Objective: To investigate the characteristics of consonant among children with speech sound disorder (SSD) and to provide an empirical basis for the subsequent clinical evaluation and evidence-based intervention. Methods: In this retrospective research a total of 1 395 children diagnosed with SSD from the Language-Speech Clinic of the Department of Children Health Care, Children's Hospital, Capital Institute of Pediatrics from January 2007 to December 2018 were enrolled and underwent the phonological examination on the lexical level with picture naming, according to phoneme development in Chinese mandarin. The Chi-square trend test was applied to analyze the differences and trends of the proportion of consonant error subtypes in children of different age groups. The Chi-square test was conducted to compare the proportion of consonant error subtypes in different gender. Results: The 1 395 children diagnosed with SSD included 1 044 boys and 351 girls, with an age of (5.1±0.8) years. The occurrence of consonant errors in different locations of articulation was the highest for blade-alveolar /l/ (71.8%, 1 002/1 395) and the lowest for labial/b/(9.3%, 130/1 395). The occurrence of consonant errors of labial/p/f/, supra-dental/z/c/s/, blade-alveolar/t/l/, blade-palatal/ch/r/, velar/k/h/, and lingua-palatal/q/decreased with age (all P<0.05). The occurrence of consonant errors of labial/b/m/, supra-dental/z/c/, blade-alveolar/n/l/, blade-palatal/sh/, velar/h/, and lingua-palatal/x/were higher in boys than those in girls (10.3% (108/1 044) vs. 6.3% (22/351), 11.4% (119/1 044) vs. 6.0% (21/351), 64.8% (676/1 044) vs. 51.9% (182/351), 67.8% (708/1 044) vs. 59.8% (210/351), 16.7% (174/1 044) vs. 8.8% (31/351), 73.7% (769/1 044) vs. 66.1% (232/351), 58.0% (606/1 044) vs. 47.6% (167/351), 24.0% (251/1 044) vs. 14.2% (50/351), and 39.9% (417/1 044) vs. 27.6% (97/351); χ²=5.167, 8.533, 16.889, 7.447, 12.863, 7.412, 11.650, 14.900, and 17.099, all P<0.05). The error types of consonant were substitution, omission, and distortion. Omission was the main error type of blade-alveolar/l/(53.3%, 743/1 395), distortion was the main error type of velar/h/(11.8%, 165/1 395), and substitution was the main error type of all other consonants. Substitution with blade-palatal/ch/having the highest occurrence of error (60.2%, 840/1 395). Conclusions: The occurrence of the blade-alveolar/l/error is the highest in children with SSD, with boys demonstrating more serious articulation problems. The main error type of consonant is substitution, with blade-palatal/ch/having the highest occurrence of error. These results suggest the necessity of attending to preschoolers' articulation development. Phonological training targeting blade-alveolar/l/and blade-palatal/ch/should be carried out as early as possible.
目的： 了解语音障碍患儿辅音的特点，为临床评估及合理干预提供依据。 方法： 回顾性研究。选取2007年1月至2018年12月于首都儿科研究所附属儿童医院保健科语言-言语门诊诊断的语音障碍患儿1 395例为研究对象，以图片命名法在单词水平进行语音测查。采用χ2趋势检验分析不同年龄患儿不同发音部位辅音错误人数比例的差异及变化趋势，χ²检验比较不同性别患儿在不同发音部位辅音中错误人数比例的差异，并分析不同发音部位辅音的错误类型及不同年龄患儿的错误类型特点。 结果： 1 395例语音障碍患儿中男1 044例、女351例，年龄（5.1±0.8）岁。语音障碍患儿舌尖中音l的错误人数比例最高，为71.8%（1 002/1 395）；唇音b最低，为9.3%（130/1 395）。不同年龄组间比较，年龄越大唇音p和f、舌尖前音z和c及s、舌尖中音t和l、舌尖后音ch和r、舌根音k和h、舌面音q的错误人数比例越低（均P<0.05）；不同性别间比较，男童唇音b和m、舌尖前音z和c、舌尖中音n和l、舌尖后音sh、舌根音h、舌面音x的错误人数比例均高于女童［（10.3%（108/1 044）比6.3%（22/351）、11.4%（119/1 044）比6.0%（21/351）、64.8%（676/1 044）比51.9%（182/351）、67.8%（708/1 044）比59.8%（210/351）、16.7%（174/1 044）比8.8%（31/351）、73.7%（769/1 044）比66.1%（232/351）、58.0%（606/1 044）比47.6%（167/351）、24.0%（251/1 044）比14.2%（50/351）、39.9%（417/1 044）比27.6%（97/351），χ²=5.167、8.533、16.889、7.447、12.863、7.412、11.650、14.900、17.099，均P<0.05］；辅音的错误类型有替代、省略、歪曲，其中，舌尖中音l以省略为主［53.3%（743/1 395）］，舌根音h以歪曲为主［11.8%（165/1 395）］，其他辅音均以替代为主。在替代类型中舌尖后音ch的错误人数比例最高，为60.2%（840/1 395）。 结论： 语音障碍患儿辅音中舌尖中音l错误人数比例最高，男童的语音问题更为严重，替代是辅音的主要错误类型，在替代类型中舌尖后音ch的错误人数比例最高。应关注学龄前期儿童的语音发展，同时尽早开展舌尖中音l、舌尖后音ch的语音训练。.