修正式循環音韻治療法對提升聽覺損失兒童語音清晰度之成效

The Efficacy of Modified Cycles Phonological Remediation Approach to Expedite Speech Intelligibility for Children with Hearing impairment

柯巧翊(Ciao-Yi Ke)

指導教授 ： 陳凱玫

中山醫學大學/醫學科技學院/語言治療與聽力學系/碩士(2020年)

https://doi.org/10.6834/csmu202000078

摘要

本研究旨在探討修正式循環音韻治療法對中度至重度語音障礙聽損兒童的構音/音韻能力之成效。
本研究採單一受試者之跨參與者多基線設計，對象為三名重度語音障礙的聽損兒童，年齡介於4歲0個月至6歲4個月，進行兩個循環階段，共18次課程，每堂課約60分鐘。本研究使用「自編目標單字測驗單」評量「目標單字正確題數」作為主要依變項指標，並將資料記錄於基線期、介入期及維持期，再以目視分析、效果量及C統計進行分析。除此之外，相關依變項亦納入分析，包括（1）聲母正確率；（2）語詞正確率；（3）清晰度百分比；及（4）音韻歷程出現率，以暸解修正式循環音韻治療法對研究對象整體言語能力的表現及維持成效。
研究結果顯示，三位研究對象在接受修正式循環音韻治療法後「目標單字正確題數」皆一致獲得明顯立即成效及維持成效，除此之外，個案亦能類化至非目標語音（音韻歷程），使整體音韻系統獲得廣泛性改善。另一方面，在其他構音/音韻能力分析指標均有進步，整體語音障礙嚴重度從重度轉為輕度或正常，錯誤音之音韻歷程出現率及出現次數消退，言語清晰度亦隨之提升。整體而言，本研究之結果可提供國內臨床上聽損兒童語音治療以及相關研究使用。

關鍵字

循環音韻治療法 ； 語音障礙 ； 聽覺損失 ； 音韻歷程 ； 清晰度

並列摘要

The purpose of this study was to investigate the efficacy of the modified Cycles Phonological Remediation Approach to expedite speech intelligibility for children with severe speech sound disorders and hearing impairment. A multiple baseline design across subjects was used to examine intervention effects.
Three preschoolers with severe speech sound disorders and hearing impairment at age 4;0 to 6;4 participated in two cycles with 18 hours sessions of phonological remediation. The single word probes were administered during baseline, intervention, and follow-up phases to assess generalization and maintenance of phonological skills. Data were analyzed by visual analysis, effect size and C-statistic. In addition, other dependent variables, including: (1) Percentages of Consonants Correct, (2) Percentages of Words Correct, (3) Percentages of intelligibility, and (4) Percentages of Phonological Process Occurrence, were analyzed to compare the differences between pre- and post-intervention.
The results of the study showed that all participants exhibited significant improvement by the end of the intervention phase and these effects were maintained at follow-up. On the other hand, other variables also exhibited significant gains. The participants’ speech has improved from rating of severe to ratings of mild or normal. The percentages of Phonological Process Occurrence were decreased. Also, all participates speech intelligibility increased. The result of this study could provide clinical and research application of the articulation/phonological intervention for Mandarin-speaking children with hearing impairment.

並列關鍵字

Cycles Phonological Remediation Approach ； speech sound disorders ； hearing impairment ； phonological patterns（deviations） ； intelligibility

參考文獻

（一） 中文文獻

王南梅、費珮妮、黃恂、陳靜文（1984）。三歲至六歲學齡前兒童國語語音發展結構。聽語會刊，1，12-17。

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