Perfil da fluência de pré-escolares e escolares com gagueira
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Data
2018-05-30
Autores
Palharini, Talissa Almeida [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Dados precisos da avaliação da fluência de pré-escolares e escolares com gagueira, falantes do Português Brasileiro são relevantes, pois além de propiciar o perfil da fluência destas populações, terão implicações no diagnóstico e terapia da gagueira infantil. Neste sentido, o objetivo geral deste trabalho foi investigar o perfil da fluência e a gravidade da gagueira de pré-escolares e escolares que gaguejam. Participaram da pesquisa 60 crianças de ambos os gêneros, com gagueira do desenvolvimento persistente, de 3 à 11 anos e 11 meses, divididos em dois grupos: Grupo de Pré-escolares com Gagueira (GPEG) composto por 30 pré-escolares, na faixa etária de 3 a 6 anos e 11 meses; e o Grupo de Escolares com Gagueira (GEG) composto por 30 escolares, na faixa etária de 7 a 11 anos e 11 meses. Todas crianças apresentaram no mínimo 3% de disfluências típicas da gagueira e mínimo de 11 pontos no Instrumento de Gravidade da Gagueira (SSI-4), o que equivale a uma gagueira de grau leve. Os seguintes procedimentos foram utilizados: avaliação da fluência da fala espontânea e classificação da gravidade da gagueira. Foi realizada a análise estatística dos dados com o teste dos “Postos Sinalizados de Wilcoxon” e “Teste de Friedman ANOVA e Kendall” para análise intragrupos, o teste de “Mann-Whitney” para análise intergrupos e o “Spearman” para análise de correlação. O nível de significância adotado para a aplicação dos testes estatísticos foi de 0,05. A análise dos dados foi realizada utilizando software STATISTICA versão 7.0. Os resultados mostraram que pré-escolares manifestaram maior frequência de disfluências de repetição em relação às disfluências de duração (p=0,038). Os escolares mostraram maior quantidade de outras disfluências (p=0,001) em comparação aos pré-escolares. A tipologia de disfluência típica da gagueira mais frequente foi a repetição de palavra monossilábica nos pré-escolares, e bloqueio nos escolares. Os grupos mostraram semelhanças quanto às tipologias mais e menos frequentes das outras disfluências, que foram respectivamente a hesitação e a repetição de frase. O escore dos concomitantes físicos do Instrumento de Gravidade da Gagueira foi maior nos escolares (p=0,005). A maioria dos pré-escolares foram classificados com gagueira moderada (60%), e o grau de gravidade leve prevaleceu nos escolares (40%). Conclui-se que o perfil da fluência de pré-escolares e escolares com gagueira foram semelhantes com relação: à frequência de disfluências típicas da gagueira, do total das disfluências e das disfluências de duração; à velocidade de fala, e; aos escores da frequência, da duração e do total do Instrumento de Gravidade da Gagueira. Ressalta-se que, a análise do perfil de pré-escolares e escolares com gagueira demonstrou que a gagueira inicia-se com suas manifestações na idade pré-escolar, reforçando que o fonoaudiólogo deve trabalhar e avaliar crianças com a queixa persistente desde o início do distúrbio. Os resultados mostram que com o decorrer dos anos, as crianças com gagueira começam a usar recursos de outras disfluências e de concomitantes físicos como estratégias para evitar a gagueira.
