인간행동과 음악연구 (Journal of Music and Human Behavior)

  • 제21권2호
  • /
  • Pages.1-30
  • /
  • 2024
  • /
  • 2288-2774(pISSN)
  • /
  • 2799-9076(eISSN)
한국음악치료교육학회 (Korean Music Therapy Education Association)
권호 표지
DOI QR코드

DOI QR Code

ADHD 아동 대상 타이밍 조절 리듬 기반 음악중재 프로토콜 개발

Development of Timing Regulation Rhythm-Based Music Intervention Protocol for Children With ADHD

  • 조미란 (고신대학교 교회음악대학원 음악치료전공) ;
  • 박혜영 (고신대학교 교회음악대학원 음악치료전공)
  • 투고 : 2024.03.15
  • 심사 : 2024.05.07
  • 발행 : 2024.08.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구는 ADHD 아동의 타이밍 조절 향상을 위한 리듬 기반 음악중재 프로토콜을 개발하고 실행 가능성을 조사하는 데 목적이 있다. 이를 위해 ADHD 아동(부주의 우세형, 과잉행동-충동형)과 일반 아동을 대상으로 3단계의 연구를 진행하였다. 1단계에서는 청각주의력 검사(KAT), 운동 타이밍(자가 탭핑, 동기화 및 유지), 지각 타이밍(음길이 변별 및 재산출, 리듬패턴)의 그룹별 기준값을 측정 및 탐색적 요인분석을 하였고, 2단계에서는 주요 요인을 적용한 리듬 기반 음악중재 프로토콜을 개발하였다. 3단계에서는 개발된 프로토콜을 ADHD 아동에게 적용하여 타이밍 조절에 영향을 미치는 변인들을 조사하고 그 효과를 검증하였다. 연구 결과, 1단계에서는 음길이 변별과제와 정교성을 요구하는 리듬패턴 과제에서 ADHD 아동의 타이밍 값에 유의한 차이를 보였다. 또한, KAT 검사 결과와 운동 및 지각 타이밍의 탐색적 요인분석을 통해 주의 반응성, 주의 동기화, 주의 정교성의 총 3개 요인 군집을 도출하였다. 2단계에서는 속도 및 간격 조정에 따른 난이도별 동기화, 주의 전환, 리듬 산출 과제로 구성한 프로토콜 개발 후 전문가 타당도 검증을 확보하였다. 3단계 연구에서는 부주의 우세형 및 과잉행동-충동형 ADHD 아동에게 프로토콜을 개별적으로 적용한 결과, 탭핑 동기화와 음길이 산출 리듬 과제의 변별과 산출에서 유의한 차이가 있었다. 본 연구는 ADHD 아동의 자발적 주의부터 비자발적 주의까지 이끄는 효과적인 촉진 도구로 리듬을 활용하기 위한 기초자료로서 의의가 있다.

The purpose of this study is to develop a rhythm-based music intervention protocol to enhance timing regulation in children with ADHD and investigate its feasibility. For this purpose, a three-phase study was conducted involving ADHD children and typically developing children. In the first phase, group-specific baseline measurements were taken for auditory attention (KAT), motor timing, and perceptual timing. In the second phase, a rhythm-based music intervention protocol incorporating key factors was developed. In the third phase, the developed protocol was applied to ADHD children to investigate the variables affecting timing regulation and to verify its effectiveness. Results from the first phase revealed significant differences in the timing values of children with ADHD, particularly in tasks requiring discrimination of sound duration and precision in rhythm patterns. Additionally, exploratory factor analysis of KAT results and motor/perceptual timing identified three clusters: attentional responsiveness, attentional synchronization, and attentional sophistication. In the second phase, a protocol consisting of tasks involving synchronization, attentional shifting, and rhythm production at various difficulty levels was developed and validated for expert validity. In the third phase, individual application of the protocol to children with predominantly inattentive and hyperactive-impulsive ADHD subtypes demonstrated changes in timing regulation tasks. This study provided basic data for using rhythm as an effective facilitation tool that leads from voluntary to involuntary attention in children with ADHD.

