Perfil da fluência de fala de escolares segundo a gravidade da gagueira
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Data
2018-05-30
Autores
Souza, Mariane Cristina de Lorena [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A gagueira é a principal desordem da fluência e um dos mais prevalentes distúrbios desenvolvimentais na infância, e sua variabilidade, em termos de frequência, duração e presença de concomitantes físicos, interfere na gravidade da gagueira. Dados precisos da avaliação da fluência considerando o grau de gravidade da gagueira são importantes para propiciar maior compreensão da manifestação clínica nos diferentes subtipos do distúrbio. O objetivo geral foi caracterizar e comparar a fluência da fala de escolares com gagueira leve (GL), moderada (GM) e grave (GG); e relacionar os parâmetros da fluência. Participaram 30 escolares com gagueira de ambos os gêneros, divididos em três grupos de 10 escolares cada: Grupo de Gagueira Leve; Grupo de Gagueira Moderada; Grupo de Gagueira Grave. Todos apresentaram pontuação condizente com o grupo de estudo pelo Instrumento de Gravidade da Gagueira. Os procedimentos realizados foram: avaliação da fluência da fala, classificação da gravidade da gagueira e análise acústica para calcular a velocidade de fala. Foi realizada a análise estatística com os testes ANOVA – One way e Kruskal-Wallis com correção de Fisher e; Teste de Pearson e Spearman. Os resultados mostraram que o perfil da fluência da GL e GM foi semelhante na maioria das análises qualitativas e quantitativas. O prolongamento foi a única disfluência que ocorreu mais frequentemente na GM em relação à GL (p=0,045), podendo ser um importante marcador da gravidade da gagueira. No entanto, a GG se diferenciou em relação à GL e GM na maioria das variáveis. Os resultados relativos à velocidade de fala mostraram que existe uma relação inversamente proporcional entre a frequência de disfluências e os fluxos de sílabas e de palavras por minuto, uma vez que o grupo grave, que apresentou maior frequência de rupturas (disfluências típicas da gagueira, outras disfluências e total das disfluências), foi o mesmo grupo que manifestou menor velocidade de fala quando comparado com os grupos leve e moderado. Conclui-se que o perfil da fluência de escolares com GG foi divergente dos GL e GM, pois mostrou maior frequência de: disfluências típicas da gagueira, outras disfluências, total das disfluências, disfluências de duração, repetição de som, bloqueio e palavra incompleta. Assim como, manifestou maior escore de frequência e duração das DTG, escore dos concomitantes físicos e escore total do Instrumento de Gravidade da Gagueira. O perfil da fluência do GM e GL foi semelhante na maioria das variáveis, somente diferenciou quanto à maior frequência de prolongamentos. Houve relação inversamente proporcional para as seguintes variáveis: frequência de disfluências típicas da gagueira e velocidade de fala e escore total do Instrumento de Gravidade da Gagueira e velocidade de fala, e; relação diretamente proporcional para a frequência de disfluências típicas da gagueira e de outras disfluências. Acredita-se que, os resultados auxiliarão na melhor compreensão da variabilidade do distúrbio relacionada à gravidade, propiciando um diagnóstico mais preciso e uma melhor intervenção aos escolares que gaguejam de acordo com suas reais necessidades.
