Speech-aid prosthesis in velopharyngeal incompetency patient with cleft palate: can speech aids be applicable for adult patient?

강동철,박정호,석현,백진아,김다와,고승오 대한악안면성형재건외과학회 2021 Maxillofacial Plastic Reconstructive Surgery Vol.43 No.-

BackgroundVelopharyngeal incompetence (VPI) therapy for cleft palate (speech therapy alone, speech therapy using speech aids, or combined therapy such as speech therapy using a pharyngeal flap), is more effective in younger patients than in adult patients. Speech therapy is known as very difficult for patients who still have VPI as an adult. Because of the possibility of subsequent speech disorders, the timing of surgery for cleft palate is accelerating. Herein, we present a case of an adult with articulation disorder due to VPI who was treated by speech therapy and a speech-aid prosthesis. Case presentationA woman who underwent cleft palate surgery at 8 years of age still had difficulty with articulation due to VPI as a 24-year-old adult because of a lack of continuous speech therapy. We decided to use a speech-aid application using palatal lift, and a reduction program was conducted four times, along with simultaneous speech therapy, over a period of 1 year and 7 months. During the therapy period, she was able to speak normally within a relatively short period of time, and after implementation of the reduction program, the therapy was completed by completely removing the device. Long-term observations have shown normal speech function without recurrence, even after the device was removed. ConclusionAs seen in this case, speech therapy using speech aids can show a good result for adult patients with cleft palate who missed the usual timing for the treatment of articulation disorders, depending on the situation. Therefore, it is hereby reported as a therapy option worthy of consideration.

강연 제목의 기능과 유형에 관한 연구 - 강연 프로그램 ‘세상을 바꾸는 시간, 15분’을 중심으로 -

권미영 한국텍스트언어학회 2020 텍스트언어학 Vol.48 No.-

This study focused on clarifying the functions and types of speech titles. In this study, the speech titles are regarded as an important component of the speech discourse, and the functions and the types of speech titles have been analyzed in relation to the speech discourses. It has been demonstrated that the main function of speech titles is to show the topic and the theme of the speeches. In addition, it has been revealed that speech discourses directly accept the titles as the topic or the theme. This study suggests that the speech titles should be written in a direction that directly indicates the topic or the theme of the speeches.

Treatment of velopharyngeal insufficiency in a patient with a submucous cleft palate using a speech aid: the more treatment options, the better the treatment results

Park, Yun-Ha,Jo, Hyun-Jun,Hong, In-Seok,Leem, Dae-Ho,Baek, Jin-A,Ko, Seung-O Korean Association of Maxillofacial Plastic and Re 2019 Maxillofacial Plastic Reconstructive Surgery Vol.41 No.-

Background: The submucous cleft palate (SMCP) is a type of cleft palate that may result in velopharyngeal insufficiency (VPI). Palate muscles completely separate oral and nasal cavities by closing off the velopharynx during functional processes such as speech or swallow. Also, hypernasality may arise from anatomical or neurological abnormalities in these functions. Treatments of this issue involve a combination of surgical intervention, speech aid, and speech therapy. This case report demonstrates successfully treated VPI resulted from SMCP without any surgical intervention but solely with speech aid appliance and speech therapy. Case presentation: A 13-year-old female patient with a speech disorder from velopharyngeal insufficiency that was caused by a submucous cleft palate visited to our OMFS clinic. In the intraoral examination, the patient had a short soft palate and bifid uvula. And the muscles in the palate did not contract properly during oral speech. She had no surgical history such as primary palatoplasty or pharyngoplasty except for tonsillectomy. And there were no other medical histories. Objective speech assessment using nasometer was performed. We diagnosed that the patient had a SMCP. The patient has shown a decrease in speech intelligibility, which resulted from hypernasality. We decided to treat the patient with speech aid (palatal lift) along with speech therapy. During the 7-month treatment, hypernasality measured by a nasometer decreased and speech intelligibility became normal. Conclusions: Surgery remains the first treatment option for patients with velopharyngeal insufficiencies from submucous cleft palates. However, there were few reports about objective speech evaluation pre- or post-operation. Moreover, there has been no report of non-surgical treatment in the recent studies. From this perspective, this report of objective improvement of speech intelligibility of VPI patient with SMCP by non-surgical treatment has a significant meaning. Speech aid can be considered as one of treatment options for management of SMCP.

