成人运动性构音障碍言语清晰度评估的研究进展

Advance in Assessment of Speech Intelligibility in Adults with Dysarthria(review)

运动性构音障碍(简称构音障碍)在卒中后的发生率约为20%～30%,创伤性脑损伤后约为10%～60%。言语清晰度评估是构音障碍评估中不可缺少的一部分,是家属与专业治疗人员之间的沟通工具,可以用于制定训练计划、评估沟通表现及疗效。按照得出的清晰度数值是尺度数据还是计量数据,大致可分为尺度评估和项目辨认两种,还可以根据是否标准化分为非标准化评估和标准化评估。尺度评估主要包括:等距尺度、直接数值估计、言语样本对分级、百分比估算和视觉类比量表等。项目辨认评估主要包括:词汇清晰度测试、语音清晰度测试、汉语语音清晰度测试字表、汉语构音能力测试词表、句子清晰度测试、构音障碍清晰度评估和言语清晰度测试电脑软件等。其中构音障碍清晰度评估和言语清晰度测试电脑软件是综合性的标准化评估。目前国内可用的清晰度评估方法较少,本文检索近10年来清晰度评估方面的文献,总结各种评估方法,以提高大家对清晰度评估的重视,并根据工作和研究需要选用适宜的评估。

Dysarthria is a group of nerological speech disorder, which occurred in about 20%-30% after stroke, or 10%-60% after traumatic brain injury. The assessment of speech intelligibility is a necessary part of the evaluation of dysarthria, which can be used to communicate the patients' condition with their relations, and also in treatment planning, evaluating the communication performance and the treatment effects. The methods used to assess intelligibility can be divided into two groups: scaling methods and item identification methods. They are also divided into non-standard and standard methods based on whether a standard assessment or not. Scaling methods include interval scales, Direct Magnitude Estimation (DME), Speech Sample Pairs Scaling, Percentage Estimates, and Visual Analogue Scale (VAS), etc. The item identification methods mainly include: Word Intelligibility Test, Chinese Speech Intelligibility Test, Chinese Speech Intelligibility Test Character List, Chinese Articulation Ability Test Word List, Sentence Intelligibility Test, Assessment of Intelligibility in Dysarthric Speakers (AIDS) and Speech Intelligibility Test (SIT) software. Among them, AIDS and SIT softwares are comprehensively standardized assessments. There are few methods can be used in China. The literatures on intelligibility assessment in the past ten years were reviewed.