Yıl: 2009 Cilt: 19 Sayı: 3 Sayfa Aralığı: 247 - 254 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The management of developmental stuttering: Child psychiatrists' perspectives

Öz:
Amaç: Kekemelik, genellikle konuşmanın akışında aksamaların olduğu bir iletişim bozukluğudur. Gelişimsel kekemeliğin nedenlerine yönelik birçok kuram ileri sürülmesine karşın, yeterince açıklama getirilememiştir. Gelişimsel kekemeliğin kesin tedavisi yoktur, tedavi yaklaşımlarının çoğu konuşma akıcılığındaki düzensizliklerin azaltılmasına yardımcı olmaya yöneliktir. Gelişimsel kekemeliğin tedavisine yönelik profesyonellerin yaklaşım ve tutumlarında fikir birliği yoktur. Bu çalışmada, gelişimsel kekemeliğe yönelik tedavi yaklaşımları hakkındaki ülkemizdeki çocuk psikiyatrisi uzmanlarının görüşlerinin araştırılması amaçlanmıştır.Yöntem: Veriler 38 çocuk psikiyatri uzmanına, çok seçenekli sorular ve varsayımsal çerçevede vaka senaryosu içeren anket uygulanarak elde edilmiştir. Verilere tanımlayıcı analiz uygulanmıştır.Bulgular: Çocuk psikiyatristlerinin %43.3ü okul öncesi dönemde gelişimsel kekemeliğe müdahale edilmemesi görüşündeydi. %65.7i en azından başlangıçta bekle ve gör stratejisini tercih ediyordu. Çocuk psikiyatristlerinin büyük bir kısmı, birincil olarak anne-babanın hedeşendiği dolaylı müdahale lehinde görüş bildirdi. Sedatif antihistaminikler ve seçici serotonin geri alım inhibitörleri sık olarak tercih edilen ilk seçenek ilaçlardı (sırasıyla %36.8 ve %34.2). Risperidon ise %15.8 oranında ilk seçenek olarak tercih ediliyordu. Çocuk psikiyatristlerin çoğu, akıcı konuşmayı destekleyici aygıtlara aşina değillerdi ve alternatif tıp yaklaşımlarının etkisiz oldukları görüşündeydiler.Tartışma: Gelişimsel kekemeliğin tedavi yaklaşımlarına yönelik çocuk psikiyatristlerinin görüşleri heterojen tablo sergilemektedir. Türkiyedeki çocuk psikiyatristleri daha konservatif tedavi yaklaşımlarını tercih etmektedir. Gelişimsel kekemeliğin tedavisinde çocuk psikiyatristlerinin konuşma terapistleri ile yoğun işbirliği önemlidir.
Anahtar Kelime: Kekemelik Çocuk Çocuk psikiyatrisi Tedavi

Konular: Farmakoloji ve Eczacılık

Gelişimsel kekemeliğe tedavi yaklaşımları: Çocuk psikiyatristlerinin bakış açıları

Öz:
Objective: Stuttering is a communication disorder generally characterized by involuntary disruptions in the flow of speech. Various theories have been offered to explain developmental stuttering, but its causes are not well understood. There is no known cure for developmental stuttering, though many treatment approaches help children reduce the number of dysfluencies in their speech. There is no common consensus on approaches and attitudes of professionals towards management of developmental stuttering. This nationwide survey of child psychiatrists was conducted to assess child psychiatrists views about management approaches to developmental stuttering.Method: Data obtained from 38 respondents who were the child psychiatry specialists using a specific questionnaire including items formatted as multiple- choice questions and a case scenario with a hypothetical frame. Descriptive analysis was applied to the data. Results: Of the child psychiatrists, 43.3% agreed that early developmental stuttering should be ignored. 65.7% of them preferred at least initially, a wait and see strategy. An appreciable majority of the child psychiatrists were in favor of the indirect therapy, which is aimed primarily at the parents. Sedative antihistamines and selective serotonin reuptake inhibitors were preferred frequently used as first-choice drug class (36.8% and 34.2%, respectively) while risperidone was prescribed as a first- choice drug by 15.8 percent. Most of the child psychiatrists were not familiar with anti-stuttering devices, and alternative medicine was considered as non-effective and not helpful. Discussion: Child psychiatrists show a heterogeneous picture regarding their views on therapeutic approaches in developmental stuttering. Child psychiatrists in Turkey prefer more conservative approaches. It is important that child psychiatrists work in extensive collaboration with speech pathologists for treating developmental stuttering.
Anahtar Kelime: Child Child Psychiatry Therapy Stuttering

