| Objectives: Speech disorders in children with cerebral palsy are closely related with injured brain bradygenesis before birth and after birth Clinical symptoms are speech brady-genesis, dysphasia scanning speech and slurred speech . so far it is impossible for some patients to speak, It is difficult for them to speak with other people, children with speech disorders can not make them to adapt our living .Speech therapy is very necessary to improve their living quality and take them back to our society . This study's aim is to determine that speech treatment is effective and necessary for speech disorders in children with Cerebral palsy, at that time, to explore the relationship between the effect of speech training and clinical types, Speech disorder type and occupational therapy. Methods: This study was conducted among these children with cerebral palsy during two years period from Jan.2003 to Dec 2004:a total of 284(M148,F136),age ranged from 8 to 48 month (mean 21.4 土13).A total of 284 patients is asked to fit three sides: normal hearing, low-grade bradyphrenia, middle-grade obstacle.234 belong to observed group which adopts integrated rehabilitation therapy (contain speech therapy),the other 50 as contrast group only adopts integrated rehabilitation therapy(not contain speech therapy),182 of observed group also carried out occupational therapy and the other 52 patients didn't carry out.234 of observed group can be divided by language barrier into: stage before speech 25,speech bradygenesis 197,speech bradygenesis and dysarthia 12.Divided by clinical type into: spastic191,athetotic 31,mixed-up 12. All patients were examed by CRRC at the beginning of rehabilitation, metaphase and telophase. The physician carried through sythesis rehabilitation (physical therapy knead, acupuncture) and the speech therapists carried through speech treatment. Some patients added occupational therapy to sythesis treatment. Results: All patients were examed by CRRC at the end of rehabilitation. The results showed difference was significant (p<0.01), the curative effect of observed group was more excellent than that of contrast group. The observed group was divided by occupational therapy intotwo groups. The results showed the difference was significant (p<0.01), the effect of speech training of the group which adopted occupational therapy was more excellent than that of the other one. Divided by clinical type into three groups. The results showed the difference was significant among them (p<0.005), we continued to compare each two types with scheffe'CI. We obtained that the speech treatment efficacy of spastic patients was more excellent than that of the other two types, and that there was not difference between athetotic and mixed-up patients. Divided by speech disorders into three groups. The difference was significant among them (p<0.005),we continue to compare them with scheffe'CI. The results showed the effect of speech bradygenesis was more excellent than that of the other two types, moreover there was not difference between the latter two types stastically. Conclusion: Speech therapy is the one of the effective treatments for speech disorders in children with cerebral palsy, it is feasible and essential. Speech therapy is also importance element and is irrepealable. For children with cerebral palsy with normalhearing, low-grade bradyphrenia and middle-grade obstacle, the speech training effect of spastic, speech bradygenesis patients and patients who adopted occupation-al therapy are significant. In the article, abnormal gesture presented by clinical spastic patients was corrected through movement therapeutics (Bobath), hypomyotonia and body random activity was controlled, constructor action was enhanced and corresponded. Thus pronunciation was promoted, speech fluency and definition were improved. But dysmyotonia from athetotic patients often changed and can't be controlled easily. So it is relative that the speech therapy efficacy of spastic patients is more excellent than that of athetotic patients. Occupational therapy includes body-holding function, upper limbs function, hand function, cognize and intelligence and daily activity training. Among them daily activity training still contains oral random action and take-food activity training, moreover, there is close relationship between take-food function and speaking. The original reflect presented by patients was conformed through body-holding training, abnormal gestmes were controlled. Adjustment was enhanced and myotonia stability... |
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