언어발달지체를 동반한 말소리장애 아동의 음운인식능력 특성 비교

고정희(Junghui, Ko),황민아(Mina, Hwang),최경순(Kyungsoon, Choi) 단국대학교 특수교육연구소 2020 특수교육논총 Vol.36 No.3

연구목적: 본 연구는 언어발달지체를 동반한 말소리장애아동의 음운인식능력이 단순언어장애아동, 순수 말소리장애 아동 및 일반아동과 비교하여 어떠한 특성을 보이는지 확인하고자 함에 있다. 연구방법: 연구대상은 언어연령 5세 1개월에서 5세 11개월에 있는 언어발달지체 동반한 말소리장애 아동 9명, 단순언어장애 8명, 순수 말소리장애 아동 10명, 일반아동 10명의 총 37명 아동이었다. 아동들은 음절분리, 음절탈락, 음절대치, 음소변별, 음소대치의 음운인식과제를 각 8문항씩 총 40문항을 수행하였다. 연구결과: 음운인식과제 총점에서 일반아동 수행이 유의미하게 가장 높았고, 다음으로 순수 말소리장애가 높았다. 언어발달지체 동반 말소리장애아동이 가장 낮았으나 단순언어장애아동과 비교하여 유의미한 차이를 보이지는 않았다. 음운인식 과제유형에 따른 집단별 수행을 살펴본 결과 음절분리와 음절탈락에서만 언어발달지체 동반 말소리장애아동은 순수 말소리장애 아동보다 저조한 능력을 보였다. 결론: 언어발달지체 동반 말소리장애는 단순언어장애아동과 유사한 음운인식패턴을 보이며, 순수 말소리장애보다는 저조한 음운인식능력을 보이고 있으나, 그 차이는 음운인식과제 유형에 따라 다른 양상을 보임을 확인하였다. Purpose: This study sought to determine the characteristics of the phonological awareness of children with speech sound disorders accompanied by language impairments compared to children with pure speech sound disorders, children with a specific language impairment(SLI), and general children. Method: The subjects included 9 children with speech sound disorders accompanied by language impairments, 8 children with specific language impairment 10 children with pure speech sound disorders, and 10 general children(a total of 37). All children performed a total of 40 tasks, 8 phoneme discriminations, 8 phoneme substitutions, 8 syllable isolations, 8 syllable deletions, and 8 syllable substitutions. Results: the performance of the general children was significantly highest in the total score of the phonological awareness tasks at a significant level, followed by those with pure speech sound disorders. The scores of children with speech sound disorders accompanied by language impairment were the lowest, but there was no significant difference in their performance from that of children with SLI. As a result of examining the performance of each group according to the type of phonological awareness task children with speech sound disorders accompanied by language impairments showed poorer ability than children with pure speech sound disorders in syllable separation and syllable deletion. Conclusion: The results showed that children with speech sound disorders accompanied by language impairments showed a similar phonological awareness pattern to children with SLI, and showed poorer phonological awareness abilities than pure speech sound disorders, but the difference varied according to the type of phonological awareness task.

