• Clinical and Experimental Pediatrics
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• 제51권9호
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• pp.922-934
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• 2008

Developmental language disorder is the most common developmental disability in childhood, occurring in 5-8% of preschool children. Children learn language in early childhood, and later they use language to learn. Children with language disorders are at increased risk for difficulties with reading and written language when they enter school. These problems often persist through adolescence or adulthood. Early intervention may prevent the more serious consequences of later academic problems, including learning disabilities. A child's performance in specific speech and language areas, such as phonological ability, vocabulary comprehension, and grammatical usage, is measured objectively using the most recently standardized, norm-referenced tests for a particular age group. Observation and qualitative analysis of a child's performance supplement objective test results are essential for making a diagnosis and devising a treatment plan. Emphasis on the team approach system in the evaluation of children with speech and language impairments has been increasing. Evidence-based therapeutic interventions with short-term, long-term, and functional outcome goals should be applied, because there are many examples of controversial practices that have not been validated in large, controlled trials. Following treatment intervention, periodic follow-up monitoring by a doctor is also important. In addition, a systematized national health policy for children with speech and language disorders should be provided.

• Clinical and Experimental Pediatrics
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• 제58권1호
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• pp.8-14
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• 2015

In patients with a language developmental delay, it is necessary to make a differential diagnosis for autism spectrum disorders (ASDs), specific language impairment, and mental retardation. It is important that pediatricians recognize the signs and symptoms of ASDs, as many patients with language developmental delays are ultimately diagnosed with ASDs. Pediatricians play an important role in the early recognition of ASDs, because they are usually the first point of contact for children with ASDs. A revision of the diagnostic criteria of ASDs was proposed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) that was released in May 2013. The autism spectrum describes a range of conditions classified as neurodevelopmental disorders in the fifth edition of the DSM. The new diagnostic criteria encompasses previous elements from the diagnosis of autistic disorder, Asperger disorder, childhood disintegrative disorder, and pervasive developmental disorder-not otherwise specified. An additional change to the DSM includes synthesizing the section on social and communication deficits into one domain. In ASD patients, the appropriate behavioral therapies and rehabilitation treatments significantly affect the prognosis. Therefore, this makes early diagnosis and treatment very important. In conclusion, pediatricians need to be able to recognize the signs and symptoms of ASDs and be attentive to them in order to make an early diagnosis and provide treatment.

• 한국콘텐츠학회논문지
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• 제19권9호
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• pp.262-270
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• 2019

본 연구는 문화와 언어의 장벽으로 인해 발달장애 발생 위험이 높은 다문화가정의 자녀를 위한 발달장애 조기선별 검사지 디자인 개발을 목적으로 한다. 일반적인 발달장애 조기 선별검사지와 달리 다문화가정을 위한 조기 선별 검사지에 대한 연구는 극히 드물며, 특히 다문화가정의 부모와 관련 사회복지사들이 현장에서 겪는 언어적, 문화적 소통의 한계점을 극복할 수 있는 시도는 전무하다. 이에 본 연구에서는 전문가 세미나를 통하여 기존의 발달장애 조기 선별검사지 현황과 개발의 필요성을 확인하고, 이해관계자를 대상으로 한 설문조사와 인터뷰를 통해 니즈를 파악한 후 인사이트와 디자인 핵심요소를 도출하였다. 이를 통해 다문화가정 부모가 선호하는 일러스트레이션 스타일과 언어권별 음성지원시스템을 포함한 발달장애 조기 선별검사지를 개발하였다. 리플릿 형식의 검사지는 지역의 다문화센터 및 장애인복지센터에서 다문화가정의 영유아 발달장애 조기 선별에 실질적으로 활용될 예정이다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제3권1호
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• pp.46-55
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• 1992

