말소리와 음성과학 (Phonetics and Speech Sciences)

  • 제16권3호
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  • Pages.59-69
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  • 2024
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  • 2005-8063(pISSN)
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  • 2586-5854(eISSN)
한국음성학회 (Korean Society of Speech Sciences)
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말소리장애 아동과 일반 아동 간 입술 및 혀 근력 비교 연구

Tongue and lip strength in children with and without speech sound disorders

  • 방지철 (대구대학교 재활과학대학원 언어치료학과) ;
  • 하지완 (대구대학교 재활과학대학원 언어치료학과) ;
  • 우승탁 (동서울대학교 전자공학과) ;
  • 최현주 (나사렛대학교 언어치료학과) ;
  • 나승대 (경북대학교 병원 의공학과) ;
  • 편성범 (고려대학교 의과대학 재활의학교실)
  • Jicheol Bang (Department of Speech and Language Pathology, Graduate School of Rehabilitation Science, Daegu University) ;
  • Ji-Wan Ha (Department of Speech and Language Pathology, Graduate School of Rehabilitation Science, Daegu University) ;
  • Seong-Tak Woo (Department of Electronic Engineering, Dong Seoul University) ;
  • Hyunjoo Choi (Department of Communication Disorders, Korean Nazarene University) ;
  • Sungdae Na (Department of Biomedical Engineering, Kyungpook National University Hospital) ;
  • Sung-Bom Pyun (Department of Physical Medicine and Rehabilitation, Korea University College of Medicine)
  • 투고 : 2024.08.16
  • 심사 : 2024.08.27
  • 발행 : 2024.09.30
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초록

원인 모르는 말소리장애 하위집단 중 말운동장애 집단을 감별진단하기 위해서는 청지각적 평가 외에 기기를 이용한 보다 객관적이고 정량적인 측정이 요구된다. 말운동장애 집단의 경우 목표한 조음위치에 접촉하는 조음기의 힘이 약하다는 공통적인 특징을 보이는 만큼, 본 연구에서는 말소리장애 집단과 일반 집단 간 조음기관의 근력을 정량적으로 측정하여 비교하였다. 말소리장애 아동 15명과 일반 아동 15명에게 IOPI(Iowa Oral Performance Instrument)를 이용하여 양순음 산출 시 입술 근력과 치경음 산출 시 혀 근력을 측정하였다. 이때 음절 내 위치(초성, 종성)와 발성유형의 차이(평음, 경음, 격음)를 분석 변수에 포함하였으며, 입술과 혀의 최대 압력과 지구력을 추가적으로 측정하였다. 또한 각 근력 수치와 자음정확도 간 상관관계를 분석하였다. 연구결과는 다음과 같다. 첫째, 양순음 산출 시 입술 근력은 초성에서는 두 집단 간 차이가 유의하지 않았으나, 종성에서는 말소리장애 집단의 근력이 일반 집단보다 유의하게 약했다. 또한 치경음 산출 시 혀 근력은 초성과 종성 모두에서 말소리장애 집단이 일반집단보다 약했으나, 종성에서는 그 차이가 더욱 두드러졌다. 둘째, 양순음 산출 시 입술 근력과 치경음 산출 시 혀 근력 모두에서 일반 집단의 경우 발성유형에 따른 차이가 유의하였으나, 말소리장애 집단은 평음, 경음, 격음 간 차이가 유의하지 않았다. 셋째, 입술과 혀 모두에서 말소리장애 집단의 최대 압력과 지구력은 일반 집단보다 유의하게 낮았다. 넷째, 대부분의 근력 수치와 자음정확도 간 유의하게 높은 정적 상관이 관찰되었다. 본 연구결과는 조음운동 실행의 약증 또한 원인 모르는 말소리장애의 기저 원인 중 하나일 가능성을 시사한다.

Among the subgroups of speech sound disorder (SSD), the motor speech disorder (MSD) group is characterized by weak articulatory force. This study quantitatively measured and compared articulatory muscle strength between SSD and typically developing (TD) children. The Iowa Oral Performance Instrument (IOPI) was used to measure lip and tongue strength in 15 children with SSD and 15 TD children. We additionally measured peak lip and tongue pressure and endurance, and analyzed the correlation between each strength measure and the percentage of consonants correct (PCC). The findings were as follows: First, lip strength for the bilabial sounds did not differ between the two groups in the initial position but was significantly weaker in the SSD group in the final position. Tongue strength for alveolar sounds was weaker in the SSD group than in the TD group for the initial and final positions. Second, for lip and tongue strength, the difference in voicing features was significant in the TD group but not in the SSD group. Third, the peak pressure and endurance of the lips and tongue were significantly lower in the SSD group than in the TD group. Fourth, significantly higher static correlations were observed between most strength measures and the PCC. These findings suggest that weakness in articulatory motor execution may be an unrecognized underlying problem of SSD with unknown origin.

키워드

과제정보

This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2019S1A5A2A03054267).

참고문헌

  1. Bilodeau-Mercure, M., & Tremblay, P. (2016). Age differences in sequential speech production: Articulatory and physiological factors. Journal of the American Geriatrics Society, 64(11), e177-e182.
  2. Choi, Y., & Sim, H. (2013). Relationship between the maximal tongue and lip strength and percentage of correct consonants and speech intelligibility in dysarthric adults with cerebral palsy. Phonetics and Speech Sciences, 5(2), 11-22. https://doi.org/10.13064/KSSS.2013.5.2.011
  3. Dodd, B. (2014). Differential diagnosis of pediatric speech sound disorder. Current Developmental Disorders Reports, 1(3), 189-196. https://doi.org/10.1007/s40474-014-0017-3
  4. Freed, D. B. (2020). Motor speech disorders: Diagnosis and treatment (3rd ed.). San Diego, CA: Plural.
  5. Friel, S. (1998). When is a /k/ not a [k]? EPG as a diagnostic and therapeutic tool for abnormal velar stops. International Journal of Language and Communication Disorders, 33(Suppl. 1), 439-444. https://doi.org/10.3109/13682829809179465
  6. Heo, H. (2023). Comparison of speech sound production performance based on oral strength in the normal elderly (Master's thesis). Daegu University, Gyeongsan, Korea.
  7. Kang, B., Kwon, H., Kim, H., & Jo, Y. (2013). Effect of orofacial exercise on the swallowing function of stroke patients. Journal of the Korean Society of Occupational Therapy, 21(1), 57-69.
  8. Kim, J. O., Shin, M. J., Song, Y. K., Kim, Y. S., & Seo, M. H. (2021). Speech mechanism screening test for children (SMST-C). Seoul, Korea: INPSYT.
  9. Kim, M. J., Ryu, E. J., & Ha, J. W. (2020a). Developmental study of distortion errors in affricative, fricative, and liquid sounds. Communication Sciences & Disorders, 25(2), 441-457. https://doi.org/10.12963/csd.20730
  10. Kim, Y. T., Shin, M. J., Kim, S. J., & Ha, J. W. (2020b). Urimal test of articulation and phonology 2 (UTAP2). Seoul, Korea: Hakjisa.
  11. Kim, Y. T., Sung, T. J., & Lee, Y. K. (2003). Preschool receptive-expressive language scale (PRES). Seoul, Korea: Seoul Community Rehabilitation Center.
  12. Lee, J. S., Lee, J. Y., & Kim, S. H. (2020). Effect of articulation abilities on the articulator strength training by IOPI of spasticity dysarthric speech. Therapeutic Science for Rehabilitation, 9(1), 91-99. https://doi.org/10.22683/TSNR.2020.9.1.091
  13. McAuliffe, M. J., Ward, E. C., Murdoch, B. E., & Farrell, A. M. (2005). A nonspeech investigation of tongue function in Parkinson's disease. The Journals of Gerontology: Series A, 60(5), 667-674. https://doi.org/10.1093/gerona/60.5.667
  14. Oh, D., Woo, S., Kim, J., Kim, M., Kim S., & Ha, J. (2022). Spatio-temporal characteristics of successive plosive consonants in the same place of articulation: An electropalatographic study. Communication Sciences & Disorders, 27(2), 393-402. https://doi.org/10.12963/csd.22901
  15. Potter, N. L., Nievergelt, Y., & VanDam, M. (2019). Tongue strength in children with and without speech sound disorders. American Journal of Speech-Language Pathology, 28(2), 612-622. https://doi.org/10.1044/2018_AJSLP-18-0023
  16. Ruscello, D. M. (2008). Treating articulation and phonological disorders in children. St Louis, MO: Mosby Elsevier.
  17. Safi, M., Alzyod, D. M., Opoku, M. P., & Agamy, Y. E. (2023). Tongue strength and endurance among typically developing children and children with idiopathic speech sound disorders in the United Arab Emirates. PLOS ONE, 18(7), e0289400.
  18. Shriberg, L. D., Fourakis, M., Hall, S. D., Karlsson, H. B., Lohmeier, H. L., McSweeny, J. L., Potter, N. L., ... Wilson, D. L. (2010). Extensions to the speech disorders classification system (SDCS). Clinical Linguistics & Phonetics, 24(10), 795-824. https://doi.org/10.3109/02699206.2010.503006
  19. Shriberg, L. D., & Kwiatkowski, J. (1994). Developmental phonological disorders I: a clinical profile. Journal of Speech & Hearing Research, 37(5), 1100-1126. https://doi.org/10.1044/jshr.3705.1100
  20. Tamura, T., Tanaka, Y., Watanabe, Y., & Sato, K. (2022). Relationships between maximum tongue pressure and second formant transition in speakers with different types of dysarthria. PLOS ONE, 17(3), e0264995.
  21. Vitorino, J. (2010). Effect of age on tongue strength and endurance scores of healthy Portuguese speakers. International Journal of Speech-Language Pathology, 12(3), 237-243.
  22. Yi, R. D., & Kim, S. J. (2022). A literature review on diagnostic markers and subtype classification of children with speech sound disorders. Phonetics and Speech Sciences, 14(2), 87-99.