말소리장애 아동의 말명료도와 음향학적 측정치 간 상관관계

강은영 대한통합의학회 2018 대한통합의학회지 Vol.6 No.4

Purpose : This study investigated the correlation between speech intelligibility and acoustic measurements of speech sounds produced by the children with speech sound disorders and children without any diagnosed speech sound disorder. Methods : A total of 60 children with and without speech sound disorders were the subjects of this study. Speech samples were obtained by having the subjectsʼ speak meaningful words. Acoustic measurements were analyzed on a spectrogram using the Multi-speech 3700 program. Speech intelligibility was determined according to a listener's perceptual judgment. Results : Children with speech sound disorders had significantly lower speech intelligibility than those without speech sound disorders. The intensity of the vowel /u/, the duration of the vowel /ɯ/, and the second formant of the vowel /ɯ/ were significantly different between both groups. There was no difference in voice onset time between the groups. There was a correlation between acoustic measurements and speech intelligibility. Conclusion : The results of this study showed that the speech intelligibility of children with speech sound disorders was affected by intensity, word duration, and formant frequency. It is necessary to complement clinical setting results using acoustic measurements ​​in addition to evaluation of speech intelligibility. 목적: 본 연구에서는 말 평가에 주로 사용되는 청지각적인 방법인 말명료도 평가와 음향학적 연구 방법을 적용하여 말소리 장애 아동의 말명료도와 조음 특성을 알아보고 말명료도와 음향학적 측정치 간에 상관관계를 규명하고자 한다. 방법: 본 연구에 말소리 장애 아동과 정상 아동 총 60명이 참여하였다. 성별과 연령은 동일하게 일치시켰고, 말소리 자료는 그리보고 명칭말하기로 획득했다. Multi-speech 3700program을 이용하여 정량적 자료에대한 분석을 하였고 말명료도평가는 청지각적인 방법으로 이루어졌다. 통계는 SPSS v21로 처리하였다. 결과 : 말소리장애 아동의 말명료도는 정상아동에 비하여 통계적으로 유의미하게 낮았다. 모음/ㅜ/의 강도, 모음/으/의 길이, 모음/으/의 제 2포먼트는 집단 간에 유의미한 차이가 있었다. 그러나 발성개시시간은 집단 간에 유의미한 차이가 없었다. 말명료도는 모음 /ㅗ/와 /ㅜ/의 강도, 모음 /ㅓ/의 제 1포먼트, 모음/ㅜ/의 제 2포먼트, 모음/ㅡ/의 길이와 /ㅡ/가 어두첫음절에 위치한 단어의 전체 길이와 상관관계가 있었다. 결론 : 본 연구 결과로 말소리장애 아동의 말명료도는 강도, 모음의 길이, 포먼트 주파수에 영향을 받는다는 것을 확인할 수 있었다. 모음의 음향학적 측정치 간 상관관계가 있었다. 본 연구의 결과는 말소리 장애를 진단하고 언어치료 계획을 수립하는 데 효과적이며 언어치료 전후의 효과성을 판정하는 데 유용한 자료로 활용될 것으로 예측된다.

Classification of Subgroups of Children with Speech Sound Disorders: A Preliminary Study

피민경(Minkyeong Pi),하승희(Seunghee Ha) 한국언어청각임상학회 2020 Communication Sciences and Disorders Vol.25 No.1

배경 및 목적: 말소리장애 아동이 산출한 오류 형태를 기반으로 하위 유형을 나눈 언어학적 증상 모델을 사용하여 우리나라 말소리장애 아동의 하위 유형을 분류하였을 때 분포 경향성이 어떠한 지 알아보고 하위 유형 별로 말·언어 특성을 살펴보고자 하였다. 방법: 3-9세 말소리장애 아동 133명을 오류패턴의 발달성과 말 산출 오류의 일관성을 기준으로 조음장애, 음운지연, 일관적 음운장애, 비일관적 음운장애로 나누었다. 또한 말소리장애 하위 유형 별로 생활연령, 자음정확도, 수용 및 표현 어휘력에 차이가 있는지 살펴보았다. 결과: 말소리장애 아동 중 조음장애 아동이 30.08%, 음운지연 아동이 44.36%, 일관적인 음운장애 아동이 18.05%, 비일관적인 음운장애 집단이 7.52%로 나타났다. 말소리장애 하위 유형에 따라 연령 분포에 유의한 차이가 있었으며 조음장애 아동의 생활연령이 다른 집단에 비해 유의하게 높았다. 말 심각도는 일관적, 비일관적 음운장애 아동이 조음장애와 음운지연 아동에 비해 유의하게 높았다. 수용 및 표현어휘력은 말소리장애 하위 유형 간 차이가 나타나지 않았다. 논의 및 결론: 본 연구는 우리나라 말소리장애 아동을 말 오류 특성을 바탕으로 하위 유형을 분류하였다. 이는 말소리장애 아동을 정확하게 감별 진단하고 유형 별 특성에 맞는 효과적인 중재를 제공하기 위한 기반이 될 것이다. Objectives: The purpose of this study is to examine the distribution tendency when classifying subgroups of children with speech sound disorders according to linguistic symptomatology, which are divided into subtypes of speech sound disorders based on the error patterns and inconsistency. Methods: Based on the error patterns and consistency of speech production, 133 children aged 3-9 years were divided into 4 groups; articulation disorder, phonological delay, consistent phonological disorder, and inconsistent phonological disorder. In addition, we examined the differences in age, percentage of consonants correct, and vocabulary by subgroups of speech sound disorders. Results: The results showed that of 133 children, 30.08% had an articulation disorder, 44.36% had a phonological delay, 18.05% had a consistent phonological disorder, and 7.52% had an inconsistent phonological disorder. There was a significant difference in age distribution according to subgroups of speech sound disorders, and age of children with articulation disorder was significantly higher than other groups. Speech severity was significantly higher in children with consistent and inconsistent phonological disorders than in children with articulation disorders and phonological delays. Receptive and expressive vocabulary did not differ between subgroups of speech sound disorders. Conclusion: This study examined linguistic symptomatology for differential diagnosis. This will be the basis for accurate differential diagnosis of children with speech sound disorders and provide effective interventions for each subgroups.

