Fundamentals of Communication Sciences and Disorders 交流科学和障碍的基础知识 Rachel Reetzke 进修生 , 中山三院

1. Fundamentals of Communication Sciences and Disorders交流科学和障碍的基础知识Rachel Reetzke 进修生, 中山三院

2. Seminar Overview（概述） • Introduction介绍 • Terms defined术语解析 • Communication（交流）: feedback（反馈）, modalities（特征）, function功能, and effectiveness（效力） • Speech（言语） • Language（语言） • Hearing （听觉） • Speech言语, Language语言, and Hearing Disorders听力障碍 • Evaluation Process（评估过程） • Preview of next week’s topic: Treatment（治疗是下周话题）

3. Introduction（引言） • The ability to communicate is an essential life skill （交流是生活最基本的技能） • Underlying to（基础的）: emotional（感情的）, social（社会的）, educational(教育的), and career development（职业发展） • Communication defines who we are and how others perceive us（交流可以让我们知道自己是谁，他人是怎么看我们的）

4. Communication交流 • The process of sharing information between two or more persons, specifically, “the transmission of thoughts or feelings from the mind of the speaker to the mind of the listener.”（交流的过程可以分享2 个或多人的信息，特别是“把思想或感受从说话者的思想中传递给听者”） • Fundamental Communication involves（交流基础包括）: • A message（信息） • A sender who expresses the message（信息发送者） • A receiver who responds to the message（对信息作出反映的接收者）

5. Communication Feedback（交流反馈） Information provided by the receiver to give acknowledgement and affirmation to the sender（接收者对信息作出确定或肯定） Observed in 3 forms: • Linguistic （语言学的） • Paralinguistic（副语言） • Extralinguistic（语言学之外的） • 注：副语言是指用于修饰意义和表达情感的非言语的沟通元素。副语言可能自觉或不自觉地表示，如抑扬顿挫等，并在某些情况下，讲话语调，by 维基百科。

6. Communication Functions交流功能 • Instrumental（需求）– to ask for something • Regulatory（指挥）– to direct others • Interactional（相互）– for social interactions • Personal（个人）– to express feelings • Heuristic（发动）– to ask for information • Imaginative（想象力的）– to tell stories and role play • Informative（提供信息的）– to provide descriptions of events or objects

7. Modalities of Communication（交流的特征） • Human communication is unique because of the use of language and speech（人类的交流是独一无二的，因为运用了语言和言语） Common Modalities（共同的特点）: • Speech（言语） • Sign language（符号语言） • Reading/writing（阅读与书写）

8. Effective Communication（ 有效的交流） Four Principles for Effective Communicators (Grice’s Maxims): （4原则） • Quantity（数量 ）– provides the right amount and type of information（提供足够数量的信息） • Quality（质量）– shares information that is accurate（共享信息的准确） • Relevance（切题）– maintains the topic（话题的维持） • Manner（方式）– speaks fluently（说话流利）

9. I. Language The formalized code that a group of people use to communicate （人们用来交流的代码） • The five dimensions of language（语言的5个组成）: • Phonology（音律学）-Systematic use of sounds to encode meaning in spoken language • Morphology（形态学）-Structure and form of smallest conceptual meaningful component of a word(e.g. affixes and suffixes词缀与后缀) • Syntax（句法）-Principles and rules for constructing phrases and sentences • Semantics（语义学）- Meaning of words and word combinations • Pragmatics（语用学）-Use of language in social context (e.g. proper use prosody韵律, gestures姿势, and intonation抑扬顿挫)

10. II. Speech言语 • Neuromuscular process that allows humans to express language（人类表达语言的神经肌肉过程） • Involves four systems（包括4结构）: Respiration呼吸-Breathing that provides power Phonation发声-Production of sound by muscle contraction声音发生的产生 Resonation发音-Sound quality shaped by throat（喉咙形成声音的质量） Articulation-Formation of recognizable speech by the mouth（口衔接-形成可识别的语言）

11. III. Hearing听力 • The perception of sound (in the communication process, the perception of speech声音（交流、言语）的感知过程 • Steps of sound processing: -Creation of sound source声源的发生 -Vibration of air particles空气的震动 -Reception by auditory system听觉系统的接收 -Cognitive comprehension认知的理解

12. Communication Disorders交流障碍 • Present when a person is either unable to or has significant difficulties in one or more of the four processes (formulation, transmission, reception, and comprehension)表现在一个人在一个或多个过程中存在明显困难（表达、传送、接收、理解） • Formulation or comprehension problems 表达或理解困难 language impairment语言表达损伤 • Transmission problems传送障碍  speech impairment言语损伤 • Reception problems接收障碍  hearing impairment听力损伤

13. A. Disorders of Language • Breakdown in one or more of the domains of semantics, syntax, morphology, phonology, and pragmatics（语义，句法，形态，音韵和语用学一方面或多方面的损害） • Receptive language disorder接受性语言障碍 • Expressive language disorder表达性语言障碍 • Child language disorders儿童语言发育障碍 -e.g. Specific language impairment (SLI，特殊语言障碍) • Adult language disorders成人语言障碍 -e.g. Aphasia （失语症）

14. A. Disorders of Language（语言障碍） • Language impairments e.g. Pragmatics impairment（语用的损害） • An expressive language impairment interferes with production of language语言产生障碍干扰语言表达 • A receptive language impairment interferes with understanding of language语言理解障碍干扰语言的接收 • Inability to perform Grice’s Maxims无法执行Grice’s 的准则 • Quantity（质、量、切题、方式） • Quality • Relevance • Manner

