australian and a United States sample. Results revealed that NEO-FFI scores for the stuttering group were within the ‘average’ range for all five personality domains. However, adults who stutter were characterized by significantly higher Neuroticism, and significantly lower Agreeableness and Conscientiousness, than normative samples. No significant differences were found between groups on the dimensions of Extraversion and Openness. These results are discussed with reference to the relationship between personality factors among adults who stutter, their directionality, and implications for predicting treatment outcome.Learning outcomes: The reader will be able to: (1) describe the Five Factor Model of personality, including the NEO-FFI personality domains of Extraversion, Neuroticism, Openness, Agreeableness, and Conscientiousness, and (2) discuss differences in NEO-FFI domain scores between adults who stutter and normative samples, and (3) understand the clinical implications of personality profiles in terms of treatment process and outcome for adults who stutter.     

Physician referral patterns for stutterers

Many children who stutter initially seek guidance from their pediatricians. Pediatricians often do not refer stutterers for speech therapy. We present a brief analysis of pediatricians' views regarding stuttering, as well as their exposure to patients who stutter. We present a practical approach to children who stutter.     

Subjective improvement of olfactory function after endoscopic sinus surgery for chronic rhinosinusitis

OBJECTIVE: The purpose of this study was to determine the effect of functional endoscopic sinus surgery (FESS) on subjective olfactory dysfunction in patients with chronic rhinosinusitis.Materials and methods Prospective collection of data on consecutive patients undergoing FESS after failing prolonged medical therapy for chronic rhinosinusitis at a tertiary institution. Patients were asked to grade their olfactory dysfunction from 0 to 10, with 0 representing normal function and 10 complete anosmia. In addition, data such as computed tomography scores, presence or absence of nasal polyps, and the presence or absence of asthma were recorded and analyzed. Patients were followed up to 1 year after surgery. RESULTS: Data were collected on 178 patients who had sinus surgery over a 2-year period. The average olfactory dysfunction score before surgery was 4.9. This improved to 0.9 at 1 year after surgery (P =.00). Higher computed tomography scores as per Lund and MacKay correlated with higher olfactory dysfunction scores (r = 0.62, P <.01) and greater improvement after surgery (r = 0.82, P <.01). Asthmatics and patients with polyps had higher subjective olfactory dysfunction scores than nonasthmatics and patients without polyps (6.8 and 7.2 v 4.4 and 4.1, respectively). All groups had subjective improvement at 1 year (2.3 and 1.5 v 0.6 and 0.7, respectively; P =.00). CONCLUSION: Patients with subjective olfactory dysfunction despite appropriate medical management for rhinosinusitis benefit from FESS.     

Effects of nasal continuous positive airway pressure therapy on partners’ sexual lives

To assess sexual functioning in male and female partners before and after nasal continuous positive airway pressure (CPAP) therapy in men with obstructive sleep apnea (OSA). Twenty-one male patients with moderate to severe OSA and erectile dysfunction, and their female partner, were recruited into this prospective study. Males diagnosed with OSA were treated with nasal CPAP therapy for 12 weeks. Women were assessed for sexual functioning using the Female Sexual Function Index (FSFI), and for mood status using the Beck Depression Inventory (BDI), before and after their male partner underwent nasal CPAP therapy. Sexual functioning was assessed in men using the International Index of Erectile Function (IIEF), before and after nasal CPAP therapy. After nasal CPAP therapy for OSA in men, IIEF scores were significantly higher than pre-treatment scores. Total pre- and post-treatment IIEF scores (mean ± standard deviation) were 50.28 ± 15.88 and 65.42 ± 7.47, respectively, P < 0.01. Pre- and post-treatment FSFI scores in women were 21.54 ± 6.62 and 29.94 ± 3.76, respectively, P < 0.01. Pre- and post-treatment BDI scores in women were 14.61 ± 9.69 and 12.42 ± 8.92, respectively, P < 0.01. Following treatment of men with OSA, our data indicate benefits for nasal CPAP therapy on sexual functioning in both the male and female partners. Moreover, our findings indicate that improved sexual function in women after their male partner underwent nasal CPAP also had psychological benefits.     

Personality changes and the role of counseling in the rehabilitation of patients with laryngeal cancer