취학전 일반아동과 말소리장애 아동의 내면적 특성과 정서행동 비교

허은지,허명진 한국청각언어장애교육학회 2022 한국청각·언어장애교육연구 Vol.13 No.1

The purpose of this study is to compare and examine the internal characteristics and emotional behaviors of children with speech sound disorder and general children. The subjects of this study were 20 preschool children and 20 children with speech sound disorder. In order to examine the internal characteristics of the child, self-esteem, self-efficacy, and communication attitude were directly performed on the child, and internalized problem behavior and externalized problem behavior were performed on the parents to examine emotional behavior. As a result of the study, first, the self-esteem and self-efficacy of the general children were higher than the children with speech sound disorder, and the communication attitude was significantly lower. Second, internalization/externalization problem behaviors were significantly lower in general children than in children with speech sound disorder. Third, looking at the subdomains of internalization problem behavior, the emotional reactivity and atrophy of general children were lower than those of children with speech sound disorder. For externalizing problem behaviors, it was found that children with speech sound disorder had higher aggressive behaviors. As a result of these studies, it will be necessary to provide appropriate education and environment so that children in the developmental process can form proper social relationships. 본 연구는 일반 아동과 말소리장애 아동의 내면적 특성과 정서행동을 비교하여 살펴보고자 하였다. 연구 대상은 취학전 일반아동 20명, 말소리장애 아동 20명을 대상으로 하였으며, 아동의 내면적 특성을 살펴보기 위해 자아존중감과 자아효능감, 의사소통태도를 아동에게 직접 실시하였고, 정서행동을 살펴보기 위해 내재화․외현화된 문제행동을 부모에게 실시하였다. 연구 결과 첫째, 일반아동이 말소리장애 아동보다 자아존중감과 자기효능감이 높았으며, 의사소통태도는 유의미하게 낮았다. 둘째, 내재화․외현화 문제행동은 일반아동이 말소리장애 아동보다 유의미하게 낮았다. 셋째, 내재화 문제행동의 하위 영역을 살펴보면 일반아동이 말소리장애 아동보다 정서적 반응성과 위축이 낮았다. 외현화 문제행동은 말소리장애 아동이 공격행동이 높은 것으로 나타났다. 이러한 연구결과로 발달과정에 있는 아동에게 올바른 사회적 관계를 형성할 수 있도록 적절한 교육과 환경을 제공할 필요가 있을 것이다.

