• 말소리와 음성과학
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• 제14권3호
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• pp.87-101
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• 2022

대전·충남지역 20-30대 여성 언어재활사 50명을 대상으로 주관적 음성 피로도 설문과 더불어 하루 4회기를 기준으로 언어치료 전/후 음성 샘플 수집을 하였다. 연구 결과, Korean Vocal Fatigue Index의 음성 피로로 인한 음성 사용회피 항목과 음성 사용으로 인한 신체 피로 항목에서 피로 집단과 피로 없는 집단 간 유의한 차이가 있었다. 두 집단의 음향음성학적 특성과 관련하여, 두 집단 모두 치료 후 저주파 대역 에너지가 상대적으로 낮아지고 고주파 대역 에너지가 상승하는 패턴을 보였다. 이러한 특징이 분산분석 결과, 주 효과로 나타난 low to high-ratio[t1(time.1)>t2(time.2)], slope_ltas(t2>t1), 3rd formant's energy(t1>t2), high energy(t2>t1) 등에 잘 반영되어 있다. 집단 간 차이는 음향변수들 중 치료 전 모음 연장발성 스펙트럼 저주파 대역의 에너지인 low energy에서만 관찰되었고 피로 없는 집단의 값이 더 컸다(no.fatigue>fatigue in t1). 음향변수에서의 이러한 특징과 더불어 치료 세션 후 피로 없는 집단의 연결발화에서의 왜도 증가는 장시간의 목소리 노동으로 인한 성대 과긴장(higher muscle tonus)과 목소리 남용 때문으로 해석할 수 있다. 섭동변수 shimmer_local은 피로 없는 집단이 언어치료 후 낮아졌고(t1>t2), 켑스트럼 변수인 RNR(rhamonics to noise ratio)은 언어치료 후 값이 높아졌다(t2>t1). NHR(noise to harmonic ratio)은 두 집단 모두 치료 후 낮아졌다. NHR의 감소와 shimmer_local의 하강은 치료 세션을 진행하면서 발성 과정이 안정화되었거나 혹은 전문 지식이 있는 언어재활사(특히 피로 없는 집단)들의 효율적 목소리 사용이 기여했다고 결론지을 수 있다. 피로 없는 집단의 경우는 치료 후에 RNR값이 유의하게 커졌으므로 치료 후 오히려 조화음(harmonic) 구조가 더 안정되었다고도 말할 수 있을 것이다.

• 말소리와 음성과학
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• 제9권4호
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• pp.129-136
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• 2017

This study investigates the effect of voice quality on speech intelligibility and the relationship between voice quality and intelligibility for children with spastic CP. We recruited 36 children with spastic CP (mean age 10.43 year, 17 girls, 19 boys, spastic type 34, mixed 2) from a special school and a rehabilitation hospital. Voice samples for the perceptual analysis of voice quality were extracted from a sustained vowel /a/ and were rated on the GRBAS scales by two experienced speech language pathologists. Ten adult subjects with no hearing problems evaluated speech intelligibility for the 37 words listed in the Assessment of Phonology and Articulation for Children on a 7-point interval scale. The children with spastic CP were divided into three groups according to the rated G scores on the GRBAS scales (G1(n)=10, G2(n)=13, G3(n)=13). Analyses of ANCOVA and Pearson correlation showed that there was a significant difference in speech intelligibility among three groups. There was also a significant correlation in G scale (grade), A scale (asthenia), B scale (breathy) score, and speech intelligibility. These findings suggest that poor speech intelligibility of spastic CP might be related to asthenia and breathiness. Vocal intensity should be increased and vocal functioning should be improved for speech therapy to improve speech intelligibility of the children with spastic CP.

