基于ICF的智力残疾儿童言语功能障碍和沟通活动受限特征与康复干预

doi:10.3969/j.issn.1006-9771.2025.04.004

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (4): 398-405.doi: 10.3969/j.issn.1006-9771.2025.04.004

• 专题 ICF应用研究 • 上一篇下一篇

基于ICF的智力残疾儿童言语功能障碍和沟通活动受限特征与康复干预

易玲¹(), 周静¹, 陈雪芬², 陈川帆³, 陈科伊¹, 董慧繁¹

1.宁波卫生职业技术学院，浙江宁波市 315100
2.宁波市鄞州区小小虎特殊儿童康复训练中心，浙江宁波市 315100
3.宁波市康复医院，浙江宁波市 315040

收稿日期:2025-03-25 修回日期:2025-03-27 出版日期:2025-04-25 发布日期:2025-04-25
通讯作者: 易玲，E-mail: 375427683@qq.com
作者简介:易玲(1988-)，女，汉族，四川广安市人，硕士，讲师，主要研究方向：言语语言功能康复、ICF。
基金资助:
1.健康宁波研究基地项目(JD6-329);2.宁波市教育科学规划重点课题(2024YZD038);3.浙江省教育科学规划课题(2024SCG131)

Characteristics and intervention of speech function impairments and communication limitation in children with intellectual disabilities based on ICF

YI Ling¹(), ZHOU Jing¹, CHEN Xuefen², CHEN Chuanfan³, CHEN Keyi¹, DONG Huifan¹

1. Ningbo College of Health Sciences, Ningbo, Zhejiang 315100, China
2. Ningbo Yinzhou District Little Tiger Special Children Rehabilitation Training Center, Ningbo, Zhejiang 315100, China
3. Ningbo Rehabilitation Hospital, Ningbo, Zhejiang 315040, China

Received:2025-03-25 Revised:2025-03-27 Published:2025-04-25 Online:2025-04-25
Contact: YI Ling, E-mail: 375427683@qq.com
Supported by:
Healthy Ningbo Research Center Project(JD6-329);Ningbo Education Science Plan (Key)(2024YZD038);Zhejiang Education Science Plan(2024SCG131)

摘要/Abstract

摘要：

目的系统分析智力残疾儿童言语和沟通障碍的特点，设计整体性的康复方案。
方法运用《国际功能、残疾和健康分类》(ICF)的理论和方法，从身体功能和结构、活动和参与、环境因素等多个维度对智力残疾儿童的言语和沟通功能障碍特征进行深入分析。在言语康复和特殊教育情境下实施综合干预方法。
结果在身体功能和结构方面，言语功能障碍常常表现为语言的心理功能、发音功能、言语的流畅性和节律功能等障碍。在活动和参与层面，表现为沟通障碍，包括说话、倾听、对话以及人际互动等方面可能存在障碍或困难。环境因素，如家庭支持、同伴态度、专业服务以及辅助沟通技术的可及性，对智力残疾儿童的言语功能和沟通功能的发展有重要的影响。本研究基于ICF架构提出了儿童的言语功能和沟通活动功能的系统性评估方法，强调从整体视角理解智力残疾儿童的言语功能障碍和沟通活动障碍，注重沟通活动功能对智力残疾儿童的学习和日常生活的影响。在言语康复治疗和教育康复情境下，针对智力残疾儿童的言语障碍和沟通活动障碍的特点，设计个别化的干预方法，注重培养儿童的功能性沟通技能，并将其融入到日常生活和教育活动中。辅助和替代沟通技术、自然情境下的语言干预、视觉支持以及同伴介导等干预均是有效的康复措施。
结论本研究运用ICF架构和方法，对智力残疾儿童的言语功能和沟通活动功能进行了系统分析，从身体功能和结构、活动和参与以及环境因素3个层面，系统探讨了智力残疾儿童的言语功能和沟通活动功能的特征，并且提出了在言语康复治疗和教育康复情景下，推动智力残疾儿童言语功能和沟通活动功能发展的系统性方法，包括设计个别化干预方法、辅助技术应用、视觉辅助支持以及同伴介导等措施。

关键词: 智力残疾, 儿童, 言语功能障碍, 沟通活动受限, 国际功能、残疾和健康分类

Abstract:

