DOI QR코드

DOI QR Code

Laryngeal height and voice characteristics in children with autism spectrum disorders

자폐스펙트럼장애 아동의 후두 높이 및 음성 특성

  • 이정헌 (동신대학교 언어치료학과) ;
  • 김고운 (한국플로어타임연구소) ;
  • 김성태 (동신대학교 언어치료학과)
  • Received : 2021.06.03
  • Accepted : 2021.06.12
  • Published : 2021.06.30

Abstract

The purpose of this study was to investigate laryngeal characteristics in children with autism spectrum disorders (ASD). A total of 50 children participated, including eight children aged 2 to 4 years old diagnosed with ASD and 42 normal controls at the same age. All children recorded X-ray images of the midsagittal plane of the cervical spine and larynx, and compared the laryngeal positions of ASD and control. In addition, samples of children with vowel prolongation were collected and analyzed for acoustic parameters. X-rays showed that the height of the hyoid bone in the normal group was the lowest at 3 years of age, and ascended at 4 years of age. Nevertheless, the distance from the external acoustic meatus to the hyoid bone was longest at age 4. 4-year-olds with explosive language development showed laryngeal height elevation and anteriorization. In contrast, the hyoid height of the ASD group of all ages was lower than that of the control group, and there was no difference in the hyoid position between the ages. As a result of acoustic evaluation, PFR, vFo, and vAm were significantly higher ASD than control. Low laryngeal height of ASD children may be associated with delayed language development. PFR, vFo, and vAm seem to be voice markers showing the difference between normal and ASD children.

본 연구의 목적은 자폐스펙트럼장애를 가진 아동의 후두 특성을 확인하고자 하였다. 자폐스펙트럼장애로 진단받은 2~4세 아동 8명과 같은 연령의 정상 대조군 42명을 포함하여 총 50명의 아동이 실험에 참여하였다. 모든 아동들은 경추와 후두의 중앙시상면의 X-ray 영상을 촬영하여 두 군의 후두 위치를 비교하였다. 또한 모음 연장발화 시 음성 샘플을 수집하여 음향 매개 변수들을 분석하였다. X-ray 검사 결과, 정상군의 설골 높이는 3세가 가장 낮았으며, 4세에 후두 높이가 상승하였다. 다른 한편으로, 외이도에서 설골까지의 거리는 4세가 가장 긴 것으로 나타났다. 이와는 대조적으로, 모든 연령대의 자폐스펙트럼장애군의 설골 높이는 정상군보다 낮았으며, 연령에 따른 설골 위치의 차이는 없었다. 음향학적 평가 결과, PFR, vFo, vAm은 정상 대조군에 비해 자폐스펙트럼장애군이 통계적으로 유의미하게 높게 나타났다. 결론적으로, 자폐스펙트럼장애 아동들의 낮은 후두 높이는 언어발달의 지연과 관련이 있는 것으로 사료된다. 음향학적 변수들 중 음성 조절기능을 보여주는 PFR, vFo, vAm은 정상 아동과 자폐스펙트럼장애 아동의 음질 차이를 보여주는 voice marker로 생각된다.

