O atraso na retroalimentação auditiva e seus efeitos nas disfluências típicas da gagueira
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Data
2016-04-25
Autores
Buzzeti, Paula Bianca Meireles de Moura [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Pesquisas científicas têm apontado os benefícios do atraso na retroalimentação auditiva na fluência de pessoas que gaguejam. Entretanto, existe uma grande variabilidade nos resultados e nem todos os indivíduos apresentam uma melhora significativa com a utilização deste recurso. Com base na hipótese de que os diferentes tipos de disfluências possam influenciar na eficácia do atraso na retroalimentação auditiva como intervenção no tratamento da gagueira, este estudo teve por objetivo analisar os efeitos imediatos do atraso na retroalimentação auditiva sob as diferentes tipologias de disfluências típicas da gagueira, em indivíduos acometidos pelo distúrbio. Participaram desta pesquisa trinta indivíduos, de oito a 46 anos e onze meses, com gagueira do desenvolvimento persistente. Os participantes deveriam apresentar no mínimo 3% de disfluências típicas da gagueira e gagueira leve de acordo com o Instrumento de Gravidade da Gagueira. Foram utilizados os seguintes procedimentos: avaliação audiológica, avaliação da fluência (fala espontânea) em duas situações de escuta - com retroalimentação auditiva habitual (RAH) e atrasada (RAA) - e o Instrumento de Gravidade da Gagueira. O software Fono Tools foi utilizado para provocar o efeito da RAA com atraso de 100 ms. A análise estatística dos dados foi realizada por meio da aplicação do Teste dos Postos Sinalizados Wilcoxon, Teste Qui-quadrado para proporções e Teste da Razão e Verossimilhança. Os resultados mostraram que o atraso na retroalimentação auditiva diminuiu a frequência da maioria das disfluências típicas da gagueira, sendo que a redução de repetição de palavras foi estatisticamente significante. O número de indivíduos que diminuiu repetição de palavras e que manteve intrusões foi estatisticamente significante. Na análise comparativa entre disfluências de duração e de repetição, apenas a redução de disfluências de repetição se mostrou estatisticamente significante. A maioria dos indivíduos diminuiu os fluxos de sílabas por minuto (SPM) e palavras por minuto (PPM) e a redução do fluxo de SPM para o grupo foi significante. Concluiu-se, portanto, que o efeito do atraso na retroalimentação auditiva é mais eficiente para reduzir as disfluências de repetição do que as disfluências de duração, e que embora a taxa de articulação tenha diminuído significantemente sob o efeito da RAA, não houve prejuízo no fluxo de informação.
Scientific researches indicate the benefits of the delayed auditory feedback in fluency of people who stutter. However, there is a great variability in the results and a significant improvement is not demonstrated in all the individuals with the use of this resource. Based on the hypothesis that different types of disfluencies can influence the effectiveness of delayed auditory feedback as an intervention in the treatment of stuttering, this study aimed to compare the immediate effects of delayed auditory feedback in different typologies of stuttering-like disfluencies, for people affected by this disorder. Thirty individuals participated of this research, between the age of eight to 46 years and eleven months, with persistent developmental stuttering. Participants should present at least 3% of stuttering-like disfluencies and mild stuttering according to the Stuttering Severity Instrument. The following procedures were used: audiological evaluation, fluency evaluation (spontaneous speech) in two listening situations - with normal auditory feedback (NAF) and delayed auditory feedback (DAF) - and the Stuttering Severity Instrument. The Fono Tools software was used to create the DAF effects with 100 ms delay. The statistical analyzes were performed by applying the Wilcoxon signed-rank test, Chi-squared test and Likelihood ratio test. The results showed that the delayed auditory feedback decreases the frequency of most stuttering-like disfluencies, and the word repetition reduction was statistically significant. The number of individuals that decreased word repetition and kept intrusion was statistically significant. In the comparative analysis between the duration and repetition disfluencies, only repetition disfluencies reduction was statistically significant. Most individuals decreased flow of syllables per minute (SPM) and words per minute (PPM) and the group reduction of SPM flow was significant. Therefore, the conclusion is that the effect of delayed auditory feedback is more efficient to reduce repetition disfluencies than duration disfluencies, and although articulating rate has significantly decreased under the effect of DAF, there was no loss in the information flow.
Scientific researches indicate the benefits of the delayed auditory feedback in fluency of people who stutter. However, there is a great variability in the results and a significant improvement is not demonstrated in all the individuals with the use of this resource. Based on the hypothesis that different types of disfluencies can influence the effectiveness of delayed auditory feedback as an intervention in the treatment of stuttering, this study aimed to compare the immediate effects of delayed auditory feedback in different typologies of stuttering-like disfluencies, for people affected by this disorder. Thirty individuals participated of this research, between the age of eight to 46 years and eleven months, with persistent developmental stuttering. Participants should present at least 3% of stuttering-like disfluencies and mild stuttering according to the Stuttering Severity Instrument. The following procedures were used: audiological evaluation, fluency evaluation (spontaneous speech) in two listening situations - with normal auditory feedback (NAF) and delayed auditory feedback (DAF) - and the Stuttering Severity Instrument. The Fono Tools software was used to create the DAF effects with 100 ms delay. The statistical analyzes were performed by applying the Wilcoxon signed-rank test, Chi-squared test and Likelihood ratio test. The results showed that the delayed auditory feedback decreases the frequency of most stuttering-like disfluencies, and the word repetition reduction was statistically significant. The number of individuals that decreased word repetition and kept intrusion was statistically significant. In the comparative analysis between the duration and repetition disfluencies, only repetition disfluencies reduction was statistically significant. Most individuals decreased flow of syllables per minute (SPM) and words per minute (PPM) and the group reduction of SPM flow was significant. Therefore, the conclusion is that the effect of delayed auditory feedback is more efficient to reduce repetition disfluencies than duration disfluencies, and although articulating rate has significantly decreased under the effect of DAF, there was no loss in the information flow.
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Palavras-chave
Fonoaudiologia, Distúrbio da fala, Gagueira, Retroalimentação, Audição, Speech, Language and hearing sciences, Speech disorders, Stuttering, Feedback, Hearing