단순언어장애로 진단된 환아의 임상적 고찰
Clinical Review of Children Diagnosed as Specific Language Impairment
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목적:언어 발달 문제를 주소로 내원하여 단순언어장애로 진단받은 아동의 임상적 경과를 관찰하고자 이 연구를 시행 하였다. 방 법:대동 병원 소아청소년과 외래에 2007년 7월부터 2008년 6월까지 말과 언어 지연을 주소로 내원하여 언어 및 발달 검사를 받았던 아동 125명 중 단순언어장애로 진단받은 아동 51명에 대한 치료 및 임상 경과를 조사 하였다. 자료에 대한 설문조사는 전화 및 외래 방문 면담으로 시행하였다. 결과:단순언어장애로 진단 받은 51명의 아동 중 혼합 수용-표현언어장애는 39명(76.5%), 표현언어장애는 12명(23.5%) 이었다. 추적관찰이 불가능한 10명과 치료를 하지 않았거나, 치료 도중 탈락한 아동 11명을 제외한 30명 중 혼합 수용-표현언어장애 아동은 23명(76.7%), 표현언어장애 아동은 7명(23.3%)이었다. 이들 아동 30명 중에서 전체적인 치료기간은 혼합 수용-표현언어장애 아동은 18.1±10.0개월, 표현언어장애 아동은 8.6±3.6개월로 통계적으로 유의한 차이가 있었다(P=0.014). 언어치료를 받은 혼합수용-표현언어장애 아동 23명 중 13명(57%)과 표현언어장애 아동 7명중 모두(100%)에서 치료가 종결되었다. 그러나 언어치료가 종결된 아동에서 언어치료가 종결되기 까지의 기간은 혼합 수용-표현언어장애 아동에서 12.2 ±8.2개월, 표현언어장애 아동 군에서 8.6±3.6개월로 표현언어장애 아동에서 치료기간이 짧아 보였으나 통계적으로 유의한 차이는 없었다(P=0.287). 결론:이전의 논문들의 고찰 및 본 연구를 통하여 볼 때, 단순언어장애 아동을 외래에서 진료 시 혼합 수용-표현언어장애 아동과 표현언어장애 아동으로 구분하여 치료하는 것은 단순언어장애 아동의 치료기간 뿐만 아니라 언어치료에 대한 경과나 예후를 예측하는데 도움이 될 것으로 생각된다. 앞으로 소아청소년과 차원에서의 단순 언어장애 아동에 대한 조기평가와 효과적인 치료방법에 대한 관심이 절실히 요구된다.
Abstract
Purpose:The purpose of this study was to evaluate the clinical characteristics of children who had been diagnosed as specific language impairment as outpatients. Methods:One hundred twenty-five speech- or language-delayed patients were enrolled in Dae-Dong Hospital from July 2007 to June 2008. Fifty-one of 125 children were diagnosed as specific language impairment in whom clinical factors such as duration of therapy and progress after therapy were evaluated. Data were obtained from telephone or direct personal interviews. Results:Among 51 children diagnosed as specific language impairment, 39 (76.5 %) had mixed receptive-expressive-type language disorder and 12 (23.5%) had expressive-type language disorder. Thirty children in total were studied as ten children were unavailable for follow-up and eleven dropped out during treatment. The final 30 children consisting of 23 with mixed receptive-expressive type language disorder and seven children with expressive-type language disorder were treated after diagnosis. Total average treatment duration of children with mixed receptive- expressive-type and expressive-type language disorder were 18.1 months and 8.6 months, respectively, a statistically significant difference (P=0.014). Thirteen (57 %) of 23 children with mixed receptive-expressive-type language disorder and all (100%) seven children with expressive-type language disorder completed speech therapy with an average treatment duration of 12.2 and 8.6 months, respectively; however, this difference was not statistically significant(P=0.287). Conclusion:Classifying patients with specific language impairments into mixed receptive-expressive-type and expressive-type language disorder in an outpatient department can be useful for predicting duration of and prognostic effects of language therapy, as our study and other previous articles have shown. More attention is needed from pediatricians to ensure the effective assessment and management of specific language impairment.
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