말더듬성인의 조음기관 구조 및 기능

Abstract

Speech production involves adequate speech mechanism and motor abilities, and the speech mechanism and motor abilities become the basis of oral motor skills. Compared to other stuttering factors, the effect of stuttering caused by oral motor skills is not less. Despite such circumstances, studies on oral motor skills for people who stutter are insufficient in Korea. The fact that there are insufficient research concerning this study in Korea raises the question of whether the oral motor skills for people who stutter in the actual clinical setting are not evaluated with importance or that directive treatment could be limited. Therefore, this study is aimed to compare whether there are differences in speech mechanism and motor abilities between adults who stutter (AWS) and do not stutter (AWNS). Furthermore, the study provides a research of the relationships between stuttering severity and speech mechanism and motor abilities. Speech Mechanism Screening Test (SMST) was used as a screening tool. Among the categories of SMST, speech mechanism and motor abilities in the first category was used. This involves direct administering and there are 13 subcategories to assess speech mechanism structure and 17 subcategories to assess speech mechanism function. The structural and functional judgments for speech mechanism and motor abilities include face, lips, tongue, jaw and teeth, hard palate and soft palate, pharynx, and breathing. A total of 34 subjects were studied in the research. Out of 34 subjects, 17 (14 male subjects and 3 female subjects) were over the age of 19 and they were AWS and 17 subjects, with same sex ratio and age, that AWNS. The average age for AWS was around the age of 32 and 9 months (age range: between 19 and 11 months and 57 and 9 months), and the average age for AWNS was around the age of 32 and 3 months (age range: between 20 and 3 months and 57 and 1 month). In this research, the speech mechanism and motor abilities of the subjects were examined and assessed by SMST from a non-verbal level. The relationship between stuttering severity and speech mechanism and motor abilities the stuttering group was studied. As a result of implementing the statistical test of normality, the scores in all areas did not follow a normal distribution, and thus, Wilcoxon’s rank sum test, the non-parametric statistics, was used. Moreover, in order to verify the relationship between stuttering severity and structure and function of AWS, Spearman’s correlation analysis, which is a non-parametric correlation analysis, was used. For reliability evaluation between the subjects, 20 % of the subjects were examined by dental specialists. The reliability evaluation showed consistent rate of 89.0 % in speech mechanism structure and 97.9 % in speech mechanism function. As a result of the study, AWS and AWNS do not have a significant difference in speech mechanism and motor abilities. This result signifies that the speech mechanism and motor abilities of AWS is in fact in the normal range. This proves that the oral motor skills of AWS are not a simple matter of non-verbal level in speech mechanism and motor abilities. However, oral motor skills can be studied in various methods. Up to now, many researchers have presented different research results on oral motor skills since diverse research methodologies exist. Additionally, after researching the group of AWS on the relationship of each area, between the stuttering severity and speech mechanism structure and stuttering severity and speech mechanism function, there was no relationship in all areas except the area of tongue function. The area of tongue function, which was the only area that showed relationship, showed that the more severe the stuttering is, the lower the score was. However, after reassessing the relationship of tongue function in stuttering severity and speech mechanism, excluding the two areas that apply the law of dominance, the area of tongue function, likewise, did not have any correlation with stuttering severity. Then the result of the study becomes more evident. The result of the study shows that, through observation in non-verbal means, it is difficult to verify the difference in speech mechanism and motor abilities between the groups as well as the difference in stuttering severity. In speech mechanism and motor ability assessment, a significant difference was not found in any areas, including structure and function in AWS and AWNS, but variations clearly exist. In addition, in both areas, in speech mechanism and motor abilities, significant differences were not found between AWS and AWNS. However, there are individual variations, and for this reason, if there are any areas that could be problematic, even in the most fundamental areas, it should be taken into a careful consideration.