彰化基督教醫院小兒科兒童語言障礙五年個案分析

Speech and Language Disorders in Children: Five Years' Experiences in Changhua Christian Hospital

趙文崇(Wun-Tsong Chaou)

《聽語會刊》 13期 (1998/06) Pp. 89-99

摘要

彰化基督教醫院兒童語障研究室就民國八十年八月至八十四年七月四年間450名患童因語音語言發育問題經由小兒科接受評估之兒童作整理報告。其中男有310名，女有140名。就醫時常見的主訴是「不會說話」68.2%或「說話不清楚」40.9%。臨床理學檢查有39.8%的患童是正常的，常見的異常是46.9%有細動作協調笨拙，其次為19.3%有異常的頭圍。患童之語音語言障礙在臨床表現最大部份為構音方面的異常 26.7%，語音語言的表達異常有20.7%，及對口語的刺激反應不佳有19.3%。有16.7%只是語音語言的發展遲緩而無異常。部份患童除了有語言方面的障礙表現外，尚合併有行為方面的異常，最常見的是注意力無法集中或過動徵候，兩者合併約有15%，其次是視覺接觸不良有9.3%。按照語障的病理原因分類，可以分成五個大類。第一類是單純說話障礙沒有語言認知與表達的影響。第二類是語障次發於語音環境刺激缺乏。第三類是語障導因於先天性中樞神經發展障礙。第四類是語障次發於後天性中樞神經惕害。第五類是包含退化性疾患、不尋常語音語言發展等難以歸類的兒童語障。本篇報告顯示造成兒童語音語言障礙原因及其臨床表現但有多樣性，處理方式及預後也因此各異。臨床醫療人員宜仔細分辨，有助於治療策略的擬定。

並列摘要

Beginning from August 1991 until July 1995, there were 450 children came to the hospital for the problem of speech and language disturbances. There were 310 boys and 140 girls. Common chief complaint presented at time of the first visit were speech inabilities (68.2%) and slurring speech (40.9%). ON physical examination, about 39.8% of children were normal. Common abnormal findings were fine motor dysfunction (46.9%) and abnormal head circumsference (19.3%). Articulation disorders are the most common clinical sighs of their verbal disturbances (26.7%). There were 20.7% of expressive language disorders, and 19.3% presenting poor responses to verbal stimulation. There were behavior disturbance associated, attention deficit and/or hyperkinetics (15%) poof eye-contact (9.3%), self-mutilation (3.8%) or aggressive behavior (2.4%). According to major function of verbal language which is disordered and associated clinical etiology, we categorized these children into 5 groups. This study revealed various causes were responsible for a child's verbal language disorders. A single medical may cause various presentation of speech and language disorders.