一直以來,文獻都提及運用checklist診斷兒童言語失用症。有經驗的言語治療師根據小朋友在評估時的表現,觀察是否有checklist上的臨床表徵。較常用的checklist 是Strand’s 10 points checklist (Shriberg, Potter, & Strand, 2011),之前都有介紹過:
https://www.facebook.com/CantoneseCAS/posts/283139915526980
但checklist 的validity 一直都存有疑問。澳洲的研究團隊留意到這一點,作出了一項研究。Murray, McCabe, Heard, and Ballard (2015) 的研究發現四個表徵能達致91%診斷準確性,分別是:
1. syllable segregation,
2. lexical stress matches,
3. percentage phonemes correct from a polysyllabic picture-naming tasks, and
4. articulatory accuracy on repetition of /pǝtǝkǝ/.
雖然文章並沒有詳細交待如何運用這些表徵作診斷(例如,syllable segregation 是出現一次就可用作診斷?Percentage phoneme correct 要達到多少?articulatory accuracy 又如何計算?),但此項研究為使用checklist作診斷帶來方向,日後可循這相對客觀的方法為兒童作診斷。
P.S. 第二項表徵是英語的lexical stress 問題,在廣東話又應如何處理呢?我寫了一份journal article,有討論到這一點,provisionally accepted,但仍需作少許修改,希望發布後可以跟大家分享。
Reference:
Murray, E., McCabe, P., Heard, R., & Ballard, K. J. (2015). Differential diagnosis of children with suspected childhood apraxia of speech. Journal of Speech, Language, and Hearing Research, 58, 43-60.
Shriberg, L. D., Potter, N. L., & Strand, E. A. (2011). Prevalence and phonotype of childhood apraxia of speech in youth with galactosemia. Journal of Speech, Language, and Hearing Research, 54(2), 487-519.
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