調整說話速度訓練方案對痙攣型腦性麻痺者說話清晰度的影響

The Impact of a Speaking-Rate Training Program on Speech Intelligibility in Students with Spastic Cerebral Palsy

10.6172/BSE200712.3204004

楊青燕(Ching-Yeng Yang)；劉惠美(Huei-Mei Liu)

痙攣型腦性麻痺者 ； 說話清晰度 ； 元音構音空間 ； 說話速度 ； Spastic cerebral palsy ； Speech intelligibility ； Vowel working-space ； Speaking rate ； Training program

特殊教育研究學刊

32卷4期（2007 / 12 / 01）

65 - 83

繁體中文

本研究主要以前後測的教學實驗設計，探討調整說話速度訓練方案的介入對痙攣型腦性麻痺者在提升說話清晰度、擴大元音構音空間及降低說話速度的效果，受試者為為十六名痙攣型腦性麻痺者，參與六週的調整說話速度訓練方案。方案介入前後，受試者分別進行介入前、介入後及維持期等共三次的語詞及短文說話樣本的收錄，以瞭解此訓練方案的介入及維持效果。研究結果顯示，調整說話速度訓練方案可提升痙攣型腦麻者的說話清晰度、擴展元音構音空間及增加元音時長，但短文說話速度無則顯著差異；經兩週的追蹤，受試者在說話清晰度及元音構音空問仍持續保留介入效果，但元音時長和短文說話速度則無保留介入效果。就變項間的關係而言，不論在前測和後測階段，元音構音空間大小對短文清晰度得分皆有顯著的迴歸解釋力，分別為32.7％及68.4%；在後測階段，元音構音空間的改變量對短文清晰度得分改變量的預測力為67.3%，顯示說話者元音構音空間大小可作為說話清晰度的指標外，且介入後所產生的元音構音空間改變量亦可作為說話清晰度介入成效的參考依據。本研究結果可以作為語言治療師及特教老師為腦性麻痺者擬定相關語言治療計畫及活動設計的參考。

The purpose of this study was to explore the effects of the speaking-rate training program on speech intelligibility for 16 students with spastic cerebral palsy. All participants received the speaking-rate training program for six 45-minute sessions. Before and after the intervention of speech training programs, individual subjects' speech intelligibility, vowel working-space and speaking rate were measured to evaluate the effects of training. The results showed that the speaking-rate training program was effective in improving speech intelligibility, expanding vowel working- space areas, and decreasing speaking rate. Over a two-week tracking period, the effects of this program on speech intelligibility and vowel working-space were maintained, Furthermore, individual subjects' vowel working-space was found to positively correlate with their speech intelligibility, and it could account for 67.3% of the improvement in speech intelligibility after the intervention. These results suggest that speakers with spastic cerebral palsy can benefit from the speaking-rate intervention program, and furthermore that vowel working-space area could be an important component of global estimates of speech intelligibility. The improvement of vowel working-space after the training program can be taken as a measure of the positive impact of training on speech intelligibility.

