학령기 말더듬 아동의 주관적 말더듬 중증도, 불안 및 의사소통태도 간의 상관

Abstract

School-age children who stutter(school-age CWS) can experience negative responses of listeners or fluency failures of in various verbal communication situations, and this would bring internal anxiety or burden on their own speech. Therefore, speech-language pathologists should consider children’s own thoughts(subjective perspective) toward stuttering as well as overt stuttering symptoms reflecting quantitative and qualitative characteristics of core behaviors and struggle behaviors when evaluating children who stutter. In addition, it would be difficult to transfer or maintain achieved fluency through speech therapy unless proper resolution of anxious feelings, which could predict negative influence on prognosis of therapy. The purpose of this study was (1) to compare the degree of trait anxiety and speech-related state anxiety between school-age CWS and CWNS(children who do not stutter), (2) to seek relation between overt stuttering severity and subjective stuttering severity of school-age CWS, and (3) to seek relation among overt and subjective stuttering severities, characteristics of anxiety, and communication attitude. Participants were 15 school-age CWS and 16 CWNS. To measure the overt stuttering severity of CWS, the ratio of abnormal disfluencies(AD ratio) was used, and the subjective stuttering severity was measured through 10cm- visual analog scale(VAS) by dividing into two categories: overall subjective stuttering severity and task-related subjective stuttering severity. The Trait Anxiety Inventory for Children(TAI-C) was used to measure trait anxiety and the Speech Situation Checklist-Emotional Reaction(SSC-ER) was used to measure speech-related state anxiety. The Communication Attitude Test-Revised(CAT-R) was used to identify communication attitudes of CWS. The results of this study were as follows: (1) there was no significant difference between school-age CWS and CWNS in the degree of trait anxiety but CWS showed significantly higher degree of speech-related state anxiety than CWNS. (2) There was no signification correlation among task-related subjective stuttering severity, overall subjective stuttering severity and AD ratio. (3) AD ratio had no significant correlation with anxiety levels and communication attitude scores of CWS. By contrast, overall subjective stuttering severity showed significantly positive correlation between trait anxiety(r=.567), and speech-related state anxiety(r=.703). There was no correlation between anxiety and task-related subjective stuttering severity. In addition, the correlation coefficient between communication attitude and the task-related subjective stuttering severity was -.536 showing negative correlation. (4) There was no significant correlation between trait anxiety, speech-related state anxiety and communication attitude. There was no significant correlation between the trait anxiety and the speech-related state anxiety. This study confirmed that the anxiety level observed in verbal communication situation of school-age CWS was significantly higher than CWNS and there was significant relation between subjective stuttering severity perceived by CWS and anxiety. On the basis of the results of this study, it needs to consider the level of anxiety occurred in verbal communication situation as well as evaluation reflected subjective perspective to evaluate and mediate school-age CWS. It is considered to expect to improve fluency of children who stutter when the desensitization toward communication or situation related to speech which increases anxiety of each children who stutter.