发音训练

发音训练是指在聋儿对声音有了一定的认识之后，对他们发音的诱导，使他们逐步掌握正确的发音部位和发音方法，能够基本正确地发音。聋儿在学习发音时，要对他们进行呼吸、节奏、发音器官等方面的有意识地训练。语音是有声语言的物质基础，所以，要让聋儿学习如何灵活控制和运用发音器官，并能将呼吸与发音很好地协调起来，这样才能准确发音。大多数聋儿的发音器官并没有器质性病变，     

功能性发声及言语障碍的发声训练矫治

功能性发音及言语障碍是一种常见病、多发病,不仅严重影响患者的生活及社会交往,更能带来严重的心理负担,其治疗十分重要.根据我院杨宝琦教授的两级中枢理论[2],10年来对349例患者进行发声训练矫治.     

控制用声导致的功能性发声障碍的临床特点研究

目的 探讨不当的控制用声、禁声导致的功能性发声障碍患者的临床特点.方法 回顾性分析94例有不当的控制用声、禁声且确诊为功能性发声障碍患者的初始诱因、病程、控制用声时间、临床表现、声嘶程度、既往治疗史及频闪喉镜下表现.结果 94例患者中男性23例(24.5％)、女性71例(75.5％),初始发病诱因包括上呼吸道感染(28...     

发声、发音和发音障碍

书刊中常有将“发音”一词和“发声”一词通用、混用的情况。“发音”(articulation)和“发声”(phonation)有不同含义。“phonation”在《英汉耳鼻咽喉科学词汇》中和《语音学和音系学词典》中译为‘发声’。“发声”指“在气流帮助下 ,利用喉产生可听声的声源 ,这个声源的声能量 ,可受声道的调制。”“某些时候特别作为voicing的同义词”(《语音学和音系学词典》)。发声是在呼出气流的同时 ,声门区与之作相关活动的行为。声门区不同类型的动作 ,使“发声”可分为不同的类型 ,如清音发声 (nilphonation)、气音 (breath)、耳语、挤喉音、正…     

语音训练治疗儿童功能性构音障碍的疗效分析

目的 分析儿童功能性构音障碍患者经语音训练治疗价值。方法 筛选2018年4月～2021年12月本院收治的儿童功能性构音障碍患者60例作为研究对象,并按“随机抽样法”分2组（每组30例）,对照组给予口部肌肉训练,观察组在对照组基础上进行语音训练治疗,对比2组临床疗效、口部运动功能、语音清晰度。结果 观察组临床疗效高于对照组（P<0.05）;观察组舌、唇、下颌、整体口部运动功能评分高于对照组（P<0.05）;观察组干预3个月、6个月后语音清晰度高于对照组（P<0.05）。结论 选择语音训练对儿童功能性构音障碍进行治疗可改善其临床疗效,亦可促进患者口部运动功能恢复,继而提高语音清晰度,值得借鉴及参考。     

半封闭声道训练在嗓音障碍中的应用

嗓音在言语交流中发挥重要作用,嗓音障碍直接影响沟通。以声道远端部分封闭为特点的半封闭声道训练(semioccluded vocal tract exercises,SOVTEs)越来越多地应用于声乐训练和嗓音疾病治疗中。SOVTEs通过改善声带-声道耦合(source-filter coupling)和优化声带振动模式,提高发声效率,同时减少声带损伤。本文介绍了SOVTEs在嗓音障碍中的应用,包括其理论基础、各变体对比、临床应用及疗效分析。     

发声训练治疗痉挛性发声障碍一例

患者，男，42岁，说话费力，语句不连贯，停顿，伴咽异物感7年。7年前，在当地医院因鼻息肉行激光治疗，术后说话费力，1年后加重，说话不连续。酒后症状减轻，紧张及情绪波动时症状加重。检查：快速读报时，语音颤抖，言语结巴、失去连续性，无正常节律，同时，面部肌肉不时出现抽动。但患者打哈欠时讲话清晰，歌唱、咳嗽、大笑不受影响。电子喉镜检查：鼻腔、咽喉部均正常，双侧声带黏膜光滑，声门闭合好，诊断：痉挛性发声障碍。     

语言训练

聋儿的语言训练是在其语言学习的基础上进行的。单就训练内容而言．广义的语言训练一般可分为语音、词语．句子和语用四项。但在聋儿早期康复实践过程中．教学上常采用“二分法”以明确构成语言训练的内容项目。即将听觉训练、呼吸训练．发音训练．词语训练和句子训练统称为语言基本训练．而将对话训练．复述训练．朗诵训练和体态语等方面的训练统称为语言交际训练。     