내측 측두엽 간질에서 간질발작 중 언어증상

이장준,이승환,이형,김지언,임정근,손은익,이상도,박영춘 계명대학교 의과학연구소 2000 계명의대학술지 Vol.19 No.1

Background and Objectives : Several speech manifestation are observed in temporal lobe epilepsy(TLE). We studied the frequency of ictal speech manifestations and their localizing and lateralizing value in TLE. Methods : We reviewed 379 seizures recorded on videotape in 135 patients who underwent temporal lobectomy for intractable TLE. We divided patients into group A(n=75) who became seizures free after surgery, and group B(n=60) who were only slightly benefited or unchanged after surgery. Speech manifestations were classified as normal speech, vocalization, or abnormal speech. Abnormal speech was subdivided into speech arrest, dysarthria, dysphasia, or nonidentifiable speech. Results : Speech manifestations occurred in 70(18.5%) seizures of 28 patients. Forty eight seizures of 20 patients were observed in group A, and 22 seizures of 8 patients were observed in group B. In group A, 25 seizures of 11 patients were originating from dominant hemisphere, 23 seizures of 9 patients from nondominant hemisphere. In group B, 13 seizures of 5 patients were originating from dominant hemisphere, and 9 seizures in Lt. side and 6 seizures in Rt. side, respectively) of group A(P>0.05), and eleven seizures of 4 patients(8 seizures from Lt. side and 3 seizure from Rt. side) in group B(P>0.05). Normal speech was observed only seizures from Rt. side in both groups(3 seizures in 1 patient, each group). Dysphasia occurred only in seizures originating from Lt. side. Nonidentifiable speech occurred in 22 seizures of 9 patients(11 seizures from each side) in group A(P<0.01), and 3 seizures of 1 patient occurred only from Lt. side in group B. Conclusion : Ictal speech manifestations were not uncommon(18.5%). All kinds of ictal speech manifestations except normal speech have no reliable lateralizing and localizing value in TLE. Normal speech could be a good indicator of seizure originating from nondominant hemisphere.

발표 능력 향상을 위한 자기 평가 활용의 의의

오현진 한국 리터러시 학회 2019 리터러시 연구 Vol.10 No.4

This study presents ‘self-evaluation’ as a way to improve the speech skills of university students, organizes how students feel about it when it is utilized, and attempts to observe how ‘self-evaluation’ contributes to the speech skill improvement of students. Speech education that is needed by university students who have learned speech knowledge several times provides an opportunity for students to experience entire speech situations within actual and detailed situations and accurately recognize their own speech skills while having the identity and distinction of university education. ‘Self-evaluation’, which allows students to not only observe speech in themselves but also allows them to reflectively observe the entire process of presenting while looking into their own strengths and weaknesses, is significant because it places focus on the speech skills of individual students and allows them to improve their negative perceptions on past speech. Through self-evaluation made through actual videos, students were able to recognize various aspects of their own speech skills that they were not aware of before and they gained interest in interactions with the listening audience and reports were given that self-evaluation methods had a positive effect on the improvement of speech skills and that they can be used as learning tools. This shows the utilization possibilities and educational significance of ‘self-evaluation’ in the speech education of university students and it implicated the need for the development of detailed self-evaluation methods or models. 이 연구는 대학생을 대상으로 발표 능력을 향상시키기 위한 방법으로 ‘자기 평가’를 제안하고 그것을 활용했을 때 학생들의 소감을 정리하여 ‘자기 평가’가 학생들에게 미친 영향을 살펴보고자 하였다. 발표에 관한 지식을 여러 차례 학습한 바 있는 대학생에게 필요한 발표 교육은 실제적이고 구체적인 상황 속에서 발표의 전 상황을 경험해 보고 자신의 발표 능력에 대한 정확한 인식할 수 있는 기회를 제공하는 것이어야 하고, 이것은 대학 교육만의 정체성과 차별성을 확보할 것이다. 발표만이 아니라 발표의 전 과정에 대해 스스로 반성적으로 살펴보고 자신의 장, 단점을 파악해 보는 과정인 ‘자기 평가’는 학생 개개인의 발표 능력을 중심에 두고 이전 발표에 대한 부정적 인식을 개선할 수 있게 한다는 점에서 의의가 있다. 실제 동영상을 통한 자기 평가를 통해 학생들은 이전에 알지 못했던 자신의 발표 능력의 다양한 측면을 인지할 수 있었고, 청중과의 상호작용에 관심을 갖게 되었으며, 자기 평가 방법이 발표 능력 향상에 긍정적인 영향을 미치며 학습 도구로 활용가능하다는 것을 알게 되었다고 보고하였다. 이는 대학생을 위한 발표 교육에 ‘자기 평가’의 활용 가능성과 교육적 의의를 보여주는 것이며, 향후 구체적인 자기 평가 방법이나 모형 개발의 필요성을 시사한다.

