• 음성과학
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• 제7권2호
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• pp.19-35
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• 2000

Speech evaluation and treatment planning for the patients with articulation disorders have traditionally been based on perceptual judgement by speech pathologists. Recently, various computerized speech analysis systems have been developed and commonly used in clinical settings to obtain the objective and quantitative data and specific treatment strategies. 10 dysarthric children (6 neurogenic and 4 functional dysarthria) participated in this experiment. Speech evaluation of dysarthria was performed in two ways; first, the acoustic analysis by Visi-Pitch and a Computerized Speech Lab and second, the perceptual scoring of phonetic errors rates in 100 word test. The results of the initial evaluation served as primary guidlines for the indivisualized treatment planning of each patient's speech problems. After mean treatment period of 5 months, the follow-up data of both dysarthric groups showed increased maximum phonation time, increased alternative motion rate and decreased occurrence of articulatory deviation. The changes of acoustic data and therapeutic effects were more prominent in children with dysarthria due to neurologic causes than with functional dysarthria. Three cases including their pre- and post treatment data were illustrated in detail.

• 음성과학
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• 제2권
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• pp.67-88
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• 1997

The aim of this study is to develop an assessment program of speech rehabilitation for children having some language and speech disorders. Patients of dysarthria, tonsillectomy, tonsilhypertrophy, and nasal obstruction were selected for this experimental clinical phonetic study. Formant variations ($F_1\;&\;F_2$) show pre- and post-operation differences in tonsillectomy and cleft palate patients. Nasal formants ($NF_1\;&\;NF_2$) show pre- and post-operation differences in nasal obstruction. The articulation reaction time (ART) as a parameter was used to assess Voice Onset Time(VOT). It was shown longer duration for hypokinetic dysarthria and shorter for atoxic dysarthria.. The diadochokinetic rate was measured by Visi-pitch. Lower diadochokinetic rate appeared to spastic and dysarthria in comparison with the control group. It was shown that the nasalance of tonsilhypertrophy, nasal obstruction, and cleft palate patients was seen to increase after operation. In addition, the assessment of nasality can be measured only by simple vowels such as /a/ and /i/.

• 대한두경부종양학회지
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• 제25권2호
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• pp.119-122
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• 2009

Objectives : Ablation of carcinoma of the tongue leads to deficits in speech and swallowing, but none to date has provided all of the qualities of mobility and sensation to simulate the complex function of the tongue. The authors evaluated postoperative swallowing and pronouncing function in patients who underwent tongue reconstruction using free flap. Material and Methods : This is a retrospective review documenting the outcome of 42 patients between January of 1991 and August of 2008. We classified patients according to the size of resection of the tongue like as 7 partial glossectomy, 25 hemiglossectomy, 2 subtotal glossectomy, and 8 total glossectomy. Swallowing function was graded into 4 point scale and pronouncing function was analyzed using picture consonant articulation test. Aspiration was evaluated with videofluoroscopic swallowing study. Results : The average points for swallowing function were 3.43 in partial glossectomy, 3.52 in hemiglossectomy, 3 in subtotal glossectomy, and 2.63 in total glossectomy. The percentage of consonants correct showed 76.5% in partial glossectomy, 72.29% in hemiglossectomy, 47.69% in subtotal glossectomy, and 29.94% in total glossectomy. Aspiration was noted in 3 patients(1 hemiglossectomy and 2 total glossectomy) and 2 total glossectomy patients were taken permanent feeding gastrostomy. Conclusion : Free flap gave us proper volume in tongue reconstruction and showed good result in preserving swallowing function. Swallowing function difference according to the size of defect showed no statistical significance, whereas articulation function was shown to decrease in accuracy as the size of defect was larger.

