循環音韻治療法應用遠距科技復健模式於偏遠地區重度語音異常兒童之成效

The Efficacy of Cycles Phonological Remediation Approach via Telepractice for Children with Severe Speech Sound Disorders in Rural Areas

10.6143/JSLHAT.202406_(50).0002

魏文言(Wen-Yan Wei)；陳凱玫(Kai-Mei Chen)

循環音韻治療法 ； 遠距復健 ； 語音異常 ； 偏遠地區 ； 音韻模式 ； Cycles Phonological Remediation Approach ； telepractice ； speech sound disorders ； rural areas ； phonological pattern

台灣聽力語言學會雜誌

50期（2024 / 06 / 01）

11 - 41

繁體中文;英文

本研究探討循環音韻治療法（CPRA）結合遠距科技復健模式，介入國內偏鄉重度語音異常兒童以提升語音能力之成效。透過平行單一個案跨行為多基線設計，將本方案應用於年齡為5歲0個月及6歲9個月且住在偏鄉的兩名重度語音異常兒童，進行兩個循環（24堂）每次60分鐘的CPRA課程，皆以視訊方式上課。本研究使用「音韻模式內音素正確數」作為主要介入目標，並將資料記錄於基線期、介入期（第一／第二循環）、維持期與追蹤期，並以目視分析、效果量及C統計進行分析。此外，其他次要目標：（1）音韻歷程出現率；（2）聲母正確率；（3）詞語正確率；（4）言語清晰度；及（5）社會效度，亦納入分析，以瞭解本遠距語音介入方案對研究對象整體語音能力的改變效果。研究結果顯示，在本方案介入後，兩名個案的三種「音韻模式內音素正確數」皆一致獲得明顯立即成效及維持成效，能將正確的發音技巧類化至自發性言語當中，改善整體言語清晰度。此外，兩名個案在治療後，語音障礙嚴重度從重度轉為正常，音韻歷程也幾乎褪除。家長對遠距語音治療方案感到非常滿意，認為透過遠距接受服務對偏鄉來說是有效且便捷的方式。本研究為國內外遠距語音治療研究提供實證及詳細介入方式。最後，本研究闡述CPRA與遠距科技復健模式在偏鄉之應用及未來研究建議，提供後續研究與臨床實務上之參考。

The purpose of this study was to investigate the efficacy of the Cycles Phonological Remediation Approach via telepractice to expedite speech intelligibility for children with severe speech sound disorder living in rural areas. A parallel multiple baseline design across behaviors was used to examine intervention effects. Two preschoolers with severe speech sound disorder living in rural areas at age 5;0 to 6;9 participated in two cycles with 24 hours sessions of phonological remediation. The treatments were delivered by online conferencing software. The word probes were administered during baseline, intervention (Cycle I), intervention (Cycle II), maintenance, and follow-up phases to assess generalization and maintenance of phonological skills. Data were analyzed by visual analysis, effect size, and C statistic. 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 normal. The percentages of Phonological Process Occurrence were decreased. Also, all participates speech intelligibility increased. The parents were very satisfied with this program, and believed that receiving services through telepractice was a convenient and effective way for rural areas to improve the daily communication function.