15. B. Disorders of Speech（言语障碍） • Breakdown in one or more of the systems of respiration, phonation, and articulation（呼吸、发生、口衔接一方面或多方面的损伤） • Motor动作 • Articulation and Phonology（咬合、音律） • Fluency流利性 • Voice说话声

16. B. Disorders of Speech言语障碍 • Motor Disorders e.g. Apraxia, Dysarthria（运动障碍，例如失用，构音障碍） • Articulation and Phonological disorders（衔接和音韵障碍） • Distortions曲解 • Substitutions代用 • Omissions遗漏 • Additions增加 • Fluency disorders e.g. stuttering and cluttering流畅性障碍（口吃、语言急促） • Voice disorders e.g. aphonia, dysphonia语音障碍如失声、发声困难 • A phonation disorder causes the voice to sound breathy, hoarse, husky, or strained发声障碍 （声音嘶哑、发声的紧张或粗糙） • Resonance disorders are hypernasality or hyponasality共振障碍（鼻音过多或过少）

17. C. Disorders of Hearing听力障碍 • Breakdown in the reception or transmission of sound声音的接受和传输障碍 • Sensorineural hearing impairment神经性听力障碍 -Inner ear or auditory nerve内耳或听神经 • Conductive hearing impairment传导性听力障碍 -Outer or middle ear外耳或中耳 • Auditory processing disorder听觉处理障碍 -Auditory center in the brain大脑听觉中心

18. Evaluation Purpose评估目的 • Speech and language evaluation in children has three components:儿童言语和语言评估由三部分组成 1. To determine whether an impairment in communication skills exists确定是否存在沟通技巧障碍 2. To specify the nature of any impairments确定损伤的类型 3. To initiate appropriate intervention strategies采取恰当的干预策略 (Carter & Musher, 2011)

19. Evaluation Process • Standardized tests标准测试 • Interaction and Observation: identify strengths and weaknesses the child has and where to focus the speech testing 互动与观察：明确孩子的长处语言弱项然后锁定语言测试的项目 • Hearing Screening: rule out hearing loss as a contributing factor 听力测试，排除听力方面的障碍 • Parent Interview父母访谈 • Analysis and scoring of the tests对测试进行分析与计分 • Goals and recommendations目标与建议 • Written Report书面报告

20. Speech-Language Evaluation Report语言-言语评估报告 • Tests Administered测试实施 • Background Information个人背景信息 • Medical History病史 • Clinical Observations临床观察 • Peripheral Speech System外围言语系统 • Articulation/Phonology • Fluency流利 • Voice and Resonance语言与共振 • Language 语言 • Clinical Impressions临床看法 • Recommendations推荐

21. History • Brief summary of the child’s development, the reason for evaluation, and any medical issues relevant to the child’s speech-language development • 对孩子的发展简要总结，进行评估的原因，对孩子与言语-语言发展相关的医学医学问题

22. Related Testing相关测试 • If the child has undergone any other testing that could be relevant to his/her speech or language skills, a brief summary of results are listed here.如果孩子有相关语言、言语技巧测试方面的障碍，这里列了简要的介绍。 • This could include occupational or physical therapy, psychometric testing, cognitive skills testing, etc. • 包括职业或物理疗法，心理测试，认知技能测试等

23. Tests and Results • This is the section describing what measures were used to assess the child's abilities, and the results of those measures. Ideally, there will be some sort of explanation of the results. Percentile ranks and standard scores are no help at all if you don't know what they mean. • 这是一节简述了哪些措施来评估孩子的能力，以及这些措施的结果。理想的情况下，将会有对某种结果进行解释。如果你不知道他们的意思，那么对得出的百分等级分数和标准分数是完全没有用的 。

24. Clinical Impressions临床看法 • Here the SLP discusses strengths and weaknesses that have shown up during the testing session. • 在测试部分过程中会显示出SLP的长处及弱项。 • Some of these will be based on test results, but they may also come out of observation of the child's spontaneous interaction during the testing session. • （临床看法）部分会根据测试结果，但也会参照孩子在测试过程中即兴互动的观察。 • This section may also make note of factors that may warrant follow-up through related services (e.g., concerns about hearing loss or attention deficit disorder本这个过程中的记录也会保障后续的相关处理，如听力丧失或注意力缺陷

25. Summary and Recommendations • This section will recap the child‘s background and reasons for the referral, the test results, and the clinical impressions. 本节回顾了儿童的背景，转诊的理由和临床看法 • The main component of this section will describe the SLP‘s recommendation for addressing the child’s speech and language needs.本节的主要组成部分，为解决孩子的言语和语言的需要提供建议。 • Contains clear recommendation regarding speech-language therapy, including frequency and length of sessions; if therapy is warranted, this section will also list short-term and long-term goals to be targeted.包括对言语-语言治疗的明确建议（如频率及疗程），如果治疗是必须的，也会列出治疗的短期和长期目标。

26. Next week… • Treatment Methods • Speech Disorders • Articulation/Phonological Disorders • 下周是关于治疗方面的讨论。

27. References Carter, J. Musher, K. (2011). Evaluation and treatment of speech and language disorders in children. Kurtz, R. (2011). The speech-language evaluation process: what to expect. Speech-Language Development. www.speech-language-development.com (2006). Pearson Education, Inc. Upper Saddle River, New Jersey (2008). The Bercow Report: A Review of Services For Children with Speech Language and Communication Needs What is Language? What is Speech? American Speech-Language Hearing Association. Retrieved: September 25, 2011 from http://www.asha.org/public/speech/development/language_speech.htm