키워드

참고문헌

  1. American Psychiatric Association Division of Research. (2013). Highlights of changes from dsm-iv to dsm-5: Somatic symptom and related disorders. Focus, 11(4), 525-527.  https://doi.org/10.1176/appi.focus.11.4.525
  2. Barnes, R., & Jones, M. R. (2000). Expectancy, attention, and time. Cognitive Psychology, 41(3), 254-311.  https://doi.org/10.1006/cogp.2000.0738
  3. Ben-Pazi, H., Gross-Tsur, V., Bergman, H., & Shalev, R. S. (2003). Abnormal rhythmic motor response in children with attention-deficit-hyperactivity disorder. Developmental Medicine and Child Neurology, 45(11), 743-745.  https://doi.org/10.1111/j.1469-8749.2003.tb00883.x
  4. Bondopadhyay, U., Diaz-Orueta, U., & Coogan, A. N. (2022). A systematic review of sleep and circadian rhythms in children with attention deficit hyperactivity disorder. Journal of Attention Disorders, 26(2), 149-224.  https://doi.org/10.1177/1087054720978556
  5. Cho, S. Z., Chun, S. Y., Hong, K. E., & Shin, M. S. (2000). A study of the development and standardization of ADHD diagnostic system. Journal of the Korean Academy of Child and Adolescent Psychiatry, 11(1), 91-99. 
  6. Cicerone, K. D., Langenbahn, D. M., Braden, C., Malec, J. F., Kalmar, K., Fraas, M., ... Ashman, T. (2011). Evidence-based cognitive rehabilitation: Updated review of the literature from 2003 through 2008. Archives of Physical Medicine and Rehabilitation, 92(4), 519-530.  https://doi.org/10.1016/j.apmr.2010.11.015
  7. Crasta, J. E., Thaut, M. H., Anderson, C. W., Davies, P. L., & Gavin, W. J. (2018). Auditory priming improves neural synchronization in auditory-motor entrainment. Neuropsychologia, 117, 102-112.  https://doi.org/10.1016/j.neuropsychologia.2018.05.017
  8. Dodd, B. (2014). Differential diagnosis of pediatric speech sound disorder. Current Developmental Disorders Reports, 1, 189-196.  https://doi.org/10.1007/s40474-014-0017-3
  9. Frid, A., Lavner, Y., & Rabinowitz, I. (2012). Analysis of finger tapping parameters in people with ADHD. IEEE, 27, 1-4.  https://doi.org/10.1109/EEEI.2012.6377064
  10. Gordon, C. L., Cobb, P. R., & Balasubramaniam, R. (2018). Recruitment of the motor system during music listening: An ale meta-analysis of fMRI data. PloS One, 13(11), e0207213. 
  11. Graf, R. A. G., Kuo, C. Y., Dowling, A. P., & Graham, W. R. (2002). On the horn effect of a tyre/road interface part 1: Experiment and computation. Journal of Sound and Vibration, 256(3), 417-431.  https://doi.org/10.1006/jsvi.2001.4238
  12. Grahn, J. A., & Rowe, J. B. (2009). Feeling the beat: Premotor and striatal interactions in musicians and nonmusicians during beat perception. Journal of Neuroscience, 29(23), 7540-7548.  https://doi.org/10.1523/JNEUROSCI.2018-08.2009
  13. Hillard, B., El-Baz, A. S., Sears, L., Tasman, A., & Sokhadze, E. M. (2013). Neurofeedback training aimed to improve focused attention and alertness in children with ADHD: A study of relative power of EEG rhythms using custom-made software application. Clinical EEG and Neuroscience, 44(3), 193-202.  https://doi.org/10.1177/1550059412458262
  14. Jalalkamali, H., Tajik, A., & Nezamabadi-Pour, H. (2021). Classification of auditory event-related potentials in a time discrimination task based on the oddball paradigm. Advances in Cognitive Science, 23(1), 73-84. 
  15. Jantzen, K. J., Steinberg, F. L., & Kelso, J. S. (2005). Functional MRI reveals the existence of modality and coordination-dependent timing networks. Neuroimage, 25(4), 1031-1042.  https://doi.org/10.1016/j.neuroimage.2004.12.029
  16. Jeong, E. (2011). Development and validation of a music-based attention assessment for patients with traumatic brain injury (Unpublished doctoral dissertation). University of Miami, Florida.
  17. Kim, J. O. (1998). Current status and methodological considerations of cognitive neuroscience approaches to attention. Psychological Issues, 5, 1-28. 
  18. Kim, S. K., Lee, K. J., Lee, S. H., Nam, M., & Chung, Y. C. (2003). Neurocognitive functions in posttraumatic stress disorder. Journal of Korean Society of Biological Psychiatry, 10(2), 147-158. 
  19. Kincaid, A. E., Duncan, S., & Scott, S. A. (2002). Assessment of fine motor skill in musicians and nonmusicians: Differences in timing versus sequence accuracy in a bimanual fingering task. Perceptual and Motor Skills, 95(1), 245-257.  https://doi.org/10.2466/pms.2002.95.1.245
  20. Lee, K. M., & Lee, Y. S. (2019). Beat synchronization development of Korean elementary school students. Music Theory Forum, 26(2), 251-270.  https://doi.org/10.16940/YMR.2019.26.2.251
  21. Legrain, V., Van Damme, S., Eccleston, C., Davis, K. D., Seminovicz, D. A., & Crombez, G. (2009). A neurocognitive model of attention to pain: Behavioral and neuroimaging evidence. Pain, 144(3), 230-232.  https://doi.org/10.1016/j.pain.2009.03.020
  22. Loras, H., Stensdotter, A. K., Ohberg, F., & Sigmundsson, H. (2013). Individual differences in motor timing and its relation to cognitive and fine motor skills. PLoS One, 8(7), e69353. 
  23. Matsuda, S., Matsumoto, H., Furubayashi, T., Hanajima, R., Tsuji, S., Ugawa, Y., & Terao, Y. (2015). The 3-second rule in hereditary pure cerebellar ataxia: A synchronized tapping study. PLoS One, 10(2), e0118592. 
  24. Miller, J. E., Carlson, L. A., & McAuley, J. D. (2013). When what you hear influences when you see: Listening to an auditory rhythm influences the temporal allocation of visual attention. Psychological Science, 24(1), 11-18.  https://doi.org/10.1177/0956797612446707
  25. Mohammadi, M. R., Malmir, N., Khaleghi, A., & Aminiorani, M. (2015). Comparison of sensorimotor rhythm (SMR) and beta training on selective attention and symptoms in children with attention deficit/hyperactivity disorder (ADHD): A trend report. Iranian Journal of Psychiatry, 10(3), 165-174. 
  26. Noreika, V., Falter, C. M., & Rubia, K. (2013). Timing deficits in attention-deficit/hyperactivity disorder (ADHD): Evidence from neurocognitive and neuroimaging studies. Neuropsychologia, 51(2), 235-266.  https://doi.org/10.1016/j.neuropsychologia.2012.09.036
  27. Park, S. R. (2019). The cognitive control mechanism of children in visual and auditory processing: A cognitive neurological study (Unpublished doctoral dissertation). Seoul National University, Seoul. 
  28. Price, C. N., & Moncrieff, D. (2021). Defining the role of attention in hierarchical auditory processing. Audiology Research, 11(1), 112-128.  https://doi.org/10.3390/audiolres11010012
  29. Rubia, K., Smith, A. B., Woolley, J., Nosarti, C., Heyman, I., Taylor, E., & Brammer, M. (2006). Progressive increase of frontostriatal brain activation from childhood to adulthood during event-related tasks of cognitive control. Human Brain Mapping, 27(12), 973-993.  https://doi.org/10.1002/hbm.20237
  30. Solanto, M. V., Gilbert, S. N., Raj, A., Zhu, J., Pope-Boyd, S., Stepak, B., ... Newcorn, J. H. (2007). Neurocognitive functioning in AD/HD predominantly inattentive and combined subtypes. Journal of Abnormal Child Psychology, 35(5), 729-744.  https://doi.org/10.1007/s10802-007-9123-6
  31. Song, C. (2010). A review on executive function of ADHD: Theoretical approach and current trends of research in Korea. The Korean Journal of Learning Disabilities, 7(1), 177-196. 
  32. Takano, K., & Miyake, Y. (2007). Two types of phase correction mechanism involved in synchronized tapping. Neuroscience Letters, 417(2), 196-200.  https://doi.org/10.1016/j.neulet.2007.02.044
  33. Thaut, M. H. (2005). The future of music in therapy and medicine. Annals of the New York Academy of Sciences, 1060(1), 303-308.  https://doi.org/10.1196/annals.1360.023
  34. Zamanzadeh, V., Ghahramanian, A., Rassouli, M., Abbaszadeh, A., Alavi-Majd, H., & Nikanfar, A. R. (2015). Design and implementation content validity study: Development of an instrument for measuring patient-centered communication. Journal of Caring Sciences, 4(2), 165.