學前單純語音異常兒童與伴隨語言發展異常之語音異常兒童的語音錯誤表現

Speech Sound Errors of Preschool Children with Speech Sound Disorders and Co-Occurring Language Problems

本研究探討單純語音異常兒童與伴隨語言發展異常之語音異常兒童在語音 錯誤類型和語音異常嚴重度之差異，並檢視語言能力和構音錯誤類型及語音異 常嚴重度的相關性。研究對象為年齡58 ～ 74 個月大之20 名單純語音異常兒 童（Speech Sound Disorders， SSD）與16 名伴隨語言發展異常之語音異常兒童 （Speech Sound Disorders & Language Development Disorder， SSD+LDD）。本研 究以一套涵蓋國語21 個子音之自編情境詞語測驗蒐集語音樣本，分析兩組兒童 在構音錯誤類型、音韻歷程、語音異常嚴重度與錯誤子音之變異表現的差異。 結果顯示，兩組兒童構音錯誤類型皆以替代類型為主，且SSD+LDD 組的替代類 型出現次數顯著多於SSD 組。音韻歷程部分，兩組兒童在後置音化與塞音化的 出現次數有顯著差異。兩組之語音異常嚴重度有顯著差異，SSD 組的平均嚴重 度為輕—中度；SSD+LDD 組則為中—重度。兩組在錯誤子音的變異出現率上無 顯著差異，而SSD+LDD 組的錯誤子音變異程度顯著大於SSD 組。檢驗語言能 力和語音表現的關聯性，發現語言理解與子音正確率、替代次數、音韻歷程次 數有顯著相關，口語表達與子音正確率、替代／歪曲次數、音韻歷程次數有顯 著相關，其中以口語表達能力和語音表現的相關較高。研究結果支持，伴隨有語 言發展異常的語音異常兒童與單純語音異常兒童的語音表現有差異，前者表現 出較多的構音替代錯誤次數、較多的音韻歷程次數和種類以及較高的語音異常嚴重度，且個別兒童的語言能力與語音錯誤類型和嚴重度間均有關聯性。建議對語音異常兒童進行評估與療育時，亦應考慮其語言能力差異可能造成的影響。

This study explored the early speech sound performance of Mandarin-speaking children with speech sound disorders (SSDs) and different language profiles. Purposes: This study had two main purposes. First， the types of articulation errors and severity of articulation difficulties in two groups of children， namely one involving children with SSDs (the SSD-only group) and one involving children with co-occurring language development disorders (the SSD+LDD group)， were explored and compared. Second， the correlation between the language abilities and speech production of the two groups was further examined. Methods: Thirty-six preschool children with SSDs were selected as participants and classified into the SSD-only group (n = 20， average age = 66.15， SD = 5.575) and SSD+LDD group (n = 16， average age = 66.81， SD = 4.902). Standardized tests were used to examine the children’s nonverbal IQ and language comprehension and production abilities. A self-invented test called the Mandarin Speech Production Test was used to collect and assess a child’s speech production abilities， including articulation error types， phonological processes， error sound variation， and SSD severity. A two-way mixed analysis of variance (ANOVA) and one-way ANOVA were adopted to investigate any significant differences in the speech sound performance between the two groups. The correlations among language comprehension ability， language production ability， speech error types， and speech error severity were also examined. Results/Findings: The results demonstrated that substitution errors were the most frequent articulation error types in the two groups， and the SSD+LDD group exhibited a higher frequency of substitution errors. For the group comparison of phonological processes， the SSD+LDD group exhibited a significantly higher frequency than SSD group. Regarding the variation of the children’s sound errors， the SSD+LDD group exhibited a greater degree of variation than the SSD group. For SSD severity， the average level was from mild to moderate in the SSD-only group and moderate to severe in the SSD+LDD group. The Pearson product-moment correlation coefficient was used to examine the correlation between language abilities and speech production abilities; the results showed that both were significantly correlated with their substitution errors， phonological processes， and SSD severity levels. Conclusions/Implications: The results support the literature that children with SSDs and language problems exhibit a greater level of severity in speech production than those with SSD only. The children in the SSD+LDD group were observed to produce much more substitution error types in their articulation than those in the SSD-only group. The major outcomes reveal that the differences in the children’s language ability may influence the production of their speech sound errors and SSD severity. On the basis of these findings， to convey a complete speech and language treatment plan， clinicians should allocate greater attention to the language difficulties of children with SSDs.