DOI QR코드

DOI QR Code

Development and clinical application of Korean-version nonword intervention to improve speech motor programming

말운동프로그램 향상을 위한 한국어 비단어 중재접근법의 확립 및 임상 적용

  • Oh, Da-Hee (Department of Speech and Language Pathology, Graduate School of Rehabilitation, Daegu University) ;
  • Ha, Ji-Wan (Department of Speech Pathology, Daegu University)
  • 오다희 (대구대학교 대학원 재활과학과) ;
  • 하지완 (대구대학교 언어치료학과)
  • Received : 2021.06.02
  • Accepted : 2021.06.10
  • Published : 2021.06.30

Abstract

This study is to develop a Korean version of nonword intervention by modifying and supplementing a Rapid syllable transition treatment (ReST) and to determine its effect by applying it to children with CAS. Ultimately, the purpose of this study is to investigate whether nonword interventions are effective for nonword production ability and generalization of real words. Single-subject research using the ABA design was performed for a child aged five years and six months with diagnostic features of CAS. The nonwords used in the interventions were made suitable for the individual child. The intervention was provided in one-hour sessions, twice a week for six weeks. In all cases, performance of the treated three-syllable nonwords improved, and untreated three-syllable words, four-syllable words, and nonwords showed a generalization effect. However, the generalization of treatment effects to words was smaller than for nonwords. The nonword intervention was effective in improving the subject's speech motor programming skills. As a result, transition errors due to impaired speech motor programming were greatly reduced, and the ability to produce untreated nonwords was greatly increased. However, there was a limit to the full improvement of strongly habitable word errors, which would be expected if a more intensive and repetitive intervention schedule was provided.

본 연구는 국외에서 개발된 비단어 중재접근법을 수정 및 보완하여 한국어 비단어 중재접근법을 확립하고, 아동기 말실행증 아동에게 직접 적용하여 그 효과를 확인하기 위해 실시되었다. 궁극적인 목적은 비단어를 이용한 중재가 아동기 말실행증의 말운동프로그래밍 능력을 개선시켜 비단어 산출 및 단어로의 일반화에 효과적인지 알아보기 위함에 있다. 중재는 아동기 말실행증의 진단 특성을 보이는 5세 6개월의 남아를 대상으로, ABA설계를 사용한 단일대상연구를 실시하였다. 중재에 사용된 비단어는 아동 맞춤형으로 제작하였으며, 한 회기당 60분씩 주 2회로, 총 12회기를 실시하였다. 그 결과 중재한 3음절 비단어의 모든 지표가 향상되었으며, 중재하지 않은 3음절, 4음절 비단어 및 단어로의 일반화를 확인하였다. 단, 단어로의 일반화 효과는 비단어로의 일반화 효과에 비해 미비하였다. 비단어 중재는 대상 아동의 말운동프로그래밍 능력을 개선시키는데 효과적이었다. 그 결과 운동프로그래밍 손상에 기인한 전환 오류가 크게 감소하였고, 중재하지 않은 비단어의 산출 능력이 큰 폭으로 증가하였다. 그러나 강력하게 습관화된 단어 오류를 완전히 개선시키는 데에는 한계가 있었으며, 이는 보다 집중적이고 반복적인 중재 일정을 제공했을 때 기대할 수 있는 결과일 것이다.

Keywords

Acknowledgement

이 논문은 2020년도 정부(교육부)의 재원으로 한국연구재단의 지원을 받아 수행된 기초연구사업임(NRF-2020R1I1A3074130).

