실어증 환자의 생성이름대기 능력과 작업기억용량과의 관계

성지은(Jeeeun Sung),최현미(Hyonmi Choi) 한국언어치료학회 2014 言語治療硏究 Vol.23 No.2

Purpose: The purpose of the present study was to investigate the relationship between working memory capacity and clustering and switching abilities in generative naming of persons with aphasia. Methods: Fourteen healthy adults and 12 persons with aphasia were administered the semantic fluency tasks (animal, market) and the phonemic fluency tasks (‘ㄱ’, ‘ㅇ’, ‘ㅅ’). Digit Forward (DF) and Word Forward (WF) pointing tasks were administered as short-term memory (STM) tasks, while Digit Backward (DB) and Word Backward (WB) pointing tasks served as working memory (WM) tasks. The number of correctly generated words, mean cluster size, the number of clustering, and the number of switching served as dependent measures. Results: For the semantic fluency tasks, there were significant differences between the groups in the number of clustering, the number of switching, and the number of correctly generated words. For the phonemic fluency tasks, group differences were observed in the number of correctly generated words, mean cluster size, the number of clustering and the number of switching. WM was significantly and positively correlated with the number of generated words, mean cluster size, the number of clustering and the number of switching in phonemic fluency for normal controls. In persons with aphasia, WM was significantly correlated with the number of correctly generated words and the number of clustering in semantic fluency, and with the number of correctly generated words, mean cluster size, the number of clustering and the number of switching in the phonemic fluency. Conclusions: The results revealed that persons with aphasia have deficits in searching for generation strategies which is important in generating words independent of semantic systems and phonological processes. The qualitative analyses including clustering and switching components in generative word naming tasks is useful to provide the additionally important information about the cognitive aspects of generating words in persons with aphasia.

청자의 경험, 화자의 조음 중증도, 단서 유형이 인공와우이식 선천성 농 성인의 말명료도에 미치는 영향

이영미(Lee YoungMee),성지은(Sung JeeEun),박정미(Park JeongMi),심현섭(Sim HyunSub) 한국음성학회 2011 말소리와 음성과학 Vol.3 No.1

The current study investigated the effects of experience of deaf speech, severity of speaker’s articulation, and linguistic cues on speech intelligibility of congenitally deafened adults with cochlear implants. Speech intelligibility was judged by 28 experienced listeners and 40 inexperienced listeners using a word transcription task. A three-way (2 × 2 × 4) mixed design was used with the experience of deaf speech (experienced/inexperienced listener) as a between-subject factor, the severity of speaker’s articulation (mild to moderate/moderate to severe), and linguistic cues (no/phonetic/semantic/combined) as within-subject factors. The dependent measure was the number of correctly transcribed words. Results revealed that three main effects were statistically significant. Experienced listeners showed better performance on the transcription than inexperienced listeners, and listeners were better in transcribing speakers who were mild to moderate than moderate to severe. There were significant differences in speech intelligibility among the four different types of cues, showing that the combined cues provided the greatest enhancement of the intelligibility scores (combined > semantic > phonological > no). Three two-way interactions were statistically significant, indicating that the type of cues and severity of speakers differentiated experienced listeners from inexperienced listeners. The current results suggested that the use of a combination of linguistic cues increased the speech intelligibility of congenitally deafened adults with cochlear implants, and the experience of deaf speech was critical especially in evaluating speech intelligibility of severe speakers compared to that of mild speakers.

뇌성마비로 인한 마비말장애 성인의 자음 오류 분석

이영미(Lee, Youngmee),성지은(Sung, JeeEun),심현섭(Sim, HyunSub) 한국음성학회 2013 말소리와 음성과학 Vol.5 No.1

The aim of this study was to analyze consonant articulation errors produced by 90 speakers with cerebral palsy (CP). Phonetic transcriptions were made for 37 single-word utterances containing 70 phonemes: 48 initial consonants and 22 final consonants. Errors of substitution, omission, and distortion were analyzed using a confusion matrix paradigm showing the visualization of error patterns. Results showed that substitution errors in initial and final consonants were most frequent, followed by omission and distortion. Consonant omission occurred more frequently on final consonants. In both initial and final consonants, the within-place errors were more prominent than the within-manner errors. The current results suggest that consonant confusion matrices for dysarthric speech may provide useful information for evaluating speech intelligibility and developing automatic speech recognition system of adults with CP associated dysarthria.