Objective To systematically analyze the characteristics of impairment of speech function and activity limitation of communication in children with intellectual disabilities, and to develop comprehensive rehabilitation interventions.
Methods An in-depth analysis of impairments of speech functions and activity limitation of communication in children with intellectual disabilities across multiple dimensions was conducted using International Classification of Functioning, Disability and Health (ICF) framework, from the aspects of body structures and functions, activities and participation, and environmental factors. Integrated intervention methods were implemented within speech rehabilitation and special education settings.
Results Speech function impairments often manifested as deficits in the mental functions of language, articulation functions, and the fluency and rhythm of speech. Communication limitations were evident, including potential deficits or difficulties in speaking, listening, engaging in conversations and interpersonal interactions. Environmental factors such as family support, peer attitudes, professional services and the accessibility of assistive communication technologies significantly impacted the development of speech function and communication activity in these children. This study proposed a systematic assessment methodology for children's speech function and communication activity based on the ICF framework, emphasizing a holistic understanding of impairments of speech functions and activity limitation of communication in children with intellectual disabilities, and highlighting the impact of communication activity on children's learning and daily life. In speech rehabilitation therapy and educational rehabilitation settings, individualized intervention strategies should be designed according to the specific characteristics of impairments of speech functions and activity limitation of communication in children with intellectual disabilities, focusing on fostering functional communication skills and integrating them into daily life and educational activities. Augmentative and alternative communication technologies, natural context language interventions, visual supports, and peer-mediated interventions might be effective.
Conclusion This study has utilized the ICF framework to systematically analyze impairments of speech functions and activity limitation of communication in children with intellectual disabilities, interms of body functions and structures, activities and participation, and environmental factors. A systematic approach to promoting the development of speech function and communication activity in children with intellectual disabilities has been proposed within speech rehabilitation therapy and educational rehabilitation settings, including individualized intervention strategies, the application of assistive technologies, the use of visual support, and the implementation of peer-mediated interventions.

Key words: intellectual disability, children, impairments of speech function, activity limitation of communication, International Classification of Functioning, Disability and Health

中图分类号:

R748

易玲, 周静, 陈雪芬, 陈川帆, 陈科伊, 董慧繁. 基于ICF的智力残疾儿童言语功能障碍和沟通活动受限特征与康复干预[J]. 《中国康复理论与实践》, 2025, 31(4): 398-405.

YI Ling, ZHOU Jing, CHEN Xuefen, CHEN Chuanfan, CHEN Keyi, DONG Huifan. Characteristics and intervention of speech function impairments and communication limitation in children with intellectual disabilities based on ICF[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 398-405.

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身体功能和结构	ICF编码	ICF类别	智力残疾儿童的常见障碍描述
身体功能-精神功能(b1)	b167	语言精神功能	语言习得延迟、词汇量不足、词语使用不当、理解和表达困难
身体功能-嗓音和言语功能(b3)	b320	清晰度功能	发音不清、音素替代、遗漏或扭曲、语音异常
	b330	言语的流畅度和节奏功能	口吃、语速过快或过慢、不流畅、重复音节或词语
	b310	嗓音功能	声音嘶哑、音调异常、音量控制困难、鼻音过重或过轻
身体功能-感觉功能和疼痛(b2)	b230	听觉功能	听力损失可能进一步加剧沟通困难
身体结构	s320-s340	参与发声和言语的结构	腭裂等物理异常可能影响言语产生

活动和参与	ICF编码	ICF 类别	智力残疾儿童的常见特征描述
交流(d3)	d330	说	表达性词汇量有限、难以形成复杂句子、言语可理解性低
	d310	交流-接收-口头讯息	理解指令困难、难以理解复杂的口语信息、对语境线索理解不足
	d350	交谈	难以发起和维持对话、轮流说话困难、偏离主题、语用技能不足
人际交往和联系(d7)	d710	基本的人际交往	难以建立和维持友谊、理解社会线索困难、情感表达不当
基本学习(d1)	d131	通过与物体和人的行动进行学习	语言发展里程碑延迟、学习新词汇和语法规则困难
	d133	掌握其他的语言	发展用词语、符号、短语和句子来表达人物、物体、事件、感觉的能力受限
	d140	学习阅读	流利且准确阅读书面材料(包括盲文和其他符号)的能力受限
	d163	思考	理解抽象概念和隐喻性语言困难，推理能力受限

环境因素	ICF编码	ICF类别	智力残疾儿童言语和沟通功能的影响描述
支持和相互关系(e3)	e310	直系亲属	家庭支持、鼓励沟通、使用清晰简单的语言、提供沟通机会对儿童的语言发展至关重要
	e320	朋友	同伴互动提供语言练习和社交学习的机会
	e325	熟人、同龄人、同事、邻居和社区成员	包容和积极的态度能够促进儿童的社会参与和沟通
	e355	卫生健康专业人员	言语治疗师、教师等专业人员提供的早期干预和持续支持对改善沟通能力至关重要
服务、体制和政策(e5)	e580	卫生健康的服务、体制和政策	获得早期干预服务、特殊教育资源和辅助沟通技术的机会对儿童的沟通发展至关重要
用品和技术(e1)	e120	用于个人室内外移动和交通的产品和技术	辅助和替代沟通(augmentative and alternative communication, AAC)可以显著提高非言语儿童的沟通能力
态度(e4)	e410	直系亲属家庭成员的个人态度	对智力残疾的负面态度和污名化会阻碍儿童的社会融合和沟通

基于ICF的智力残疾儿童言语功能障碍和沟通活动受限特征与康复干预

Characteristics and intervention of speech function impairments and communication limitation in children with intellectual disabilities based on ICF

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