• Archives of Plastic Surgery
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• v.47 no.6
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• pp.542-550
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• 2020

Background This study aimed to identify the initial diagnostic characteristics and treatment status of children with submucous cleft palate (SMCP) and to examine the relationship between the timing of surgical correction and the degree of articulation and resonance improvement. Methods This retrospective study included 72 children diagnosed with SMCP between 2008 and 2016. The evaluation criteria were the age of the initial visit, total number of visits, age at the end of treatment, speech problems, resonance problems, and speech therapy. Results Children with SMCP first visited the hospital at an average age of 34.32 months, and speech problems were identified at an average age of 48.53 months. Out of 72 children, 46 underwent surgery at an average age of 49.74 months. Four of these children required secondary surgery at an average age of 83.5 months. Among the children who underwent surgery before 3 years of age, 70% exhibited articulation improvements, with mild-to-moderate hypernasality. Articulation improvements showed no statistically significant differences according to age at the time of surgery. However, children who underwent surgery before 4 years had a better hypernasality rating than those who underwent surgery after 4 years of age. Conclusions Children with SMCP tend to undergo delayed treatment because the anatomical symptoms in some children with SMCP are unclear, and surgical interventions are considered only after speech problems are clarified. Starting interventions as early as possible reduces the likelihood of receiving secondary surgery and speech therapy, while increasing expectations for positive speech function at the end.

• Speech Sciences
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• v.11 no.2
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• pp.27-38
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• 2004

This study attempted to determine the effects of a cooperative and cognitive group therapy compared to individual therapy in 24 aphasic subjects. Two dependent variables were measured overall language performance, functional communication skills. 18 subjects with different types and severity of aphasia participated in the group therapy. 6 aphasic subjects participated in the individual therapy and they functioned as a control group. The subjects were ranged from 27 to 59 years in age. The group therapy using the cooperative learning utilized the following procedures. First, 6 aphasics constituted 1 group where each subject peformed a task and they monitored one another. Second, 2 aphasics consisted 1 group and they cooperated to perform a task. Third, 3 groups with 2 aphasics in a group competed one another in a task where the 2 aphasics had to cooperated. Finally, the investigator gave the feedback to the group and she and the subjects discussed the overall procedures of the therapy. The above mentioned 2 tests were administered pre- and post-treatment. A repeated two-way ANOVA was performed for analysis. The results showed that the group therapy was more effective in improving overall language performance as compared to the individual therapy. And, the group therapy was more effective in increasing functional communication skills as compared to the individual therapy.

• Speech Sciences
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• v.4 no.2
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• pp.91-102
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• 1998

The present study attempted to modify the conventional Melodic Intonation Therapy (MIT) in three aspects: number of syllables of adjacent target utterances (ATU), melody patterns of ATU, and initial listening of melody and intoned speech with the eyes closed. The modified Melodic Intonation Therapy (MMIT) was applied to two severe Korean aphasics. The patients exhibited a severely nonfluent aphasia resulting from a left CVA(Cerebrovascular Accident). The purpose of the modification was to avoid perseveration and improve reflective listening skills. First, the treatment program avoided ATU with the same number of syllables. Second, four different patterns of melody were developed: rising type, falling type, V-type, and inverted V-type. One type of prosodic pattern was preceded and followed by another type of melody. These two variations were to decrease perseverative behaviors. Finally, the patients kept their eyes closed when the clinician played and hummed a target melody at the initial stage of the program in order to improve reflective listening skills. A single-subject alternating treatment design was used. The effects of MMIT were compared to the conventional MIT. Differing the number of syllables and the type of melodic patterns decreased perseverative behaviors and produced more correct names. The initial listening of the target melody with the patients' eyes closed seemed to increase their attentiveness and result in a more fluent production of target utterances. Probable reasons for the effectiveness of MMIT were discussed.

• Korean Journal of Cleft Lip And Palate
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• v.11 no.1
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• pp.1-12
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• 2008

In cleft palate patient, characteristic of speech disorder is the resonance disorder result from velopharyngeal incompetence. Clinically VPI caused by congenital factor as congenital palatal incompetence, submucosal cleft palate, and caused by acquired factor as CNS damage, tumor, palatal palsy. The clinicians more concerned about the speech disorders after cleft palate surgery rather than language pathologist. The resonance disorder devided for hypernasality, hyponasality and nasal emission, but as a rule, hypernasality is typical phenomenon of the resonance disorder. Traditionally clinicians and language pathologists evaluated four-stage or five-stage of hypernasality by subjective assessment. Although language pathologist is well-trained, results of the language level should be different. In late 1980s, Kay Elemetrics Corp. developed nasometer that objective nasalance identified with well-trained language pathologist and originate from nasometer Tonar I and II were developed by Fletcher. Therefore objective nasalance test was possible, the nasometer used in hospital, collage and speech clinic both and home and abroad. Standardization of the cleft palate speech assessment must be settled without delay because of different character result in different language and different assessment results by dialect in same language. In our study, we provide the data base for the standardization of cleft palate speech assessment which through report of objective assessment method, speech therapy effects and problems result in interdisciplinary teamwork by nasometer use in treatment of cleft palate patient.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.23.1-23.6
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• 2018

Background: Velopharyngeal insufficiency that accompanies speech resonance and articulation disorders can be managed through several intervention methods such as speech-language therapy, prosthetic aids, and surgery. However, for patients with severe hypernasality, surgical interventions are highly recommended. Among available surgical techniques, the posterior pharyngeal flap is most common. Case presentation: Two adult males with high nasalance scores underwent superiorly based posterior pharyngeal flap surgery, followed by speech testing by an expert speech-language therapist. Nasalance scores and articulation accuracy were assessed up until 1 year after the surgery. Nasalance scores were measured five times using a nasometer, after which the average value was calculated. Conclusions: Consistent declines in hypernasality over time are not easy to explain since the pedicled pharyngeal flap narrowed over time, secondary to cicatrization. However, scar tethering of the soft palate in a posterior direction could reduce the velopharyngeal port size over time. Therefore, long-term follow-up with intensive speech therapy is suggested for patients with severe hypernasality.