Phonemic Awareness Assessment of Children With and Without Speech Sound Disorders: A Comparison Study

Donna Thomas,Dee M. Lance,Jacqueline L. Rainey 한국언어재활사협회 2018 Clinical Archives of Communication Disorders Vol.3 No.2

Purpose: When assessing phonemic awareness (PA) ability, tasks that require verbal (oral) responses are often used. If verbal (oral) answers contain speech sound errors, it may be difficult for the evaluator to determine accuracy of PA skill. The present study aimed to investigate the relationship between speech sound production and PA in first and second grade children with and without speech sound disorders (SSD) using a nonverbal (non-oral) response format. Methods: Thirty children with SSD (M age=7;3; SD=0.6) and 30 children with typical development (TD) (M age=7;3; SD=0.6) were given measures of speech sound production and phonemic awareness. Two measures of PA were administered: (1) a static assessment of phoneme deletion that required a verbal (oral) response and (2) a dynamic assessment of phoneme deletion that did not require a verbal (oral) response. Results from the two PA tasks and a speech sound production measure were compared. Results: Results showed that performance on measures of speech sound production and PA were significantly correlated (r=0.59) and a strong correlation between a verbal (oral) measure of phoneme deletion and a nonverbal (non-oral) measure of phoneme deletion using a dynamic format (r=−0.75). Children with SSD scored more poorly than did the TD children on PA skills (p<0.01). Conclusions: This study strengthens the findings of other researchers who found significant correlations between speech sound production and PA and that children with SSD have more difficulties with PA skills than TD children.

말소리장애 아동의 단어와 자발화 문맥의 음운오류패턴 비교

박가연(Park, kayeon),김수진(Kim, Soo-Jin) 한국음성학회 2015 말소리와 음성과학 Vol.7 No.3

This study was aim to compare the phonological error patterns and PCC(Percentage of Correct Consonants) derived from the single word and spontaneous speech contexts of the speech sound disorders with unknown origin(SSD). The present study suggest that the development phonological error patterns and non-developmental error patterns of the target children, in according to speech context. The subjects were 15 children with SSD up to the age of 5 from 3 years of age. This research use 37 words of APAC(Assessment of Phonology & Articulation for Children) in the single word context and 100 eojeol in the spontaneous speech context. There was no difference of PCC between the single word and the spontaneous speech contexts. Significantly different developmental phonological error patterns between the single word and the spontaneous speech contexts were syllable deletion, word-medial onset deletion, liquid deletion, gliding, affrication, fricative other error, tensing, regressive assimilation. Significantly different non-developmental phonological error patterns were backing, addtion of phoneme, aspirating. The study showed that there was no difference of PCC between elicited single word and spontaneous conversational context. And there were some different phonological error patterns derived from the two contexts of the speech sound disorders. The more important interventions target is the error patterns of the spontaneous speech contexts for the immediate generalization and rising overall intelligibility.

소아의 말소리 장애

김성태 대한이비인후과학회 부산,울산,경남 지부회 2019 임상이비인후과 Vol.30 No.2

Background and Objectives:Speech-sound disorders (SSD) in children is a complex behavioral disorder characterized by speech-sound production errors associated with deficiencies in articulation, phonological pro- cesses, and cognitive language processes. SSDs are widespread in childhood and are accompanied by language disorders, spelling and reading disorders, or dyslexia. The purpose of this study was to investigate the causes, diagnosis and treatment of SSD in children during developmental stages. Causes:The cause of the SSD is in- creasing research suggesting a genetic cause, and various genetic effects may work in the acquisition process. Similar cognitive linguistic bases of SSD and dyslexia suggest that they share a genetic etiology. Diagnostic Evaluation:The screening test is a test that identifies a simple question within 5 minutes by mechanical utter- ance, saying a word with a developmental phoneme, selecting a word, and looking at a picture. The deepening test is a secondary test for the purpose of collecting information related to speech therapy, conducts spontane- ous sample analysis and evaluates speech errors according to various phonological environments. Treat- ments:The treatment of SSD in children can be divided into speech therapy and phonological therapy. In par- ticular, the clinician should first treat the speech of the child’s speech during the SSD treatment that has a stimulus response. Conclusions:How to solve the SSD in children will be able to solve the speech problem by various research efforts and cooperation of the relevant clinicians.