발달성언어장애는 학령기 아동에서 약 $3{\sim}10%의$ 높은 빈도로 발견이 되며 그대로 방치할 경우 열등감, 좌절감, 우울증 등의 정서적인 문제를 일으키며 이차적인 학습장애를 동반한다. 이러한 발달성언어장애의 원인으로서는 사회환경적인 영향, 언어발달시기에 생긴 전도성청음장애로 인한 청각자극의 결핍, 유전적인 영향, 국소적인 뇌의 손상 등 때문으로 주장되지만 아직까지 정확한 기전은 밝혀지지 않고 있다. 이에 본 연구는 뇌전산화단층촬영이나 뇌파검사 등에는 나타나지 않는 국소적인 기질적인 병변이 존재하기 때문이라는 가설을 세우고, 뇌의 기능적인 이상을 알 수 있는 '단일광자방출전산화단층촬영'을 시행한 결과, 61.9%(26/42)에서 혈류의 감소가 있음을 발견하였다. 이상소견이 발견된 뇌의 부위가운데에서 대뇌피질이 47.6%(20/42)로서 가장 많았고, 그 다음으로는 시상부위가 33.3%(14/42)로 많았다. 이러한 결과로 미루어 볼 때 발달성언어장애가 뇌혈류의 이상소견과 관련된 뇌기능장애와 관련되어 나타날 가능성이 있음을 알 수 있었다. 향후 동일한 대상 환아군들을 추적 조사하여 증상이 호전된 후에 다시 단일광자방출전산화단층촬영을 실시하여 본 연구결과와 비교연구를 시행한다면 보다 정확한 원인 규명이 가능할 것으로 판단된다.

• Clinical and Experimental Pediatrics
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• 제49권10호
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• pp.1019-1025
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• 2006

Motor delay, when present, is usually the first concern brought by the parents of children with developmental delay. Cerebral palsy that is the most common motor delay, is a nonspecific, descriptive term pertaining to disordered motor function that is evident in early infancy and is characterized by changes in muscle tone, muscle weakness, involuntary movements, ataxia, or a combination of these abnormalities. A wide range of causative disorders and risk factors have been identified for cerebral palsy, and broadly classified into 5 groups; perinatal brain injury, brain injury related to prematurity, developmental abnormalities, prenatal risk factors, and postnatal brain injury. Delay in attaining developmental milestones is the most distinctive presenting complaint in children with cerebral palsy. A detailed history and thorough physical and neurologic examinations are crucial in the diagnostic process. The clinician should be cautious about diagnostic pronouncement unless the findings are unequivocal. Several serial examinations and history review are necessary. All children with cerebral palsy should undergo a neuroimaging study, preferably MRI, because an abnormality is documented on head MRI(89%) and CT(77%). The high incidence rates for mental retardation, epilepsy, ophthalmologic defects, speech and language disorders and hearing impairment make it imperative that all children with cerebral palsy be screened for mental retardation, ophthalmologic and hearing impairments, and speech and language disorders; nutrition, growth, and swallowing also should be closely monitored.

• 생물정신의학
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• 제4권1호
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• pp.12-18
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• 1997

In this article neuroanatomical theory and verbal developmental process were introduced, followed that disorders and assesment of language function were reviewed. Finally, the causes and assesment of developmental dyslexia as a childhood disorder related to verbal function were reviewed.

• Clinical and Experimental Pediatrics
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• 제49권4호
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• pp.341-353
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• 2006

Learning disorders are diagnosed when the individual's achievement on standardized tests in reading, mathematics, or written expression is substantially below that expected for age, schooling, and level of intelligence. Subtypes of learning disorders may be classified into two groups, language-based type learning disorders including reading and writing disorder, and nonverbal type learning disorder (NLD) such as those relating to mathematics & visuospatial skills, and those in the autism spectrum. Converging evidence indicates that reading disorder represents a disorder within the language system and more specifically within a particular subcomponent of that system, phonological processing. Recent advances in neuroimaging technology, particularly the development of fMRI, provide evidences of a neurobiological basis for reading disorder, specifically a disruption of two left hemisphere posterior brain systems, one parieto-temporal, the other occipito-temporal. The former is the reading system for beginner reading, the latter for skilled reading. Compensatory engagement of anterior systems around the inferior frontal gyrus(Broca's area) and a posterior(right occipito-temporal) system is noted in persistent poor readers in long-term follow up study. The theoretical model proposed to explain NLD's source is not right hemisphere damage, but rather the white matter model. The working hypothesis of the white matter model is that the underdevelopment of, damage to, or dysfunction of cerebral white matter(long myelinated fibers) is the source of this disorder. The role of an evidence-based effective intervention in the remediation of children with learning disorder is discussed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제8권2호
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• pp.256-265
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• 1997