의미범주기반 작업기억 중재가 실어증환자의 문장이해 및 단어유창성에 미치는 일반화 효과

손희정(HeeJeong Son),성지은(JeeEun Sung) 한국언어청각임상학회 2016 Communication Sciences and Disorders Vol.21 No.1

본 연구는 실어증환자를 대상으로 의미범주기반 작업기억 중재를 실시하여 작업기억과 문장이해 및 단어유창성으로의 일반화 효과를 알아보고자 하였다. 실어증환자는 뇌손상으로 인해 인지 및 언어장애가 나타나며, 작업기억은 언어 및 인지 관련 과제를 처리하는 데 있어 정보를 유지하는 동시에 정보의 조작 및 수행에 관여하는 근본적인 기제로 연구되어 왔다. 이에 본 연구는 이러한 작업기억이론에 근거하여 의미범주기반 작업기억 중재를 개발하여 그 효과를 검증하고자 한다. 방법: 실어증환자 7명을 대상으로 6-8주에 걸쳐서 주 2-3회 중재를 실시하였고, 사전•사후 평가를 포함하여 총 16회기 동안 진행되었다. 의미범주기반 작업기억 중재는 특정 작업기억 과제를 반복하는 동안 순차적으로 단서가 제공되는 중재 프로토콜이다. 결과: 중재 작업기억 과제의 단어폭이 통계적으로 유의한 증가를 보였고, 비중재 작업기억 과제에서는 단어 바로 따라말하기 과제에서만 유의한 증가를 보였다. 문장이해과제 정확도와 단어유창성 과제 중 동물 범주유창성 과제에서 유의미한 증가를 보였다. 논의 및 결론: 의미범주기반 작업기억 중재가 비중재 작업기억 과제와 음소유창성 과제로의 일반화 효과는 제한적이었으나 중재 작업기억 과제와 문장이해, 범주유창성 과제로의 중재 및 일반화 효과를 나타냈다. 의미범주기반 작업기억 중재는 실어증의 근본적인 기제와 관련된 인지과정인 작업기억을 촉진하여 언어능력으로 확장하는 중재기법으로 다양한 유형의 실어증환자를 대상으로 작업기억뿐 아니라 언어능력의 향상을 가져올 수 있다는 점에서 의미가 있다. Objectives: The purpose of this study was to examine the generalization effect of semantic category-based working memory (SCWM) treatment on sentence comprehension and word fluency in persons with aphasia. It was predicted that SCWM treatment would en¬hance working memory capacity and increase sentence comprehension ability and word fluency in patients with aphasia. Methods: Seven Korean individuals with mild to moder¬ate aphasia caused by left hemisphere stroke participated in this study. The interventions were provided in 16 sessions, approximately half an hour per day 2 to 3 times a week. Treat¬ment protocol consisted of an SCWM span task and 4 cues: telling a word list to the partici¬pants, showing the participants category cards, showing the participants random word cards, and asking the participants to match category and word cards. A pretest-posttest design was used. Pre-post comparisons were analyzed with the Wilcoxon signed-ranks test. Results: There were significant score increases in the SCWM span task. Furthermore, the SCWM treatment effects were generalized to sentence comprehension ability, categor¬ical word fluency, and working memory span with word forward repetition tasks. Conclu¬sion: The current study suggests that SCWM treatment is effective in enhancing working memory capacity for people with aphasia. Furthermore, the treatment effects were gener¬alized to sentence comprehension ability and categorical word fluency in these patients. The results indicate that working memory is an underlying mechanism associated with sentence comprehension and categorical word fluency and is a critical factor to be consid¬ered in language treatment for persons with aphasia.

소음 유형과 신호대잡음비가 마비말장애인의 말명료도에 미치는 영향

이영미(Lee YoungMee),심현섭(Sim HyunSub),성지은(Sung JeeEun) 한국음성학회 2011 말소리와 음성과학 Vol.3 No.4

This study investigated the effects of the types of noise and signal to noise ratios (SNRs) on speech intelligibility of an adult with dysartrhia. Speech intelligibility was judged by 48 naive listeners using a word transcription task. Repeated measures design was used with the types of noise (multi-talker babble/environmental noise) and SNRs (0, +10 ㏈, +20 ㏈) as within-subject factors. The dependent measure was the percentage of correctly transcribed words. Results revealed that two main effects were statistically significant. Listeners performed significantly worse in the multi-talker babble condition than the environmental noise condition, and they performed significantly better at higher levels of SNRs. The current results suggested that the multi-talker babble and lower level of SNRs decreased the speech intelligibility of adults with dysarthria, and speech-language pathologists should consider environmental factors such as the types of noise and SNRs in evaluating speech intelligibility of adults with dysarthria.