• 말소리와 음성과학
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• 제1권4호
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• pp.165-170
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• 2009

This study was to investigate for comparison between single rating and average ratings from multiple presentations of the same stimulus for measuring the voice quality of dysphonia using 7-point equal-appearing interval (EAI) rating scale. Overall severity of voice quality for 46 /a/ vowel stimuli (23 stimuli from dysphonia, 23 stimuli from control) was rated by 3 experienced speech-language pathologists (averaged 19 years; range = 7 to 40 years). For average ratings, each stimulus was rated five times in random order and averaged from two to five times. Although higher inter-rater reliability was found in average ratings than in single rating, there were no significant differences in rating scores between single and multiple average ratings judged by experienced listeners, suggesting that auditory perceptual ratings judged by well-trained listeners have relatively good agreement with the same stimulus across the judgment. Larger variations in perceptual ratings were observed for moderate voices than for mild or severe voices, even in the average ratings.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.80-86
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• 2024

Background Among the cleft types, bilateral cleft lip and palate (BCLP) generally requires multiple surgical procedures and extended speech therapy to achieve normal speech development. This study aimed to describe speech outcomes in 5-year-old Korean children with BCLP and examine whether normal speech could be achieved before starting school. Methods The retrospective study analyzed 52 children with complete BCLP who underwent primary palatal surgery at a tertiary medical center. Three speech-language pathologists made perceptual judgments on recordings from a speech follow-up assessment of 5-year-old children. They assessed the children's speech in terms of articulation, speech intelligibility, resonance, and voice using the Cleft Audit Protocol for Speech-Augmented-Korean Modification. Results The results indicated that at the age of five, 65 to 70% of children with BCLP presented articulation and resonance within normal or acceptable ranges. Further, seven children with BCLP (13.5%) needed both additional speech therapy and palatal surgery for persistent velopharyngeal insufficiency and speech problems even at the age of five. Conclusion This study confirmed that routine follow-up speech assessments are essential as a substantial number of children with BCLP require secondary surgical procedures and extended speech therapy to achieve normal speech development.

• 대한후두음성언어의학회지
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• 제30권1호
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• pp.39-47
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• 2019

Background and Objectives : Pediatric vocal health problems are relatively common. However, it is not yet well studied whether uniform diagnosis and treatment is done properly in South Korea. The purpose of this study was to investigate the methods that the Korean speech therapists use to diagnose and treat pediatric voice problem. Materials and Method : An anonymous online questionnaire was administered to 32 speech language therapists registered at the Korean laryngeal speech linguistics society detailing demographics, employment institution, general management of pediatric patients with vocal problem including assessment and treatment procedures. Results : Current practice patterns were analyzed on 32 speech language therapists providing services in South Korea mostly working at tertiary university hospital. One third of pediatric patients were assessed without proceeding to treatment. One fifth of patients were treated without assessment. Perceptual assessment was the main pretreatment assessment methods used. Treatment was done in the following order : Voice rest, SOVT, yawn-sigh and resonant voice. Post-treatment evaluation was used in the following order : Instrumental assessment, clinical judgment, and recording comparison. Conclusion : Speech language therapists practice in South Korea mostly follows the ASHA practice guidelines. However, there are still great amount of cases in which only the evaluation was done without appropriate treatment. Further research is needed to make SPLs more systematic and efficient for evaluating and treating pediatric vocal patients.

• 말소리와 음성과학
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• 제8권3호
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• pp.67-78
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• 2016

This study examined the affective prosodic characteristics observed from the children with cochlear implant (CI, hereafter) and normal hearing (NH, hereafter) along with listener's perception on them. Speech samples were acquired from 15 normal and 15 CI children. 8 SLPs(Speech Language Pathologists) perceptually evaluated affective types using Praat's ExperimentMFC. When it comes to the acoustic results, there were statistically meaningful differences between 2 groups in affective types [joy (discriminated by intensity deviation), anger (by intensity-related variables dominantly and duration-related variables partly), and sadness (by all aspects of prosodic variables)]. CI's data are much more louder when expressing joy, louder and slower when expressing anger, and higher, louder, and slower when it comes to sadness than those of NH. The listeners showed much higher correlation when evaluating normal children than CI group(p<.001). Chi-square results revealed that listeners did not show coherence at CI's utterance, but did at those of NH's (CI(p<.01), normal(p=.48)). When CI utterances were discriminated into 3 emotional types by DA(Discriminant Analysis) using 8 acoustic variables, speed related variables such as articulation rate took primary role.