전반적발달장애 환자와 발달성언어장애 환자의 뇌혈류량의 분포를 조사하여 각 질환의 국소적 뇌기능의 특성을 알아보고자 한다. 14명의 전반적발달장애 환자와 13명의 발달성언어장애 환자를 대상으로 뇌 technetium-99m-EDC SPECT를 촬영하여 2명의 핵의학 전문의가 판독하고, 대뇌의 측두엽, 두정엽, 기저핵, 시상, 소뇌를 관심 영역(region of interest)으로 하여 뇌혈류량을 양적으로 측정하여 양군을 비교한다. 뇌 SPECT 소견상 전반적발달장애와 발달성언어장애에서 모두 측두엽, 두정엽, 기저핵, 시상, 소뇌의 혈류량의 감소를 보였고, 혈류량을 양적으로 측정한 결과, 상기부위의 혈류량이 전반적발달장애군과 발달성언어장애군에서 유의한 차이를 보이지 않았다. 이는 전반적발달장애와 발달성언어장애는 뇌기능의 특정 국소부위의 이상이 아니고, 대뇌피질과 피질하부위의 신경발달-신경연결(interneural connection)-상의 이상에 의한 질환이며, 두 질환이 스펙트럼장애일 가능성을 시사한다.

• 재활복지
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• 제21권2호
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• pp.233-246
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• 2017

본 연구는 디지털 세계와 물리적 세계가 접목하는 증강현실을 언어치료에 적용하기 위한 기초 연구이다. 특히, 아동들에게 동사를 지도할 때 증강현실로 구현한 동사 목록이 해당 움직임을 정확하게 나타내고 있는지와 같은 동작 타당도, 그리고 해당 동사 목록이 어휘 지도 목표로 적절한 것인지에 대한 어휘 타당도를 살펴본 연구이다. 선행 연구들을 참고하여 45개의 동사를 어휘 지도 목록으로 선정하고 이 동사들에 대하여 1급 언어재활사 자격증을 소지한 언어치료학과 교수 3명으로 하여금 어휘 타당도를 평가하도록 하였다. 그 결과, 39개 동사에서 높은 어휘 타당도를 얻었다. 높은 어휘 타당도를 얻은 39개 동사에 대한 동작 타당도를 살펴보기 위하여 언어치료 전공 석사과정 대학원생들에게 각 동사를 증강현실로 구현하여 보여주고 생각나는 동사를 기록하게 하였다. 증강현실로 구현된 동작 애니메이션을 보고 난 후 50% 이상의 대학원생이 해당 동사로 기록한 동사는 32개였다. 이차적으로는 이 32개 동사만 증강현실로 구현하여 87명의 언어치료 전공 대학생들에게 보여주고 Likert 5점 척도로 각 동사와 구현된 동작의 일치도를 평가하게 하였다. 최종적으로 30개 동사가 증강현실로 구현하여 지도하기에 타당한 동사 목록으로 선정되었다. 이 연구 결과를 바탕으로 향후 공인 타당도 및 적용 타당화 연구를 지속하여 증강현실을 활용한 어휘 평가 및 지도가 언어치료 임상 현장에서 활용되기를 기대한다.

• Clinical and Experimental Pediatrics
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• 제57권8호
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• pp.363-369
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• 2014

Purpose: This study examines changes in developmental profiles of children with language delay over time and the clinical significance of assessment conducted at age 2-3 years. Methods: We retrospectively reviewed the medical records of 70 children (62 male, 8 female), who had visited the hospital because of delayed language development at 2-3 years, and were reassessed at ages 5-6. Language and cognitive abilities were assessed using multiple scales at the initial and follow-up visits. Results: At the initial test, 62 of the 70 children had mental development index (MDI) below 70 of Bayley Scales of Infant Development Test II. Of the 62 children in the follow-up assessment, 30 children (48.4%) remained within the same cognitive range (full-scale intelligence quotient, FSIQ<70 of Wechsler preschool and primary scale of intelligence), 12 had borderline intellectual functioning (FSIQ, 70-85), 6 improved to average intellectual functioning (FSIQ>85), and 5 had specific language impairment, 9 had autism spectrum disorders. At the initial test, 38 of the 70 children had cognitive developmental quotients (C-DQ) below 70. Of the 38 children in the follow-up assessment, 23 children (60.5%) remained within the same cognitive range (FSIQ<70). The correlation coefficient for MDI and FSIQ was 0.530 (P<0.0001) and that for C-DQ and FSIQ was 0.727 (P<0.0001). There was a strong correlation between C-DQ and FSIQ, and a moderate correlation between MDI and FSIQ. Conclusion: Low MDI scores reflect a specific delay in cognitive abilities, communication skills, or both. The C-DQ, receptive language development quotient, and social maturity quotient also help to distinguish between children with isolated language delay and children with cooccurring cognitive impairment. Moreover, changes in the developmental profile during preschool years are not unusual in children with language delay. Follow-up reassessments prior to the start of school are required for a more accurate diagnosis and intervention.