Konular: Farmakoloji ve Eczacılık
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Bloodstein O. A Handbook on Stuttering. San Diego, CA: Singular Publishing Group, 1995.
  • 2. Finn P. Establishing the validity of recovery from stuttering without formal treatment. J Speech Hear Res 1996; 39:1171-1181
  • 3. Yairi E, Ambrose NG. Early childhood stuttering: I. persistency and recovery rates. J Speech Lang Hear Res 1999; 42:1097-1112
  • 4. Bothe AK, Davidow JH, Bramlett RE, Ingham RJ. Stuttering treatment research 1970-2005: I. systematic review incorporating trial quality assessment of behavioral, cognitive, and related approaches. Am J Speech Lang Pathol 2006;15:321-341
  • 5. Bothe AK, Davidow JH, Bramlett RE, Franic DM, Ingham RJ. Stuttering treatment research 1970-2005: II. systematic review incorporating trial quality assessment of pharmacological approaches. Am J Speech Lang Pathol 2006; 15:342-352
  • 6. Yairi E, Carrico DM. Early childhood stuttering pediatricians' attitudes and practices. Am J Speech Lang Pathol 1992; 1:54-62
  • 7. Ingham J C, Riley G. Guidelines for documentation of treatment efficacy for young children who stutter. J Speech Lang Hear Res 1998; 41:753-770
  • 8. Ansel B. Treatment efficacy research in stuttering. J Fluency Disord 1993; 18:121-123
  • 9. Conture EG. Treatment efficacy: stuttering. J Speech Hear Res 1996; 39:18-26
  • 10. Thomas C, Howell P. Assessing efficacy of stuttering treatments. J Fluency Disord 2001; 26:311-333
  • 11. Ingham R J. Spontaneous remission of stuttering: when will the emperor realize he has no clothes on? In: Prins D., Ingham R.J., editors. Treatment of Stuttering In Early Childhood: Methods and Issues. San Diego, CA: College-Hill Press, 1983; p.113-140
  • 12. Ingham RJ, Cordes AK. On watching a discipline shoot itself in the foot: some observations on current trends in stuttering treatment. In: Ratner NB, Healey EC, editors. Stuttering Research and Practice: Bridging the Gap. Mahwah, NJ: Erlbaum, 1999; p.211-230
  • 13. Ezrati-Vinacour R, Platzky R, Yairi E. The young child's awareness of stuttering-like disfluency. J Speech Lang Hear Res 2001; 44:368-380
  • 14. Ingham R J. Stuttering. In: Bellack AS, Hersen M, Kazdin AE, editors. International Handbook of Behavior Modification and Therapy (2nd ed.). New York: Plenum Press. 1990; p.599-631
  • 15. Bloodsteln O. A Handbook on Stuttering (4th ed.). Chicago: National Easter Seal Society, 1987
  • 16. Yaruss JS, Coleman C, Hammer D. Treating preschool children who stutter: description and preliminary evaluation of a family-focused treatment approach. Lang Speech Hear Serv Sch 2006; 37:118-136
  • 17. Gottwald SR, Starkweather CW. Fluency intervention for preschoolers and their families in the public schools. Lang Speech Hear Serv Sch 1995; 2:117-126
  • 18. Shapiro DA. Stuttering Intervention: A Collaborative Journey to Fluency Freedom. Austin, TX: Pro-Ed, 1999.
  • 19. Conture EG. Stuttering: Its Nature, Diagnosis and Treatment. Boston: Allyn & Bacon, 2001
  • 20. Hill D. Differential treatment of stuttering in the early stages of development. In: Gregory H, editor. Stuttering Therapy: Rationale and Procedures. Boston: Allyn & Bacon. 2003; p.142-185
  • 21. Walton P, Wallace M. Fun with Fluency: Direct Therapy with the Young Child. Bisbee, AZ: Imaginart, 1998
  • 22. Costa D, Kroll R. Stuttering: an update for physicians. CMAJ 2000; 162:1849-1855
  • 23. Lavid N. Understanding Stuttering. The University Press of Mississippi, 2003
  • 24. Yairi E, Ambrose N. A longitudinal study of stuttering in children: a preliminary report. J Speech Hear Res 1992; 35:755-760
  • 25. