경직형 뇌성마비 아동의 저작 능력과 자모음 조음 특성 간의 상관관계

이경민(Kyung min Lee),나동욱(Dong wook Rha),최예린(Yae lin Choi),김향희(Hyang hee Kim) 한국언어치료학회 2016 한국언어치료학회 학술발표대회 논문집 Vol.2016 No.12

Purpose: The purpose of this study was to investigate the relationship between chewing ablilty and articulation ability of children with spastic cerebral palsy. Children with cerebral palsy are more likely to be associated with eating disorders and speech disorders, and consideration of the related oral mechanisms is essential. METHODS: Thirteen subjects with rigid cerebral palsy, aged 7-12 years, underwent an assessment of eating disorder and articulation ability. Eating disorders (food, water, yogurt, tofu, snack) were evaluated by evaluating the eating ability. In the case of articulatory ability, the APAC test was conducted to measure the articulation accuracy of 37 words and the extended vocalization task was performed to determine the spatial area of the short vowel (/i/, /æ/, /ɑ/, /u/), and diphthong (/ja/, /jə/, /jo/, /ju/) F2 slope were measured. Results: There was a strong correlation between chewing ability and total articulation accuracy. Between the accuracy of articulation of the bilabial and the movement of the lips, and between the movement of the tongue and accuracy of articulation of alveolar sound were also correlated. There was a significant correlation between chewing ability and vowel space area. The movement of lips, vowel space area, jaw movement and vowel space area were also significantly correlated. The chewing ability correlated with the F2 slope of the diphthong. There was a significant correlation between the transition period of the bipolar /yeo/ yo / yu/ and the total score of the eating disorder, and there was a correlation between the transition period of bipolar /yo/ /yu/. CONCLUSION: Eating function belonging to pre-speech is one of the predictors of speech intelligibility and it is meaningful that early intervention is possible by predicting the ability of articulation based on early feeding ability .

‘ASHA 의사소통 삶의 질 척도’의 한국어판 번안

최혜윤(Hye-Yoon Choi),김용욱(Yong-Wook Kim),나동욱(Dong-Wook Rha),김향희(HyangHee Kim) 한국언어청각임상학회 2011 Communication Sciences and Disorders Vol.16 No.3

배경 및 목적: 의사소통능력은 심리사회적 적응 및 타인과의 상호작용에 필수적이다. 본 연구에서는 의사소통 삶의 질 척도(Quality of Communication Life Scale: QCL, 이하 QCL)를 우리말로 번안하고 신뢰도와 타당도를 검증하고자 청각장애 및 정상청력 청소년에게 시행하였다. 방법: 대상자로는 언어치료를 받고 있거나 농학교에 재학 중인 만 13~18세의 청각장애청소년 90명, 그리고 이들과 성별 및 연령을 일치시킨 정상청력 청소년 180명을 포함하였다. QCL과 PedsQL을 실시한 후 비교하고, 문항 내적일관성과 검사-재검사 신뢰도, 내용타당도, 대면타당도, 공인타당도 및 내적 구성타당도를 산출하였다. 결과: 두 집단 사이에 의사소통 관련 삶의 질의 유의한 차이가 있었다. 또한 QCL은 높은 문항 내적일관성 신뢰도를 지니고 있으며, 의사소통 관련 삶의 질을 측정하는데 높은 타당도를 보여 의사소통 관련 삶의 질 평가도구로서 매우 유용한 도구임을 알 수 있었다. 논의 및 결론: 본 연구는 QCL을 우리말로 타당하게 번안하고 검증하여 국내에서 사용할 수 있는 도구로 제시하였다는데 의의가 있다. 앞으로 QCL을 다양한 의사소통장애 집단을 대상으로 실시하여 QCL이 치료 및 중재 계획과 목표 설정에 도움이 되고, 나아가 언어치료를 통해 의사소통 관련 삶의 질을 증진하는데 이바지하기를 기대해 본다. Background & Objectives: Communication skills are required for interacting with others and for psychosocially adapting to society. Therefore, the Quality of Communication Life Scale (QCL) was adapted from the English version and was implemented on adolescents with hearing impairment and normal hearing in order to verify its validity and reliability. Methods: In the study, 90 adolescents with hearing impairment in the ages between 13 and 18 who were enrolled in a school for the deaf or who were recieving speech therapy were assessed wirh the QCL and the PedsQL. Some of the adolescents were also receiving speech therapy. An additional 180 subjects with normal hearing within the same age range and similar gender factors were also assessed as a control group. The outcomes of the QCL and the PedsQL were compared between the two groups, and test-retest reliability, content validity, face validity, concurrent validity, and interconstruct validity were measured. Results: There were significant differences between the two groups in quality of communication life. Further, the QCL explained high inter-relations for each question and high test-retest reliability. The test was also determined to be a highly valid assessment tool for measuring quality of communication life. Discussion & Conclusions: This study is significant in that it illustrates the validity of adapting the QCL into a Korean version. Future research should be directed at applying the Korean version to various communication disorders and age groups.

