A Study of Communication Intervention for Children with Severe Speech and Language Impairment

近年来，增强型和替代性沟通已被公认为一种有效的干预策略。研究继续报告，AAC系统通常只在特定的演讲和语言会话中使用。为了发展使用AAC系统的能力，儿童需要在一系列日常活动中有机会进行实用和有意义的交流。本研究调查了一名正常学龄前儿童交流行为的发展情况，为非语言儿童的评估提供指导。从2岁到4岁，母亲和她的孩子在自然环境中玩玩具的互动被观察到。孩子获得了保持更长时间对话的能力，方法是增加相关话语，不仅依靠母亲的话，而且还提供新的信息，引起母亲的进一步反应。我们报告了AAC在一名严重构音障碍和言语障碍儿童的交流干预中的应用。这名儿童6岁，患有巨细胞病毒引起的智力和运动障碍。他有很好的口头理解能力，会说几个单词，比如“是”或“不是”。经过5年的干预，他能够用手势和语言与家人和朋友交流，并掌握了假名字母和汉字。有时，他使用假名字母的语音输出通信辅助工具。然而，他不能充分利用任何一种沟通策略，他逐渐能够成功地沟通，组合了几种策略。研究结果表明，多通道交际策略在言语和语言障碍儿童的信息表达中是有效的。

In recent years, augmentative and alternative communication has become recognized as one of effective intervention strategies. Research studies continue to report that AAC systems are often only used in specific speech and language sessions. To develop competence in using an AAC systems a child needs opportunities for functional and meaningful communication in a range of daily activities.1. The study investigated the development of communication behaviors in a normal preschool child to provide guideline for assessment of non-speaking children. The interactions of the mother and her child were observed in natural settings playing with toys, from 2 years old until 4 years of age. The child acqufred her ability to maintain longer dialogue by increasing related utterances not merely relying to her mother's words but also providing new information which elicits the mother's further responses.2. We reported the application of AAC in communication intervention for a child with severe dysarthria and delayed speech and language. The child was six years old, and had intellectual and motor disorders due to cytomegalovirus. He had good verbal comprehension and a few spoken words such as "yes" or "no". After 5 years' intervention, he became able to communicate with his family and friends using gestures and speech, and has mastered Kana letters and Kanji. Sometimes he used a voice output communication aid of Kana letters. However he could not fully utilize any single communication strategy, he gradually became able to communicate successfully, combining several strategies. The findings suggested that multi-modal communication strategy is effective in the expression of a message of children with severe speech and language disorders.