語音異常兒童的語音聽辨與聲韻覺識能力與不同治療方式的關係

本研究欲探討語音異常兒童的語音聽辨與聲韻覺識能力和不同治療方式之間的關係。將29位4到6歲語音異常的兒童，分成實驗組15位，使用音韻治療訓練十二個與目標結合的語音，經過五大階段（概念建立→音節→詞彙→片語、句子→對話）的練習，進入下一階段的標準為目標語音達到80%正確率；及14位對照組，使用動作技巧為主的構音訓練五個與目標結合的語音，也經過五大階段的練習，分階段標準為各個結合語音各得到二十次練習正確的回饋後隨即進入下一階段。治療結果顯示，兩組於治療後聲母正確百分比及音素正確百分比都有顯著增加，兩組進步程度無顯著差異，且對照組的進步成效和治療前的語音聽辨、聲韻覺識及語言能力有相關性。總結，臨床上治療師選擇治療策略時，應考慮孩童的聲韻覺識能力及其他基本能力，若發現上述能力較弱者，則應避免使用單純動作技巧為主的構音治療方式。 

The purpose of this study is to investigate the correlation between phonetic discrimination, phonological awareness (PA) and different treatment approach for children with speech sound disorders. Twenty-nine preschool children with speech sound disorders between the age of 4 to 6 were recruited in the study, and they were randomly assigned to either experimental group (language-based approach) or control group (traditional approach). There are five different levels in treatment protocol, including production and ear training in concept establishing, syllable level, word level, phrase-sentence level and conversation level, and the discharge criterion is 80% accuracy of the target sound at each level in experimental group and 20 times feedbacks of accurate practice in every target word at each level in control group. Treatment outcomes were discussed based on the percentage of consonant correct (PCC), the percentage of phoneme correct (PPC). And the progress was used to analyze the correlation to abilities of phonetic discrimination and phonological awareness before the treatment.The result indicated that both groups had significant increase in PCC and PPC in words and spontaneous speech context and had no significant difference in the progress degrees. In addition, the results also showed in control group PA, phonetic discrimination and language ability are related to the degree of progress. In sum, this study pointed out a high correlation between PA and the treatment effectiveness, so that traditional approach has its limitation for children with poor PA. Copyright © 2013台灣聽力語言學會 & Airiti Press Taiwan.