功能性构音障碍塞音异常患者的语音特点及训练效果

目的 探讨功能性构音障碍(functional articulation disorders,FAD)塞音异常患者的语音特点和语音训练方法.方法 通过语音评估归类分析87例4~26岁FAD塞音异常患者的语音特点,分析异常塞音/b/、/p/、/d/、/t/、/g/、/k/的构音错误方式和错误表现形式;针对性实施语音训练矫正异常塞音构音部位及构音方式的错误,分析疗效.结果 塞音/t/错误例数最多(82/87),其他依次为/k/(77/87)、/d/(67/87)、/g/(60/87)、/p/(59/87),/b/音例数最少(3/87).发生率最高的错误方式为擦音化(65.52%),其他主要为不送气化(63.22%)、舌前音化(54.02%)、构音扭曲(33.33%)、双唇音化(32.18%)、舌后音化(18.39%)、辅音脱落(17.24%).经过2~10次语音训练,87例患者中完全治愈71例(81.61%),部分治愈16例(18.39%),塞音错误字数由训练前的67.97±18.56个减少到训练后的4.03±2.71个,差异有统计学意义(t=34.301,P<0.001).结论 本组FAD患者异常塞音发生例数由多到少依次为/t/、/k/、/d/、/g/、/p/、/b/,构音方式错误主要为擦音化、不送气化、构音扭曲、辅音脱落,构音部位错误主要为舌前音化、双唇音化、舌后音化;根据错误部位及错误方式集中开展针对性的语音训练可有效矫治塞音异常.     

痉挛性发音障碍的研究进展

本对近年来痉挛性发音障碍的研究进行综述。回顾了本病的基本概念，发生机制的研究进展，收集了有关诊断方面的信息，并着重介绍了本病的治疗现状，尤其是对肉毒杆菌素的治疗情况进行详述。     

噪音医学进展

本文主要从嗓音医学研究及嗓音治疗等方面 概述近10年来嗓音医学领域的研究探索。     

Correlates of phonological awareness in preschoolers with speech sound disorders.

PURPOSE: The purpose of this study was to examine the relationships among variables that may contribute to poor phonological awareness (PA) skills in preschool-aged children with speech sound disorders (SSD). METHOD: Ninety-five 4- and 5-year-old children with SSD were assessed during the spring of their prekindergarten year. Linear structural equation modeling was used to compare the fit of 2 models of the possible relationships among PA, speech perception, articulation, receptive vocabulary, and emergent literacy skills. RESULTS: Half the children had significant difficulty with speech perception and PA despite demonstrating receptive language skills within or above the average range. The model that showed the best fit to the data indicated that speech perception is a pivotal variable that has a direct effect on PA and an indirect effect that is mediated by vocabulary skills. Articulation accuracy did not have a direct impact on PA. Emergent literacy skills were predicted by PA abilities. CONCLUSIONS: Children with SSD are at greatest risk of delayed PA skills if they have poor speech perception abilities and/or relatively poor receptive vocabulary skills. Children with SSD should receive assessments of their speech perception, receptive vocabulary, PA, and emergent literacy skills.     

植入年龄对婴幼儿人工耳蜗植入患者早期言语可懂度的影响

目的本研究评估使用人工耳蜗的婴幼儿患者早期言语可懂度发育并探讨植入年龄对言语可懂度的影响,为患儿的听力言语康复提供指导。方法共有272例极重度语前聋人工耳蜗植入婴幼儿参加本次研究。手术年龄9～36个月,平均（21±7）个月。根据植入年龄将患儿分为3个组：A组小于18个月,B组为19～24个月,C组为25～36个月。使用言语可懂度分级（speech intelligibility rating,SIR）问卷在术前及术后开机后1、3、6、9个月和1年时对患儿进行评估。结果患儿SIR平均得分在术前、术后开机后1、3、6、9个月和1年之间的差异有显著性。3个组患儿SIR平均得分在术后开机后3个月、6个月之间的差异有显著性,在术前、术后开机后1个月、9个月、1年之间的差异无显著性。结论极重度语前聋人工耳蜗植入婴幼儿患者的言语可懂度在术后1年内有显著提高。植入年龄对婴幼儿人工耳蜗患者术后早期言语可懂度发育没有显著影响。     

构音干预对人工耳蜗植入儿童言语清晰度的影响

目的考查构音干预对人工耳蜗植入儿童言语清晰度的影响。方法选取17名人工耳蜗植入儿童进行研究,实验组11名聋儿接受构音干预。对照组6名聋儿不接受干预,对两组儿童实验前后言语清晰度的变化情况进行比较。结果实验组聋儿言语清晰度提高速度快,平均增幅约为30％;对照组聋儿言语清晰度提高速度相对较慢。结论针对性构音干预对提高人工耳蜗儿童声母、韵母、声调的清晰度有着积极的影响。     

聋儿语音获得分析

目的分析聋儿语音获得情况及语音错误走向,据此提出教学建议。方法25个声韵母测试30例平均4岁7个月,平均听力损失重度以上聋儿的言语清晰度、语音获得情况并分析其错误情况,用三级人员评估法测试。结果被试聋儿掌握韵母发音的顺序为单韵母、复韵母、鼻韵母;最先掌握的声母为/b.p.d.t.m.l/等,其次为/h.f.s.x.n/等,较差的是/c.z.zh.ch.j.q.r/。结论以发音方法对声母进行分析,塞音正确率最高,塞擦音正确率低。从韵母的结构分类分析,单韵母成绩最好,其次是复韵母,然后是鼻韵母;声母的替代错误较多,韵母的添加错误最多。     

Speech appliances in the treatment of phonological disorders

Some individuals are unable to achieve correct production of the /r/ phoneme after receiving substantial amounts of treatment. Clark, Schwarz, and Blakeley (1993) developed a removable speech appliance that positions the tongue to produce the /r/ phoneme. Their results indicate that the appliance was successful with a large group of clients. The rationale and issues related to the use of speech appliances are discussed.     

