儿童孤独症康复因素分析

目的：探讨儿童孤独症康复的相关因素。资料来源：应用计算机检索Medline 1990—01／1998—12有关儿童孤独症的文献．检索词为“autism，rehabilitation，therapy”，限定语言种类为English；同时应用计算机检索www．cnki．net（中国知网）电子期刊全文数据库1990-01／2005-11有关儿童孤独症的文献，检索词为“孤独症，康复，治疗”，限定语言种类为中文。 资料选择：对资料进行初审，选择有关儿童孤独症的病因、临床表现、早期诊断、康复治疗及康复治疗影响因素等方面的文献，排除重复性研究。 资料提炼：收集到符合要求的文献41篇，排除19篇重复性研究，22篇符合纳入标准，被选为参考文献。 资料综合：通过检索发现，单独研究儿童孤独症康复因素的文献较少，因此对儿童孤独症的病因、临床表现、诊断、康复及其相关影响因素进行综合分析。影响儿童孤独症康复治疗的因素包括以下几点：①孤独症患儿的智力水平。②孤独症患儿的语言发育水平。③社会、家庭的支持及患儿父母的文化素质。④孤独症患儿的其他并发症。 结论：儿童孤独症的康复是多角度、多层次的，与患儿疾病本身的严重程度、病因及并发症是否及时控制有关，早期预防、早期诊断与治疗是孤独症患儿康复的关键。特别需要注意的是治疗或教育要注重个体化。     

非言语测试在儿童语言康复中的应用

儿童语言障碍多采用传统的评价标准，但在某些时候，由于各种原因可能高估或低估患儿的语言能力。为此，非言语测试可以弥补其不足。本组30例患儿采用非言语测试的方法评估患儿的能力，同时用此方法，根据儿童生长发育特点，应用其喜欢的游戏，针对个体情况，建立良好的护患关系，达到语言康复治疗的目的。     

儿童孤独症康复因素分析

目的:探讨儿童孤独症康复的相关因素。资料来源:应用计算机检索Medline1990-01/1998-12有关儿童孤独症的文献,检索词为“autism,rehabilitation,therapy”,限定语言种类为Eng-lish;同时应用计算机检索www.cnki.net(中国知网)电子期刊全文数据库1990-01/2005-11有关儿童孤独症的文献,检索词为“孤独症,康复,治疗”,限定语言种类为中文。资料选择:对资料进行初审,选择有关儿童孤独症的病因、临床表现、早期诊断、康复治疗及康复治疗影响因素等方面的文献,排除重复性研究。资料提炼:收集到符合要求的文献41篇,排除19篇重复性研究,22篇符合纳入标准,被选为参考文献。资料综合:通过检索发现,单独研究儿童孤独症康复因素的文献较少,因此对儿童孤独症的病因、临床表现、诊断、康复及其相关影响因素进行综合分析。影响儿童孤独症康复治疗的因素包括以下几点:①孤独症患儿的智力水平。②孤独症患儿的语言发育水平。③社会、家庭的支持及患儿父母的文化素质。④孤独症患儿的其他并发症。结论:儿童孤独症的康复是多角度、多层次的,与患儿疾病本身的严重程度、病因及并发症是否及时控制有关,早期预防、早期诊断与治疗是孤独症患儿康复的关键。特别需要注意的是治疗或教育要注重个体化。     

听觉统合训练对智力障碍儿童语言迟缓的效果

目的探讨听觉统合训练对智力障碍儿童语言迟缓的效果。方法将智力障碍患儿40例分为观察组和对照组,每组各20例。对照组采用语言训练,观察组采用听觉统合训练结合语言训练。治疗前后采用Gesell发育量表中的适应性和语言两个领域进行评分。结果治疗6个月后,两组患儿的适应性DQ及语言DQ均较治疗前提高(P<0.05),观察组疗效较对照组更优(P<0.05)。结论结合听觉统合训练对智力障碍儿童语言迟缓康复效果优于单纯语言训练。     

口肌训练联合语言认知训练在智力低下儿童语言康复中的应用

目的 探讨口肌训练联合语言认知训练在智力低下儿童语言康复中的应用效果。方法抽取2020年4月至2021年4月期间我院医治的88例智力低下儿童作为研究对象,按照抽签法随机设为两组,其中对照组共44例患儿采取语言认知训练,观察组44名患儿进行了口肌锻炼和言语认知训练。在治疗前和治疗3个月后使用Gesell发育量表和S-S语言发育迟缓评价（S-S法）两组患儿语言恢复效果。结果 在Gesell发育量表方面,治疗前两组患儿语言发育商（DQ）值无明显差异（P＞0.05）;治疗后,观察组语言DQ值相比对照组显著更高,两组差异具有统计学意义（P＜0.05）。在S-S法结果方面,治疗3个月后,观察组语言发育迟缓率改善情况明显优于对照组,两组有统计学差异（P＜0.05）。结论 智力低下儿童语言康复中采取口肌训练联合语言认知训练,能够有效提高患儿语言功能。     

