耳蜗性聋患者在噪声竞争下言语测听的探讨

为了观察耳蜗性聋患者噪声竞争下言语清晰度曲线与正常听力者的区别，不同噪声对清晰度曲线的不同影响，以及该测试方法对听力障碍的评价能力。文中报道了２９名耳蜗性聋，在３种不同噪声竞争下测得的言经结果。     

聋童语法能力现状剖析与教学对策

本文在剖析聋生“语法能力”现状的基础上，阐述了语法能力对补偿聋童语言缺陷的理论意义，总结了其实践经验，提出了聋校语文教学应该把语法能力的培养作为一个具有突破性的问趣来抓。     

先天性语前聋中国儿童双耳人工耳蜗植入疗效观察

目的：评估双侧耳人工耳蜗植入对极重度感音神经性语前聋患儿的听觉与言语康复疗效。方法：2例先天性极重度感音神经性聋儿童，单侧耳人工耳蜗植入术后2年和3年分别施行对侧耳人工耳蜗植入。术后1年评估患儿左、右耳单耳及双耳人工耳蜗助听听阈和言语识别率。以及言语清晰度。结果：①双耳人工耳蜗助听与单耳人工耳蜗助听相比。平均听阈降低分别为13dB和11dB；②在安静环境中双耳人工耳蜗植入儿童的言语识别率(开放项列)分别平均提高为9％和10％，2例双耳人工耳蜗植入儿童的言语识别率(开放项列)分别达97％和95％；③在嘈杂环境中对言语的识别能力明显提高；④言语清晰度有明显改善。结论：双耳人工耳蜗植入可明显提高极重度感音神经性语前聋患儿在安静和噪声环境下的言语识别率，对语前聋儿童的言语和语言发育有明显的帮助。     

语前聋青少年人工耳蜗植入发音清晰度与嗓音声学参数的分析

目的探讨语前聋青少年人工耳蜗植入患者发音清晰度、嗓音特点及其影响因素，为研究影响人工耳蜗植入患者言语清晰度的机制提供相关资料。方法8例资料完整的语前聋青少年人工耳蜗植入患者，分别进行耳蜗听力测试、发音清晰度评估及嗓音声学参数测试。结果发音清晰度与嗓音声学参数中的基频标准差（FOSD）及耳蜗听力有统计学上的相关性。相关系数分别为-．767（P〈0．026）和-．726（P〈0．041）；多元回归分析只有FOSD对发音清晰度有影响。结论人工耳蜗植入患者对音调的控制能力是影响言语清晰度的因素之一。患者发声时基频的变化，能够客观地反映人工耳蜗植入带来的听力补偿及形成的听觉-发音环路对发音准确度的影响。对音调的控制能力是评价人工耳蜗植入效果的有效手段之一。     

从儿童中心到家庭中心，聋童早期干预的生态转变

儿童的聋不仅影响儿童,也影响家庭生活的各个方面.家庭作为聋童社会生态环境的中心,正在成为国际聋童早期干预关注的焦点.本文介绍了有关聋童早期干预从儿童中心到家庭中心的发展趋势,总结了一些建立在大量研究基础上的有效干预措施,比如积极建构聋的意义、借用聋人经验帮助聋人、建立聋人家庭支持小组等,希望对我国的聋童早期干预有所启迪.     

一例5岁聋儿音位识别能力、构音能力评估结果与分析

目的通过聋儿音位识别能力、构音能力评估结果与分析,为制定聋儿康复计划提供依据。方法选择1例在康复中心训练的5岁聋儿作为被试,采用《儿童音位识别能力评估》词表在安静房间中进行听觉识别能力评估。采用《构音语音能力评估》词表进行幼儿声母、韵母、声调、构音清晰度评估。结果该幼儿声母识别率为68.9%,韵母识别率为84.48%,声调识别率为100%,需要有针对性地进行最小音位对比的训练。构音语音清晰度为33.3%,相对年龄小于2岁半,构音清晰度发展落后两年,需进行构音能力训练。结论正确的评估与矫治,是提高聋幼儿言语流畅性和清晰度的基础和前提。     

北京市四所聋校1—7年级学生耳聋调查和研究

为了促进聋校教育听力学的发展，听力学医师有责任定期监测聋校学生的听力和语言状况，逐步地，科学地推广助听器选配和口主教学，增强聋童的口语交往能力，使其中一部分聋生进入普通小学学习，摆脱聋哑状态，回归主流社会，我们将这几年聋校学生的听力和语言状况，分别在1982年和1988年进行了两次调查，现就其结果进行对比，分析。     

多媒体训练软件在聋童言语康复训练中的实践研究

目的考察多媒体训练软件对聋童言语康复训练的作用。方法根据前测结果将实验对象分为实验组和对照组，实验组使用多媒体训练软件配合教学，对照组采用传统的教学方法。教学结束后，对两组进行相同的测试，对比其发音的准确性。结果实验组成绩显著高于对照组。结论多媒体训练软件有助于提高聋童发音的准确性，多媒体教学方式是聋儿康复教学的有效手段。     