1. Agresti, A.,Finlay, B.(1999).Statistical methods for the social sciences.New Jersey:Prentice Hall.
2. Arvedson, C. J.,McNeil, M. R.,West, T.(1985).Prediction of Revised Token Test overall, subtest, and linguistic unit scores by two shortened versions.Clinical Aphasiology,15,57-63.
3. Blosser, J. L.,Weidner, W. E.,Dinero, T.(1976).The effect of rate-controlled speech on the auditory receptive scores of children with normal and disordered language abilities.The Journal of Special Education,10,291-298.
4. Boiler, F.,Vignolo, L. A.(1966).Latent sensory aphasia in hemisphere-damaged patients: an experimental study with the Token Test.Brain,89,815-830.
5. Bornstein, M. H.,Cote, L. R.(2005).Expressive vocabulary in language learners from two ecological settings in three language communities.Infancy,7,299-316.
6. Buck, G.(2001).Assessing listening.Cambridge:Cambridge University press.
7. Cohen-Miniran, R.,Sapir, S.(2007).Deficits in working memory in young adults with reading disabilities.Journal of Communication Disorders,40,168-183.
8. D''Arcy, R. C. N.,Connolly, J. F.(1999).An event-related brain potential study of receptive speech comprehension using a modified Token Test.Neuropsychologla,37,1477-1489.
9. Davis, G. A.(1983).A survey of adult aphasia.Englewood Cliffs, New Jersey:Prentice-Hall.
10. De Renzi, E.,Vignolo, L. A.(1962).The token test: A sensitive test to detect receptive disturbance in aphasia.Brain,85,665-678.
11. DiSimoni, F.(1978).The Token Test for children manual.Austin, Texas:Pro-ed.
12. Eberwein, C. A.,Pratt, S. R.,McNeil, M. R.,Fossett, T. R. D.,Szuminsky, N. J.,Doyle, P. J.(2007).Auditory performance characteristics of the Computerized Revised Token Test (CRTT).Journal of Speech, Language, and Hearing Research,50,865-877.
13. Groth-Marnat G.(2003).Handbook of psychological assessment.Hoboken, New Jersey:John Wiley & Sons..
14. Hallowell, B.,Wertz, R. T.,Kruse, H.(2002).Using eye movement responses to index auditory comprehension: An adaptation of the Revised Token Test.Aphasiology,16,587-594.
15. Hula. W.,Doyle. P. J.,McNeil. M. R.,Mikolic J. M.(2006).Rasch modeling of Revised Token Test performance: Validity and sensitivity to change.Journal of Speech, Language, and Hearing Research,49,27-46.
16. Keegstra, A, L.,Knijff, W. A.,Post, W. J.,Goorhuis-Brouwer, S. M.(2007).Children with language problems in a speech and hearing clinical: Background variables and extent of language problems.International Journal of Pediatric Otorhinolarygology,71,815-821.
17. Keith, R. W.,Engineer, P.(1991).Effects of methylphenidate on the auditory processing abilities of children with attention deficit hyperactivity disorder.Journal of Learning Disabilities,24,630-636.
18. Kirk, S. A.,McCarthy, J. J.,Kirk, W. D.(1968).Illinois Test of Psycholinguistic Abilities examiner's manual.Urbana:University of Illinois Press.
19. Kurnatowski, P.,Putynski, L.,Lapienis, M.,Kowalska, B.(2006).Neurocognitive abilities in children with adenotonsillar hypertrophy.International Journal of Pediatric Otorhinolaryngology,70,419-424.
20. Lahey, M.(1988).Language disorders and language development.New York:Macmillan.
21. McCauley, R. J.(2001).Assessment of language disorder in children.Mahwah, New Jersey:Lawrence Erlbaum Associates.
22. McNeil, M. R.,Prescott, T. E.(1978).Revised Token Test.Austin, Texas:Pro-ed.
23. Miller, J. F. (Eds.),Fletcher, P. (Eds.)(2005).Developmental theory and language disorders.Amsterdam:John Benjamins.
24. Miller, J. F.,Paul, R.(1995).The clinical assessment of language comprehension.Baltimore, Maryland:Paul H. Brookers.
25. Orgass B.,Poeck, K.(1966).Clinical validation of a new test for aphasia: an experimental study of the Token Test.Cortex,2,222-243.
26. Park, G. H.,McNeil, M. R.,Tompkins, C. A.(2000).Reliability of the Five-Item Revised Token Test for individuals with aphasia.Aphasiology,14,527-535.
27. Paul, R.(1990).Comprehension strategies: World knowledge and the development of sentence comprehension.Topics in Language Disorders,10(3),63-75.
28. Rescorla, L. A.,Lee, E. C.,T. L. Layton (Eds.),E. R. Crais (Eds.),L. R. Watson (Eds.)(2000).Handbook of early language impairment in children: Nature.Albany, NY:Delmar Thomson Learning.
29. Shiota, M.,Koeda, T.,Takeshita, K.(2000).Cognitive and neurophysiological evaluation of Japanese dyslexia.Brain & Development,22,421-426.
30. Silverman, I.,Raskin, L. M.,Davidson, J. L.,Bloom, A. S.(1977).Relationships among Token Test, age, and WISC Score for children with learning problems.Journal of Learning Disabilities,10,104-107.
31. Spellacy, F. J.,Spreen, O.(1969).A short form of the Token Test.Cortex,5,390-397.
32. Wiig, E. H.,Lapointe, C.,Semel, E. M.(1977).Relationships among language processing and production abilities of learning disabled adolescents.Journal of Learning Disabilities,10,292-299.
33. Williams, P. D.,Soetjiningsih, H.,Williams, A. R.(2000).Balinese mothers' developmental timetables for young children.Western Journal of Nursing Research,22,717-735.
34. Yliherva, A.,Olsen, P.,Jarvelin, M.-R.(2001).Linguistic skills in relation to neurological findings at 8 years of age in children born preterm.Log Phon Vocol,26,66-75.
35. 巴甫仁(2007)。台灣版C-RTT。私人通訊
36. 余玻莉(2007)。國立高雄師範大學聽力學與語言治療研究所碩士論文（未出版）。
37. 吳裕益(2003)。實驗效果之評估。國立高雄師範大學特殊救育學系。
38. 吳裕益(2007)。驗證性因素分析各分量表題目分群的優缺點。國立高雄師範大學特殊救育學系。
39. 吳裕益(2005)。線性結構模式的理論與應用。國立高雄師範大學特殊救育學系。
40. 李珊珊(2007)。國立高雄師範大學聽力學與語言治療研究所碩士論文（未出版）。
41. 林寶貴、杞昭安、李芃娟、林玉霞、曹純瓊、黃玉枝、黃桂君、錡寶香、韓福榮(2007)。修訂學前兒童語言障礙評量表第四階段執行成果報告修訂學前兒童語言障礙評量表第四階段執行成果報告,國立臺灣師範大學特殊教育學系。
42. 張欣戊(1991)。學前兒童語言能力的測驗·行政院國家科學委員會專題研究計畫成果報告學前兒童語言能力的測驗·行政院國家科學委員會專題研究計畫成果報告,國立台灣大學心理系。
43. 陳振宇、謝淑蘭、成戎珠、黃朝慶、洪碧霞、櫻井正二郎、吳裕益、邱上真、陳小娟、曾進興(1996)。兒童認知功能綜合測驗使用手冊。教育部社教司。
44. 陳榮華、陳心怡(2000)。魏氏幼兒智力量表修訂版（中文版）指導手冊。台北:中國行為科學社。
45. 陳璽琳(2006)。樹德科技大學幼兒保育系碩士論文（未出版）。
46. 陸莉、劉鴻香(1994)。修訂畢保德圖畫詞彙測驗指導手冊。台北:心理。
47. 曾進興(1996)。兒童認知功能綜合測驗之七－語言測驗使用手冊。教育部社教司。
48. 曾進興譯、R. Cattell著(2006)。兒童語言發展。台北:心理。

1. 劉惠美、張曉涵(2012)。延長言語時長與刻意停頓對痙攣型腦性麻痺兒童言語清晰度的影響。特殊教育研究學刊，37(1)，27-51。