DOI QR코드

DOI QR Code

말더듬이 지속된 아동과 회복된 아동의 기질 특성 비교: 종단연구

Temperament characteristics of children with persistent and recovered stuttering: A longitudinal study

  • 전희정 (조선대학교 언어치료학과)
  • Chon, HeeCheong (Department of Speech-Language Pathology, Chosun University)
  • 투고 : 2021.11.16
  • 심사 : 2021.12.09
  • 발행 : 2021.12.31

초록

본 연구의 목적은 말더듬의 지속과 회복에 따른 하위유형의 기질 특성을 종단적으로 비교하고, 외현적 말더듬 중증도와 기질 특성의 관련성을 살피는 것이었다. 연구 참여자는 학령전 아동으로 41명의 말더듬 아동(CWS, children who stutter)과 30명의 말을 더듬지 않는 아동(CWNS, children who do not stutter)이었다. 아동들은 4년간 종단연구에 참여하였으며, 마지막 평가에 참여하였을 때 전체 CWS 중 27명은 말더듬이 회복된 아동으로, 14명은 말더듬이 지속된 아동으로 최종 진단되었다. 각 아동의 기질 특성은 유아기질척도-간편형을 사용하여 평가하였으며, 기질 평가는 첫 평가 이후 1년이 지난 시점과 첫 평가 이후 2년이 지난 시점에서 각각 이루어졌다. 기질 특성 비교를 위해 유아기질척도-간편형의 상위요인(외향성, 부정적 정서, 의도적 통제)과 15개의 하위영역 점수를 분석하였으며, 집단과 평가 시점에 따른 차이를 각각 비교하였다. 연구 결과, 말더듬이 지속된 아동 집단은 말더듬이 회복된 아동 집단과 CWNS보다 상위요인인 부정적 정서 점수가 평가 시점과 관계없이 유의하게 높은 것으로 나타났다. 또한, 말더듬이 지속된 아동 집단은 다른 아동 집단보다 부정적 정서를 구성하는 하위영역인 '공포'와 '분노/좌절' 점수가 유의하게 높았다. 말더듬이 지속된 아동 집단을 대상으로 평가 시점별로 외현적 말더듬 중증도와 기질의 상위요인 및 하위영역 점수 간 상관분석을 실시한 결과, 외현적 말더듬 중증도와 기질 특성은 유의한 상관을 보이지 않았다. 본 연구결과는 기질 특성이 말더듬의 지속 및 회복과 관련 있는 요인이라는 이론적 관점을 지지하며, 시간이 지남에 따라 기질이 말더듬으로 인한 반복적인 경험의 영향을 받을 수 있음을 시사한다.

The purpose of this study was to investigate the temperament characteristics associated with stuttering subtypes (persistent and recovered) over time and the relationship between those characteristics and stuttering severity. This four-year longitudinal study covered 41 preschool children who stutter (CWS) and 30 preschool children who do not stutter (the CWNS group). At the final visit, 27 CWS were classified as the Recovered group and 14 CWS were classified as the Persistent group. Using the Children's Behavior Questionnaire-Short Form, each participant's temperament characteristics were measured twice: at one year and two years after the initial visit. The three subscale scores (Extraversion, Negative Affectivity, and Effortful Control) and the 15 component scores were analyzed, and they were used for between-group and between-visit comparisons. The Persistent group showed a significantly higher Negative Affectivity subscale score at every visit than the Recovered and CWNS groups. Within this subscale, significant group differences were found in the 'Fear' and 'Anger/Frustration' components, demonstrating that the Persistent group scored higher than the Recovered and CWNS groups. There was no significant correlation between the subscale and component scores and the stuttering severity scores within the Persistent group at any visit. These results support the proposition that these two stuttering subtypes have different temperament characteristics; they also imply that temperament might be influenced by stuttering experience over time.

키워드

과제정보

본 연구는 National Institutes of Health, National Institute on Deafness and Other Communication Disorders의 연구비(# R01-DC05210, First PI: Ehud Yairi; second PI: Nicoline G. Ambrose) 지원을 받았음.

