音声言語理解に比し発語面に著しい遅れを呈した言語発達遅滞の一例

A case of speech delay with limited output lagging disproportionately relative to comprehension

　音声言語理解に比し発語面に特異な症状を呈した言語発達遅滞の一例に，文字やジェスチャーの視覚的モダリティを用いて訓練を実施したところ，発語が可能となったので，訓練経過を分析し若干の考察を加えた．本例は4歳2か月時に当科を初診した．当初から音声言語理解面に比し発語に重篤な障害がみられた．本例は，文字言語が音声言語表出に先行し，呼称が困難な場合でも書称が可能であり，それを音読する経由で音声言語表出が可能なことがみられた．そこで視覚的モダリティを取り入れて訓練を実施したところ発語が促進された．以上より，発語より文字言語が先行する症例の存在を認識し，訓練プログラムを立案する必要があると考えた．

　A female subject with delayed speech was observed for her oral language development over a period of 29 months, starting at the age of 4 years, 2 months.　In contrast to relatively good development in auditory comprehension, the subject's speech output was remarkably delayed.　For remediation, we began teaching written language and the use of gestures from the first visit to our clinic, and also provided auditory verbal stimulation.　During the course of training, the subject made more progress in written language than in oral expression.　For example, she was observed on some occasions to write a word using kana letters and then read it aloud after exhibiting difficulty in saying it initially.　This shows that written language and gesture instruction in early life may be beneficial for some children with delayed language acquisition, indicating that this approach should be given a consideration when planning treatment.