Visual and Auditory Sustained Attention in Children with Speech Sound Disorders with and without Comorbid Language Disorders

Mi-Jin Joo(주미진),Ji-Wan Ha(하지완) 한국언어청각임상학회 2018 Communication Sciences and Disorders Vol.23 No.2

배경 및 목적: 본 연구에서는 순수 말소리장애 아동, 언어장애를 동반한 말소리장애 아동, 일반 아동을 대상으로 시각과 청각의 자극 양식에 따른 지속주의과제 수행력을 비교하고, 수용어휘량, 표현어휘량, 자음정확도와 지속주의 수행력과의 상관관계를 살펴보았다. 방법: 연구대상자는 6세 말소리장애 아동 20명(순수 말소리장애 10명, 언어장애 동반 말소리장애 10명)과 일반 아동 20명이었다. E-Prime 소프트웨어로 숫자자극을 이용하여 시각적 및 청각적 지속주의과제를 제작하였다. 대상자들에게 개별적으로 실험을 진행한 후, 지속주의 정반응 점수와 반응시간을 측정하였다. 결과: 순수 말소리장애 집단과 언어장애 동반 말소리장애 집단은 일반 집단에 비해 지속주의과제의 정반응 점수가 유의하게 낮았다. 언어장애 동반 말소리장애 집단의 경우 반응시간도 일반 집단보다 유의하게 느렸다. 자극 양식에 따른 정반응 점수의 차이는 유의하지 않았으나, 반응시간에서는 집단에 상관없이 시각 과제가 청각 과제보다 유의하게 빨랐다. 일반 집단에서는 지속주의 수행력과 수용어휘량, 표현어휘량, 자음정확도 간 유의한 상관관계가 관찰되지 않았으나, 말소리장애 집단의 경우 자음정확도는 시각과 청각 지속주의과제의 정반응 점수와, 표현어휘량은 청각 지속주의과제의 정반응 점수와 유의하게 상관이 있었다. 논의 및 결론: 본 연구결과는 말소리장애와 관련한 요인으로 지속주의 결함의 가능성을 시사하고 있으며, 말소리장애 아동의 자음정확도 및 표현어휘 발달과 주의력 간 관련성을 제시하고 있다. Objectives: Although research has demonstrated that children with specific language impairment and reading disorders exhibit sustained attention deficits, there have been few studies about sustained attention in children with speech sound disorders. This study investigated the performance of children with pure speech sound disorders (pure SSD), children with speech sound disorders and comorbid language disorders (SSD+LD), and typically developing (TD) peers on visual and auditory sustained attention tasks. Methods: Both visual and auditory tasks were used to assess sustained attention in 20 6-year-old children with SSD (10 pure SSD, 10 SSD+LD) and 20 TD age-matched controls. The accuracy score and response time were analyzed, and the correlation among receptive and expressive vocabulary sizes, accuracy of articulation, and performance of tasks was examined. Results: The pure SSD group and SSD+LD group performed significantly worse on both visual and auditory tasks than the TD group. The response time of the SSD+LD group was significantly slower on both tasks than the TD group. The response time of the auditory task was significantly slower than that of the visual task in all groups. In the SSD group, the correlation between the accuracy of articulation and visual/auditory sustained attention, and the correlation between expressive vocabulary size and auditory sustained attention were significantly positive. Conclusion: Children with SSD with and without LD have reduced attention skills that could contribute to speech sound learning. These results suggest that attention difficulties could be one of the underlying factors of the speech sound impairment in children with SSD.