Keywords

References

  1. Adolphs, R., Sears, L., & Piven, J. (2001). Abnormal processing of social information from faces in autism. Journal of Cognitive Neuroscience, 13(2), 232-240. https://doi.org/10.1162/089892901564289
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: APA Press.
  3. Baltaxe, C. A. (1981). Acoustic characteristics of prosody in autism. International congress for the scientific study of mental deficiency. In P. Mittler (Ed.), New frontiers of knowledge in the scientific study of mental deficiency (pp. 223-233). Baltimore, MD: University Park.
  4. Benninger, M. S., Murry, T., & Johns M. M. III, (2016). The performer's voice (2nd ed.). San Diego, CA: Plural.
  5. Bontrager, K. L., & Lampignano, J. (2005). Textbook of radiographic positioning and related anatomy (6th ed.). St. Louis, MO: Elsevier.
  6. Bregman, J. D. (2005). Definitions and characteristics of the spectrum. In D. Zager (Ed.), Autism spectrum disorders: Identification, education, and treatment (3rd ed., pp. 3-46). Mahwah, NJ: Lawrence Erlbaum Associates.
  7. Ferrand, C. T. (2011). Speech science: An integrated approach to theory and clinical practice. Boston, MA: Allyn & Bacon.
  8. Freed, D. B. (2012). Motor speech disorder, diagnosis and treatment (2nd ed.). Clifton Park, NY: Delmar/Cengage Learning.
  9. Jo, K. J., & Kim, J. K. (2011). The relationship between autistic features and empathizing-systemizing traits. Science of Emotion & Sensibility, 14(2), 245-256.
  10. Johnson-Root, B. A. (2015). Oral-facial evaluation for speech-language pathologists. San Diego, CA: Plural Publishing.
  11. Jung, K. S., & Seong, C. J. Comparison of prosody characteristics in sentence reading of children with autism spectrum disorder and normal children. Communication Sciences & Disorders, 12(4), 625-642.
  12. Jeong, O. R. (2003). Speech pathology anatomy, Pusan: Korean Speech-language & Hearning Association.
  13. Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child: Journal of Psychopathology, Psychotherapy, Mental Hygiene, and Guidance of the Child 2, 217-250.
  14. Kanner, L. (1971). Follow-up study of eleven autistic children originally reported in 1943. Journal of Autism and Childhood Schizophrenia, 1(2), 119-145. https://doi.org/10.1007/BF01537953
  15. Kent, R. D., Kent, J. F., Duffy, J. R., Thomas, J. E., Weismer, G., & Stuntebeck, S. (2000). Ataxic dysarthria. Journal of Speech, Language, and Hearing Research, 43(5), 1275-1289. https://doi.org/10.1044/jslhr.4305.1275
  16. Kent, R. D., Vorperian, H. K., & Duffy, J. R. (1999). Reliability of the multi-dimensional voice program for the analysis of voice samples of subjects with dysarthria. American Journal of Speech-Language Pathology, 8(2), 129-136. https://doi.org/10.1044/1058-0360.0802.129
  17. Kim, B. N., Kim, J. W., Kwon, M. K., Youn, S. A., Kang, T. W., & Han, I. W. (2017). Autism parent education. Seoul, Korea: Hakjisa.
  18. Kim, Y. T. (2014). Diagnosis and treatment of language disorders in children (2nd ed.). Seoul, Korea: Hakjisa.
  19. Kwon, J. A. (2014). A study on the diagnosis of autism spectrum disorder in DSM-5 through the history of the concept of autism: Focusing on PDD-NOS, Soonchunhyang Journal of Humanities, 34(1), 101-130.
  20. Laitman, J. T., & Crelin, E. S. (1976). Postnatal development of the basicranium and vocal tract region in man. In J. F. Bosma (Ed.), Symposium on the development of the basicranium (pp. 206-219). Washington, DC: US Government Printing Office.
  21. Laitman, J. T., & Reidenberg, J. S. (1993). Comparative and developmental anatomy of laryngeal position. In B. Bailey (Ed.), Head and neck surgery-otolaryngology (pp. 36-43). Philadelphia, PA: Lippincott.