• Speech Sciences
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• v.9 no.3
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• pp.113-120
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• 2002

The purpose of this study was to determine the effects of group therapy on the language performance of aphasic patients. Four aphasic subjects participated in group therapy. Their aphasic types were TCMA (transcortical motor aphasia), conduction, anomie, and Broca's aphasia. The focus of the therapy was to stimulate cooperative learning skills. For this purpose, categorization tasks, semantic association tasks, convergent thinking, and divergent thinking tasks were employed. The results showed that all of the aphasic subjects demonstrated some improvement in writing ability, categorization ability, and speaking ability in sentences.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.4
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• pp.191-206
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• 2018

Purpose : This study investigated the correlation between speech intelligibility and acoustic measurements of speech sounds produced by the children with speech sound disorders and children without any diagnosed speech sound disorder. Methods : A total of 60 children with and without speech sound disorders were the subjects of this study. Speech samples were obtained by having the subjects? speak meaningful words. Acoustic measurements were analyzed on a spectrogram using the Multi-speech 3700 program. Speech intelligibility was determined according to a listener's perceptual judgment. Results : Children with speech sound disorders had significantly lower speech intelligibility than those without speech sound disorders. The intensity of the vowel /u/, the duration of the vowel /${\omega}$/, and the second formant of the vowel /${\omega}$/ were significantly different between both groups. There was no difference in voice onset time between the groups. There was a correlation between acoustic measurements and speech intelligibility. Conclusion : The results of this study showed that the speech intelligibility of children with speech sound disorders was affected by intensity, word duration, and formant frequency. It is necessary to complement clinical setting results using acoustic measurements in addition to evaluation of speech intelligibility.

• Speech Sciences
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• v.15 no.2
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• pp.145-156
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• 2008

The purpose of this study was to investigate the reason why puberphonia patients revisit hospitals after completion of its treatment and the effect of visual voice therapy on voice improvement. The subject the study included are two puberphonia patients who had been diagnosed by laryngologists. The patients who were diagnosed as puberphonia by the laryngologist and treated by the a speech pathologist, completed their treatment and revisited hospital. The study used laryngoscopy, acoustic and aerodynamic analysis before and after voice treatment to investigate what change happens and why generalization of treatment effect did not occur naturally in the daily life. Their voices of pre-therapy and post-therapy were analyzed on the aspects of acoustics, aerodynamics and laryngeal endoscopy. As a result, it was found that fundamental frequency(Fo) was significantly lowered in respect of acoustic change and maximum phonation time(MPT) was increased to some extent in respect of aerodynamic change. In addition, there was a laryngoscopic change and commissure glottic chink disappeared generally in the phonation. The reason why the generalization did not occur naturally in one’s daily routine was mainly due to the fact that high-pitched voicing was used for a long time. Other than that reason, negative reaction or attitude of surrounding people and lack of confidence were to blame for failure of generalization.

• Journal of Oriental Neuropsychiatry
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• v.24 no.4
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• pp.393-402
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• 2013

Objectives: This study is a clinical report of a patient with ADHD and learning disorders who is being treated with hyperbaric oxygen, scalp acupuncture, cognitive enhancement therapy and speech-language therapy. Methods: The BASA-R, BASA-M and REVT tests were used for the diagnosis of learning disorders. For the treatment, hyperbaric oxygen therapy, scalp acupuncture, cognitive enhancement therapy and speech-language therapy were all being used. The Raven's matrix tests were compared for between before and after the abovementioned therapies. Results: After the treatment, Raven's matrix test grade improved from 4 to 5. The improvement of the patient's concentration, communication, motion, confidence, and sleep conditions were observed. Conclusions: These therapies including the hyperbaric oxygen therapy are efficient for the treatment of ADHD and learning disorders.

• Speech Sciences
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• v.9 no.4
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• pp.237-252
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• 2002

MIT has been applied for nonfluent aphasic patients on the basis of lateralization of brain hemisphere. However, its applications for different languages have some inquiry for aphasic patients because of prosodic and rhythmic differences. The purpose of this study is to develop the Korean Melodic Intonation Therapy program using personal computer and its clinical effects for nonfluent aphasic patients. The algorithm was composed to voice analog signal, PCM, AMDF, Short-time autocorrelation function and center clipping. The main menu contains pitch, waveform, sound intensity and speech files on window. Aphasic patients' intonation patterns overlay on selected kMIT patterns. Three aphasic patients with or without kMIT training participated in this study. Four affirmative sentences and two interrogative sentences were uttered on CSL by stimulus of ST. VOT, VD, Hold and TD were measured on Spectrogram. In addition, articulation disorders and intonation patterns were evaluated objectively on spectrogram. The results indicated that nonfluent aphasic patients with kMIT training group showed some clinical effects of speech intelligibility based on VOT, TD values, articulation evaluation and prosodic pattern changes.