Eficácia e efeitos de um programa de intervenção para pré-escolares com gagueira
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2021-05-10
Autores
Anjos, Heloisa de Oliveira dos [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A terapia fonoaudiológica na gagueira infantil deve ser realizada o mais próximo do início das disfluências, tendo em vista a evolução do quadro clínico e os impactos adversos que podem surgir na vida do falante. Neste sentido, o objetivo geral desta pesquisa foi verificar a eficácia e os efeitos do Programa de Intervenção para Pré-Escolares com Gagueira - PROPEG. Participaram 20 pré-escolares de ambos os sexos, com gagueira do neurodesenvolvimento, e seus respectivos familiares. Os critérios de inclusão foram: assinatura do termo de consentimento livre e esclarecido, pelos responsáveis; ser falante nativo do português brasileiro; ter idade cronológica entre 3 e 6 anos e 11 meses; apresentar as manifestações da gagueira por no mínimo 12 meses; apresentar no mínimo 3% de disfluências típicas da gagueira e 11 pontos no Instrumento de Gravidade da Gagueira – SSI-4; além de não estar participando, na ocasião do estudo, de nenhum programa de terapia fonoaudiológica para a gagueira. Os procedimentos metodológicos foram: avaliação inicial da fluência e classificação do grau de gravidade gagueira; aplicação do Programa de Intervenção para Pré-escolares com Gagueira - PROPEG, em 14 sessões de 50 minutos de duração; avaliação da fluência e classificação do grau de gravidade da gagueira intermediária, realizada durante o processo de intervenção, após a aplicação da nona sessão; e avaliação da fluência final e classificação do grau de gravidade da gagueira após o término da intervenção do PROPEG. Como efeitos positivos na avaliação intermediária, os resultados mostraram: redução da frequência de disfluências típicas da gagueira, das repetições de parte da palavra, do escore da frequência de disfluências típicas da gagueira e do escore total do Instrumento de Gravidade da Gagueira. Na avaliação final, também houve diminuição da repetição de palavra monossilábica, prolongamento, bloqueio e pausa; e escore dos concomitantes físicos. Não houve alteração na velocidade de fala, na frequência das outras disfluências e no total das disfluências. Observou-se, ainda, redução na comparação dos escores dos concomitantes físicos e do escore total entre as avaliações intermediária e final, após a aplicação do PROPEG. Portanto, conclui-se que, já na avaliação intermediária, o PROPEG melhorou a capacidade dos pré-escolares em falar fluentemente e reduziu a gravidade da gagueira. Os concomitantes físicos, descritos como comportamentos secundários, apresentaram redução significativa a partir da segunda metade do programa. Acredita-se que o programa de intervenção poderá auxiliar os fonoaudiólogos a minimizarem os problemas relacionados à gagueira, proporcionando aos pré-escolares uma intervenção eficaz para melhorar a comunicação e reduzir os impactos adversos oriundos da mesma.
Speech therapy in childhood stuttering should be started as soon as possible to the onset of disfluencies, regarding the evolution of the clinical condition and adverse impacts that may arise in the speaker's life. Thus, the general objective of this study was to verify the effectiveness and effects of the Intervention Program for Preschoolers with Stuttering -PROPS. Twenty preschoolers from both genders, with neurodevelopment stuttering and their respective family members, participated in the study. Inclusion criteria were: signing the informed consent form by guardians; being a native speaker of Brazilian Portuguese; chronological age from 3 to 6 years and 11 months; having stuttering manifestations for at least 12 months; having at least 3% of stuttering-like disfluencies and 11 points on the Stuttering Severity Instrument - SSI-4; also not participating, at the time of the study, in any speech therapy program for stuttering. The methodological procedures were: initial fluency assessment and classification of the degree of stuttering severity; application of the Intervention Program for Preschoolers with Stuttering - PROPS, in 14 sessions of 50 minutes; fluency assessment and classification of the degree of severity of the intermediate stutter, conducted during the intervention process, after applying the ninth session; and, final fluency assessment and classification of the degree of stuttering severity after the end of the PROPS intervention. The results showed positive effects in the intermediate assessment: reduction of the frequency of stuttering-like disfluencies, part-word repetitions, in the score of the frequency of stuttering-like disfluencies and the total score of the Stuttering Severity Instrument. In the final assessment, there was also a decrease in the monosyllabic word repetition, prolongation, blockage and pause; and physical concomitant score. There was no alteration in speech rate, frequency of other disfluencies and total disfluencies. There was also a reduction in the comparison of physical concomitant scores and the total score between the intermediate and final assessments, after the application of PROPS. Therefore, it is concluded that PROPS improved the preschoolers’ ability to speak fluently and reduced the severity of stuttering from the intermediate assessment. Physical concomitants, described as secondary behaviors, showed a significant reduction from the second half of the program. It is believed that the intervention program can assist speech therapists to minimize problems related to stuttering, providing preschoolers with an effective intervention so that in addition to improving communication, it can reduce adverse impacts arising from it.
Speech therapy in childhood stuttering should be started as soon as possible to the onset of disfluencies, regarding the evolution of the clinical condition and adverse impacts that may arise in the speaker's life. Thus, the general objective of this study was to verify the effectiveness and effects of the Intervention Program for Preschoolers with Stuttering -PROPS. Twenty preschoolers from both genders, with neurodevelopment stuttering and their respective family members, participated in the study. Inclusion criteria were: signing the informed consent form by guardians; being a native speaker of Brazilian Portuguese; chronological age from 3 to 6 years and 11 months; having stuttering manifestations for at least 12 months; having at least 3% of stuttering-like disfluencies and 11 points on the Stuttering Severity Instrument - SSI-4; also not participating, at the time of the study, in any speech therapy program for stuttering. The methodological procedures were: initial fluency assessment and classification of the degree of stuttering severity; application of the Intervention Program for Preschoolers with Stuttering - PROPS, in 14 sessions of 50 minutes; fluency assessment and classification of the degree of severity of the intermediate stutter, conducted during the intervention process, after applying the ninth session; and, final fluency assessment and classification of the degree of stuttering severity after the end of the PROPS intervention. The results showed positive effects in the intermediate assessment: reduction of the frequency of stuttering-like disfluencies, part-word repetitions, in the score of the frequency of stuttering-like disfluencies and the total score of the Stuttering Severity Instrument. In the final assessment, there was also a decrease in the monosyllabic word repetition, prolongation, blockage and pause; and physical concomitant score. There was no alteration in speech rate, frequency of other disfluencies and total disfluencies. There was also a reduction in the comparison of physical concomitant scores and the total score between the intermediate and final assessments, after the application of PROPS. Therefore, it is concluded that PROPS improved the preschoolers’ ability to speak fluently and reduced the severity of stuttering from the intermediate assessment. Physical concomitants, described as secondary behaviors, showed a significant reduction from the second half of the program. It is believed that the intervention program can assist speech therapists to minimize problems related to stuttering, providing preschoolers with an effective intervention so that in addition to improving communication, it can reduce adverse impacts arising from it.
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Palavras-chave
Gagueira, Pré-escolares, Terapêutica, Criança, Terapia de linguagem, Fonoterapia, Stuttering, Preschoolers, Therapy, Kid, Language therapy, Speech therapy