  22. Laitman, J. T., Crelin, E. S., & Conlogue, G. J. (1977). The function of the epiglottis in monkey and man. Yale Journal of Biology and Medicine, 50(1), 43-48.
  23. LaPointe, L. L., Murdoch, B. E., & Stierwalt, J. A. G. (2010). Brain-based communication disorders. San Diego, CA: Plural.
  24. Lee, J. H., Kim, K. U., Kim, S. T. (2020). Characteristics of voice in children with autism spectrum disorders, Journal of Rehabilitation Welfare Engineering & Assistive Technology, 14(3), 195-202. https://doi.org/10.21288/resko.2020.14.3.195
  25. Lieberman, P. (1984). The biology and evolution of language. Cambridge, MA: Harvard University Press.
  26. Lieberman, P., Kako, E., Friedman, J., Tajchman, G., Feldman, L. S., & Jiminez, E. B. (1992). Speech production, syntax comprehension, and cognitive deficits in Parkinson's desease. Brain and Language, 43(2), 169-189. https://doi.org/10.1016/0093-934X(92)90127-Z
  27. Logemann, J. A. (1998). The Evaluation and treatment of swallowing disorders (2nd ed.). Austin, TX: Pro-Ed.
  28. Magriples, U., & Laitman, J. T. (1987). Developmental change in the position of the fetal human larynx. American Journal of Physical Anthropology, 72(4), 463-472. https://doi.org/10.1002/ajpa.1330720406
  29. Mayes, S. D., Black, A., & Tierney, C. D. (2013). DSM-5 underidentifies PDDNOS: Diagnostic agreement between the DSM-5, DSM-IV, and checklist for autism spectrum disorder. Research in Autism Spectrum Disorders, 7(2), 298-306. https://doi.org/10.1016/j.rasd.2012.08.011
  30. Nakai, Y., Takashima, R., Takiguchi, R., & Takada, S. (2014). Speech intonation in children with autism spectrum disorder. Brain and Development, 36(6), 516-522. https://doi.org/10.1016/j.braindev.2013.07.006
  31. Paul, R., Augustyn, A., Klin, A., & Volkmar, F. R. (2005). Perception and production of prosody by speakers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 35(2), 205-220. https://doi.org/10.1007/s10803-004-1999-1
  32. Sasaki, C. T., Levine, P. A., Laitman, J. T., & Crelin, E. S. (1977). Postnatal descent of the epiglottis in man. A preliminary report. Archives of Otolaryngology, 103(3), 169-171. https://doi.org/10.1001/archotol.1977.00780200095011
  33. Sataloff, R. T. (2005). Voice science. San Diego, CA: Plural.
  34. Seikel. J. A., Drumright, D. G., & Seikel, P. (2013). Essentials of anatomy & physiology (4th ed.). Boston, MA: Cengage Learning.
  35. Shipp, T., (1975). Vertical laryngeal position during continuous and discrete vocal frequency change. Journal of Speech, Language, and Hearing Research, December, 18(4), 707-718. https://doi.org/10.1044/jshr.1804.707
  36. Shipp, T., & Izdebski, K. (1975). Vocal frequency and vertical larynx positioning by singers and nonsingers. Journal of Acoustical Society of America, 58(5), 1104-1106. https://doi.org/10.1121/1.380776
  37. Smerbeck, A. M. (2015). Nasal voice in boys with high-functioning autism spectrum disorder. Research in Autism Spectrum Disorders, 17, 116-125. https://doi.org/10.1016/j.rasd.2015.06.009
  38. The Korean Society of Laryngology, Phoniatrics and Logopedics (2016). Laryngeal speech linguistic medicine: Understanding vocalization and speech therapy. Seoul, Korea: Panmun Education.
  39. Turkmen, S., Cansu, A., Turedi, S., Eryigit, U., Sahin, A., Gunduz, A., & Ahavit, I. (2012). Age-dependent structural and radiological changes in the larynx. Clinical Radiology, 67(11), e22-e26. https://doi.org/10.1016/j.crad.2012.07.006
  40. Wing. L. (1992). The handbook of autism. Routledge. London EC4P 4EE.
  41. Yoon, H. Y. (2015). Different brain activation patterns of children with autism spectrum disorder during recognition of facial expression. Journal of Special Education & Rehabilition Science, 54(1), 59-74. https://doi.org/10.15870/jsers.2015.03.54.1.59