중증도에 따른 경직형 뇌성마비 아동의 조음교대운동속도 과제 수행력

양지아(Ji A Yang),박은숙(Eun Sook Park),김향희(Hyang Hee Kim),나동욱(Dong Wook Rha) 한국언어치료학회 2010 言語治療硏究 Vol.19 No.1

Children with cerebral palsy (CP) demonstrate a lack of range in, strength of, and rate of movements and coordination because they feel it is hard to control the muscles for respiration, phonation, resonance, and articulation. Diadochokinetic tasks that involve fast repetitions of meaningless syllables evaluate oromotor abilities and coordination skills. The result of diadochokinetic tasks depends on the severity of cerebral palsy. Thus, this study separates severity by GMFCS, which is developed for the objective evaluation of motor disorders of children with cerebral palsy and examines the performance of AMR and SMR. The average age of the 31 spastic cerebral palsied children was five years and five months of age. The types of CP and GMFCS were based on medical records; subjects consisted of 21 diplegic, 7 hemiplegic, 2 quadriplegic, and 1 triplegic types. Children with cerebral palsy (CP) demonstrate a lack of range in, strength of, and rate of movements and coordination because they feel it is hard to control the muscles for respiration, phonation, resonance, and articulation. Diadochokinetic tasks that involve fast repetitions of meaningless syllables evaluate oromotor abilities and coordination skills. The result of diadochokinetic tasks depends on the severity of cerebral palsy. Thus, this study separates severity by GMFCS, which is developed for the objective evaluation of motor disorders of children with cerebral palsy and examines the performance of AMR and SMR. The average age of the 31 spastic cerebral palsied children was five years and five months of age. The types of CP and GMFCS were based on medical records; subjects consisted of 21 diplegic, 7 hemiplegic, 2 quadriplegic, and 1 triplegic types.

Protein C 결핍에서 발생한 소모성 응고질환으로 인한 뇌내출혈로 야기된 뇌성마비 환자에 대한 증례기록

조유나(Yoo na Cho),이영목(Young Mock Lee),박은숙(Eun Sook Park),최자영(Ja Young Choi),박천웅(Chun ung Park),나동욱(Dong wook Rha) 대한소아신경학회 2017 대한소아신경학회지 Vol.25 No.1

Protein C는 응고인자 Va와 VIIIa를 비활성시키는 항응고 인자로써 PROC 결핍은 매우 희귀한 질환으로 열성유전이 되며 다양한 혈전성 또는 허혈성 질환을 일으킬 수 있는 것으로 알려져 있다. 심한 경우에는 소모성 응고병증 상태를 야기시켜 사망에 이르게 할 수도 있다. 우리는 본 논문을 통하여 합성이질접합형(compound heterozy gous)으로 유전된 PROC 결핍 환자에서 소모성 응고병증으로 인한 출혈성 뇌졸중 환아 두 명을 기술하였고, 진단검사와 유전자검사, 뇌 자기공명영상 이미지와 기능적 상태를 함께 분석하였다. 또한 PROC 결핍 환자에서 발생할 수 있는 합병증 중 전격성 자반 피부병변을 소개하여 항응고인자 투약치료로 인하여 발생가능한 혈종과 구별이 필요함을 소개하고자 하였다. Protein C (PROC) is a potent anticoagulant inactivating coagulation factors Va and VIIIa. PROC deficiency is very rare condition inherited as an autosomal dominant or recessive trait, and associated with various thromboembolic and ischemic conditions. Moreover, severe form of PROC deficiency can cause fatal hemorrhagic complications due to consumptive coagulopathy. We reported two children with hemorrhagic stroke who were diagnosed as severe PROC deficiency caused by two different types of compound heterozygous PROC gene mutations. We described results of laboratory tests, genetic analysis, brain magnetic resonance images, and functional outcomes. Both children received prophylactic anticoagulation therapy and presented with purple-colored skin lesions during rehabilitation. Purpura fulminans caused by insufficient anticoagulation should be differentiated from hematoma caused by excessive anticoagulation therapy in these children.