학령기 인공와우 아동의 비단어 따라말하기 수행력과 관련 요인 분석
Nonword Repetition Performance and Related Factors in School-Aged Children with Cochlear Implants
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본 연구에서는 학령기 인공와우 아동과 정상청력 아동의 음절길이에 따른 비단어 따라말하기의 정확도에 차이가 있는지 비교해보고, 보청기 착용 연령, 인공와우이식 연령, 수용어휘 점수가 인공와우 아동의 비단어 따라말하기의 정확도에 미치는 영향을 살펴보았다. 본 연구에서는 학령기 인공와우 아동(n=25)과 생활연령을 일치시킨 정상창력 아동(n=25)을 대상으로 하였다. 음운기억 능력은 비단어 따라말하기 검사로 평가하였으며, 비단어 음절길이에 따라 정확도를 산출하였다. 집단(인공와우 아동, 정상청력 아동)과 음절길이(2∼6음절)에 따른 비단어 따라말하기의 정확도에 차이가 있는지 살펴보기 위해서 이원혼합 분산분석을 실시하였으며, 보청기 착용 연령, 인공와우이식 연령, 수용어휘 점수가 인공와우 아동의 비단어 따라말하기의 정확도에 미치는 영향을 살펴보기 위해서 단계적 중다회귀분석을 실시하였다. 연구 결과, 인공와우 아동의 비단어 따라말하기의 정확도는 정상청력 아동에 비해서 유의하게 낮았으며(p<.001), 비단어의 음절길이가 길 때의 정확도가 짧을 때에 비해서 유의하게 낮았다(p<.001). 단계적 중다회귀분석 결과, 보청기 착용 연령만이 인공와우 아동의 비단어 따라말하기의 정확도에 유의한 영향을 미치는 것으로 나타났다(β=-.462, p<.05). 학령기 인공와우 아동의 비단어 따라말하기의 정확도는 정상청력 아동보다 낮았으며, 보청기를 일찍 착용할수록 인공와우 아동의 비단어 따라말하기의 정확도가 높았다. 그러므로, 신생아청각선별검사를 통해서 조기에 난청을 발견하고 보청기를 즉시 착용하도록 청각재활 상담을 진행하여, 인공와우 아동의 음운기억 발달을 촉진하도록 해야 할 것이다.
Abstract
The purposes of this study were to investigate the nonword repetition (NWR) performance according to the nonword length in children with cochlear implants (CIs) and children with normal hearing (NH) and to assess which factors could explain variance in NWR scores in children with CIs. Twenty-five deaf children who received a CI before 5 years of age were included in this study, and they ranged from 6 to 13 years. Twenty-five children with NH as a control group were matched to children with CIs on the basis of chronological age (+/3 months). Phonological memory skills were measured by the NWR task in a quiet condition. Children with CIs performed significantly lower than children with NH on NWR scores (p<.001). There were significant differences in NWR scores according to the nonword length (p<.001), indicating that their NWR scores decreased as the nonword lengh was longer. Among age at implantation, age at fitting hearing aids, and receptive vocabulary scores, age at fitting hearing aids contributed significant amount to NWR performance in children with CIs (p<.05). The results demonstrated that children with CIs showed delays in NWR in comparison with age-matched children with NH. For children with CIs, age at fitting hearing aids played an important role of developing phonological memory skills.
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