심리음향 특성을 이용한 음성 향상 알고리즘

전유용(Yuyong Jeon),이상민(Sangmin Lee) 대한전기학회 2010 전기학회논문지 Vol.59 No.6

In the speech system, for example hearing aid as well as speech communication, speech quality is degraded by environmental noise. In this study, to enhance the speech quality which is degraded by environmental speech, we proposed an algorithm to reduce the noise and reinforce the speech. The minima controlled recursive averaging (MCRA) algorithm is used to estimate the noise spectrum and spectral weighting factor is used to reduce the noise. And partial masking effect which is one of the human hearing properties is introduced to reinforce the speech. Then we compared the waveform, spectrogram, Perceptual Evaluation of Speech Quality (PESQ) and segmental Signal to Noise Ratio (segSNR) between original speech, noisy speech, noise reduced speech and enhanced speech by proposed method. As a result, enhanced speech by proposed method is reinforced in high frequency which is degraded by noise, and PESQ, segSNR is enhanced. It means that the speech quality is enhanced.

청자의 친숙도에 따라 낱말수준에서 살펴본 24∼48개월 아동의 말 명료도 발달 연구

김미진(Mijin Kim),하승희(Seunghee Hab) 한국언어청각임상학회 2012 Communication Sciences and Disorders Vol.17 No.4

Background & Objectives: Speech intelligibility is an important index for determining a child’s verbal communication competence and the need for intervention and for evaluating the effectiveness of intervention. The present study investigated the developmental patterns of speech intelligibility based on single-word productions in typically developing children between 24 and 48 months of age according to listener’s familiarity with child’s speech. Methods: The participants in this study were 40 typically developing children that were divided into 4 age groups (6-month intervals, 10 children per group). The listener groups consisted of 40 children’s mothers and 42 individuals who were not familiar with the child’s speech. A picture list of 23 target words was presented to children who were asked to produce each target word spontaneously. Listeners listened to children’s recorded speech samples and transcribed what they understood. Speech intelligibility was measured by dividing the number of fully intelligible target words by the total number of words and multiplying by 100. Results: 1) There were significant differences among the 4 different age groups in both listener groups. Post-hoc test revealed that speech intelligibility in the early 2-year-old group was significantly different from the late 2-year-old and early and late 3-year-old groups. Additionally, there was significant difference of speech intelligibility between the late 2-year-old group and late 3-year-old group. 2) There was no significant difference of speech intelligibility percentages between listener groups. Discussion & Conclusion: Speech intelligibility rapidly developed at 2 years of age and gradually progressed showing more than 70% of speech intelligibility after 3 years of age. The results suggested that listener’s familiarity with a child’s speech did not affect the speech intelligibility measures in single-word levels. 배경 및 목적: 말 명료도는 아동의 말 산출 능력을 결정하고 언어치료 중재의 필요성과 중재의 효과를 평가하는 데 중요한 정보를 제공하는 지표이다. 본 연구에서는 아동의 어머니가 청자일 경우와 아동 발화에 친숙하지 않은 청자일 경우에 따라 월령별 말 명료도 발달 양상은 어떻게 달라지는지 살펴보고자 하였다. 방법: 화자는 24∼48개월 일반아동을 6개월 단위로 구분하여 각 10명씩, 총 네 집단으로 구성하였고 청자는 아동의 어머니 40명과 아동의 발화에 친숙하지 않은 사람 42명으로 구성하였다. 말 명료도 평가를 위해 선정된 23개의 목표낱말을 그림으로 제시해 단어명명하기 방법으로 검사를 실시하여 아동의 발화를 녹음하였다. 녹음된 발화를 두 청자 집단에게 들려준 뒤 아동이 의도한 낱말과 청자가 이해한 낱말의 수를 퍼센트로 산출하여 말명료도를 측정하여 이원배치 분산분석을 실시하였다. 결과: 월령에 따라 말 명료도 측정치가 유의미한 차이를 보이는 것으로 나타났다. 두 청자에 따라 말 명료도 결과는 유의미한 차이를 보이지 않았으며 월령과 청자 집단 간 상호작용도 유의미하지 않았다. 사후분석결과, 2세 전반의 말 명료도 결과는 2세 후반, 3세 전반, 3세 후반 말 명료도 결과와 통계적으로 유의미하게 차이가 있었고 2세 후반의 말 명료도 결과는 3세 후반의 말 명료도 결과와 유의미하게 차이가 있었다. 논의 및 결론: 낱말수준의 말 명료도 검사에서 아동의 발화에 대한 청자의 친숙도는 크게 영향을 미치지 않는 것으로 나타났다. 말 명료도 발달은 2세 전반과 후반에 비약적으로 발달하였고, 3세 이후의 연령부터 점진적인 발달을 이루어 70%이상의 말 명료도를 나타내었다.

