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研究生:王心薇
研究生(外文):Shin-wei Wang
論文名稱:徒手療法介入對痙攣型腦性麻痺國小學童說話清晰度之研究
論文名稱(外文):The Speech Intelligibility Effect of Manual Therapy on Elementary SchoolChildren with Cerebral Palsy Spastic Type
指導教授:李芃娟李芃娟引用關係
指導教授(外文):PONE-CHUAN LEE
學位類別:碩士
校院名稱:國立臺南大學
系所名稱:特殊教育學系碩士班
學門:教育學門
學類:特殊教育學類
論文種類:學術論文
論文出版年:2005
畢業學年度:93
語文別:中文
論文頁數:151
中文關鍵詞:構音腦性麻痺痙攣型徒手療法說話清晰度
外文關鍵詞:manual therapyspeech intelligibilityarticulationcerebral palsyspastic type
相關次數:
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本研究之目的在探討徒手療法介入對腦性麻痺國小學童說話清晰度,及構音錯誤類型的改善成效,並比較使用不同聽知覺說話清晰度評量方法的相關。本研究對象為六名中、重度腦性麻痺學生,由研究者擔任治療者,本研究的自變項為徒手療法,依變項指腦性麻痺學童在徒手療法介入後說話清晰度的改變情形,包括使用開放式(opened-set)辨字法及直接大小估計法(direct magnitude estimation)由兩組評分者所評得的結果。採單一受
試研究法之跨受試多探試設計(multiple probe design)為本研究之實驗設計,資料分析方法有:目視分析、時間序列C 統計及家長與教師訪談資料的社會效度。研究結果如下:
一、徒手療法介入能夠增進六名腦性麻痺學童說話清晰度。
二、徒手療法對痙攣型腦性麻痺學童的捲舌音、圓唇音、鼻聲隨、舌面後
音有明顯矯治效果。
三、腦性麻痺學童的構音錯誤類型,省略、替代、歪曲、贅加皆有,以替代音的錯誤率最高,徒手療法介入後替代音的進步幅度也最大,徒手療法介入後腦性麻痺學童以
省略和替代音此兩種構音錯誤類型為主。
四、對腦性麻痺學童說話清晰度的評量中,開放式辨字法以目標音素出現率計分,直接大小估計法則由評量者直接給予所聽得語音一個說話清晰度分數,評量所得開放式辨字法清晰度分數高於直接大小估計法,兩種評量法所得結果相似,兩者間具高相關。
五、以徒手療法介入來增進腦性麻痺學童說話清晰度獲班級老師及家長正向支持。
The aim of the study is to investigate the speech intelligibility effect of manual therapy and the improvement of articulation error pattern on elementary school children with cerebral palsy spastic type. Differentiate various auditory perception assessments and their correlation. The study subjects were six cerebral palsy children with spastic type, the five were severe disability and one was moderate disability. The independent variable is manual therapy and the dependent variable is speech intelligibility. They include the score of two parts of opened-set item identification and direct magnitude estimation. Phonic data were collected during baseline, intervention , and maintenance phases .Visual analysis ,time series C statistic and the questionnaires collected from teachers and parents were used to evaluated the effect of manual therapy on cerebral palsy children with spastic type .
The major findings of this study:
1. Manual therapy can improve the speech intelligibility in cerebral palsy children with
spastic type.
2. Manual therapy can correct the retroflexion, round vowel , nasal and velar articulation
errors in cerebral palsy children with spastic type and aspiration -unaspiration transition
control.
3. Before manual therapy intervation, cerebral palsy children’s articulation errors have substitution, omission, distortion and addition . Substitution has the highest mistake rate and improvement rate.when investigation processes into intervention phase, the major problems in articulation errors were substitution and omission then can have correct articulation.
4. In assessment of the speech intelligibility, opened-set item identification and direct magnitude estimation have high correction, but the score of opened-set item identification
is higher than direct magnitude estimation.
5. Parents and teachers confirmed that manual therapy can improve speech intelligibility of
the cerebral palsy children with spastic type.
中文摘要⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ ⅰ
英文摘要⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ ⅱ
第一章 緒論 ⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 1
第一節 研究動機⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 1
第二節 研究目的與研究問題⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ . 8
第三節 名詞釋義⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯9
第二章 文獻探討 ⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯10
第一節 徒手療法⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯10
第二節 腦性麻痺兒童的說話障礙⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ . 18
第三節 聽知覺說話清晰度評量⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯22
第四節 痙攣型腦性麻痺兒童的語言矯治⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯31
第三章 研究方法 ⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯36
第一節 研究架構⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯36
第二節 研究對象⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯40
第三節 研究工具⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯46
第四節 研究設計⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯50
第五節 研究變項⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯52
第六節 資料分析⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯54
第四章 結果與討論⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯58
第一節 徒手療法介入對腦性麻痺孩童說話清晰度的效果分析⋯ .⋯ . 58
第二節 介入前後構音錯誤類型分析⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯70
第三節 二種聽知覺說話清晰度評量方法差異⋯ .⋯ .⋯ .⋯ .⋯ .⋯102
第四節 班級老師及家長對徒手療法介入之意見調查⋯ .⋯ .⋯ .⋯ . 106
第五章 結論與建議⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯109
第一節 結論⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯109
第二節 研究限制⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯110
第三節 建議⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯111
參考文獻
一,中文部分 ⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 113
二,英文部分 ⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 114
附錄次
附錄一:說話清晰度測試字卡清單⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 120
附錄二:開放式(opened-set)辨字法紀錄單⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 121
附錄三:直接大小估計法(direct magnitude estimation)評量單⋯ 122
附錄四:肌肉骨骼系統評估步驟⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 123
附錄五:徒手療法治療步驟⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 125
附錄六:運動衛教單⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 128
附錄七:教師訪談大綱⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 129
附錄八:家長訪談大綱⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 130
附錄九:受試A 基線期構音評量結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 131
附錄十:受試A 介入期構音評量結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 132
附錄十一:受試A 保留期構音評量結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 133
附錄十二:受試B 基線期構音評量結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 134
附錄十三:受試B 介入期構音評量結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 135
附錄十四:受試B 保留期構音評量結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 136
附錄十五:受試C 基線期構音評量結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 137
附錄十六:受試C 介入期構音評量結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯ 138
附錄十七:受試C 保留期構音評量結果⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯139
附錄十八:受試D 基線期構音評量結果⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯140
附錄十九:受試D 介入期構音評量結果⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯141
附錄二十:受試D 保留期構音評量結果⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯142
附錄二十一:受試E 基線期構音評量結果⋯ .⋯ .⋯ .⋯ .⋯ .⋯ . 143
附錄二十二:受試E 介入期構音評量結果⋯ .⋯ .⋯ .⋯ .⋯ .⋯ . 144
附錄二十三:受試E 保留期構音評量結果⋯ .⋯ .⋯ .⋯ .⋯ .⋯ . 145
附錄二十四:受試F 基線期構音評量結果⋯ .⋯ .⋯ .⋯ .⋯ .⋯ . 146
附錄二十五:受試F 介入期構音評量結果⋯ .⋯ .⋯ .⋯ .⋯ .⋯ . 147
附錄二十六:受試F 保留期構音評量結果⋯ .⋯ .⋯ .⋯ .⋯ .⋯ . 148
附錄二十七:家長與教師訪談內容⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯ .⋯149
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