传导性聋患者在不同噪声竞争下的言语测听

目的　为了观察传导性聋患者在噪声竞争下言语清晰度曲线及不同噪声对清晰度曲线的不同影响;方法　测试２２ 名（３５ 耳） 传导性聋患者三种不同噪声竞争下测得的言语识别率结果,这三种噪声为①白噪声（ｗｈｉｔｅ ｎｏｉｓｅ,ＷＮ） ,②言语噪声（ｓｐｅｅｃｈ ｎｏｉｓｅ,ＳＮ） ,③多人谈话声（ｂａｂｂｌｅ ｎｏｉｓｅ,ＢＮ） ,即由８ ～１２ 人同时讲话录制而成,其频谱与言语长时平均频谱接近。所选用的测试词表为沈晔等有１９８３ 年编制的单音节语音平衡词表,每词表有２５ 个测试字。同时也测得不同信噪比（ｓｉｇｎａｌ ｔｏ ｎｏｉｓｅ ｒａｔｉｏ,ＳＮＲ）对清晰度曲线的影响。结果　传导性聋患者的言语识别率整体趋势是随ＳＮＲ 的增大而增加;不同噪声条件下清晰度曲线斜率变化不同,为ＢＮ＞ ＳＮ＞ ＷＮ,但无统计学意义;在信噪比较低时,ＢＮ 组的影响明显高于ＳＮ、ＷＮ 组（ Ｐ＜ ０ ．０５） 。结论　在嘈杂环境中,多人谈话声对言语识别的影响更明显     

试论言语功能评估的标准及方法

本文旨在讨论言语功能评估标准及方法，阐述言语功能评估的一个基本理念：夯实基础，循序渐进，螺旋上升，即言语评估、测量与矫治是一个动态的过程。言语矫治以言语评估和测量为起点，在言语矫治中或训练一个阶段后，应再次进行言语评估和测量，从而监控言语矫治方案的有效性，调整言语矫治方案或提出更高的言语矫治目标。     

JCI标准在语言治疗学教学中的探索与实践

目的探讨JCI标准在语言治疗学教学过程中的作用。方法在语言治疗学教学过程中,针对失语症、吞咽障碍和构音障碍的评定和治疗,采用自行设计的问卷调查表对2个班级122名学生分别进行传统教学模式、传统教学与JCI标准相结合的教学模式,比较两种模式的教学效果。结果与传统教学相比,语言治疗师在安全目标、康复治疗连续性、患者及其权益、患者的康复治疗、患者和家属教育和沟通与信息管理等6个方面均有显著提高(P<0.05)。结论传统教学模式与JCI标准相结合的教学模式,有利于提高语言治疗学课程的教学质量和水平,提高语言治疗师的基本素质。     

聋儿康复教师备课系统的研究

对聋儿实施有效的听觉言语康复是一个艰辛而复杂的教学过程。教学目的性不强．教学针对性差以及辅助性教学管理手段与系统支持不足,是影响康复教师教学效能不高的重要原因。本研究从实际需要出发,以有效教学方案为蓝本,遵从听力语言康复教学的规范化流程,利用日益成熟的教育信息技术和计算机编程技术,研制适用于网络环境的0～6岁聋儿听力语言康复教学教师备课系统,使之成为听力语言康复教师教务管理、目标制订、教案编辑,计划编排。教育评价．经验分享和自我反思的有力工具,初步实现康复教学准备手段的数字化、网络化和智能化,以期通过研究成果的推广应用,进一步提升聋儿康复教学质量和水平,提高聋儿听力语言康复效果。     

Phonetic and otological results after early palate closure in 18 consecutive children presenting with cleft lip and palate

OBJECTIVE: First, to analyze the speech and hearing results at 3.5 years of age when early palate closure has been performed. Second to assess at 7 years of age the need for speech therapy and/or additional surgery in the form of cranial-based pharyngeal flap for obtaining normal speech. METHODS: Retrospective study in a tertiary teaching hospital concerning 18 consecutive cases presenting cleft lip and palate with no associated abnormalities. Interventions included early palatine closure (velum at 3 months, hard palate and lip at 6 months). Speech therapy was initiated at 3.5 years of age when needed. Cranial-based pharyngeal flap was performed when normal nasal emission was not obtained by speech therapy at 7 years of age. Phonetic and otological assessment were performed in all cases. RESULTS: Good to excellent speech in the majority (95%) of children, with only 3/18 undergoing pharyngoplasty to obtain type I or I/II speech by the age of 7 (range: 6.5-8.0). 6/18 children had drain insertion, and 2/18 had hearing loss of 20-40 dB in all frequencies. CONCLUSION: Most children (95%) start school with good or excellent speech. However, the high incidence of middle ear problems shows that more effective screening and treatment are warranted.     

