口吃(俗称“结巴”、“磕巴”,广东话称为“漏口”或“口窒窒”,是一种言语障碍,表现为言语频繁地与正常流利的人在频率和强度上不同、且非自愿的重复(语音,音节,单词或短语)、停顿、拖长打断。术语“口吃”通常是与非本意的语音重复相联系的,可以涵盖从最轻微而难以察觉的障碍程度一直到最严重、足以阻碍大多数语言交流的障碍程度。不过它也包括言语前的反常犹豫或停顿(被口吃者称为“语塞”)和某些语音的拖长(通常为元音)。口吃的许多表现不能被他人观察到;这包括对特定音素(通常为辅音)、字和词的恐惧,对特定情景的恐惧,还会出现焦虑、紧张、害羞和言语中“失控”的感觉。
口吃这一疾病的病理机制尚未完全探明,目前认为和遗传,神经生理,家庭和社会多方面都有关系。口吃与发音障碍不同,口吃患者通常在发出语声方面没有障碍。且与失语症(Aphasia)等其它一些言语障碍不同,口吃者通常能够正常地组织词序、语法和语句。与人们通常想象地不同,口吃这一疾病和智力高低没有直接关系。大多数口吃患者除了言语有障碍,身心其他各方面都可以相当健康。而且,焦虑、自信缺乏以及紧张等心理因素通常不是口吃这一疾病的导致因素,而更大程度上是这一疾病的结果。这些心理因素使得口吃在一些情况下属于严重残疾。口吃者对自身口吃反应出的情绪状态也是最难校正的方面。口吃患者的言语流利程度可能随情境而变化。这和情境所造成的焦虑程度有关。比如在打电话时,一些口吃患者的病状可能会加重。在一些特定的活动,例如唱歌、自言自语或朗读时,一些口吃患者的病状会显著减轻。(有学者认为在这些特定活动中,言语发生的神经机制和其它情境中的不同。)
对于许多中度或重度口吃患者来说,该疾病是生活和事业上的一个巨大障碍。虽然现在有许多针对口吃的治疗和校正方法(参见言语治疗),但是尚未找到治愈口吃的有效手段。
参考资料
- Proctor A., Duff, M.. and Yairi, E. (2002). "Early childhood stuttering: African Americans and European Americans." ASHA Leader, 4:15, p.102.
- Yairi, E, & Ambrose, N. (2005). Early childhood stuttering. Austin, TX: Pro-Ed, Inc. Kloth, S., Janssen, P., Kraaimaat, F. & Brutten, G. (1995). "Speech-motor and linguistic skills of young stutterers prior to onset." Journal of Fluency Disorders, 20, 157-170. Yairi, 2005;“On the Gender Factor in Stuttering,”Stuttering Foundation of America newsletter, Fall 2005, page 5.
- Comings, D., et al., "Polygenic Inheritance of Tourette Syndrome, Stuttering, Attention Deficit Hyperactivity, Conduct, and Oppositional Defiant Disorder," American Journal of Medical Genetics 67:264-288 (1996).
- Braun, A.R., Varga, M., Stager, S., Schulz, G., Selbie, S., Maisog, J.M., Carsom, R.E., Ludlow, C.L. "Atypical Lateralization of Hemispehral Activity in Developmental Stuttering: An H215O Positron Emission Tomography Study," in Speech Production: Motor Control, Brain Research and Fluency Disorders, edited by W. Hulstijn, H.F.M. Peters, and P.H.H.M. Van Lieshout, Amsterdam: Elsevier, 1997.
- A. L. Foundas, MD, A. M. Bollich, PhD, J. Feldman, MD, D. M. Corey, PhD, M. Hurley, PhD, L. C. Lemen, PhD and K. M. Heilman, MD. "Aberrant auditory processing and atypical planum temporale in developmental stuttering," Neurology, 2004;63:1640-1646.
- Wood F.Stump D,Mckeehan A,et a1.Patterns of regional cerebral blood flow during attempted reading aloud by stutterers both on and off haloperidol medication:evidence for inadequate left frontal activation during stuttering[J].Brian and Language.1980.9(1):141-144.
- Pool KD,Devous MD.Freeman FJ.et al.Regional cerebral blood flow in developmental slutterers[J].Arch Neurol.1991.48(5):509—512
- Watson BC,Freeman FJ.Devous MD.et al. Linguistic performance and regional cerebral blood flow in persons who stutter[J].Journal of Speech and Hearing Research.1994.37(6):1221-1228.
- Fox PT.Ingham RJ,Ingham HC.et al.A PET study of the neural systems of Stuttering[J].Nature.1996,382(6603):158-162.
- Dronkers NF.A new brain region for coordinating speech articulation[J].Nature,1996,384(6605):159-161.
- Ingham RJ,Fox PT.Ingham JC.et al.Is overt stuttered speech a prerequisite for the neural activations associated with chronic developmental stuttering[J]? Brain and Language,2000,75(1):163-194.
- Fox PT.Ingham RJ,Ingham HC.et al.A PET study of the neural systems of Stuttering[J].Nature.1996,382(6603):158-162.
- Wu JC,Maguire G,Riley G,et al. A positron emission tomography [18F] deoxyglucose study of developmental stuttering[J].Neurorepot.1995,6(5):501- 505.
- Yairi, E., Ambrose, N. "Onset of stuttering in preschool children: Selected factors," Journal of Speech and Hearing Research, 35, 1992, 782-788
- Yairi, E. (1993) "Epidemiologic and other considerations in treatment efficacy research with preschool-age children who stutter," Journal of Fluency Disorders, 18, 197-220. Yairi, E., Ambrose, N. "Onset of stuttering in preschool children: Selected factors," Journal of Speech and Hearing Research, 35, 1992, 782-788.
- Andrews, et al., "Stuttering: a review of research findings and theories," Journal of Speech and Hearing Disorders, 48, 226-246, 1983.
- Yairi, E, & Ambrose, N. (2005). Early childhood stuttering. Austin, TX: Pro-Ed, Inc. Kloth, S., Janssen, P., Kraaimaat, F. & Brutten, G. (1995). "Speech-motor and linguistic skills of young stutterers prior to onset. Journal of Fluency Disorders, 20, 157-170.
- Yairi, 2005; "On the Gender Factor in Stuttering," Stuttering Foundation of America newsletter, Fall 2005, page 5.
- Craig, et al., 2002; Craig, A. Tran, Y., Craig, M., & Peters, K. (2002). "Epidemiology of stuttering in the communication across the entire life span." Journal of Speech, Language, and Hearing Research, 45, 1097-1105.
- Boberg, E., & Kully, D. (1994). "Long-term results of an intensive treatment program for adults and adolescents who stutter." Journal of Speech and Hearing Research, 37, 1050-1059.
- Blomgren, M., Roy, N., Callister, T., Merrill, R. "Intensive Stuttering Modification Therapy: A Multidimensional Assessment of Treatment Outcomes," Journal of Speech and Hearing Research, 48:509-523, June 2005.
- Maguire, G., Riley, G.D., Wu, J.C., Franklin, D.L., Potkin, S. "Effects of risperidone in the treatment of stuttering," in Speech Production: Motor Control, Brain Research and Fluency Disorders, edited by W. Hulstijn, H.F.M. Peters, and P.H.H.M. Van Lieshout, Amsterdam: Elsevier, 1997
- Olanzapine for Developmental Stuttering. Clinical Psychiatry News, Volume 30, Issue 7, (July 2002). Retrieved on June 11, 2006.