游戏法在腭裂术后低龄儿童异常舌尖前音、舌面音治疗中的应用

Application of game method in the treatment of abnormal apical anterior and lingua-palatal phoneme in young children

目的:初步探讨感官探索性游戏疗法在腭裂术后低龄儿童异常舌尖前音、舌面音治疗中的效果。方法:纳入34例腭裂术后,舌尖前音、舌面音异常,部分伴有发音时面部扭曲的儿童,根据年龄分为低龄组(3.5~4岁)和适龄组(4.1~6岁),运用游戏法控制发音时气流及舌位,对舌尖前音和舌面音进行训练,每周1次。对两组患儿语音治疗次数、效果进行对比。结果:经过6~15次治疗,低龄组和适龄组治疗次数分别为12.0±2.4和10.6±2.7(P>0.05)。全部患儿发音清晰度均明显改善,两组患儿舌尖前音、舌面音清晰度分别由18.4%、24.6%提高到98.2%、97.6%(治疗前后比较,P<0.05;组间比较,P>0.05)。结论:合适的游戏治疗方法可以锻炼腭咽闭合功能,控制鼻漏气,缩短音位诱导时间,有效提高腭裂术后低龄组儿童语音的清晰度。

Objective: To study the effect of sensory exploratory play therapy in the treatment of abnormal apical anterior and lingua-palatal phoneme in young children after cleft palate operation. Methods: 34 children with abnormal Blade-alveolar vowel and Alveo-palatal sound after cleft palate operation, and some of them accompanied with facial distortion during articulation, were divided into the young group(3.5-4 years old) and the appropriate age group(4.1-6 years old). The airflow and tongue position during articulation were controlled by the game method, and the Blade-alveolar vowel and Alveo-palatal sound were trained. The treatment was given once a week. The frequency and effects of speech therapy were compared between the 2 groups. Results: After 6-15 times of training, the speech articulation of all the subjects was improved. The therapy was given to young and appropriate age group for 12.0±2.4 and 10.6±2.7 times respectively(P>0.05). The clear articulation of pretip-of-tongue and that of tongue surface in the 2 groups increased from 18.4% and 24.6% to 98.2% and 97.6%, respectively(between pre-and post-treatment, P<0.05;between groups, P>0.05). Conclusion: Appropriate game therapy can exercise the palatopharyngeal closure function, control nasal air leakage and shorten the time of phonemic induction and can effectively improve the articulation of speech in the young children after cleft palate operation.