연인두폐쇄부전 아동의 낱말과 자발화수준에서 나타난 보상조음 출현율 비교 = A Comparison of Compensatory Articulation Appearance Rate between Single Word Test and Connected Speech Test for Children with Velopharyngeal Insufficiency

국문 초록 (Abstract)

배경 및 목적: 보상조음은 말 명료도를 저하시킬 뿐만 아니라 말 산출에 필요한 연인두의 정상적인 움직임을 방해한다. 보상조음을 치료하기 위해서는 이에 대한 정확한 청지각적 평가가선행되어야 한다. 본 연구에서는 연인두폐쇄부전으로 인해 보상조음을 하는 구개열 아동을대상으로 낱말검사와 자발화검사를 실시하여 두 검사 간에 보상조음 출현율에서 어떠한 차이를 보이는지 알아보고자 한다. 방법: 연인두폐쇄부전이 있고 주요 조음문제가 보상조음이며,만 3세-7세인 아동 10명을 대상으로 하였다. 임상현장에서 주로 사용하는 조음검사도구를본 연구에 맞게 수정하여 낱말수준의 말 표본을 얻고, 놀이를 통해서 아동의 자발화 표본을얻었다. 각각의 말 표본을 조음위치별？조음방법별？음소별로 분류하여 보상조음 출현율을분석하였다. 결과: 구개열 아동들은 낱말검사보다 자발화검사에서 더 높은 보상조음 출현율을보였고, 그 차이가 통계적으로 유의미하였다. 조음방법별 보상조음 출현율의 검사간 비교에서는 파열음과 파찰음, 조음위치별 보상조음 출현율의 검사간 비교에서는 경구개음과 연구개음의 보상조음 출현율이 두 검사 사이에서 유의미하게 차이를 보였다. 음소별 보상조음 출현율의 검사간 비교에서는 경음의 보상조음 출현율이 낱말검사와 자발화검사 모두에서 다른 말소 리에 비하여 높은 보상조음 출현율을 나타냈다. 논의 및 결론: 구개열 아동의 보상조음을 평가할 때에는 낱말검사뿐만 아니라 자발화검사를 통해서 얻은 말 표본으로 보상조음을 평가하는것이 필요하다는 것을 알 수 있었다

다국어 초록 (Multilingual Abstract)

Background & Objectives: The purpose of the present study is to investigate whether children with velopharyngeal insufficiency due to cleft palate produce compensatory articulation at a different rate depending on the type of speech task. Specifically, we compared their frequencies of compensatory articulation in a single word production test and in connected speech. Methods: The participants were ten children with velopharyngeal insufficiency of ages ranging from 3 to 7 and their main articulation problem was compensatory articulation. Cleft type, the time of surgery, and the method of primary palatal surgery were not controled. A single word production task was generated by adjusting three formal articulation tests. Each child was tested with the single word production task and was asked play with the examiner to obtain connected speech. The rate of compensatory articulation was calculated from the two types of speech samples. The occurrence of compensatory articulation was analyzed according to the manner and the place of articulation. Results: In terms of the total number of compensatory articulation, the children with velopharyngeal insufficiency exhibited significantly higher rate of compensatory articulation during connected speech relative to single word production. Further analysis based on the manner and the place of articualtion revealed that such difference was observed only in some specific types of phonemes. The children produced compensatory articulation more frequently in connected speech than in single word production, when they produced velar stops and affricates which are all palatal in Korean. Discussion & Conclusion: Based on the findings of the present study, it is recommended to obtain connected speech as well was single word production in order to evaluate compensatory articulation of children with cleft palate. It is also suggested that for planning effective intervention of compensatory articulation, an in-depth analysis of compensatory articulation is necessary rather than a binary analysis procedure such as percent correct consonant. In addition, a list of words oriented to pressure consonants needs to be developed for more efficient assessment of compensatory articulation.

목차 (Table of Contents)

• Ⅰ. 서 론
• Ⅱ. 연구 방법
• Ⅲ. 연구 결과
• Ⅳ. 논의 및 결론

참고문헌 (Reference)

1 김민정, "아동용 발음평가(APAC)" 휴브알엔씨 2007

2 Willadsen, E., "Phonetic description of babbling in Danish toddlers born with and without unilateral cleft lip and palate" 43 (43): 189-200, 2006