• 말소리와 음성과학
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• 제5권4호
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• pp.3-15
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• 2013

The acoustic analysis of diadochokinesis(DDK) has been used to evaluate dysarthria. However, there has not been an automatic method to evaluate dysarthria. The aim of this study was to introduce a new automated program to measure DDK tasks and to apply this to clinical patients with idiopathic Parkinson's disease(IPD). Fourty-seven patients with IPD and a healthy control group of twenty participants were selected with every DDK task recorded three times. Twenty-five acoustic parameters in the program were developed. The relevant parameters were times of DDK, pitch related parameters, intensity parameters which were analyzed by 2-way ANOVA. Significant differences between the groups were found in the times of DDK, pitch related parameters, and intensity parameters. The findings indicated that the pitch of control group was more stable than that of the IPD. Even though the patients with IPD had a higher intensity value, this phenomenon was caused by the weakness of the IPD group who could not control their speech with a breath.

• 말소리와 음성과학
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• 제16권1호
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• pp.57-65
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• 2024

정상압 수두증(normal pressure hydrocephalus, NPH)은 뇌의 뇌척수압은 정상 범위에 있지만 뇌척수액이 정상 수준보다 증가해 뇌실확장증을 유발하는 질환으로, 조음기관의 운동성과 범위가 감소해 조음교대운동(diadochokinesis, DDK)과 말명료도에 영향을 줄 수 있다. 본 연구에서는 NPH 환자 38명과 정상 노인 38명을 대상으로 /파/, /타/, /카/ 및 /파타카/에 대한 DDK 과제를 실시한 후, 정확한 산출만 측정한 DDK(accurate token-DDK)와 부정확한 산출 포함, 모든 산출시도를 측정한 DDK(all token-DDK)의 두 방법을 모두 사용해 그 결과를 비교하였다. 또한 DDK가 NPH와 정상 노인의 두 집단을 얼마나 정확하게 분류 가능한지, 그리고 DDK와 말명료도 간 상관관계는 어떠한지에 대해서도 알아보았다. 연구결과, NPH 집단과 정상 노인 집단 간에는 accurate token-DDK와 all token-DDK 모두에서 유의한 차이가 있었고, 집단 분류정확도는 accurate token-DDK의 경우 75.0%, all token-DDK의 경우 77.6%로 비교적 높았다. 그러나 NPH 집단에서 DDK 속도와 말명료도 측정값 간에는 유의한 상관관계가 없었다. 본 연구는 NPH 환자의 말운동능력을 민감하게 평가하는 데에 DDK가 유용한 방법임을 시사한다.

• 재활복지
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• 제22권2호
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• pp.231-246
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• 2018

조음교대운동(DDK)은 구강운동능력과 운동 협응 능력을 평가하여 조음기관의 기능을 알아본다. 현재 국내에는 초등학생을 대상으로 한 DDK 규준데이터가 부족하여 초등학교 1, 2학년 아동을 대상으로 학년 및 성별에 따른 DDK 속도와 규칙성의 특성을 알아보고 규준데이터를 제공하기 위해 실시하였다. 연구대상은 광주광역시 초등학교에 재학 중인 1학년(남자 45명, 여자 50명)과 2학년(남자: 47명, 여자: 52명), 총 194명이며 수행과제는 AMR '퍼', '터', '커'와 SMR '퍼터커'를 사용하였고 Motor Speech Profile advanced (Model 5141)와 Window용 Praat을 사용하여 분석하였다. 연구결과 첫째, AMR 속도는 '퍼', '터', '커' 모두 학년에 따라 통계적으로 유의한 차가 있었으며 2학년의 AMR 속도가 더 빨랐고 성별에 따라 통계적으로 유의한 차이는 없었다. 둘째, AMR 규칙성은 '퍼', '터', '커' 모두 성별에 따라 통계적으로 유의한 차이가 있었으며 여학생의 AMR이 더 규칙적인 것으로 나타났고 학년에 따른 규칙성에서는 차이가 없었다. 셋째, SMR 속도는 '퍼터커' 모두 학년에 따라 통계적으로 유의한 차이가 있었으며 2학년 집단에서 SMR 속도가 더 빨랐고 성별에 따라 통계적으로 유의한 차이가 없었다. 학년과 성별에 따른 상호작용 효과는 AMR과 SMR 속도와 규칙성에서는 모두 나타나지 않았다. 본 연구를 통해 초등학교 1, 2학년 아동의 DDK 수행력이 학년과 성별에 따라 다소 차이가 있는 것으로 나타났다. 차후 연구에서는 속도와 규칙성 외에 조음정확도, 말 명료도 등과의 상관을 알아봄으로써 조음평가에서 DDK 수행력의 활용성을 알아볼 필요가 있다.