We conducted a study of 65 adults who had undergone laryngectomy for the treatment of laryngeal cancer. Our goal was to identify any abnormal personality traits in these patients and to assess the effect that psychological counseling might have on correcting these abnormalities and thereby improving postoperative voice rehabilitation. A Personality Trait Inventory (PTI) administered to all patients preoperatively identified 47 patients who had abnormal scores for at least three personality traits. These 47 patients were sent for preoperative psychological counseling, and 3 months following surgery, they underwent a follow-up PTI. At the follow-up assessment, 40 of these patients-32 men and 8 women-still registered abnormal scores for at least three traits. Half of the men and half of the women were randomized to receive 12 sessions of individualized psychological counseling over 6 months in addition to standard speech therapy (group I); the other patients received speech therapy only (group II). A follow-up PTI was administered at the completion of psychological counseling and/or speech therapy (postoperative month 9). Statistical analysis of the data was performed with the paired-samples test. Intragroup analysis of the follow-up PTI results revealed that both groups experienced a significant improvement in activity scores (p < 0.001) compared with their previous PTI results and that group I had significantly better scores for two other PTI traits-cyclothymia (mood swings) and depressive tendency (p < 0.05); neither group showed a significant improvement in dominance scores. Intergroup comparisons revealed that group I's activity and depressive tendency scores were significantly better than those of group II; there was no significant difference between the two groups in cyclothymia and dominance scores. Finally, comparison of results by sex, regardless of group, revealed that men had a significantly higher score for dominance and women had significantly higher scores for depressive tendency, emotional instability, introversion, and social desirability. We conclude that a preoperative personality analysis should be carried out in all patients scheduled for laryngectomy to identify those with personality problems that might benefit from psychological counseling. Correction of these problems should help in the physical, mental, vocational, and social rehabilitation of these patients.     

Speaking rates, response time latencies, and interrupting behaviors of young stutterers, nonstutterers, and their mothers.

The purpose of this study was to investigate the speaking rates, interrupting behaviors, and response time latencies (RTL) produced by stuttering and nonstuttering children and their mothers, and the relationship these three paralinguistic behaviors have to children's speech disfluencies. Subjects were 13 boys who stutter (mean age = 4:0) and their mothers and 13 nonstuttering boys (mean age = 4:0) and their mothers. No significant differences were found between the two groups of children or between the two groups of mothers for any of the three paralinguistic behaviors with the exception that the mothers of nonstuttering children exhibited significantly (p < 0.01) faster rates of speech than either group of children. A strong positive correlation (r = .84) was found between stuttering children's scores on the Stuttering Severity Instrument (Riley, 1980) and the durations of the overlapping portions of their mothers' interruptions (i.e., their simultalk). Findings of this study are taken to support a facilitative demands-capacities model of conversational interaction in which mothers adjust the demands of their speaking models in response to their children's demonstrated capacities for fluent speech production.     

An investigation into the relationship between anxiety and stuttering

The relationship between self-reported anxiety and stuttering was explored. Although previous research has mostly shown that persons who stutter are no more anxious than persons who do not stutter, many of these studies had inadequate power to detect significant differences. In this study, a large number of stutters were assessed on state and trait anxiety before, and on trait anxiety after, intensive behavioral treatment. Their levels of anxiety were compared to those of nonstuttering controls matched for gender, age, and occupational status. Results showed that persons who stutter had significantly higher levels of fear (state anxiety) in a demanding speech situation. They were also shown to have higher levels of chronic anxiety (trait anxiety) than matched controls. However, trait anxiety measured after treatment was within normal levels. Although not allowing the conclusion that anxiety causes stuttering, these results do have important implications for the management of the disorder.     

中度和重度聋儿助听后早期听觉能力及言语可懂度发育

目的：评价耳聋儿童助听后1年内听觉及言语能力发展变化趋势,探讨耳聋程度对聋儿的听觉及言语发育水平的影响,为聋儿的有效康复提供临床参考资料。方法：患儿29例,男19例,女10例。助听器选配年龄3～8岁,平均5．6岁。根据听力损失程度将患儿分为中度听力损失组（14例）和重度听力损失组（15例）。分别使用听觉行为分级（CAP）和言语可懂度分级（SIR）问卷在助听前及助听后1、3、6、9、12个月时对患儿的听觉能力及言语可懂度发育情况进行评估。结果：经单因素方差分析,中度和重度聋患儿CAP平均得分在助听前差异有统计学意义（P〉0．05）。在助听后1、3、6、9、12个月均差异无统计学意义（P〉0．05）。同样中度和重度聋患儿SIR平均得分在助听前差异有统计学意义（P〈0．05）。在助听后1、3、6、9、12个月均差异无统计学意义（P〉0．05）。中度聋患儿cAP平均得分助听前与助听后6、9、12个月差异有统计学意义（P〈0．05）。中度聋患儿SIR平均得分助听前与助听后6、9、12个月差异有统计学意义（P〈0．05）;助听后1个月与12个月差异有统计学意义（P〈0．05）。重度聋患儿CAP平均得分助听前与助听后3、6、9、12个月差异有统计学意义（P〈0．05）,助听后1个月与9、12个月差异有统计学意义（P〈0．05）。重度聋患儿SIR平均得分助听前与助听后3、6、9、12个月差异有统计学意义（P〈0．05）,助听后1个月与6、9、12个月差异有统计学意义（P〈0．05）。结论：中度和重度聋组患儿助听后1年内早期听觉及言语能力有显著提高,但各自有不同的发育特点和规律。