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인공와우이식 난청인의 말소리 운율변화에 따른 구어 이해와 음도 변별, 선율윤곽 확인 간 관련성

The Relationship Between Perception of Prosody, Pitch Discrimination, and Melodic Contour Identification in Cochlear Implants Recipients

  • 김은연 (명지대학교 사회교육대학원 언어치료학과) ;
  • 문일준 (성균관대학교 의과대학 삼성서울병원) ;
  • 조양선 (성균관대학교 의과대학 삼성서울병원) ;
  • 정원호 (성균관대학교 의과대학 삼성서울병원) ;
  • 홍성화 (성균관대학교 의과대학 삼성창원병원)
  • Kim, Eun Yeon (Department of Speech and Language Pathology, Graduate School, Myongji University) ;
  • Moon, Il Joon (Department of Otorhinolaryngology-head and Neck Surgery, Samsung Seoul Medical Center, School of Medicine, Sungkyunkwan University) ;
  • Cho, Yang-sun (Department of Otorhinolaryngology-head and Neck Surgery, Samsung Seoul Medical Center, School of Medicine, Sungkyunkwan University) ;
  • Chung, Won-ho (Department of Otorhinolaryngology-head and Neck Surgery, Samsung Seoul Medical Center, School of Medicine, Sungkyunkwan University) ;
  • Hong, Sung Hwa (Department of Otorhinolaryngology-head and Neck Surgery, Samsung Changwon Medical Center, School of Medicine, Sungkyunkwan University)
  • 투고 : 2017.09.26
  • 심사 : 2017.11.21
  • 발행 : 2017.11.30

초록

본 연구에서는 인공와우이식 난청인(N = 15)을 대상으로 말소리 운율변화에 따른 구어 이해와 음도 변별, 선율윤곽 확인(Melodic contour identification: MCI) 간 관련성을 살펴보았다. 말소리 운율 변화에 따른 구어이해를 살펴보기 위해 말소리 운율지각 검사를 시행하였고, 긍정적인 운율과 부정적인 운율 조건에 따른 의미 변화를 피검자에게 판단하게 하였다. 검사 시 긍정적인 의미(Positive meaning: PW)와 중립적인 의미(Neutral meaning: NW)를 갖는 낱말 및 낱말 조합 형태를 제시하고, 긍정적인 운율과 부정적인 운율 조건에 따른 의미 변화를 피검자에게 판단하게 하였다. 음도 변별 검사를 위해서는 단음도 변화 변별 과제와 3개 음으로 구성된 패턴에서의 음도 변별 과제가 실시되었다. MCI 검사는 기대 확률을 달리한 세부 검사 1, 2로 구성하여 시행하였다. 실시한 검사 간 관련성을 살펴본 결과, 말소리 운율지각 검사 결과는 보청기 착용으로도 청지각적 이득을 기대할 수 없었던 기간과 유의한 관련성을 보였다. PW와 NW 검사에서 운율 조건에 따라 유의한 수행 차를 보였지만, 단어조합 형태에 따른 통계적 유의성은 발견하지 못하였다. 말소리 운율지각 검사 결과는 MCI 1과 유의한 상관을 보인 반면(p < .01), 말지각 검사 수행력과는 유의한 관련성을 보이지 않았다. 이는 인공와우이식 후 시각적 단서 없이 말소리, 음소 지각이 가능해졌다 하더라도 미묘한 운율 변화에 따른 의미 지각의 제한은 계속될 수 있음을 시사한다. 또한 인공와우이식 후 선율윤곽 변화 확인은 음도 변별에 비해 제한을 보이며, 운율지각과 관련 있음을 확인할 수 있었다.

The relationships between the ability to understand changes in meaning depending on the prosody of spoken words and the ability to perceive pitch and melodic contour in cochlear implants (CI) recipients were examined. Fifteen postlingual CI recipients were measured in terms of speech prosody perception, speech perception, pitch discrimination (PD), and melody contour identification (MCI). The speech prosody perception test consists of words with positive (PW) and neutral meaning (NW). Participants were asked to identify the meaning of words depending on the conditions of positive and negative prosody. The MCI consists of subtests 1 and 2 with different chance levels to choose. Then, the relationships between speech prosody perception, speech perception, PD, and MCI performance were analyzed. There was a significant difference in identifying the meaning of words expressed in a different prosody between the PW and NW conditions. Speech prosody perception showed a significant correlation with MCI 1 while there was no significant relationship with speech perception. Although speech perception may be possible after CI, limited spoken word comprehension due to decreased sensitivity for prosodic changes may persist in CI recipients. In addition, there was a limitation in perception of melodic contour change compared to pitch discrimination, which is related to speech prosody perception.

키워드

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