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題名:聽力損失兒童的視聽語音知覺表現及其相關因素的探討
作者:楊惠美
作者(外文):Hui-Mei Yang
校院名稱:國立高雄師範大學
系所名稱:特殊教育學系
指導教授:陳小娟
學位類別:博士
出版日期:2008
主題關鍵詞:視聽語音知覺讀話追述法人工耳蝸助聽器聽力損失兒童audiovisual speech perceptionspeechreadingcontinuous discourse trackingcochlear implantationhearing aidshearing impaired children
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視聽語音知覺是溝通歷程的自然行為,不僅可以促進聽力損失者的溝通能力,而且可以增進在噪音環境的訊息處理能力。本研究的主要目的在瞭解學齡階段聽力損失兒童的視聽語音知覺表現及其相關影響因素。以自編的讀話辨識測驗和短文追述測驗,並採用「學齡前兒童語彙毗鄰測驗」和「噪音背景辨識語音測驗」為語音聽知覺能力,「畢保德圖畫詞彙測驗」、「魏氏兒童智力量表」語文智商、及「語文成就測驗」為語文相關能力,及「魏氏智力測驗」的記憶廣度測驗和「構音速率測驗」為認知相關能力,蒐集並評量受試者相關能力的表現。研究對象為23位人工耳蝸植入學童和8位使用助聽器的聽力損失兒童,就讀於國民小學三至六年級普通班。研究設計採不完全受試者內的實驗設計和相關研究法,操弄變項為施測情境和材料類型,測量變項為讀話測驗各種作業的表現,並探討影響視聽語音知覺表現的相關因素。本研究結果分述如下:
(一)讀話辨識測驗的傳統試題分析結果顯示測驗難度適中,平均鑑別度佳,內部一致性高。在單參數項目分析中,單音節作業的難度最高,雙字詞作業次之,語句作業最低。在單音節和雙字詞作業的高出現率和低出現率語詞表現具有顯著差異,但語句作業的有意義和無意義語句表現則無難度差異,這與測量模式的驗證性因素分析結果一致。而且各個作業中表單的難度參數並無顯著差異、且相關性高,顯示各個表單的難度相當,具有複本信度。
(二)短文追述測驗運用的測量向度,包含反應正確率、反應時間、追述速率、及策略使用次數,皆可有效反映聽力損失兒童在連續短文的語音知覺歷程。但施測情境對追述表現的影響並不一致,測驗內容的文體、及文章所屬的學科和年級會影響作業難度,聽力損失兒童在敘述文的表現優於說明文,自然學科和高年級測驗內容的表現較差。
(三)聽力損失兒童在視聽情境表現皆比聽覺情境佳,且其視覺增益皆為正值,顯示視覺線索有助於聽力損失兒童的視聽語音知覺表現。施測情境(聽覺和視聽情境)、材料類型(高出現和低出現語詞,或有意義和無意義語句)、及作業種類(單音節、雙字詞、及語句作業)對視聽語音知覺表現的影響,兩兩之間會有交互作用(p<.05),顯示視聽情境的視覺線索有助於讀話辨識測驗三種作業和兩種施測材料的表現,而且材料類型的語詞熟悉度和語句脈絡線索也有助於視聽語音知覺表現,在缺乏視覺線索的聽覺情境和語詞熟悉度的低出現語詞會使得單音節和雙字詞作業表現差距變小。
(四)聽力損失兒童的語音聽知覺能力約在中等程度,詞彙和語文智商表現和同年齡聽力正常兒童相當,但工作記憶表現則較為落後。各種語文測驗呈現顯著正相關,語文相關能力和工作記憶呈現正相關,而與構音速率呈現負相關,且工作記憶與構音速率亦呈現負相關,顯示各種語文相關測驗之間具有顯著關聯性。
(五)聽力損失兒童的視聽語音知覺表現並不受性別和就讀年級的影響,但會受到聽覺輔具的影響,人工耳蝸學童的表現大於助聽器學童,而且人工耳蝸植入年齡愈小和使用時間愈長皆有助於視聽語音知覺表現。受試者輔具配戴年齡可有效預測視聽語音知覺表現,對單音節、雙字詞、及語句作業的解釋量分別為25.3%、22.1%、及15.5%。語詞辨識和語文智商能力可以預測單音節作業,其解釋量為74.2%和6%(合計為80.2%);語詞辨識和詞彙能力可以預測雙字詞作業,其解釋量為71.1%和11.7%(合計為82.8%);而噪音背景辨識語音測驗和詞彙能力可預測語句作業,其解釋量為61.9和15.5%(合計為77.4%)。
綜合各項研究結果可以發現聽力損失兒童在視聽情境表現皆比聽覺情境佳,且其視覺增益皆為正值,視聽語音知覺表現和語音聽知覺能力、語文相關能力、及工作記憶能力有顯著相關。顯然愈早發現聽力損失問題並開始使用聽覺輔具,可以增進聽力損失兒童的視聽語音知覺表現,而且提升其語音聽知覺能力和語文相關能力,增進個體語詞和語句的視聽語音知覺表現,促進整體溝通效能。
The purposes of this study were to investigate the audiovisual performance of hearing impaired children and the relationship of audiovisual performance with its related factors. There were 31 mainstreamed primary school children, 23 received cochlear and 8 used hearing-aids, with severe or profound hearing loss enrolled in the study. Subjects identified spoken words and paragraphs presented in auditory-only and audiovisual conditions. Seven additional measures ( lexical neighborhood test, speech perception in noise, Peabody picture vocabulary test, verbal intelligence quotation, reading achievement test, reading achievement test, and articulation speed test) were used to assess speech perception, language and cognition abilities. Results indicated that subjects’ audiovisual performance would be better under more familiar words as well as meaningful sentences. All of the subjects received benefit from audiovisual condition as compared to auditory-only condition. Audiovisual performance was found to be strongly correlated with several measures in speech perception, vocabulary, and language. Results also suggested close links exist among audiovisual skills, speech perception, vocabulary, and language abilities. There was a common underlying language basis for audiovisual enhancement effects. The implications and suggestions of this study for future research were discussed.
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