Clinical risks indicators for the constitution of the speaking subject

PURPOSE: to propose clinical risk indicators of the constitution of the speaking subject. METHODS: from the risk indicators for child development and from the operating model of language symptoms, four axes were drawn that support the constitution of the speaking subject: the assumption of a speaking subject, recognition of the speaking subject, recognition of the significant and responsiveness of the speaker to the speech of the other. Parental information mentioned during speech therapy interviews of users of three Basic Health Units were grouped by similarity, classified, and analyzed according to each of the four axes of the constitution of the speaking subject. RESULTS: the analysis allowed us to establish twelve preliminary clinical indicators for the constitution of the speaker. These indicators point to a possibility that the subject might present speech and language disorders, supporting not only their intervention but also measures to promote the health of the speaker. CONCLUSION: the results suggest the importance of the speech therapist in the primary health care of the population and in promotional health measures.

## 研究目的（PURPOSE）：本研究旨在提出言说主体（speaking subject）建构的临床风险指标。
## 研究方法（METHODS）：本研究基于儿童发育风险指标与语言症状作用机制模型，梳理出支撑言说主体建构的四大维度：言说主体的身份确立、言说主体的辨识、关键言语要素的辨识，以及言说者对他者言语的响应性。随后，对三家基层卫生单元（Basic Health Units）的言语治疗（speech therapy）服务对象在访谈中由家长提及的相关信息，按相似度进行聚类、分类，并依据上述四大维度逐一开展分析。
## 研究结果（RESULTS）：本次分析最终确立了12项针对言说主体建构的初步临床风险指标。此类指标可提示个体存在言语与语言障碍的可能性，不仅可为临床干预提供依据，亦能为促进言说者健康的相关措施提供支撑。
## 研究结论（CONCLUSION）：本研究结果凸显了言语治疗师在人群初级卫生保健与健康促进措施中的重要价值。