참고문헌

  1. Ahadi, S. A., Rothbart, M. K., & Ye, R. (1993). Child temperament in the US and China: Similarities and differences. European Journal of Personality, 7(5), 359-378. https://doi.org/10.1002/per.2410070506
  2. Ambrose, N. G., Yairi, E., Loucks, T. M., Seery, C. H., & Throneburg, R. (2015). Relation of motor, linguistic and temperament factors in epidemiologic subtypes of persistent and recovered stuttering: Initial findings. Journal of Fluency Disorders, 45, 12-26. https://doi.org/10.1016/j.jfludis.2015.05.004
  3. Anderson, J. D., Pellowski, M. W., Conture, E. G., & Kelly, E. M. (2003). Temperamental characteristics of young children who stutter. Journal of Speech, Language, and Hearing Research, 46(5), 1221-1233. https://doi.org/10.1044/1092-4388(2003/095)
  4. Arnold, H. S., Conture, E. G., Key, A. P. F., & Walden, T. (2011). Emotional reactivity, regulation and childhood stuttering: A behavioral and electrophysiological study. Journal of Communication Disorders, 44(3), 276-293. https://doi.org/10.1016/j.jcomdis.2010.12.003
  5. Bates, J. E., Freeland, C. A. B., & Lounsbury, M. L. (1979). Measurement of infant difficultness. Child Development, 50(5), 794-803. https://doi.org/10.2307/1128946
  6. Buss, A. H., & Plomin, R. (1984). Temperament: Early developing personality traits. Hillsdale, NJ: Lawrence Erlbaum Associates.
  7. Cha, H. (2015). Characteristics of temperament and communication attitudes in school-age children who stutter (Master's thesis). Chosun University, Gwangju, Korea.
  8. Chang, S. E., Zhu, D. C., Choo, A. L., & Angstadt, M. (2015). White matter neuroanatomical differences in young children who stutter. Brain, 138(3), 694-711. https://doi.org/10.1093/brain/awu400
  9. Choi, D., Conture, E. G., Walden, T. A., Jones, R. M., & Kim, H. (2016). Emotional diathesis, emotional stress, and childhood stuttering. Journal of Speech, Language, and Hearing Research, 59(4), 616-630. https://doi.org/10.1044/2015_JSLHR-S-14-0357
  10. Conture, E. G., Walden, T. A., Arnold, H. S., Graham, C. G., Hartfield, K. N., & Karrass, J. (2006). Communication-emotional model of stuttering. In N. Bernstein Ratner & J. A. Tetnowski (Eds.), Current issues in stuttering research and practice (pp. 17-46). Mahwah, NJ: Lawrence Erlbaum Associates.
  11. Cumberland-Li, A., Eisenberg, N., & Reiser, M. (2004). Relations of young children's agreeableness and resiliency to effortful control and impulsivity. Social Development, 13(2), 193-212. https://doi.org/10.1111/j.1467-9507.2004.000263.x
  12. de la Osa, N., Granero, R., Penelo, E., Domenech, J. M., & Ezpeleta, L. (2014). The short and very short forms of the Children's Behavior Questionnaire in a community sample of preschoolers. Assessment, 21(4), 463-476. https://doi.org/10.1177/1073191113508809
  13. Eggers, K., De Nil, L. F., & Van den Bergh, B. R. H. (2009). Factorial temperament structure in stuttering, voice-disordered, and typically developing children. Journal of Speech, Language, and Hearing Research, 52(6), 1610-1622. https://doi.org/10.1044/1092-4388(2009/07-0065)
  14. Eggers, K., De Nil, L. F., & Van den Bergh, B. R. H. (2010). Temperament dimensions in stuttering and typically developing children. Journal of Fluency Disorders, 35, 355-372. https://doi.org/10.1016/j.jfludis.2010.10.004
