Oralna praksija i mucanje

Abstract

Mucanje predstavlja višedimenzionalni problem kako u dijagnostici tako i u terapiji. To je poremećaj fluentnosti govora koji pogađa približno 5% dece i 1% odraslih. Različiti faktori utiču na smanjenje učestalosti i težine mucanja, često tako što smanjuju zahteve za motornom kontrolom govora i jezičkom formulacijom iskaza. Postoji veća verovatnoća za spontani oporavak ako su u pitanju osobe ženskog pola, osobe koje imaju dobre fonološke, jezičke i neverbalne sposobnosti, desnoruke su, imaju stabilniji motorni govorni sistem i adekvatno porodično okruženje. Tokom višegodišnjeg rada sa decom i odraslima koji mucaju zapazili smo da veliki broj dece, ali i starijih pacijenata koji nam se obrate zbog problema mucanja pokazuju i druge govorne i/ili jezičke probleme. Zato smo želeli da ispitamo jedan od važnih segmenata govornog funkcionisanja, a to je oralna praksija, odnosno kinestetska i motorna kontrola pokreta mišića orofacijalne regije koji se, kombinovani, koriste i pri govoru. Subjekti su bili grupa od 10 pacijenata Zavoda za psihofiziološke poremećaje i govornu patologiju ’’Prof. Dr Cvetko Brajović’’, na tretmanu zbog mucanja, uzrasta 9-12 godina, i kontrolna grupa od 10-oro dece istog uzrasta i pola, koja ne mucaju niti imaju druge govorne ili jezičke probleme. Korišćen je Test oralne praksije autora Radičević i Stevanković. Rezultati ukazuju na značajnu razliku u sposobnosti izvođenja zadatih pokreta, u korist kontrolne grupe. S obzirom na mali uzorak planirano je opsežnije istraživanje na većem uzorku, kako bi se isključila slučajnost u dobijanju ovakvih rezultata. Međutim, imajući u vidu već pomenute nalaze različitih istraživanja koji potkrepljuju naše rezultate, smatramo da je i ovaj nalaz dovoljan da bi se u tretman mucanja dece ovog uzrasta uključile i vežbe za poboljšanje sposobnosti oralne praksije.

Stuttering is a multidimensional problem in diagnostics and in therapy. It is fluency disorder that affects aproximatelly 5% of children and 1% of adults. Different factors influence decrease in stuttering frequency and severity by reducing demands for motoric-speech control and language formulation. There is higher posibillity for spontaneous recovery amnog female individuals, individuals with adequate family environment, righthanded, who have good phonological, linguistic and non verbal skills, and have more stable motoric speech sistem. During years of working with children and adults who stutter, we noticed that large number of children, but also older patients who come to us for teatment of stuttering, show other speech and/or language problems as well. This was the reason for us to investigate status of oral praxia, as one of important segments of speech functioning, showing level of kinestetic and motor control of movements of orofacial muscles, wich are used during speech as well. Subjects were a group of 10 patients, aged 9-11, on therapy treatment for stuttering at the Institute for Psychophysiological Disorders and Speech Pathology “Prof. Dr Cvetko Brajovic” in Belgrade. Control group consisted of 10 children, age and gender matched, without stuttering or other speech or language disorder. We used the Test of oral praxia, by Radičević&Stevanković. Results show signifficant diference in performing in favour of non-stuttering children. Since we used small group in our research, we plan to repead it on considerably larger number of subjects, in order to exclude statistical coincidence/ incidental results. However, considering already mentioned results of other researches, we belive that even this finding is enough to include oral motor excercises into the treatment of stuttering among this age group.