听障幼儿人工耳蜗植入术后追赶发育实施效果

目的探讨运用健听小儿听能言语发育进程规律,加速听障幼儿人工耳蜗术后的感知觉发育进程。方法选择1.5～3岁人工耳蜗植入幼儿33例。进行为期5～6个月的听觉言语训练后,考察其追赶发育实施效果。结果听觉感受能力、语言表达能力均有显著改善。结论运用小儿生长发育规律,对听障幼儿实施追赶发育,可缩短开机后听能感知时间,使其尽快在大脑中形成听觉记忆。     

Speech development in hearing-impaired children

Many hearing-impaired children are unable to speak intelligibly. Research indicates, however, that patterns of errors typically found in the speech of such children could be largely avoided by systematic teaching. The purpose of this paper is to present and discuss a model for the progressive development of speech skills to the levels of automaticity required for fluent spoken language.     

Project parent: a preschool speech program implemented through parents

The effectiveness of parents as teachers of speech production skills was assessed by comparing changes in the phonological skills of their children, made during a period with no intervention, to changes that occurred when parents served as teachers, and by comparing those changes with changes that occurred in a contrast group who received no intervention. Twenty children, 12 in the experimental group and 8 in the contrast group, served as subjects. All children were between 4 and 5 years old at the beginning of the study. Parents were taught, in weekly sessions, to model, reinforce, and in other ways to teach their children. Both teaching goals and teaching materials were provided, and progress was monitored weekly. The speech production skills of children in the experimental group improved significantly when parents did the teaching. This was true for both within-subject and across-subjects comparisons.     

Speech and voice outcomes in oropharyngeal cancer and evaluation of the University of Washington Quality of Life speech domain

Background: Radical treatment of oropharyngeal cancer can have significant impact on speech & voice outcomes. Aims: (i) To assess the extent of speech & voice handicap in disease‐free survivors of oropharyngeal squamous cell cancer. (ii) To assess the validity of the speech domain of UWQOL as a screening tool. (iii) To identify clinical characteristics associated with worse speech/voice outcome. Design: Cross‐sectional survey. Setting: University Hospital Aintree, a university teaching hospital and tertiary referral centre. Patients: All who were treated for oropharyngeal cancer between 1 January 1999 and 31 May 2005, were alive, disease free and willing to participate. Interventions: Three patient‐based questionnaires: University of Washington Quality of Life (UWQOL), voice handicap index (VHI) and voice related quality of life (VRQOL). Three expert‐based assessments: GRBAS rating, speech intelligibility and dysarthria rating. Results: Sixty‐six per cent of patients participated. Median VHI score (29) & VRQOL score (15) imply mild to moderate voice impairment. 20% of patients had severe handicap (VHI score >60). Forty‐eight per cent had normal voice ratings. Speech was normal in 26%, mildly impaired in 62% and significantly impaired in 12% patients (UWQOL). Correlation between UW‐QOL speech domain with speech intelligibility rating was 0.52 (P < 0.001). There were clear demarcations between UW‐QOL scores of 30, 70 and 100 on the voice questionnaires. Adverse speech and voice function were associated with tumour stage, radiotherapy (RT) & free‐flap surgery. Conclusions: Voice & speech impairment is prevalent in >70% of oropharyngeal cancer patients. There is moderate correlation between UWQOL speech domain and speech intelligibility assessment & voice tools making it a quick and easy screening instrument. The main clinical correlates associated with adverse patient and observer rated speech and voice outcomes were tumour stage, RT and free‐flap reconstruction.     

我国听障儿童语言康复教育中语言学视角研究概观

本文以近20余年间我国有关“语言康复”的130余篇文献为基础，从语言学视角在康复课程设置理念中的应用、听障儿童语言要素习得情况、语言要素教学法、听说读写技能研究4个方面进行了回顾分析，指出听障儿童语言康复教育学科需要在应用语言学的理论框架下科学发展。     

聋生语言学习的特点及其教育对策

本文对聋生语言学习的特点及教育对策进行了探讨，认为聋生语言理解具有以目代耳，语言表达具有以手代口的特点。在聋生语言学习的过程中，教师应该营造良好的语言学习环境。调动聋生学习语言的积极性；要充分发挥视觉优势，培养聋生的观察能力；要加强阅读训练。提高聋生的阅读能力；要以书面语言为重点，增强聋生的语言表达能力。     

听觉描述在听障儿童康复教学中的应用

在听障儿童康复教育教学中,听觉描述活动可以帮助听障儿童认识事物、积累经验,有效提高听障儿童的注意力、观察力、想象力、表达能力,促进思维能力的发展.本文从听觉描述在听障儿童语训教学中的作用、教师在开展听觉描述教学活动时的准备工作以及组织听觉描述活动的注意事项等方面进行了介绍.