  15. Eggers, K., De Nil, L. F., & Van den Bergh, B. R. H. (2013). Inhibitory control in childhood stuttering. Journal of Fluency Disorders, 38(1), 1-13. https://doi.org/10.1016/j.jfludis.2012.10.001
  16. Embrechts, M., Ebben, H., Franke, P., & van de Poel, C. (2000, August). Temperament: A comparison between children who stutter and children who do not stutter. In H. G. Bosshardt, J. S. Yaruss, & H. F. M. Peters (Eds.), Proceedings of the 3rd World Congress on fluency disorders: Theory, research, treatment, and self-help (pp. 557-562). Nijmegen, Netherlands.
  17. Felsenfeld, S., van Beijsterveldt, C. E. M., & Boomsma, D. I. (2010). Attentional regulation in young twins with probable stuttering, high nonfluency, and typical fluency. Journal of Speech, Language, and Hearing Research, 53(5), 1147-1166. https://doi.org/10.1044/1092-4388(2010/09-0164)
  18. Howell, P., Davis, S., Patel, H., Cuniffe, P., Downing-Wilson, D., Au-Yeung, J., & Williams, R. (2004, August). Fluency development and temperament in fluent children and children who stutter. In A. Packman, A. Meltzer, & H. F. M. Peters (Eds.), Proceedings of the 4th World Congress on fluency disorders: Theory, research, and therapy in fluency disorders (pp. 250-256). Nijmegen, Netherlands.
  19. Jones, R. M., Walden, T. A., Conture, E. G., Erdemir, A., Lambert, W. E., & Porges, S. W. (2017). Executive functions impact the relation between respiratory sinus arrhythmia and frequency of stuttering in young children who do and do not stutter. Journal of Speech, Language, and Hearing Research, 60(8), 2133-2150. https://doi.org/10.1044/2017_JSLHR-S-16-0113
  20. Kang, C., Riazuddin, S., Mundorff, J., Krasnewich, D., Friedman, P., Mullikin, J., & Drayna, D. (2010). Mutations in the lysosomal enzyme-targeting pathway and persistent stuttering. The New England Journal of Medicine, 362, 677-685. https://doi.org/10.1056/NEJMoa0902630
  21. Kefalianos, E., Onslow, M., Packman, A., Vogel, A., Pezic, A., Mensah, F., Conway, L., ... Reilly, S. (2017). The history of stuttering by 7 years of age: Follow-up of a prospective community cohort. Journal of Speech, Language, and Hearing Research, 60(10), 2828-2839. https://doi.org/10.1044/2017_JSLHR-S-16-0205
  22. Kochanska, G., & Knaack, A. (2003). Effortful control as a personality characteristic of young children: Antecedents, correlates, and consequences. Journal of Personality, 71(6), 1087-1112. https://doi.org/10.1111/1467-6494.7106008
  23. Kusanagi, E. (1993). A psychometric examination of the Children's Behavior Questionnaire. Research and Clinical Center for Child Development: Annual Report, 15, 25-33.
  24. Lee, E. A., Choi, S. H., Choi, C. H., & Lee, K. (2020). Temperamental characteristics of pre-school children who stutter. Audiology and Speech Research, 16(4), 339-346. https://doi.org/10.21848/asr.200052
  25. Lee, K. O. (2004). Validation study for CBQ scale with Korean children. Journal of Early Childhood Education, 24(5), 101-120.
  26. Lewis, K. E., & Golberg, L. L. (1997). Measurements of temperament in the identification of children who stutter. European Journal of Disorders of Communication, 32(4), 441-448. https://doi.org/10.3109/13682829709082258
  27. Lim, J. Y., & Bae, Y. J. (2015). Validation study of Korean version of the Rothbart's Children's Behavior Questionnaire. Korean Journal of Human Ecology, 24(4), 477-497. https://doi.org/10.5934/kjhe.2015.24.4.477