"功能康复链"在儿童四肢软组织缺损皮瓣修复手术中的应用

近年来，因意外伤所致的儿童创伤愈来愈多，部分患儿由于肢体软组织缺损面积过大，或深部组织裸露过多，需行皮瓣转移或移植手术修复覆盖。如何提高患儿伤肢的手术效果，是手术医生需要考虑的一个问题。我科自1997年10月以来，在对29例儿童四肢软组织缺损皮瓣移植手术的同时，将“功能康复链”的全程康复概念，贯穿于患儿整个治疗过程中，取得了较好的效果。现报道如下：     

42例脑瘫患儿语言障碍治疗和分析

目的：脑瘫是一种由脑损伤引起的具有多重表现的综合症，同时脑瘫患儿常伴有语言障碍和构音障碍。本文中42例脑瘫患儿语言障碍均采用中国康复研究中心，儿童语言发育迟缓检查法(sign—significance，S-S法)进行评价与治疗。同时也采用构音障碍评定(CRRC版)进行评价与治疗。方法：语训多选择儿童注意力较集中的上午，每次30-60分钟／次，1-2次／日，三个月一个疗程，根据评价结果制定相对应的训练计划，即要有长期目标也要有短期目标。语言治疗主要通过：日常交流能力训练；理解能力训练；表达能力训练；非言语操作训练；手眼协调能力训练。构音治疗首先进行呼吸训练，可做“吹”训练，如吹泡泡、等。其次，进行咀嚼肌、舌及其它构音器官的协调运动训练。结果：本组42例患儿通过一对一语言训练，其语言能力与对语句的可懂度及清晰度均在其原有的基础上都有不同的进步与提高。结论：脑瘫患儿语言障碍发病率较高，如能在6个月内就做出正确的诊断，并立即进行有效的干预。通过有目的的训练可促进更多新突触的形成，使得相关神经通路与一些不稳定的突触变成稳定的突触连接，使神经环路发生永久性的变化，最终保留最佳的神经通路。所以，早期诊断，早期干预是脑损伤患儿语言康复的前提和基础，也是患儿能否获得良好预后的关键。     

儿童电子耳蜗植入术后的护理问题分析及对策

目的　探讨解决儿童行电子耳蜗植入术后出现的护理问题的措施 ,提高手术成功率 ,为儿童听觉言语康复创造良好的条件。方法　针对患儿年龄小 ,听觉言语障碍而引起的不易沟通、术后易感染及患儿家长语言康复知识缺乏等护理问题 ,制定和实施有效护理措施及指导。结果　术后与患儿顺利沟通 ,满足其需要 ,无 1例感染 ,患儿家长掌握了语言康复的基本知识 ,能配合完成康复期的听觉言语训练 ,患儿听力语言均有不同程度的提高。结论　及时解决和预防电子耳蜗植入术后儿童易出现的护理问题是实现手术目的 ,恢复患儿听觉语言的有效方法。     

儿童期分泌性中耳炎与语言发育迟缓的临床分析

目的探讨儿童期分泌性中耳炎所致感音神经性耳聋对语言、认知和交流能力的影响，及对分泌性中耳炎感音神经性耳聋患儿早期确诊、早期治疗、早期进行听力语言康复的重要性。方法根据26例语言发育迟缓的分泌性中耳炎患儿就诊情况及听力调查资料，分析高频听力损失和语言频率的关系以及对语言、认知和交流能力的影响。结果分泌性中耳炎所致感音神经性耳聋患儿对语言、认知和交流能力有影响，只有当高频听力损失达到一定程度，并波及到语频时，才会引起语言发育迟缓。早期发现分泌性中耳炎感音神经性耳聋儿童，早期确诊，早期进行听力语言康复非常必要，可以大大地减少因感音神经性耳聋所致的语言障碍。结论儿童期分泌性中耳炎所致的感音神经性耳聋可以引起患儿语言发育迟缓。对分泌性中耳炎患儿早期诊断、早期治疗可避免残余听力障碍对语言、认知和交流能力的影响。我们将病程超过3个月以上的儿童期分泌性中耳炎作为感音神经性耳聋的高危儿童，在儿童保健系统开展听力筛查，及早发现感音神经性耳聋儿童，可将此类儿童的早期诊断的确诊率、早期配戴助听器和早期开展听觉语言康复的年龄提前。     

儿童电子耳蜗植入术后的护理问题分析及对策

目的探讨解决儿童行电子耳蜗植入术后出现的护理问题的措施,提高手术成功率,为儿童听觉言语康复创造良好的条件.方法针对患儿年龄小,听觉言语障碍而引起的不易沟通、术后易感染及患儿家长语言康复知识缺乏等护理问题,制定和实施有效护理措施及指导.结果术后与患儿顺利沟通,满足其需要,无1例感染,患儿家长掌握了语言康复的基本知识,能配合完成康复期的听觉言语训练,患儿听力语言均有不同程度的提高.结论及时解决和预防电子耳蜗植入术后儿童易出现的护理问题是实现手术目的,恢复患儿听觉语言的有效方法.     