Accurate data of fluency assessment of preschool and school children who stutter, speakers of Brazilian Portuguese are relevant, besides providing the fluency profile of these populations, will have implications in the diagnosis and therapy of childhood stuttering. In this sense, the general objective of this work was to investigate the fluency profile and stuttering severity of preschool and school children who stutter. Participated of this study 60 children of both genders, with diagnosis of developmental persistent stuttering, from 3 to 11 years old and 11 months, divided in two groups: Preschool Group with Stuttering (PGS) composed of 30 preschool who stutter, aged 3 to 6 years old and 11 months; and the Schoolchildren Group with Stuttering (SGS) composed of 30 schoolchildren who stutter, aged 7 to 11 years old and 11 months. All children presented at least 3% of stuttering-like disfluencies and minimum the 11 points in the Stuttering Severity Instrument (SSI-4), which is equivalent to a mild stuttering. The following procedures were used: assessment of spontaneous speech fluency and classification of stuttering severity. Statistical analysis of the data was performed using the “Wilcoxon Signal Post” and “Friedman ANOVA and Kendall” tests for intragroup analysis, the “Mann-Whitney” test for intergroup analysis and the “Spearman” for correlation analysis. The level of significance adopted for the application of the statistical tests was 0.05. Data analysis was performed using STATISTICA software version 7.0. The results showed that the preschool group has a higher frequency of repetitive disfluencies in relation to duration disfluencies (p = 0.038). Schoolchildren showed more other disfluencies (p = 0.001) compared to preschoolers. The typology most frequent of stuttering-like disfluencies was monosyllabic word repetition in preschoolers, and block in schoolchildren. The groups showed similarities regarding the more and less frequent typologies of the other disfluencies, which were respectively the hesitation and the phrase repetition. The scores of the physical concomitants of the Stuttering Severity Instrument were higher in the schoolchildren (p = 0.005). Most preschoolers were classified with moderate stuttering (60%), and the degree of mild stuttering severity prevailed in schoolchildren (40%). It’s concluded that the fluency profile of preschoolers and schoolchildren who stutter were similar regarding to: the frequency of stuttering-like disfluencies, total of disfluencies and duration disfluencies; speech rate, and; frequency, duration, and total scores of the Stuttering Severity Instrument. It should be noted that the analysis of the profile of preschoolers and schoolchildren who stutter demonstrated that stuttering begins with their manifestations at the preschool age, reinforcing that the speech-language pathologist must work and evaluate children with persistent complaint since the beginning of the disorder. The results show that over the years, children who stutter begin to use resources from other disfluencies and physical concomitants as strategies to avoid stuttering.
Accurate data of fluency assessment of preschool and school children who stutter, speakers of Brazilian Portuguese are relevant, besides providing the fluency profile of these populations, will have implications in the diagnosis and therapy of childhood stuttering. In this sense, the general objective of this work was to investigate the fluency profile and stuttering severity of preschool and school children who stutter. Participated of this study 60 children of both genders, with diagnosis of developmental persistent stuttering, from 3 to 11 years old and 11 months, divided in two groups: Preschool Group with Stuttering (PGS) composed of 30 preschool who stutter, aged 3 to 6 years old and 11 months; and the Schoolchildren Group with Stuttering (SGS) composed of 30 schoolchildren who stutter, aged 7 to 11 years old and 11 months. All children presented at least 3% of stuttering-like disfluencies and minimum the 11 points in the Stuttering Severity Instrument (SSI-4), which is equivalent to a mild stuttering. The following procedures were used: assessment of spontaneous speech fluency and classification of stuttering severity. Statistical analysis of the data was performed using the “Wilcoxon Signal Post” and “Friedman ANOVA and Kendall” tests for intragroup analysis, the “Mann-Whitney” test for intergroup analysis and the “Spearman” for correlation analysis. The level of significance adopted for the application of the statistical tests was 0.05. Data analysis was performed using STATISTICA software version 7.0. The results showed that the preschool group has a higher frequency of repetitive disfluencies in relation to duration disfluencies (p = 0.038). Schoolchildren showed more other disfluencies (p = 0.001) compared to preschoolers. The typology most frequent of stuttering-like disfluencies was monosyllabic word repetition in preschoolers, and block in schoolchildren. The groups showed similarities regarding the more and less frequent typologies of the other disfluencies, which were respectively the hesitation and the phrase repetition. The scores of the physical concomitants of the Stuttering Severity Instrument were higher in the schoolchildren (p = 0.005). Most preschoolers were classified with moderate stuttering (60%), and the degree of mild stuttering severity prevailed in schoolchildren (40%). It’s concluded that the fluency profile of preschoolers and schoolchildren who stutter were similar regarding to: the frequency of stuttering-like disfluencies, total of disfluencies and duration disfluencies; speech rate, and; frequency, duration, and total scores of the Stuttering Severity Instrument. It should be noted that the analysis of the profile of preschoolers and schoolchildren who stutter demonstrated that stuttering begins with their manifestations at the preschool age, reinforcing that the speech-language pathologist must work and evaluate children with persistent complaint since the beginning of the disorder. The results show that over the years, children who stutter begin to use resources from other disfluencies and physical concomitants as strategies to avoid stuttering.
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Palavras-chave
Gagueira, Estudos de avaliação, Fala, Criança, Distúrbios da fala, Stuttering, Evaluation studies, Speech, Child, Speech disorders