조음복잡성 및 조음중증도에 따른 마비말장애인의 자음정확도와 말명료도

송한내(Song, HanNae),이영미(Lee, Youngmee),심현섭(Sim, HyunSub),성지은(Sung, JeeEun) 한국음성학회 2013 말소리와 음성과학 Vol.5 No.1

This study examined the effects of phonetic complexity and articulatory severity on Percentage of Correct Consonant (PCC) and speech intelligibility in adults with dysarthria. Speech samples of thirty-two words from APAC (Assessment of Phonology and Articulation of Children) were collected from 38 dysarthric speakers with one of two different levels of articulatory severities (mild or mild-moderate). A PCC and speech intelligibility score was calculated by the 4 levels of phonetic complexity. Two-way mixed ANOVA analysis revealed: (1) the group with mild severity showed significantly higher PCC and speech intelligibility scores than the mild-moderate articulatory severity group, (2) PCC at the phonetic complexity level 4 was significantly lower than those at the other levels and (3) an interaction effect of articulatory severity and phonetic complexity was observed only on the PCC. Pearson correlation analysis demonstrated the degree of correlation between PCC and speech intelligibility varied depending on the level of articulatory severity and phonetic complexity. The clinical implications of the findings were discussed.

실어증 환자들을 위한 CILT 중재 효과에 대한 메타분석

홍새미(SaeMi Hong),강진경(JinKyung Kang),엄보라(Bora Eom),김영태(YoungTae Kim),성지은(JeeEun Sung),심현섭(HyunSub Sim),정필연(PilYeon Jeong) 한국언어청각임상학회 2016 Communication Sciences and Disorders Vol.21 No.1

Constraint-Induced Language Therapy (CILT) 중재는 집중적인 일정 동안 구어를 극대화하여 사용할 수 있게 구조화한 실어증 중재방법이다. 여러 연구들이 CILT 중재의 효과를 검증하였지만 상이한 연구결과가 혼재하였다. 이에 본 연구에서는 메타 분석을 통해 실어증 환자 대상으로 CILT 중재의 효과성을 보고한 개별 연구들의 결과를 종합하여 증거기반 실제를 구축하고자 하였다. 방법: 총 5개의 국내외 데이터베이스를 이용하여 실어증 환자를 대상으로 CILT 중재를 실시한 연구들 중 선정기준에 부합한 총 9편의 문헌을 수집하였다. 그리고 중재에 따른 언어검사 결과를 종합하여 언어의 하위 영역 및 실어증 발병기간에 따른 효과크기를 각각 살펴보았다. 결과: CILT 중재는 실어증 환자의 전반적인 언어능력을 비롯하여 청각적 이해력, 따라 말하기, 이름대기 능력 향상에 유의한 효과가 있는 것으로 나타났다. 또한 CILT 중재는 급성실어증과 만성실어증 환자의 전반적인 언어능력 및 모든 언어 하위 영역 향상에서도 유의한 효과가 있는 것으로 나타났다. 논의 및 결론: 본 연구는 CILT 중재의 종합적인 효과 검증을 통해 CILT 중재가 발병기간과 무관하게 실어증 환자의 전반적인 언어능력과 언어의 각 하위 영역을 향상시키는 데 효과적이라는 결과를 도출하였다. 이를 통해 CILT 중재에 대한 기존 연구들의 상반된 결과들을 통일하여 임상적 유용성을 제고하는 근거를 마련하였다. Objectives: Constraint-Induced Language Therapy (CILT) is an aphasia treatment program which comprises forced use of verbal language and massed practice. There are many stud¬ies about the efficacy of CILT on aphasia, but the results are controversial. Thus, the pur¬pose of the present meta-analysis study was to systematically evaluate the effects of CILT for aphasia and to establish the evidence-based practice of CILT. Methods: Data collection was performed from 5 databases (DBPIA, EBSCOhost, ProQuest, PubMed, RISS) which were about CILT for aphasia. Nine studies which met the inclusive criteria were entered into the meta-analysis. Effect sizes for each study outcome (standardized language test outcome) were calculated. Results: There were two main findings from the current study. First, the meta-analysis results indicated that CILT is an effective treatment method for improving both overall language ability and each sub-language area. Second, CILT was effective for both chronic aphasia and acute aphasia—overall and in each sub-language area. Conclu¬sion: The present study suggests the comprehensive effectiveness of CILT for aphasia in each sub-language area including auditory comprehension, repetition, and naming, and its treatment effectiveness for both chronic aphasia and acute aphasia regardless of post onset time. This research unifies the complicated results of previous studies and lays the foundation for clinical implications.