神经肌肉电刺激在脑瘫儿童语言治疗中的作用

目的：探讨神经肌肉电刺激在脑瘫患儿语言治疗中的作用。方法：47例脑瘫患儿分为电刺激组25例和对照组22例,均采取常规语言训练,电刺激组同时增加面部肌群的神经肌肉电刺激。治疗前后2组均采用S-S语言发育迟缓检查法（S-S法）及构音器官功能评定（主要针对口腔开合度及流涎程度）。结果：治疗6个月后,S-S法评定,电刺激组总有效率明显高于对照组（92.1%与68.2%,P〈0.01）;构音器官功能评定,电刺激组口腔开合度及流涎程度达1～2级的患者明显多于对照组（P〈0.05）。结论：神经肌肉电刺激与常规语言训练相结合治疗脑瘫语言障碍能显著提高临床疗效。     

作业疗法在小儿脑瘫康复中的作用

目的:观察作业疗法在小儿脑瘫康复中的作用。方法:脑瘫患儿116例,分为A组56例和B组60例,均采用运动疗法,言语、针灸、按摩等综合康复治疗,并指导患儿家属配合家庭康复治疗,B组同时辅以作业疗法。2组治疗前后采用中国韦氏儿童智力量(C-WISC)、修订的小儿脑瘫粗大运动功能测试量表(GMFM)及ADL评定量表(Barthel指数)进行评定。结果:治疗6个月后,2组患儿C-WISC、GMFM及Barthel指数评分均较治疗前明显提高(P<0.01);与A组比较,B组C-WISC及Barthel指数评分提高更显著(P<0.01)。结论:对脑瘫的治疗中增加作业疗法能明显提高患儿的智力及ADL能力。     

A comparison between computer and tabletop delivery of phonology therapy

This paper reports on the development and evaluation of a software program aimed at assisting children with phonological impairment. An experimental approach was used whereby children's speech output was assessed pre- and post-therapy. Children were randomly assigned to a computer, a tabletop or a no therapy group. Those children receiving the computer therapy were exposed to an experimental software program that mirrored the tabletop activities using interactive computer games. The results showed no significant difference between any of the three groups with regard to change in speech output. These results may relate to the amount and frequency of therapy given and also to the heterogeneous nature of children included in the study. There was considerable variation in individual performance across all three groups and the data were therefore analysed to look for patterns that might predict performance. Stimulability and gender were identified as possible predictors. Female children and those who were able to produce a greater number of consonant speech sounds in isolation were more likely to make progress in their speech output. Future research might use a similar methodology to compare the therapy conditions but with a more homogenous group in terms of stimulability and using a greater intensity of intervention.     

Intervention for a child with persisting speech and literacydifficulties: A psycholinguistic approach

This paper illustrates a psycholinguistic approach to investigating children's speech and literacy difficulties by describing a “three-way” intervention plan for Jarrod, a 7 year old boy with unintelligible speech. First, a speech processing profile, a speech processing model and developmental phase models of speech and literacy were used to determine the relationship between his spoken and written language skills and what strengths could be built on in an intervention programme. Second, an analysis of the speech data was used to examine contributing factors to Jarrod's unintelligibility and what intervention targets might be selected to promote his speech, phonological awareness and literacy skills. Third, who might be involved in his intervention programme is suggested and what training might be needed to ensure appropriate interaction between child and listener in the therapy/teaching situation. A psycholinguistic approach can be helpful for children like Jarrod as it tackles speech and literacy simultaneously and has inbuilt assessments, monitoring and evaluation. The intervention can also be carried out by others and in groups. However, this approach needs to be combined with that derived from other perspectives (e.g. linguistic, educational, medical and psychosocial) to ensure a comprehensive management programme is carried out.     

