知多一點點 - 溝通障礙及香港言語治療師

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溝通障礙及香港的言語治療師

Communication difficulties and Speech Therapist in Hong Kong

　

有科學家曾經指出 , 人類和其他動物的最大分別在於我們懂得使用語言作為溝通的工具 .

姑勿論這位科學家的言論是否真確 , 自古以來 , 人們已經能夠有效地使用說話來表達自己 , 用耳朵來聆聽他人的說話 . 憑著說話和聆聽 , 人們互相交流經驗和知識 , 改善生活 , 達至文明 .

Some scientists said that the major difference between human beings and other animals is that human being can use speech and language for communication.

We are not going to judge whether those scientists are correct or not. Actually, human beings are able to use speech to language to express ourselves and comprehend from others. They improve their lives through communication with each others.

　

語言發展的過程 Language Development of Human

　

可是 , 並不是人人都可以有效地說話和聆聽 . 一些不幸的人 , 基於各種不同的原因 , 在說話和或在聆聽方面出現了不同程度上的阻礙 . 如果我們對他們了解多一點 , 便會懂得如何正確地面對他們 , 令他們可以過正常人的生活 .

However, it is not true that everybody can communicate with others without difficulties. Some unfortunate individuals have some communication disorders in different ways. They have problems on expressing and comprehending themselves based on different kinds of etiologies.

If we can look into these communication disorders, we can realize the difficulties of those unfortunate individuals. Thus, we can find some ways to help them to survive with dignity.

據2006年的一項研究，本港有4-5%的學童有不同程度的溝通障礙 According to a research in 2006, about 4-5% children in Hong Kong have different degrees of communication difficulties.



        本港學童常見的溝通障礙 Some common communication difficulties in childhood in Hong Kong

    þ 非言語方面的問題 Non-verbal means, problems at prelinquistic skills

例如: 眼神注視欠佳、溝通意欲薄弱 e.g. Poor eye contact, low communicative intention

    þ 言語理解方面的問題 Inadequate receptive language skills

例如: 未能跟從指令、未能回答問題、未能作言語上的邏輯推理 e.g Difficulties in command following, question answering and verbal logical reasoning

    þ 言語表達方面的問題 Inadequate expressive language skills

例如: 說話結構、內容、用途的問題 e.g. Poor expressive language form, content or use (pragmatic)

    þ 咬字發音方面的問題 Articulation problem

    þ 聲線上的問題 (Voice Disorder)

    þ 說話流暢度方面的問題 Fluency problem (dysfluency)

        例如: 口吃 e.g. Stuttering

　

會引致言語溝通障礙的病情 Some Disorders causes Communication Difficulties:

弱智 Mental retardation

大腦麻痺 Cerebral Palsy

唐氏綜合症 Down's Syndrome

自閉症 Autism

中風 Cerebral Vascular Accident (CVA, stroke)　　

聽覺上的問題 (Hearing Impairment)

現行的本港的復康及醫療體制，處理溝通障礙的專業人士為「言語治療師」
According the medical and rehabilitation services in Hong Kong, "Speech Therapist' is the professional provides the assessment and treatment to persons with communication difficulties.

本港的言語治療師服務 Speech Therapy service in Hong Kong

為有溝通障礙及吞嚥障礙人士提供評估及相關的訓練 Provide assessment and treatment to people with communication difficulties or swallowing difficulties
支援照顧者對有關人士提供訓練 Support their families
促進有關人士的溝通及吞嚥能力 Facilitate and promote people with communication difficulties or swallowing difficulties to improve their communication and swallowing in daily living

本港言語治療師對溝通障礙所使用的評估工具

言語評估 (5-12歲)

Lauguage (5-12yrs)

香港兒童口語(粵語)能力量表 (2006) HKCOLAS

Hong Kong Cantonese Oral Language Assessment Scale

需時 80-90 分鐘

80-90 minutes

言語評估 (1-7歲)

Language (1-7yrs)

雷妮氏語言發展量表(粵語版本) (1987) RDLS

Reynell Developmental Language Scale (Chinese Version)