Speech Outcomes in 5-Year-Old Korean Children with Bilateral Cleft Lip and Palate

Kyung S. Koh,Seungeun Jung,Bo Ra Park,Tae-Suk Oh,Young Chul Kim,Seunghee Ha Korean Society of Plastic and Reconstructive Surge 2024 Archives of Plastic Surgery Vol.51 No.1

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.

Comparison of Speech Rate and Long-Term Average Speech Spectrum between Korean Clear Speech and Conversational Speech

유제은,오홍엽,정승엽,진인기 대한청각학회 2019 Journal of Audiology & Otology Vol.23 No.4

Background and Objectives: Clear speech is an effective communication strategy used in difficult listening situations that draws on techniques such as accurate articulation, a slow speech rate, and the inclusion of pauses. Although too slow speech and improperly amplified spectral information can deteriorate overall speech intelligibility, certain amplitude of increments of the mid-frequency bands (1 to 3 dB) and around 50% slower speech rates of clear speech, when compared to those in conversational speech, were reported as factors that can improve speech intelligibility positively. The purpose of this study was to identify whether amplitude increments of mid-frequency areas and slower speech rates were evident in Korean clear speech as they were in English clear speech. Subjects and Methods: To compare the acoustic characteristics of the two methods of speech production, the voices of 60 participants were recorded during conversational speech and then again during clear speech using a standardized sentence material. Results: The speech rate and longterm average speech spectrum (LTASS) were analyzed and compared. Speech rates for clear speech were slower than those for conversational speech. Increased amplitudes in the mid-frequency bands were evident for the LTASS of clear speech. Conclusions:The observed differences in the acoustic characteristics between the two types of speech production suggest that Korean clear speech can be an effective communication strategy to improve speech intelligibility.

언어장애인용 언어치료 솔루션 개발을 위한 사용성 평가 연구

김기욱(Gi-Wook Kim),강승록(Seung-Rok Kang),한갑수(Kap Soo Han),조윤주(Yun-ju Jo),김라연(Ra-Youn Kim),정영재(Young-Jae Jung),김준혁(Jun-Hyuk Kim),유희천(Heecheon You),고명환(Myoung-Hwan Ko) 대한구순구개열학회 2021 대한구순구개열학회지 Vol.24 No.2

Objective: We performed a usability test for the speech therapy solutions Smart SpeechTM and Smart NasometerTM to apply usability testing results for the development of an optimal speech therapy solution. Materials and Methods: A total of 19 health professionals (12 doctors and 7 speech therapists) practicing speech therapy were recruited. They performed a usability evaluation by simulating speech therapy tasks for the speech-impaired after being familiarized with Smart Speech and Smart Nasometer for 30 minutes. The participants performed the tasks using oral training contents, breathing training contents, and vocal training contents of Smart Speech. Then, they conducted tasks of wearing Smart Nasometer and checking nasalance data measured by Smart Nasometer. Lastly, they completed a satisfaction survey of Smart Speech and Smart Nasometer. Results: The usability evaluation showed that more than 60% of the participants were satisfied with Smart Speech and more than 50% with Smart Nasometer. The participantssuggested improvements of Smart Speech in the game description, content color, guide video, audio, data analysis and management, and difficulty-level control function. Conclusion: The results of this study showed the importance of usability evaluation with users when developing healthcare devices.