文字を用いた自閉症児の発語指導―認知特性の違いから示唆される指導方法の差

Developing oral naming in speechless autistic children using printed words

　無発語の自閉症児に文字を用いた呼称の言語指導を行った．他の報告例では，名称を書字し追字音読する方法や文字を構成する方法で発語が可能となっている．本報の方法は書字を行わず，文字と音声を対提示することと仮名文字を構成し単語を形成したことである．症例は9歳10か月と5歳1か月の自閉症男児で，文字を用いた指導で聴理解が改善しており，この指導で用いた絵カードで呼称の指導を行った．10週間の指導の結果，症例1は文字と音声の対提示で呼称が可能となったが，症例2では文字の構成が必要であった．呼称の情報処理モデルから，症例1は語彙の検索・照合と音韻の選択を文字が介在することにより音声と結び付けたと推察した．症例2は文字の構成が必要だったことから，音韻の配列，把持を文字が仲介したと考えた．症例の差を視覚記憶の差と推論し，症例の認知特性に合わせた指導の必要性を示唆した．

　An intervention was carried out with pictures paired with printed words to help develop oral naming in two autistic boys, aged 9 years 10 months and 5 years 1 month, respectively. Their auditory comprehension had improved with previous training using printed words but they still lacked meaningful speech or writing at the start of this study. They were trained to imitate the spoken concrete nouns depicted while listening and looking at the pictures paired with printed words. They were also trained to construct the words with kana pieces while looking at and listening to the words. After ten weeks of training, the subjects had learned to name the picture cards. The older subject was successful at naming after training imitation with paired pictures and words. In contrast, the younger subject needed word construction before naming. The visual short term memory span may account for the difference between the two subjects. The results were discussed in terms of an information processing model for oral naming and they point to the need for careful consideration of individual cases' cognitive characteristics.