需時 50-60 分鐘

50-60 minutes

言語評估 (2-6歲)

Language (2-6yrs)

香港粵語詞彙理解測驗 (1996) CRVT

Hong Kong Cantonese Receptive Vocabulary Test

需時 20-30 分鐘

20-30 minutes

發音評估 (2歲-成人)

Speech (2yrs-adults)

香港粵語發音測試 (2006) HKCAT

Hong Kong Cantonese Articulation Test

需時 15-20 分鐘

15-20 minutes

除上述的標準化測試外，最常用的評估模式為言語治療師的專業觀察，由言語治療師與學童互動，憑經驗及理論，與其他同齡學童比較，找出對學童的溝通技巧最有幫助的目標加以訓練。

Apart from the standardized test mentioned above, speech therapist always assess the children by observation; During the interaction with the adults and the children, the therapist find out the discrepancies between the children and other age-matched peers. The therapist would consider the treatment goals to maximize the children's communication functioning based on theories and past experience.

本港言語治療師處理發音障礙時所用的音標 The phonetic symbols using by speech therapist in Hong Kong

因香港長久以來未有一個統一的粵語拼音系統，其一是黃錫凌《粵音韻彙》所載的標音系統，亦即大部份中文字典及教師常用的標音方法，而言語治療師及一般的發音評估測試則使用國際音標(IPA)，部份標音符號會與國際音標(IPA)有少許分別。現表列如下：

Hong Kong has two major phonetic symbols systems. One is based on S.L Wong 《粵音韻彙》, that is what typical dictionary and teacher commonly used. Another is the International Phonetic Symbol (IPA), which is used by speech therapist and some articulation tests. These two systems have some difference in between, as shown as below.

黃錫凌《粵音韻彙》所載的標音系統 S.L. Wong 《粵音韻彙》		國際音標對照 IPA
Unaspirated bilabial plosive 雙唇爆破音(不噴氣)	/b/	/p/
Aspirated bilabial plosive 雙唇爆破音(須噴氣)	/p/	/p^h/
Unaspirated alveolar plosive 舌尖爆破音(不噴氣)	/d/	/t/
Aspirated alveolar plosive 舌尖爆破音(須噴氣)	/t/	/t^h/
Unaspirated velar plosive 舌根爆破音(不噴氣)	/g/	/k/
Aspirated velar plosive 舌根爆破音(須噴氣)	/k/	/k^h/
Unaspirated alveolar affricate 舌尖塞擦音(不噴氣)	/dz/	/ts/
Aspirated alveolar affricate 舌尖塞擦音(須噴氣)	/ts/	/ts^h/

查找粵音字詞 Phonetic inventory：A Chinese-Cantonese Syllabary - 黃錫凌《粵音韻彙》電子版

粵音發音方法 Learning Speech： http://www.hkedcity.net/resources/common/res_detail.phtml?res_cntr_id=32884 (影片 video)

http://www.hkedcity.net/resources/common/res_detail.phtml?res_cntr_id=32885 (教材套 software)

本港言語治療師的執業情況 Current speech therapists in Hong Kong

聲明: 香港言語治療師的執業並無法定註冊制度 Important notes: No official registration required for speech therapist practice in Hong Kong

香港言語治療師均需持用由香港大學頒授的「理學士(言語及聽覺科學)」學士學位或同等學歷；同時需具有一定臨床實習時間。Speech therapists in Hong Kong are the degree holder of BSc (Speech and Hearing Science) by the University of Hong Kong or equivalence, in addition to a certain sum of clinical hours.

合資格的言語治療師可加入香港言語治療師協會(HKAST) 成為正式會員 (Full member) ，故有興趣人士可聯絡香港言語治療師協會查核某人的「言語治療師」的資格，香港言語治療師協會亦有提供在本港私人執業的言語治療師名冊。Qualified speech therapists are eligible to apply full membership in the Hong Kong Association of Speech Therapists (HKAST). Therefore, interested parties may contact HKAST to enquire whether a person is a speech therapist or not. HKAST also provides a list of private practice speech therapists in Hong Kong.