探讨脑瘫儿童言语障碍的康复模式与效果.doc

探讨脑瘫儿童言语障碍的康复模式与效果 ---附38例分析 ［摘要］目的：探讨脑瘫儿童言语障碍的康复模式与效果。方法：通过综合评估，了解患儿言语障碍原因和智力情况，将运动康复训练与康复教学项目编成一个连贯而流畅的程序，由治疗师、特教老师充当引导员，训练和引导患儿在一日9节课程中完成（部分课程在一周内完成）。具体方法是在系统运动康复训练中增加言语刺激；在引导式教育课程中突出言语基础训练；通过为集体教学为主导、集体的和个别化教学与音乐游戏活动训练相结合进行听理解、表达、构音与发声等方法康复言语功能；70%的家长陪同训练。结果：38例在言语和认知功能、运动功能、日常生活和社会适应能力都取得了较好的效果，尤其是构音与发声改善，言语交流能力提高。16例构音障碍者舌活动与呼吸功能得到改善，有效率88.8%，32例言语交流能力提高，有效率84.2%。家长满意度问卷调查其满意率95%。结论：对合并言语障碍的脑瘫儿童，一是不宜过于强调个别训练，而忽视集体训练。提倡集体训练为主导、个别训练与集体训练相结合。在集体训练中能提供机会使患儿练习交流与表达。二是言语康复训练特别强调室内训练与室外练习相结合，机构训练与家庭练习相结合。室外练习使康复教学活动得到充分的温习与实践，巩固了训练的效果，同时能提高患儿主动表达与交流的积极性，患儿进步更快。充分发挥家长的作用，陪同并参与训练，不但能提高患儿的言语康复效果、缩短言语康复训练时间，为日后的家庭与社区康复打下基础，同时减轻康复治疗师和特教老师的工作量。三是自行设计的引导式教育集体康复体操，强化了患儿的说话意识和言语与运动能力，是提高患儿言语与运动功能较好的教学方法。 ［关健词］ 脑瘫 言语障碍 康复 [Abstract ] Purpose: To explore the rehabilitation pattern and effect of the cerebral palsy children who suffer the dysphonia (speech disorder). Methodology: Through comprehensive evaluation, we can know the cause of the dysphonia and the IQ of the children. We create a coherent and logical training program combining the rehabilitation exercises and teaching projects. The therapist and special educator work as the guide, training and guiding the children to finish the project in nine courses in a day. (Some courses may be finished within a week.) The specific method is to add more language stimulation in the systematic rehabilitation training, to highlight the training of language in the courses, to improve the language function of comprehension, expression, articulation and vocalization through collective teaching, individualized training and music activities. 70% of the parents accompanied the training program. Result: 38 cases have improved greatly on language, acquisition, sports, daily life and social adaptability, especially in vocalization and articulation. Their language communication skills have been improved. 16 cases who suffer dysarthria have achieved progresses in tongue movements and breathing. The effective rate is 88.8%. 32 cases have improv