中等度難聴児の自由会話におけるコミュニケーションブレイクダウンと訂正方略の活用

Communication breakdown and communication repair strategies of moderately hard of hearing children

　補聴器の常時装用が3歳4か月までに可能となった5～6歳の中等度難聴児7名を対象として自由会話におけるコミュニケーションブレイクダウンと訂正方略の活用について調べ，同年齢の正常聴力児7名と比較した．手続きは各対象児と検査者の自由会話を録音してスクリプトを作成し，ブレイクダウンの出現率と訂正方略の活用数を分析した．さらに，ブレイクダウンの出現と個々の背景要因である補聴器装用下の語音明瞭度，補聴器装用開始時年齢，言語性知能，平均発話長との関連性についても検討した．その結果，中等度難聴児は聴児に比べてブレイクダウンの出現率が高く，訂正方略の活用数は少ないことが示され，訂正方略の活用が多いほどブレイクダウンの出現率は減少する傾向にあった．背景要因との関係については，語音明瞭度，補聴器装用開始時年齢，言語性知能との相関は認められなかった．しかしながら，ブレイクダウンの出現率と平均発話長は負の相関を示し，平均発話長が高いとブレイクダウンの出現率が減少する傾向が認められた．これらの結果から，訂正方略の活用や平均発話長がコミュニケーションブレイクダウンの回避につながることが示唆され，中等度難聴児のコミュニケーション指導においては訂正方略の活用を促し，併せて語彙を増やし平均発話長を促進する言語指導が重要であると考えられた．

　Communication breakdown and the use of repair strategies of moderately hard of hearing children were studied by comparing with those of normal hearing peers. Seven subjects from five to six years of age who were able to use hearing aids stably by the age of three years and four months participated in this study, along with seven normal hearing children of similar ages. Fifteen minutes of free conversation between the tester and each individual was recorded using an IC recorder. Each recording was analyzed for the frequency of communication breakdown and the use of repair strategies. In addition, the relationship between communication breakdown and individual factors such as speech reception ability, age of hearing aids use, verbal IQ, and the mean length of utterance, was examined. The study results showed that the hard of hearing children had communication breakdown more frequently and used repair strategies less effectively compared to their normal hearing peers. The frequency of communication breakdown tended to decrease with the increase in the mean length of utterance. The results suggest that improving language competence as well as teaching the use of repair strategies is important for reducing communication breakdown in moderately hard of hearing children.