• 음성과학
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• 제14권2호
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• pp.55-64
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• 2007

Laryngeal DDK involve with the rate, pattern, and regularity (periodicity) in opening and closing of vocal fold. This study was aimed at investigating the characteristics of laryngeal DDK between nonfluent and fluent speakers. One with an ataxic dysarthria (with cerebellar lesion) and the other with stuttering, and 13 normal speakers were evaluated. L-DDK were analyzed with MSP (motor speech profile, CSL 4400). Measures of DDK included: DDKavr, DDKcvp, DDKjit, DDKavp. An ataxic dysarthric speaker and a stutterer showed more reduced rate and aperiodic L-DDK (both adductory and abductory movement) than normal speakers. But the average L-DDK period (ms) in adductory movement in a speaker with stuttering showed more decreased than the other. Results from this study are preliminary. Nonetheless, results of L-DDK produced by nonfluent speakers suggested the possibility to have relation with slow rate of phonatory initiation and connected speech. In the future, perceptual studies are needed in conjuction with acoustic and speech production.

• 말소리와 음성과학
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• 제5권3호
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• pp.95-101
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• 2013

Aging is related to anatomical and physiological changes in respiratory and phonation organs. These changes influence articulation which leads to inaccurate speech and slow articulatory diadochokinesis(DDK). DDK indicates the range, rate, regularity, accuracy, and agility of articulation that reflect motor speech function. The purpose of this study is to investigate the rates and regularities of DDK in healthy Korean elderly through passive acoustic analysis (Praat). Thirty subjects between the ages of 65 and 94 participated in this study. Rate was observed for 5 seconds, while regularity was calculated based on the standard deviation on the following: 1) syllable duration of each task; 2) gap duration between syllables. Then, simple regression analysis was conducted in order to examine the effect of age on performance. The result showed that the slow rate was not a significant factor in terms of advancing age. Furthermore, regularity indicated a significant difference in the following: 1) /pʌ/, /kʌ/ and /pʌtʌkʌ/ in syllable duration; 2) /kʌ/ duration in the gap between syllables. In conclusion, articulatory coordination is reduced with the onset of aging. In particular, /kʌ/ would be a sensitive task for articulatory coordination.

• 음성과학
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• 제15권2호
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• pp.177-189
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• 2008

This study was to investigate diadochokinetic (DDK) rate, regularity and mean flow rate of articulation valves in dysarthria. DDK rate, mean airflow rate (MFR) and regularity of DDK syllable repetitions of vocal function /ihi/, tongue function /ta/, velopharyngeal function /bm/, and labial function /pa/ in 24 normal and dysarthric speakers were measured. Aerophone Ⅱ and Motor Speech Profile were used for data recording and analysis. The results of the findings were as follows: First, there were significant differences between the dysarthria and the normal group in DDK rate. DDK rates in ataxic dysarthria were the lowest and spastic, flaccid, and hypokinetic dysarthria followed in sequence. Second, there was a significant difference between the dysarthria and the normal group in DDK regularity. Third, there was a significant difference between dysarthria groups and normal group in DDK MFR. Finally, there was a significant difference between the 4 groups of dysarthria and the normal group in DDK air flow tracking. The results of this study can be guidelines for normal DDK rate, regularity and flow rate in dysarthria groups. In addition, their differential diagnoses and descriptions are important to make a decision on medical and behavioral management of the individuals with disorders according to DDK characteristics.

• 음성과학
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• 제15권4호
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• pp.171-188
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• 2008

This study was purposed to introduce Korean Oro-motor Mechanism Screening Examination (KOMSE) and to provide the standardized scores taken from 120 normal adults aged $18{\sim}59$. KOMSE was composed of 13 items of structure, 17 items of function, 3 items of voice, and 14 items of regularity and accuracy of articulation during diadochokinesis. Additionally, maximum phonation time and diadochokinetic rates were measured. Total score of KOMSE is ranged from 0 to 200. It was significantly higher in the $50{\sim}59$ age group than in the $20{\sim}29$ age group, but was not significantly different in sex. MPT had a significant difference in sex, but no significant difference among different age groups. The rate of DDK was also had no significant difference among different age groups. However, some reducing trend in the rate of DDK was observed as age increased. KOMSE would be very helpful for SLPs to screen the abnormality of oro-motor mechanism.