言语疗法对发育迟缓儿童智力的影响

目的观察言语治疗对发育迟缓儿童智力的影响。方法对20例言语发育迟缓儿童进行评估后,制订个别化言语训练计划,尤其是训练抽象思维和逻辑思维以及注意力认知能力的发育。将适合言语发育迟缓儿童的训练内容融合并演变为游戏方式进行训练,共训练1～3个疗程。训练前后分别进行言语发育水平和智力测验。结果治疗后,10例儿童(50%)言语智商达到正常水平,总有效率100%。结论综合言语康复训练可使言语发育迟缓儿童的智商、言语发育水平均明显提高。     

脑功能生物反馈治疗脑瘫伴注意障碍的临床疗效观察

目的观察脑功能生物反馈治疗伴注意障碍痉挛型脑瘫的效果。方法 2010年1月～2010年10月本院门诊及住院治疗的痉挛型脑瘫患儿44例,分成对照组(n=21)和观察组(n=23)。对照组采用综合康复治疗方法(包括运动疗法、作业疗法、感觉统合训练、言语疗法、传统中医疗法),观察组采用与对照组相同的综合康复治疗方法,另加脑功能生物反馈治疗。每周训练5 d,疗程为3个月。以盲评的方式对两组干预前、中、后进行中国比内智力测试和注意力变量检测。结果治疗后,观察组智力水平较治疗前显著提高(P<0.001);注意力变量观察指标疏漏数明显减少(P<0.01),错误数减少(P<0.05),反应时明显缩短(P<0.01),变异率明显降低(P<0.01)。治疗后,对照组智力水平与治疗前比较无显著性差异(P>0.05);注意力变量观察指标疏漏数明显减少(P<0.01),反应时明显缩短(P<0.01);错误数及变异率较治疗前无显著性差异(P>0.05)。结论脑功能生物反馈疗法能有效地提高脑瘫患儿的注意力水平。     

多媒体技术在腭裂修补术后语音治疗中的应用

目的 :利用计算机多媒体技术辅助腭裂患者术后语音治疗 ,在较短时间内强化训练 ,激励患者的训练积极性。方法 :利用实时语音工作站软件和MicrosoftPowerpoint软件为 2 1例患者进行较系统的语音训练 ,制作图文并茂的幻灯片 (带有音乐效果 ) ,用汉语输入法找出患者发音须纠正的系列字、词组 ,对被训练患者进行语音清晰度的检测及训练前后录音对比。结果 :2 1例患者经过 5天的强化训练 ,语音清晰度从平均 5 4.2 %提高到 94.7%。平均提高了 40 .5 %。结论 :利用多媒体辅助腭裂患者术后语音治疗 ,可激发其训练兴趣 ,强化针对性语音训练确能在较短时间内达到提高语音清晰度 ,改善语音功能的目的。     

Speech training aids for hearing-impaired individuals: III. Preliminary observations in the clinic and childrens' homes

Preliminary evaluation of 2 related computer-based speech training and practice aids for profoundly deaf children was conducted. The Speech Training Station (STS) uses both acoustic and physiological transducters for assessment and training in a school of clinic. The Speech Practice Station (SPS) uses the acoustic signal, and was designed primarily for use in the home. A series of games and activities was implemented on the 2 systems. Use of the STS was evaluated by 2 speech clinicians during a 15-month period. Fifteen children were subjects in the evaluation. The aid was found to be easily incorporated into clinic activities and useful for diagnosis and therapy. The SPS was evaluated during a 1-to-2-week period, during which it was placed in the homes of 5 profoundly deaf children. Using an activity log and questionnaire completed by the childrens' parents, usage statistics and impressions were obtained. Potential value and problems with such aids are discussed.     

脑瘫患儿构音障碍特点与言语治疗

对５６例脑瘫患儿的构音运动和言语特点进行了分析与治疗。结果：４５例和存在运动性构音发生率为８０．４％,其中徐动型、失调型、痉挛型四肢瘫患儿构音障碍发生主高且程度较严重痉挛型双瘫次之。偏瘫型则较少运动异常构音障碍;对其中４５例患儿采用基础性训练、构音器官运动及构音训练后总有效率为９１．０％,提示运动性构音障碍是脑瘫患儿文言语的主要问题,早期正确评价和治疗具有重大意义。     

Speech and language delay in children

Speech and language delay in children is associated with increased difficulty with reading, writing, attention, and socialization. Although physicians should be alert to parental concerns and to whether children are meeting expected developmental milestones, there currently is insufficient evidence to recommend for or against routine use of formal screening instruments in primary care to detect speech and language delay. In children not meeting the expected milestones for speech and language, a comprehensive developmental evaluation is essential, because atypical language development can be a secondary characteristic of other physical and developmental problems that may first manifest as language problems. Types of primary speech and language delay include developmental speech and language delay, expressive language disorder, and receptive language disorder. Secondary speech and language delays are attributable to another condition such as hearing loss, intellectual disability, autism spectrum disorder, physical speech problems, or selective mutism. When speech and language delay is suspected, the primary care physician should discuss this concern with the parents and recommend referral to a speech-language pathologist and an audiologist. There is good evidence that speech-language therapy is helpful, particularly for children with expressive language disorder.