• 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.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.25-30
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• 2012

Background : The soft palate functions as a valve and helps generate the oral pressure required for normal speech resonance. Speech problems and nasal regurgitation can result from a soft palatal defect. Reduction of the size of the velopharyngeal orifice is required to compensate for the lack of mobility in a reconstructed soft palate. We suggest a large volume folded free flap for reduction of the caliber and a palmaris longus tendon sling for suspension of the reconstructed palate. Methods : Six patients had total soft palate resection for tonsillar cancer and reconstruction with a large volume folded radial forearm free flap combined with a palmaris longus sling. A single surgeon and speech therapist examined the patients with three standardized speech assessment tools: nasometer test, consonant articulation test, and speech acuity test performed for speech evaluation. Results : Mean nasalance score was 76.20% for sentences with nasal sounds and 43.60% for sentences with oral sounds. Hypernasality was seen for oral sound sentences. The mean score of the picture consonant articulation test was 84% (range, 63% to 100%). The mean score of the speech acuity test was 5.84 (range, 5 to 6). These mean ratings represent a satisfactory level of speech function. Conclusions : The large volume folded free flap with a palmaris longus tendon sling for total soft palate reconstruction resulted in satisfactory prognosis for speech despite moderate hypernasality.

• Journal of Audiology & Otology
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• 제24권3호
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• pp.133-139
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• 2020

Background and Objectives: The Gaps-In-Noise (GIN) test is a clinically effective measure of the integrity of the central auditory nervous system. The GIN procedure can be applied to a pediatric population above 7 years of age. The present study conducted the GIN test to compare the abilities of auditory temporal resolution among typically developing children, children with speech sound disorder (SSD), and children with cognitive difficulty (CD). Subjects and Methods: Children aged 8 to 11 years-(total n=30) participated in this study. There were 10 children in each of the following three groups: typically developing children, children with SSD, and children with CD. The Urimal Test of Articulation and Phonology was conducted as a clinical assessment of the children's articulation and phonology. The Korean version of the Wechsler Intelligence Scale for Children-III (K-WISC-III) was administered as a screening test for general cognitive function. According to the procedure of Musiek, the pre-recorded stimuli of the GIN test were presented at 50 dB SL. The results were scored by the approximated threshold and the overall percent correct score (%). Results: All the typically developing children had normal auditory temporal resolution based on the clinical cutoff criteria of the GIN test. The children with SSD or CD had significantly reduced gap detection performance compared to age-matched typically developing children. The children's intelligence score measured by the K-WISC-III test explained 37% of the variance in the percent-correct score. Conclusions: Children with SSD or CD exhibited poorer ability to resolve rapid temporal acoustic cues over time compared to the age-matched typically developing children. The ability to detect a brief temporal gap embedded in a stimulus may be related to the general cognitive ability or phonological processing.

• 대한청각학회지
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• 제24권3호
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• pp.133-139
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• 2020

Background and Objectives: The Gaps-In-Noise (GIN) test is a clinically effective measure of the integrity of the central auditory nervous system. The GIN procedure can be applied to a pediatric population above 7 years of age. The present study conducted the GIN test to compare the abilities of auditory temporal resolution among typically developing children, children with speech sound disorder (SSD), and children with cognitive difficulty (CD). Subjects and Methods: Children aged 8 to 11 years-(total n=30) participated in this study. There were 10 children in each of the following three groups: typically developing children, children with SSD, and children with CD. The Urimal Test of Articulation and Phonology was conducted as a clinical assessment of the children's articulation and phonology. The Korean version of the Wechsler Intelligence Scale for Children-III (K-WISC-III) was administered as a screening test for general cognitive function. According to the procedure of Musiek, the pre-recorded stimuli of the GIN test were presented at 50 dB SL. The results were scored by the approximated threshold and the overall percent correct score (%). Results: All the typically developing children had normal auditory temporal resolution based on the clinical cutoff criteria of the GIN test. The children with SSD or CD had significantly reduced gap detection performance compared to age-matched typically developing children. The children's intelligence score measured by the K-WISC-III test explained 37% of the variance in the percent-correct score. Conclusions: Children with SSD or CD exhibited poorer ability to resolve rapid temporal acoustic cues over time compared to the age-matched typically developing children. The ability to detect a brief temporal gap embedded in a stimulus may be related to the general cognitive ability or phonological processing.

• 대한구순구개열학회지
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• 제8권2호
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• pp.95-105
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• 2005

Cleft lip and palate is a congenital deformity which needs a professional and consistent management from the birth and along with the physical growth of patients. The patients with cleft lip and palate can have general speech problems with resonance disorders, voice disorders and articulation disorders after the successful primary surgical management and the physical growth. Speech problems of Cleft lip and palate are characterized hypernasality, nasal air emission, increased nasal air flow, and aberrant speech marks which decrease intelligibility. These speech problems of cleft lip and palate can be treated with the secondary surgical procedure, the application of temporary prosthesis and the effective and well-timed speech therapy. The speech and language problems of cleft lip and palate, the general procedures and schedules of the speech assessment and therapy based on the multidisciplinary approach are introduced for the patients with cleft lip and palate, their family and the other members of the cleft palate treatment team.

