Neuropsychological parameters as possible indicators of speech fluency disorder in children

Abstract

Speech disfluency (stuttering) is a multifactor disorder and its aetiology is a big unknown for the experts from various fields. Hemisphere dominance as the highest level in the process of integration of cortical functions is of special significance for the entire development. Praxis and gnosis related cortical organizers are the first to form; they become differentiated and functionally full in early childhood while the process of condensing is completed somewhere around the age of 7. Cortical activity organizers are definitely set at that age and from then on act from one hemisphere which becomes dominant for that function. Laterality is determined by hemisphere dominance, but it occurs as a special phenomenon and it is of great significance for personality. The aim of this research was to examine the influence and the relationship between hemisphere asymmetry on the occurrence of speech disfluency in children. Methods. Sixty children aged 5 to 7 years participated in this research. Thirty children suffer from speech fluency disorder (person who stutters - PWS) and they belong to the experimental group while thirty children are fluent speakers (person who does not stutter - PWNS) and they were the control group. Individual testing was used as a test method. Laterality assessment test was used as an instrument which consists of 5 sub-tests as follows: the assessment of hand-use laterality, the assessment of gestural handuse laterality, the assessment of foot laterality, the assessment of auditory laterality and the assessment of visual laterality. Results. Gestural hand-use laterality and auditory laterality in the PWS examinees were considerably worse in comparison to the PWNS examinees (χ2 = 11.80, p = 0.002, and χ2 = 10.90, p = 0.003, respectively). Male examinees had worse scores in comparison with female examinees. Conclusion. There are certain changes in establishing a dominant hemisphere and differentiation of laterality in children who stutter in comparison with the children who are fluent speakers, which has been shown by statistically significant difference in accomplishments at the test of gestural hand-use laterality and the test of auditory laterality.

Disfluentan govor (mucanje) je multifaktorijalni poremećaj, a njegova etiologija velika nepoznanica za stručnjake različitih oblasti. Dominacija hemisfera kao najviši domet u procesu integracije kortikalnih funkcija, od posebnog je značaja za celokupni razvoj. Prvo se formiraju praksički i gnostički kortikalni organizatori koji se diferenciraju i dostižu svoju funkcionalnu punoću u ranijem detinjstvu, da bi se proces sažimanja dovršio negde oko sedme godine života. Tada se definitivno postave kortikalni organizatori aktivnosti koji od tada deluju iz jedne hemisfere i ona postaje dominantna za tu funkciju. Lateralizovanost je određena dominacijom hemisfera, ali se javlja kao posebna pojava i od velikog je značaja za ličnost. Cilj ovog istraživanja bio je da se ispita uticaj i odnos hemisferne asimetrije na pojavu disfluentnog govora kod dece. Metode. U istraživanje je bilo uključeno 60-toro dece, uzrasta od 5 do 7 godina. Tridesetoro dece je imalo poremećaj fluentnosti govora, (person who stutters - PWS), i oni su činili eksperimentalnu grupu, a tridesetoro dece je bilo fluentno u govoru, (person who does not stutter- PWNS), i ona su činili kontrolnu grupu. Primenjen je metod testiranja tehnikom individualnog testiranja. Kao instrument korišćen je Test za procenu lateralizovanosti koji objedinjuje pet testova i to: procenu upotrebne lateralizovanosti-ruke, procenu gestualne lateralizovanosti-ruke, procenu lateralizovanosti noge, procenu auditivne lateralizovanosti i procenu vizuelne lateralizovanosti. Rezultati. Gestualna lateralizovanost ruke i auditivna lateralizativnost kod ispitanika PWS bile su značajno lošije u odnosu na PWNS, ispitanike (χ2 = 11,80, p = 0,002, odnosno χ2 = 10,90, p = 0,003). Ispitanici muškog pola su postigli lošije rezultate na testovima u odnosu na ispitanike ženskog pola. Zaključak. Postoje izvesne promene u uspostavljanju dominantne hemisfere i diferenciranju lateralizovanosti kod dece koja mucaju u odnosu na decu koja su fluentni govornici, što je pokazala statistički značajna razlika u postignićima na testu gestualne lateralizovanosti ruke i testu auditivne lateralizovanosti.