• 말소리와 음성과학
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• 제6권3호
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• pp.3-12
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• 2014

Larynx plays an important role in phonation and protection of the respiratory tract during swallowing. The reduced anatomical and physiological function in elevation of larynx and glottis closure can cause problems in voice and swallowing. The present study investigated the Korean version of handicap index of dysphagia in elderly Koreans. Therefore, 60 normal elderly Koreans ranged from 65 to 95 and 20 normal Korean young adults aged from 20 to 25 were participated in this study to compare total (T), physical (P), functional (F), and emotional (E) index scores between two groups as well as among sub groups (60s, 70s, 80s) in elderly. For swallowing, total and sub dysphagia handicap index (DHI) scores, voice quality during /a/phonation following swallowing (saliva and water), intensity of coughing, and L-DDK were measured. The results showed that functional (P), physical (P), emotional (E) scores as well as total (T) score were significantly different between young adults and old adults in DHI(p<.05). Additionally, there was a negative correlation between total DHI score and intensity of coughing (r=-.51) as well as L-DDK (r=-.70). These findings suggest that a slow rate in vocal fold adduction and reduced intensity of coughing in the elderly affect swallowing function. Thus, recently translated Korean version of DHI may be useful as supplement in evaluating the swallowing problems in elderly people.

• 재활복지
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• 제22권3호
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• pp.189-208
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• 2018

본 연구는 세 명의 두경부암 환자들을 대상으로 말산출 관련 기능 개선을 목표로 치료적 노래부르기 중심의 음악중재를 시행하고, 각 사례 별로 변화를 관찰 기술한 사전-사후 개별 사례연구이다. 중재는 개별 세션의 형태로 매 회기 30분, 주 2회씩 총 12회기 동안 진행되었으며, 시행된 프로그램은 호흡근 이완을 위한 신체움직임, 조음기관의 운동범위 확장 및 성대이완을 위한 발성훈련과 치료적 노래부르기의 총 3단계로 구성되었다. 중재에 따른 대상자들의 말산출 관련 기능의 변화를 알아보기 위해 음성의 질, 길항반복운동속도(diadochokinesis, DDK), 모음공간면적(vowel space area, VSA) 변화 등의 음향학적 분석과 <산책>문단 읽기 과제 시의 청지각적 평가를 시행하였고, 프로그램 참여 시의 관찰 및 사전 사후 면담을 통해 대상자의 심리정서적 변화를 추가적으로 살펴보았다. 중재 과정에서 모든 대상자의 재활동기 및 음성 사용에 대한 긍정적 변화 양상이 관찰되었고, 중재 후에는 음성의 질, DDK에 변화가 있었으며, VSA의 확대가 나타났다. 본 연구를 통해 치료적 노래부르기 중심의 음악중재프로그램이 두경부암 환자들의 음성 기능 및 잔존하는 조음기관 운동성을 향상시키는데 긍정적인 영향을 미칠 수 있음을 알 수 있었다.

• 대한후두음성언어의학회지
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• 제24권1호
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• pp.41-46
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• 2013

Background & Objectives : The Speech Handicap Index (SHI) is used to assess speech problem of head and neck cancer patients. The aim of this preliminary study was to evaluate the reliability and validity the Korean version SHI. Materials and Methods : Sixteen patients with oral cavity cancer and 26 normal control were participated in the study. Test-retest reliability of the Korean version of SHI was completed by 20 out of 42 subjects after 2weeks. Mann-Whitney U test was used to compare the Korean version of SHI scores between normal population and patients group. The relationship between the Korean version of SHI and diadochokinesis (DDK) was investigated using Spearman correlation coefficients. Results : The Korean version of SHI provided a high internal consistency (${\alpha}$=0.99) and test-retest reliability (Spearman rho 0.98). The mean SHI scores [total (T), speech (S), and psychosocial (P)] in normal population were 0.8 (T), 0.2 (S) and 0.4 (P), whereas those in patients group were 58.1 (T), 27.9 (S) and 27.0 (P) respectively. There were significant differences in total SHI score as well as in all of the sub-SHI scores between two groups. Moreover, significant correlation between the Korean version of SHI parameters (T, S, P) and sequential motion rate (SMR) were yielded in patients group. Conclusion : The Korean version of SHIwas reliable and valid. It can be useful as a supplementary clinical tool for diagnosing and measuring treatment efficacy of speech problems related to oral cavity cancer.