• 재활복지
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• 제21권2호
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• pp.217-231
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• 2017

안면부 및 경부 화상 환자에게 적절한 영양 공급을 위해 일차적으로 고려하여야 할 요소는 삼킴기능의 평가와 재활치료이며, 이와 더불어 타인과의 효과적인 의사소통과 심미적 기능을 만족시키기 위해 말능력에 대한 자세한 평가와 재활 역시 고려하여야 한다. 본 연구의 목적은 안면부 몇 경부화상 환자의 삼킴장애 및 말운동장애, 음성 장애 등을 종합적으로 파악할 수 있는 의사소통장애 선별프로토콜의 예비 문항을 정리하는데 있다. 화상으로 초래되는 여러 가지 의사소통장애를 다루고 있는 국외 연구들을 참고하여 '구강기제(oral mechanism)', '호흡/음성(respiration/voice)', '삼킴(swallowing)', '조음(articulation)'을 포함한 총 4개의 평가영역으로 나누고 하위범주와 이에 필요한 문항들을 작성하였고, 전문가 5인에 의한 내용타당도 검증 후 예비 문항을 선정하였다. 내용타당도 범위는 .50~.84로 나타났다. 구강기제 및 조음 평가 영역에 포함된 대부분의 선별평가 문항들이 적절하게 나타난 것과 다르게 호흡/음성 및 삼킴 평가 영역의 경우, 전문가마다 조금씩 다른 의견을 보이기도 하였다. 안면부 및 경부 화상 환자가 보이는 의사소통장애의 이질적인 특성 상, 본 연구를 통해 정리된 선별 프로토콜 항목을 바탕으로, 향후 화상 환자의 유형 및 중증도별 평가를 통해 각 환자에게 맞춘 평가 양식으로 적절히 수정하여 활용할 수 있을 것으로 예상한다. 이로써 구강조음기관의 기능적 해부와 생리에 대한 지식이 있고 이에 적합한 재활훈련이 가능한 언어재활사들이 화상 환자의 의사소통장애에 대해 더욱 종합적인 평가와 치료 적용이 가능할 것으로 기대한다.

• 대한후두음성언어의학회지
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• 제17권2호
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• pp.98-102
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• 2006

Background and Objectives : Voice onset time(VOT) is defined as the time interval from oral release of a stop consonant to the onset of glottal pulsing in the following vowel. VOT is a temporal characteristics of stop consonants that reflects the complex timing of glottal articulation relative to supraglottal articulation. Stop consonants are characterized by creation of a pressure difference across a complete occlusion in the vocal tract, followed by a sudden release 'burst' due to opening that occlusion. The objects of this study is to evaluate a usefulness of voice onset time in the assessment of voice disorderd patients. Subjects : Subjects were 20 adults with normal voice and with benign laryngeal disorders. Subjects with voice disorders represented the following vocal pathologies : vocal polyp, vocal nodule, Reinke's edema and unilateral vocal fold paralysis(UVFP). Control subjects were matched for age (21-40 yews old) and sex(male) with the voice disorders subjects and had normal vocal qualities with no history of voice disorders. Methods : Each voice-disordered and matched control subject read the test passages containing three types of Korean bilabial consonants. VOT measures were made for the initial $/p/p^h/\;and\;/p'/$. VOT was measured using acoustic waveform or wide band spectrogram. Results : For each voiceless stop consonants, there was a significant difference in VOT between the voice disordered and normal subjects. The mean VOTs of the lax stops in UVFP was significantly shorter than those of control subjects in the UVFP. The mean VOTs of the aspirated stops in the vocal polyp and nodule were longer than those of control subjects, but not significant. The mean VOTs of the glottalized in voice disordered groups were longer than those of control subjects, and significant statistically in the UVFP. Conclusions : VOT may be a clinically useful acoustic parameter in the assessment of voice disordered patients, especially in the unilateral vocal fold paralysis.