Exploring the Utility of Speech Intelligibility Rated by Parents for Screening Children with Speech Sound Disorders

이영미(Young mee Lee) 한국언어청각임상학회 2018 Communication Sciences and Disorders Vol.23 No.1

배경 및 목적: 본 연구에서는 부모 평정 말명료도 점수와 표준화된 발음평가의 자음정확도 간에 유의한 상관이 있는지를 살펴보고, 부모 평정 말명료도 척도가 말소리장애 아동과 일반 아동을 선별하는 데 유용한 도구가 될 수 있는지를 알아보고자 하였다. 방법: 생활연령이 만 4-6세의 일반 아동 55명과 말소리장애 아동 23명의 부모를 대상으로 말명료도 척도를 이용하여 자녀의 말명료도를 평정하게 하였으며, 대상 아동에게는 표준화된 아동용 발음평가(APAC)를 실시하여 자음정확도를 산출하였다. 결과: 상관분석 결과, 두 집단 모두에서 부모 평정 말명료도 점수와 자음정확도 간에 유의한 상관을 보였다. 로지스틱 회귀분석 결과, 부모가 평정한 말명료도 점수는 일반 아동과 말소리장애 아동을 분류하는 데 유의한 변수로 나타났다. 논의 및 결론: 본 연구를 통해 부모가 평정하는 말명료도 척도가 말소리장애 아동을 조기에 선별하는 데 유용한 도구로 활용될 수 있다는 것을 확인하였다. Objectives: It is important to find earlier measures for identify speech sound disorder (SSD) in the clinical setting. This study examined the relationships among chronological age, percentage of consonants correct (PCC) and speech intelligibility rated by parents for each group, and investigated whether a speech intelligibility scale rated by parents can be a useful tool to distinguish children with SSD from children with typical speech development (TSD). Methods: A total of 78 children (55 children with TSD, 23 children with SSD) and their parents participated in this study. Parents rated their child’s speech intelligibility with the intelligibility in context scale. A speech-language pathologist evaluated the children’s speech production skills by using a standardized articulation test and analyzed the PCC of all children. Results: Speech intelligibility scores were significantly correlated with PCC in both groups (all ps<.05). In the logistic regression analysis, speech intelligibility rated by parents was a significant predictor for differentiating between the two groups (β=-.350, p< .001). Conclusion: A speech intelligibility scale rated by parents can be a useful tool in differentiating between children with SSD and children with TSD.

말소리장애와 주의력결핍/과잉행동장애 동반 여부에 따른 언어 및 문해 능력 차이: 학령전 6세 아동을 대상으로

이은주 한국언어청각임상학회 2023 Communication Sciences and Disorders Vol.28 No.4

Objectives: This study analyzed the differences in language and literacy skills in the groups (None, SSD, ADHD, and SSD+ADHD) classified according to the comorbidity of Speech Sound Disorder (SSD) and Attention Deficit/Hyperactivity Disorder (ADHD). Methods: The Korean Children’s Panel Study (PSKC) conducted SSD and ADHD screening tests on 1,489 6-year-old preschoolers. In this study, cross-analysis was conducted by dividing the two disability groups into Absent and Present to measure the significance of the degree of accompanying disability. In addition, multivariate covariance analysis (MANCOVA) was conducted using intelligence as covariance as the result of scoring language and literacy skills of the four groups (None, SSD, ADHD, and SSD+ADHD). Results: First, through the results of this study, it was confirmed that SSD and ADHD are significantly more likely to be comorbid. Second, both children with SSD and those with ADHD had significantly lower language skills than Typically Developing children. Third, there was a difference in the detailed items of the SSD and ADHD group literacy. A notable distinction between the two groups is that the ADHD group had a higher rate of writing problems. Fourth, the comorbidity of SSD and ADHD showed different characteristics from None, SSD, and ADHD in reasoning areas such as “predicting the next story”. Conclusion: Speech problems that receive a lot of attention in preschool age childhood should be able to be interpreted and diagnosed in relation to problems with language development and language learning delays in school age children. From this point of view, this study is expected to serve as a basic study on the early diagnosis of language academic ability development.