References

  1. American Speech-Language-Hearing Association. (2007). Childhood apraxia of speech. Rockville, MD: ASHA.
  2. Ballard, K. J., Robin, D. A., McCabe, P., & McDonald, J. (2010). A treatment for dysprosody in childhood apraxia of speech. Journal of Speech, Language, and Hearing Research, 53(5), 1227-1245. https://doi.org/10.1044/1092-4388(2010/09-0130)
  3. Bernthal, J. E., Bankson, N. W., & Flipsen, P., Jr. (2013). Articulation and phonological disorders: Speech sound disorders in children (7th ed.). Upper Saddle River, NJ: Pearson.
  4. Forrest, K. (2003). Diagnostic criteria of developmental apraxia of speech used by clinical speech-language pathologists. American Journal of Speech-Language Pathology, 12(3), 376-380. https://doi.org/10.1044/1058-0360(2003/083)
  5. Grigos, M. I., Moss, A., & Lu, Y. (2015). Oral articulatory control in childhood apraxia of speech. Journal of Speech, Language, and Hearing Research, 58(4), 1103-1118. https://doi.org/10.1044/2015_JSLHR-S-13-0221
  6. Kim, H. J., Choi, S. Y., & Ha, J. W. (2015). Speech-motor program/programming in children with childhood apraxia of speech, children with articulatory and phonological disorders and typically developing children. Communication Sciences & Disorders, 20(1), 60-71. https://doi.org/10.12963/csd.15224
  7. Kim, N. Y., & Ha, J. W. (2014). Phonological representations in children with articulation and phonological disorders. Communication Sciences & Disorders, 19(2), 226-237. https://doi.org/10.12963/csd.14105
  8. Kim, Y. T., & Shin, M. J. (2004). Urimal test of articulation and phonology (U-TAP). Seoul, Korea: Hakjisa.
  9. Kim, Y. T., Hong, G. H., Kim, K. H., Jang, H. S., & Lee, J. Y. (2009). Receptive & expressive vocabulary test (REVT). Seoul, Korea: Seoul Community Rehabilitation Center.
  10. Kim, Y. T., Seong, T. J., & Lee, Y. K. (2003). Preschool receptiveexpressive language scale (PRES). Seoul, Korea: Seoul Community Rehabilitation Center.
  11. Kwon, Y. H. (2008). Changes in cortical and neuromuscular modification induced by visuo-motor skill learning in young healthy subject (Doctoral dissertation). Daegu University, Daegu, Korea.
  12. Lee, H. R., & Sim, H. S. (2004). Literature review on differential diagnosis of apraxia of speech (AOS). Special Education Research, 3(1), 147-165. https://doi.org/10.18541/ser.2004.02.3.1.147
  13. Lim, H. C. (2004). Korean Raven's coloured progressive matrix (K-CPM). Seoul, Korea: Hankuk Guidance.
  14. Maas, E., Gildersleeve-Neumann, C. E., Jakielski, K. J., & Stoeckel, R. (2014). Motor-based intervention protocols in treatment of childhood apraxia of speech (CAS). Current Developmental Disorders Reports, 1(3), 197-206. https://doi.org/10.1007/s40474-014-0016-4
  15. McCabe, P., Murray, E., Thomas, D. C., & Evans, P. (2017). Clinician manual for rapid syllable transition treatment (REST). Camperdown, Australia: The University of Sydney.
  16. Murray, E., McCabe, P., & Ballard, K. J. (2012). A comparison of two treatments for childhood apraxia of speech: Methods and treatment protocol for a parallel group randomised control trial. BMC Pediatrics, 12(1), 1-9. https://doi.org/10.1186/1471-2431-12-1
  17. Murray, E., McCabe, P., & Ballard, K. J. (2014). A systematic review of treatment outcomes for children with childhood apraxia of speech. American Journal of Speech-Language Pathology, 23(3), 486-504. https://doi.org/10.1044/2014_AJSLP-13-0035
  18. Murray, E., McCabe, P., & Ballard, K. J. (2015). A randomized controlled trial for children with childhood apraxia of speech comparing rapid syllable transition treatment and the nuffield dyspraxia programme-third edition. Journal of Speech, Language, and Hearing Research, 58(3), 669-686. https://doi.org/10.1044/2015_JSLHR-S-13-0179
