語音異常幼兒，語音錯誤情形與早期讀寫能力之相關研究

The relationship between speech sound errors and early literacy skills in children with speech sound disorders

本研究目的為探討學前語音異常幼兒在語音錯誤類型、語音正確率、音韻歷程表現與早期讀寫能力之相關性及預測力。研究對象為24 位學前語音異常幼兒（平均年齡為66.78 個月），採橫斷性相關研究法，以立意抽樣法進行取樣。研究中所有幼兒接受標準化非語文智力測驗及構音測驗，作為篩選SSD 幼兒的依據，並以「華語兒童構音與音韻測驗- 語句構音測驗」及「自編語詞測驗」，蒐集SSD 幼兒在不同構音情境下（詞彙及語句）的語音產出樣本。再透過語音轉譯與分析，了解其在不同構音情境中的語音產出能力和音韻歷程表現。研究結果發現SSD 幼兒在不同構音情境下子音錯誤類型主要以替代類型為主，母音錯誤類型主要以省略類型為主。音韻歷程表現方面，在不同構音情境下出現次數由多至少依序為不捲舌化、後置化、塞音化、塞擦音化、前置化及不送氣化。透過相關分析發現，SSD 幼兒的母音添加比率及子音變異總次數與早期讀寫能力達顯著相關。音韻歷程表現部分，後置化及不送氣化比率與早期讀寫能力達顯著相關。階層迴歸分析結果顯示在控制非語文智商的影響後，SSD 幼兒的子音變異總次數、母音添加比率、不送氣化比率及後置化比率對早期讀寫能力具有顯著預測力。研究結果顯示SSD 幼兒語音錯誤和音韻歷程可能顯示其音韻表徵品質較弱，有可能成為讀寫發展困難的高危險群，故本研究建議應及早提供必要的介入，降低語音異常幼兒後續的讀寫學習困難。

Purpose: Children with persistent speech errors and delays in the development of appropriate speech sounds are considered to have speech sound disorders (SSDs), which can decrease the clarity of speech and communication. Persistent speech errors consisting of phoneme addition, omission, distortion, or substitution may result in reduced speech intelligibility and interfere with verbal communication, social participation, and even academic performance from preschool age to adolescence. The onset of SSD symptoms during childhood cannot be accounted for by other medical or neurological conditions, such as hearing impairment, cerebral palsy, and traumatic brain injury. It is estimated that approximately 3%–6% of children aged 4–6 years experience persistent SSD. Although many children (approximately 75%) may outgrow the speech production difficulties at later ages (i.e., 6 years old), as a group, preschoolers with SSD are at increased risk for later reading difficulties. Research examining the relationships between speech and reading has demonstrated that the comorbidity of SSD and reading disability is approximately 25%–30%. One of the possible explanations for this comorbidity is the underlying deficits in the development of phonological representations. In some children with SSD, uncommon or atypical speech errors, which are infrequent in age-matched children with typical development, may be observed in their speech production. Such atypical speech errors may reflect poor phonological representation during speech processes or problems in the foundation of the phonological system. However, the exact relationships between the types of speech sound errors and literacy development in preschool-age children with SSD is not well studied. The purposes of this study were to explore the types and numbers of speech sound errors, types of phonological processing and early literacy skills in preschool-aged children with SSD, and the correlations between these speech production variables and early literacy variables to understand the underlying deficits of early literacy skills.