• 말소리와 음성과학
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• 제15권4호
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• pp.27-34
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• 2023

본 연구는 임상현장에서 직업에 따라 요구되는 음성문제를 이해하는데 도움이 되는 자료를 제공하기 위해 전문 음성 사용자인 직업배우와 직업적 음성사용자인 언어재활사의 주관적 음성증상을 조사하여 그 빈도를 알아보고, 두 집단 간의 주관적 음성증상에 차이가 있는지 비교하였다. 그 결과, 두 집단은 동일하게 11개의 증상 중 '노래 시 고음발성 곤란', '말할 때 목에 힘이 들어감', '음성피로감'이 고빈도 증상으로 나타났다. 두 집단의 주관적 음성증상을 비교한 결과 직업적 음성사용자 집단은 전문 음성사용자 집단에 비해 '노래 시 저음발성 곤란(p=.049)', '쉰 목소리(p=.021)', '말할 때 힘이 듦(p=.032)', '말할 때 목에 통증이 있음(p=.009)', '음성피로감(p=.018)'의 빈도가 더 빈번한 것으로 나타났다. 이러한 차이는 두 집단의 음성사용 환경이 다르고, 직업활동 시 요구되는 발성의 차이로 인한 것으로 사료된다.

• 음성과학
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• 제5권1호
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• pp.141-149
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• 1999

Parental speaking rates reduction is frequently recommended by speech-language pathologists as a way to facilitate the fluency of preschool children who stutter. However, this clinical notion is in need of empirical support. For this reason, Sim & Zebrowski (1995) examined the ability of young children imitating different speaking rates. However, Sim & Zebrwoski's study was not made in a natural context but in the laboratory, so the findings are limited to apply to the clinical situation. The current study aimed to examine the ability of three different speaking rates(baseline, 10% slower, and 24% slower) in a natural situation both with instruction and without instruction. The results show that (1) all children were able to imitate the stimulus speaking rates adequately, (2) instruction about speaking rates for each child influenced the ability to imitate slower speaking rates. These clinical implications of findings in this study are that 4-5 year-old children are able to imitate different speaking rates with instruction and can be candidates for the parental speaking rates reduction program in the stutter therapy.

• 음성과학
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• 제14권3호
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• pp.111-125
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• 2007

It is important to examine patients' subjective evaluation as well as objective measures and clinician's rating to assess voice disorders. This study aimed to evaluate validity and reliability of Korean-version of Voice Handicap Index (KVHI) and Voice-Related Quality of Life (KVQOL) with 113 adults with voice disorders and 111 normal adults. Content validity was verified by three experienced speech-language pathologists. Concurrent validity was revealed by examining the correlation among KVHI, KVQOL, and Voice Rating Scale as well as item discrimination coefficients. Total scores of KVHI and KVQOL of adults with voice disorders were significantly different from those of normal adults. Test-retest reliability and internal consistencies were significantly high in both KVHI and KVQOL. Correlations among scores of each subscale and total score were also significantly high in each tool. The study revealed that KVHI and KVQOL are suitable tools to be used in clinics and research areas in Korea, which can subjectively evaluate the effects of voice disorders on daily life as well as on quality of life.

• 한국콘텐츠학회논문지
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• 제12권5호
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• pp.280-292
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• 2012

인간의 인지-화용언어 능력은 일반적으로 연령이 증가함에 따라 저하된다. 노년층의 인지-화용언어 능력을 평가하는 것은 인지 기능이나 치매 등 관련 질병들에 대한 예측에 도움이 된다. 본 연구에서는 노년층의 인지-화용언어 능력을 평가하기 위한 기존의 도구들을 분석하고, 현재 저자들이 연구 개발 중인 평가영역 및 문항들에 대한 내용타당도(content validity)를 검증하고자 하였다. 이를 위해 17명의 언어치료사 및 임상심리사들이 판단한 척도점수에 근거하여 내용타당도 지수(Content Validity Index, CVI)를 산정하였다. 연구 결과, 주의력, 기억력, 조직화 능력, 추론력, 문제해결력, 집행기능, 화용언어 등 7개 영역 모두 CVI가 .75를 초과하였다. 이에 따라, 현 문항들이 노년층의 인지-화용언어 능력을 평가하기 위한 목적과 적절히 부합하는 내용적 타당성을 지니는 것으로 입증되었다.