  19. Nijland, L., Maassen, B., & van der Meulen, S. (2003). Evidence of motor programming deficits in children diagnosed with DAS. Journal of Speech, Language, and Hearing Research, 46(2), 437-450. https://doi.org/10.1044/1092-4388(2003/036)
  20. Park, H. (2008). A study of naming abilities in children with develop- mental apraxia of speech. Journal of Speech & Hearing Disorders, 17(2), 35-49. https://doi.org/10.15724/jslhd.2008.17.2.003
  21. Park, M. S. (2015). Characteristics of coarticulation in childhood apraxia of speech (Master's thesis). Yonsei University, Seoul, Korea.
  22. Preston, J. L., Brick, N., & Landi, N. (2013). Ultrasound biofeedback treatment for persisting childhood apraxia of speech. American Journal of Speech-Language Pathology, 22(4), 627-643. https://doi.org/10.1044/1058-0360(2013/12-0139)
  23. Ryu, E. J., & Ha, J. W. (2018). Development and application of nonsense syllable repetition test for evaluating phonological retrieval and sequencing abilities. Communication Sciences & Disorders, 23(4), 992-1004. https://doi.org/10.12963/csd.18541
  24. Schmidt, R. A., & Lee, T. D. (1999). Motor control and learning: A behavioral emphasis (3rd ed.). Champaign, IL: Human Kinetics.
  25. Shriberg, L. D., Lohmeier, H. L., Strand, E. A., & Jakielski, K. J. (2012). Encoding, memory, and transcoding deficits in childhood apraxia of speech. Clinical Linguistics & Phonetics, 26(5), 445-482. https://doi.org/10.3109/02699206.2012.655841
  26. Song, Y. K. (2008). Comparison of compensation ability of speech motor control and ability of speech motor programming in children with and without articulation disorders(Doctoral dissertation). Ewha Womans University, Seoul, Korea.
  27. Stackhouse, J., & Wells, B. (1993). Psycholinguistic assessment of developmental speech disorders. International Journal of Language & Communication Disorders, 28(4), 331-348. https://doi.org/10.3109/13682829309041469
  28. Swinnen, S. P., Schmidt, R. A., Nicholson, D. E., & Shapiro, D. C. (1990). Information feedback for skill acquisition: Instantaneous knowledge of results degrades learning. Journal of Experimental Psychology: Learning, Memory, and Cognition, 16(4), 706-716. https://doi.org/10.1037/0278-7393.16.4.706
  29. Thomas, D. C., McCabe, P., & Ballard, K. J. (2017). Combined clinician-parent delivery of rapid syllable transition (ReST) treatment for childhood apraxia of speech. International Journal of Speech-Language Pathology, 20(7), 683-698. https://doi.org/10.1080/17549507.2017.1316423
  30. Thomas, D. C., McCabe, P., Ballard, K. J., & Bricker-Katz, G. (2017). Parent experiences of variations in service delivery of rapid syllable transition (ReST) treatment for childhood apraxia of speech. Developmental Neurorehabilitation, 21(6), 391-401.
  31. van der Merwe, A., & Steyn, M. (2018). Model-driven treatment of childhood apraxia of speech: Positive effects of the speech motor learning approach. American Journal of Speech-Language Pathology, 27(1), 37-51. https://doi.org/10.1044/2017_AJSLP-15-0193
  32. Vance, M., Stackhouse, J., & Wells, B. (2005). Speech-production skills in children aged 3-7 years. International Journal of Language & Communication Disorders, 40(1), 29-48. https://doi.org/10.1080/13682820410001716172
  33. Winstein, C. J., & Schmidt, R. A. (1990). Reduced frequency of knowledge of results enhances motor skill learning. Journal of Experimental Psychology: Learning, Memory, and Cognition, 16(4), 677-691. https://doi.org/10.1037//0278-7393.16.4.677
  34. 유승미(2016). 한국어 낭독과 자유 발화의 운율 특성 연구. 연세 대학교 박사학위논문.