말이 늦는 아동의 임상적 고찰
The Clinical Features of Late Talker
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목적:말이 늦어 내원한 2 -3세 아동의 연령의 증가에 따른 언어 및 인지 발달의 변화를 분석하여 조기 진단 및 중재에 도움이 되는 자료를 얻고자 하였다 . 방법: 2007년 1월부터 2015년 3월까지 말이 늦어 내원한 2 -3세 아동중에서 지적장애나,자폐성장애,청각장애나 신경학적 결함이 없었던 아동의 추적 지능 검사 결과를 분석하였다 . 언어발달 지연은 표준화된 검사에서 10 백분위수 미만을 기준으로 하였다 . 초기 검사로는 베일리 영유아 발달검사와 언어발달 검사가 시행되었고,언어 발달의 호전을 보인후에는 웩슬러 유아용 지능검사가 시행되었다 .사회성숙도검사는 초기와 후기 추적검사에서 모두 시행되었다 . 결과: 초기 검사에서 표현 언어에서만 발달 지연이 있었던 아동 5 명은 후기 검사에서 5명(100%) 모두 언어발달 지연이 회복되고 정상지능을 보였으나, 혼합 표현-수용 언어 발달 지연 아동 18명은 후기검사에서 6명(33.3%)은 정상 지능, 4명(22.2%)은 단순 언어장애, 8명(44.5%)은 경계급 지능을보였다 . 언어와 인지발달이 같이 지연을 보였던 아동 9명은 후기 검사에서 3명(33.3%)은 정상 지능, 1명(11.1%) 은 단순 언어 장애, 5명(55.6%)은 경계급 지능을 보였다 . 추적 검사된 아동에서 발음이 부정확하거나 정서, 행동, 학습의 문제가 동반된 아동이 많았다 . 결론: 본 연구는 말이 늦어서 내원한 아동 중에서 조기 중재가 이루어진 일부 아동의 자료만을 검토한 제한점이 있지만, 언어 발달의 회복되면서, 정상 지능을 보이는 아동이 있었다 . 말이 늦은 2 -3세 아동에서 일회성 검사로 예후를 예측하기는 어려웠고, 언어 발달의 회복을 보이더라도 지능이나 언어, 정서, 사회성 발달이 고르게 발달하는지에 대하여 지속적 관심이 필요하였다 .
Abstract
Purpose: This study examined the clinical significance of assessments and intervention of late-talker conducted at 2.3 years old. Method: We retrospectively reviewed the medical records of 32 late talkers who did not have any other deficits (such as, cognitive, neurological, socio-emotional, or sensory deficits), had visited the hospital, due to delayed language development at 2.3 years old, and were reassessed at 5.6 years old, from January 2007 to May 2015. Language and cognitive abilities were assessed using multiple scales at the initial and follow-up visits. Results: All 5(100%) children with only delayed expressive language development at initial assessment improved to the average intelligence at follow-up assessment. The 6(33.3%) of 18 children with delayed mixed expressive-receptive language development showed average intelligence at follow-up; 4(22.2%), specific language impairment; 8(44.5%), borderline intellectual functioning. The 3(33.3%) of 9 children with delayed language and cognitive development showed average intelligence at follow-up; 1(11.1%), specific language impairment; 5(55.6%), borderline intellectual functioning. Many children experienced some articulation problems or behavioral, emotional, and social difficulties. Conclusion: Trials of interventions demonstrate improvement in some outcome measures, but conclusions and generalizability are limited. Accurate prediction of persistent language difficulties was not possible at 2.3 years old. Therefore, regular long-term follow-up is required.
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