小児における特異な構音操作の誤りとそれに対するアプローチ

Approaches to persistent speech errors in children with speech sound disorders

　小児の構音障害でみられる特異な構音操作の誤りは，自然治癒しにくく，構音の練習が長期化しやすい．しかし，適切な治療で治癒可能であり，早期介入で予防可能な言語障害である．今回は，特異な構音操作による構音障害に焦点を当て，言語聴覚士としての留意点とそのアプローチについて検討した．

　特異的な構音操作に対する言語療法を行う場合，1)器質的な問題の有無の確認と他専門職との連携の適否，2)発話の聴覚的評価，3)適正音の構音操作の熟知と，特異な構音障害と適正音を対比した言語療法の立案，4)構音障害の誤学習をさせない早期介入，5)フィードバック手段の工夫，が肝要である．

　Certain speech errors in children with speech sound disorders are difficult to treat and speech therapy may be prolonged to remediate them. However, speech sound disorders can be resolved with appropriate treatment, and even prevented with appropriate early intervention. The author discusses several key points for consideration on how to approach speech sound disorders including: 1) confirmation of the presence or absence of a structural abnormality and the need for interdisciplinary cooperation with other professionals, 2) perceptual evaluation of utterances, 3) differences in the manner of articulation of proper speech sounds and erroneous speech sounds, and how to guide the production of proper speech sounds, 4) early intervention to help prevent the development of maladaptive speech errors, and 5) provision of effective feedback on sound production.