Stuttering is the main fluency disorder and one of the most prevalent developmental disorders in childhood. The variability of the manifestations, in relation to the frequency, duration and presence of concomitants, interferes with stuttering severity. Accurate data on the assessment of fluency considering the degree of severity of stuttering are important for greater understanding of the clinical manifestation in the different subtypes of the disorder. The general objective of the study was to characterize and compare speech fluency of shool-age children with mild, moderate and severe stuttering, as well as to relate the parameters of their fluency. Participated thirty school-age children with stuttering from both genders, they were divided into three groups: Mild Stuttering Group (MiS); Moderate Stuttering Group (MoS); and Severe Stuttering Group (SS). All participants should present score consistent with their research group according to the Stuttering Severity Instrument. The procedures were: evaluation of frequency fluency speech, classification of stuttering severity and acoustic analysis to measure speech rate. Statistical analysis of the data was performed with ANOVA - One way test and Kruskal-Wallis test with Fisher's correction; and Pearson and Spearman test. The results showed that the profile of fluency speech of MiS and GM groups were similar in majority of qualitative and quantitative analyses reviews. Prolongation was the single disfluency that differentiated the mild to moderate group (p= 0,045), and may be an important marker of stuttering severity. However, SS differentiated between MiS and MoS group in most variables. Speech rate results showed that there is a ratio inversely proportional between the frequency of disfluencies and the syllable and word-per-minute, because severe stuttering group differed from mild and moderate stutter groups, since severe group, which presented a higher frequency of ruptures stuttering-like disfluencies, other disfluencies and total of disfluencies), was the same group that showed lower speech rate when compared to mild and moderate groups. It concludes that the fluency profile of school-age children with severe stuttering was different from those with mild and moderate stuttering, because it showed a higher frequency of: stuttering-like disfluencies, other disfluencies, total disfluencies, duration disfluencies, sound repetition, blockage and incomplete word. As well as, severe group showed a higher frequency score and duration score of stuttering-like disfluencies, physical concomitant score and total score on Stuttering Severity Instrument. MiS and MoS fluency profile was similar in most variables, only differing in the frequency of prolongations. There was inversely proportional relation between the frequency of stutteringlike disfluency to speech rate, and total score of Stuttering Severity Instrument to speech rate, and; directly relation of frequency of stuttering-like disfluencies and other disfluencies. Stands out that the results will help to better understand the variability of the gravity-related disorder, providing a more accurate diagnosis and better intervention for school-age who stutter according to their real needs.
Stuttering is the main fluency disorder and one of the most prevalent developmental disorders in childhood. The variability of the manifestations, in relation to the frequency, duration and presence of concomitants, interferes with stuttering severity. Accurate data on the assessment of fluency considering the degree of severity of stuttering are important for greater understanding of the clinical manifestation in the different subtypes of the disorder. The general objective of the study was to characterize and compare speech fluency of shool-age children with mild, moderate and severe stuttering, as well as to relate the parameters of their fluency. Participated thirty school-age children with stuttering from both genders, they were divided into three groups: Mild Stuttering Group (MiS); Moderate Stuttering Group (MoS); and Severe Stuttering Group (SS). All participants should present score consistent with their research group according to the Stuttering Severity Instrument. The procedures were: evaluation of frequency fluency speech, classification of stuttering severity and acoustic analysis to measure speech rate. Statistical analysis of the data was performed with ANOVA - One way test and Kruskal-Wallis test with Fisher's correction; and Pearson and Spearman test. The results showed that the profile of fluency speech of MiS and GM groups were similar in majority of qualitative and quantitative analyses reviews. Prolongation was the single disfluency that differentiated the mild to moderate group (p= 0,045), and may be an important marker of stuttering severity. However, SS differentiated between MiS and MoS group in most variables. Speech rate results showed that there is a ratio inversely proportional between the frequency of disfluencies and the syllable and word-per-minute, because severe stuttering group differed from mild and moderate stutter groups, since severe group, which presented a higher frequency of ruptures stuttering-like disfluencies, other disfluencies and total of disfluencies), was the same group that showed lower speech rate when compared to mild and moderate groups. It concludes that the fluency profile of school-age children with severe stuttering was different from those with mild and moderate stuttering, because it showed a higher frequency of: stuttering-like disfluencies, other disfluencies, total disfluencies, duration disfluencies, sound repetition, blockage and incomplete word. As well as, severe group showed a higher frequency score and duration score of stuttering-like disfluencies, physical concomitant score and total score on Stuttering Severity Instrument. MiS and MoS fluency profile was similar in most variables, only differing in the frequency of prolongations. There was inversely proportional relation between the frequency of stutteringlike disfluency to speech rate, and total score of Stuttering Severity Instrument to speech rate, and; directly relation of frequency of stuttering-like disfluencies and other disfluencies. Stands out that the results will help to better understand the variability of the gravity-related disorder, providing a more accurate diagnosis and better intervention for school-age who stutter according to their real needs.
Descrição
Palavras-chave
Fonoaudiologia, Fala, Gagueira, Avaliação, Acústica da fala, Criança, Speech, Language and hearing sciences, Stuttering, Evaluation, Child