從語音處理能力看兒童語音障礙與語言障礙的共性與差異

語言障礙和語音障礙在美國精神醫學協會2013年出版的第5版《精神障礙診斷與統計手冊》中是溝通障礙下的兩個次分類，各有不同診斷準則。不過《手冊》中也指出，語言障礙患者有可能同時患有語音障礙，但是現有文獻對這兩種障礙兒童在漢語中的共病表徵卻甚少報告。故此本研究檢測了兩組被診斷為語音障礙的漢語兒童，一組只有語音的困難(PD)，另一組則同時患有語音和語言障礙(LI-PD)，比較兩組在發音、音系工作記憶和詞匯學習三項任務中的表現，並以兩個正常對照組作為參照。結果顯示，雖然兩個障礙組兒童在發音準確度上沒有重大差別，但LI-PD組出現較多的錯誤發音變異，音系工作記憶比同年齡正常對照組弱，新詞的學習也不理想。綜合各項任務分析推論，PD組兒童的發音困難可能是在口腔運動層面，而LI-PD組的發音問題，可能涉及更高層次的音系系統運作，從語音處理到語言分析都受到影響。
This study reports the findings from an experimental study of two groups of hinese-speaking children with speech sound disorders and language disorders. Thirty-four children who were clinically diagnosed as having communication disorders were further divided into two subgroups: one with phonological disorders only(PD) and one with additional language disorders(LI-PD). Their speech-language processing capacities were investigated by three tasks:(a) a picture naming task,(b) a nonword repetition task and(c) a classifier elicitation and learning task. Two control groups, one age-matched group and one younger group, were also examined. In the picture naming task, the LI-PD group showed more variations in their speech productions while the PD group was found to have more consistent substitutions. In the nonword repetition task, both the LI-PD group and the PD group performed significantly poorer than their age-matched controls. However, when consistent articulation errors were not counted incorrect in the children’s response of repeating nonword, age-level mean scores were found in the PD group while a below-age performance was still observed in the LI-PD group. Correlational analyses indicated both nonword repetition and phonological capacity might account for the variations in children’s performance in learning new classifier. These findings also suggested that the difficulties that PD group encountered were more related to oral-motor and articulation of speech sounds while the LI-PD group had processing difficulties at higher cognitive levels, involving phonological processing of speech sounds. Copyright © 2020 商務印書館有限公司.