吃音の進展した幼児に対する直接的言語指導に焦点を当てた治療 [in Japanese] Treatment Featuring Direct Speech Therapy for a Preschool Child with Fully Developed Stuttering [in Japanese]
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発話困難の意識があり重症度の高い発吃3歳3ヵ月, 初診時年齢5歳1ヵ月の男児1例に対して環境調整, 遊戯療法とともに流暢性を促すために以下の直接的言語指導による治療を実施した.1) ゆっくり, ひき伸ばし気味の発話 (カメの玩具を動かして) , 2) タッピング (蛙の玩具を弾ませて) , 3) 柔らかな起声・発話: 吸気後に呼気にのせて軟起声で, ゆっくりと母音部をひき伸ばし気味に発声・発話 (発話困難な語音に焦点を当てて実施) , 4) 自由会話.言語指導終了後, 遊戯療法に並行して母親面接を実施し環境調整を図った.家庭でも本言語指導を実施してもらった.本治療を通して, 指導および家庭場面の吃音症状は顕著に改善した.また工夫・回避反応は消失した.吃音の進展した幼児に対する遊戯的要素を取り入れた直接的言語指導に焦点を当てた治療の効果が示唆された.さらに, 言語指導と遊戯療法を組み合わせて実施することの効果も示唆された.
This study reports on a course of treatment used on a boy aged five years and one month with severe stuttering that began at the age of three years and three months. He had awareness of his speech difficulty. Treatment consisted of direct speech therapy, play therapy, and modification of the home environment through counseling of the subject's mother. The direct speech therapy was performed with an element of play involving his mother. The speech therapies consisted of the following: 1) slow, "stretched" speech using a toy turtle for metaphors and as a pacer; 2) rhythmic speech using tapping with a toy frog; 3) gentle voice onset and speech: after inspiration, the subject performed easy voice onset, followed by slow and stretched speech using a gentle voice with expiration; 4) free conversation between the subject and the therapists. After these speech therapies, the subject was administered child-centered play therapy. His mother was also encouraged through counseling to reduce stress in his daily environment. Through this treatment, the boy's stuttering and attitude improved remarkably. The study suggests that treatments featuring direct speech therapy can be useful for preschool children with fully developed stuttering. The findings also suggest that treatment which combines direct speech therapy and play therapy can be effective.
- Jpn. J. Logop. Phoniatr.
Jpn. J. Logop. Phoniatr. 48(1), 1-8, 2007-01-20
The Japan Society of Logopedics and Phoniatrics