  28. Ntourou, K., Conture, E. G., & Walden, T. A. (2013). Emotional reactivity and regulation in preschool-age children who stutter. Journal of Fluency Disorders, 38(3), 260-274. https://doi.org/10.1016/j.jfludis.2013.06.002
  29. Putnam, S. P., & Rothbart, M. K. (2006). Development of short and very short forms of the Children's Behavior Questionnaire. Journal of Personality Assessment, 87(1), 103-113.
  30. Putnam, S. P., Rothbart, M. K., & Gartstein, M. A. (2008). Homotypic and heterotypic continuity of fine-grained temperament during infancy, toddlerhood, and early childhood. Infant and Child Development, 17(4), 387-405. https://doi.org/10.1002/icd.582
  31. Reilly, S., Onslow, M., Packman, A., Cini, E., Conway, L., Ukoumunne, O., Bavin, E. L., ... Wake, M. (2013). Natural history of stuttering to 4 years of age: A prospective community-based study. Pediatrics, 132(3), 460-467. https://doi.org/10.1542/peds.2012-3067
  32. Reilly, S., Onslow, M., Packman, A., Wake, M., Bavin, E. L., Prior, M., Eadie, P., ... Ukoumunne, O. C. (2009). Predicting stuttering onset by the age of 3 years: A prospective, community cohort study. Pediatrics, 123(1), 270-277. https://doi.org/10.1542/peds.2007-3219
  33. Riley, G., & Riley, J. G. (2000). A revised component model for diagnosing and treating children who stutter. Contemporary Issues in Communication Science and Disorders, 27(Fall), 188-199. https://doi.org/10.1044/cicsd_27_F_188
  34. Rothbart, M. K., & Ahadi, S. A. (1994). Temperament and the development of personality. Journal of Abnormal Psychology, 103(1), 55-66. https://doi.org/10.1037/0021-843X.103.1.55
  35. Rothbart, M. K., Ahadi, S. A., Hershey, K. L., & Fisher, P. (2001). Investigations of temperament at three to seven years: The Children's Behavior Questionnaire. Child Development, 72(5), 1394-1408. https://doi.org/10.1111/1467-8624.00355
  36. Rothbart, M. K., & Derryberry, D. (1981). Development of individual differences in temperament. In M. E. Lamb & A. L. Brown (Eds.), Advances in developmental psychology (Vol. 1, pp. 37-86). Hillsdale, NJ: Lawrence Erlbaum Associates.
  37. Sleddens, E. F. C., Kremers, S. P. J., Candel, M. J. J. M., De Vries, N. N. K., & Thijs, C. (2011). Validating the children's behavior questionnaire in Dutch children: Psychometric properties and a cross-cultural comparison of factor structures. Psychological Assessment, 23(2), 417-426. https://doi.org/10.1037/a0022111
  38. Smith, A., & Weber, C. (2017). How stuttering develops: The multifactorial dynamic pathways theory. Journal of Speech, Language, and Hearing Research, 60(9), 2483-2505. https://doi.org/10.1044/2017_JSLHR-S-16-0343
  39. van der Merwe, B., Robb, M. P., Lewis, J. G., & Ormond, T. (2011). Anxiety measures and salivary cortisol responses in preschool children who stutter. Contemporary Issues in Communication Science and Disorders, 38(Spring), 1-10. https://doi.org/10.1044/cicsd_38_S_1
  40. Walsh, B., Mettel, K. M., & Smith, A. (2015). Speech motor planning and execution deficits in early childhood stuttering. Journal of Neurodevelopmental Disorders, 7(1), 1-12. https://doi.org/10.1186/1866-1955-7-1
  41. Watkins, R. (2005). Language abilities of young children who stutter. In E. Yairi & N. G. Ambrose (Eds.), Early childhood stuttering: For clinicians by clinicians (pp. 235-251). Austin, TX: PRO-ED.
  42. Yairi, E., & Ambrose, N. G. (2005). Early childhood stuttering: For clinicians by clinicians. Austin, TX: PRO-ED.