广义发声功能评估的实验研究及应用

发布时间：2018-06-19 15:46

本文选题：广义发声 + 发声评估　；参考：《华东师范大学》2012年博士论文

【摘要】：近年来言语康复在国内逐渐兴起,发声障碍作为言语障碍的重要分支之一,正受到越来越多的关注,全面客观的发声功能评估是发声障碍的治疗基础。随着计算机技术的发展,发声测量技术和分析工具不断增加,为发声功能评估不断完善和规范,提供了成熟的技术条件。在国内外发声研究的基础上,本文首先总结了国内常用言语评估量表在临床使用中存在的问题,着重对呼吸、发声评估展开讨论,阐明构建广义发声评估的必要性,然后应用“发声测量仪”(Phonation),分别以持续发声与断续发声两种状态展开对广义发声功能评估的系列研究,最后将研究成果进行临床验证,观察其针对性及有效性,为临床问题的解决提供方案。本研究从临床问题出发,通过实验研究,得到一些有效的实验结果,为发声功能评估的完善提供了更多可选择的参数,对发声功能客观测量的规范化进行了探讨,推进了发声康复工作的开展。研究目的：使用现有的评估指标,分析特殊儿童呼吸障碍、发声(狭义)障碍的存在情况与比例；对持续发声状态下评估指标的影响因素进行分析研究,规范其测试要求和取值标准,以确保结果分析的可靠性：对断续发声状态下评估指标进行探讨,并对影响因素进行分析研究；使用规范后的评估指标对学龄前儿童进行呼吸功能和发声功能的评估,验证其临床应用的有效性,并了解生理发育体现在上述评估指标上的特点研究方法： 1.根据研究综述中提出的问题,通过对2009至2012间收治的218名言语障碍儿童的评估结果进行分析,总结儿童言语障碍的发病特点,并着重讨论呼吸、发声障碍的发病情况及评估中存在的难点问题。 2.在理论研究的基础上,将广‘义发声功能评估研究分为持续发声与断续发声两部分进行。选择生理发展稳定、依从性较好的成人作为研究对象,以规范测试条件为目的,分别进行两种功能影响因素的研究。 3.使用“发声测量仪”(Phonation),分别对持续和断续发声的测试语料进行声学特征分析,提取多个参数进行比较分析,筛选出敏感性较好的参数。 4.选择学龄前正常儿童作为研究对象,进行学龄前正常儿童的广义发声功能的特点研究；然后选择同年龄段的听障儿童进行比较研究,对参数的有效性及临床指导意义展开讨论。研究结果：学龄前儿童是儿童言语障碍就诊的主要群体；呼吸、发声障碍的发病率占言语障碍总发病率的75%以上；呼吸方式、发音方式及语速均会对广义发声功能的部分参数造成显著性影响；呼吸支持能力及发声紧张程度的改变会使最长声时、基频标准差及Jitter值等出现显著性改变；呼吸支持能力及语速的变化会使平均音节时长、时长标准差、平均间隔时长、间隔标准差、发声有效比等出现显著性改变。结论：学龄前阶段是儿童发声障碍康复的密集期；呼吸、发声障碍在儿童言语障碍中的存在比例较高；对持续发声功能和断续发声功能参数进行测试时,有必要采用规范统一的测试条件,才能保证参数结果分析的有效性；对持续发声功能的评估指标最长声时的取值标准进行规范,以确保结果分析的有效性；发现了一些可以用于反映断续发声功能的参数；学龄前儿童的两种发声功能评估参数存在不同特点,在使用时,需要酌情考虑生理发展的影响；所选评估参数基本可以反映听障儿童与正常儿童发声功能存在的差别，可以为发声障碍的评估与治疗提供有效指导。
[Abstract]:Speech rehabilitation has gradually emerged in China in recent years. As one of the important branches of speech disorders, vocal disorders are being paid more and more attention. The comprehensive and objective evaluation of sound function is the basis for the treatment of sound disorders. With the development of computer technology, the sound measurement technology and analysis tools are constantly increasing, and the evaluation of sound function is constantly finished. On the basis of sound research at home and abroad, this paper first summarizes the problems existing in the clinical use of the common domestic speech assessment scale, and focuses on the discussion of the respiratory and vocal evaluation, clarifies the necessity of constructing the generalized sound evaluation, and then applies the "Phonation". Do not use two states of continuous sound and intermittent sound to carry out a series of studies on the evaluation of the function of the generalized sound. Finally, the research results are verified, and the pertinence and effectiveness of the research are observed and the solutions are provided for the solution of the clinical problems. The perfection of evaluation provides more optional parameters, and discusses the standardization of objective measurement of vocal function, and promotes the development of vocalization rehabilitation.
The purpose of the study is:
The existing evaluation indexes were used to analyze the existence and proportion of special children's respiratory disorder, voice (Xia Yi) obstacle, analysis and Study on the influencing factors of the evaluation indexes under the continuous sound state, standardize their test requirements and value criteria, in order to ensure the reliability of the results analysis, and discuss the evaluation indexes under the intermittent sound state. The influence factors were analyzed, and the evaluation indexes of the preschool children were evaluated by the standard evaluation index to verify the effectiveness of their clinical application and the characteristics of the physiological development on the above evaluation indexes.
Research methods:
1. according to the problems presented in the research review, through the analysis of the evaluation results of 218 speech impaired children admitted between 2009 to 2012, the characteristics of the children's speech disorders were summarized, and the incidence of respiratory and vocal disorders and the difficulties in the assessment were discussed.
2. on the basis of the theoretical study, the study of the functional evaluation of the wide 'sound' sound function was divided into two parts of continuous sound and intermittent sound. The study of two kinds of functional factors was carried out to select the adults with stable physiological development and good compliance as the research object and to standardize the test conditions.
3. "Phonation" was used to analyze the acoustic characteristics of the continuous and intermittent vocalizations, and a number of parameters were extracted and analyzed, and the parameters with better sensitivity were selected.
4. to choose normal preschool children as the research object, to study the characteristics of the generalized vocal function of normal preschool children, and then choose the children with hearing impairment in the same age group to make a comparative study, and discuss the validity and clinical significance of the parameters.
The results of the study:
Preschool children are the main group of children with speech disorders. The incidence of respiratory and vocal disorders accounts for more than 75% of the total incidence of speech disorders. Respiration, pronunciation and voice speed will have significant effects on some parameters of the generalized vocal function; the changes in respiratory support and tone tension will make the longest sound. There were significant changes in the standard deviation and Jitter value of the basic frequency. The changes in respiratory support capacity and the speed of speech would make the average syllable long, long standard deviation, the average interval time, the interval standard difference, the sound efficiency ratio, and so on.
Conclusion:
The preschool stage is the intensive period for the rehabilitation of children's vocal disorders; the proportion of respiratory and vocal disorders is higher in children's speech disorders; it is necessary to adopt standardized and unified test conditions to ensure the effectiveness of the analysis of the parameters and the function of the continuous vocal function. In order to ensure the effectiveness of the result analysis, some parameters that can be used to reflect the intermittent sound function are found. There are different characteristics of the evaluation parameters of two kinds of sound function for preschool children, and the effects of physiological development need to be considered when used. It can reflect the difference of vocal function between hearing-impaired children and normal children, and can provide effective guidance for the assessment and treatment of vocal disorders.
【学位授予单位】：华东师范大学
【学位级别】：博士
【学位授予年份】：2012
【分类号】：H018

【参考文献】