嗓音训练治疗声门闭合不全所致功能性嗓音障碍的疗效分析

目的探讨嗓音训练对声门闭合不全的功能性嗓音障碍患者的疗效。方法对24例声门闭合不全的功能性嗓音障碍患者进行8周的嗓音训练,训练内容包括健康宣教、肌肉放松、喉部按摩、暖嗓、呼吸训练、嗓音训练和共鸣训练,训练前后对患者进行电子喉镜检查、GRBAS评估、嗓音障碍指数量表（VHI）评估、计算机嗓音声学分析,比较训练前后评估结果。结果24例患者训练后电子喉镜检查16例患者声门闭合良好（66.67%,16/24）,6例声门裂隙变小（25.00%,6/24）,2例声门裂隙无明显变化（8.33%,2/24）;GRBAS评分中总嘶哑度G(0.61±0.66)明显低于训练前(1.91±0.87)（P<0.05）,粗糙声Ｒ(0.51±0.58)明显低于训练前(1.41±0.52)（P<0.05）;VHI评分总分(29.21±21.02)分明显低于训练前的(52.35±23.45)分（P<0.05）;计算机嗓音声学分析最长发声时间（15.24±3.64）s比训练前（9.02±3.45）s明显延长（P<0.05）,基频微扰、最高基频、最低音强、嗓音障碍严重指数训练后分别为（0.21±0.08）%、（420.11±44.21）Hz、（54.21±3.20）dB、（1.62±0.82）比训练前的（0.92±0.12）%、（375.21±49.21）Hz、（56.81±3.42）dB、（0.21±1.02）有改善（P<0.05）。结论嗓音训练能改善声门闭合不全的功能性嗓音障碍患者的声门闭合及嗓音质量。     

Stability and composition of functional synergies for speech movements in children with developmental speech disorders

The aim of this study was to investigate the consistency and composition of functional synergies for speech movements in children with developmental speech disorders. Kinematic data were collected on the reiterated productions of syllables spa (/spa?/) and paas (/pa?s/) by 10 6- to 9-year-olds with developmental speech disorders (five with speech sound disorder [SSD] and five with subtype childhood apraxia of speech [CAS]) and six normally speaking children using electro-magnetic midsagittal articulography (EMMA).Results showed a higher variability of tongue tip movement trajectories and a larger contribution of the lower lip relative to the jaw in oral closures for the five children with CAS compared to normally developing controls, indicating that functional synergies for speech movements in children with CAS may be both delayed and less stable. Furthermore, the SSD group showed a composition of tongue tip movements that is different from both CAS and controls. These results suggest that the differences in speech motor characteristics between SSD and subtype CAS are qualitative rather than quantitative. At the same time, the results suggest that both SSD and subtype CAS increase movement amplitude as an adaptive strategy to increase articulatory stability.Although in direct comparison no exclusive characteristics were found to differentiate subtype CAS from the group of children with SSD and from normally developing children, these preliminary results are promising for quantifying the role of speech motor processes in childhood speech sound disorders.Learning outcomes: The reader will be able to: (1) describe the development of speech motor control and explain the role of functional synergies/coordinative structures; (2) explain the measurement of the stability and composition of speech movements; (3) identify the difficulties in studying disordered speech motor development; (4) describe the differences in speech motor characteristics between SSD and subtype CAS; (5) describe the potential role of motor control strategies in developmental speech disorders.     

The treatment with rothics and generalization obtained in two models of phonological therapy

This study had the aim to analyze both the phonological changes and the generalization obtained in the treatment with rothics in two models of phonological treatment. The sample consisted of four subjects diagnosed with phonological disorder, with ages between four and six years. All of them were assessed before and after the phonological therapy. Two groups were established for the treatment with rothics. One group was treated with ABAB - Withdrawal and Multiple Probes Model, and the other group with the Maximal Opposition Model. The phonological system and the occurrence of generalizations before and after the treatment were analyzed. It was found that none of the subjects acquired the rothics that were practiced in the treatment, however, the occurrence of generalization to untreated items was observed only in the subjects treated by the ABAB - Withdrawal and Multiple Probes model. The other types of generalization occurred in both models. The Maximal Opposition Model provided greatest changes in the phonological system of the subjects, which can have been favored by the other target-sound of the pair.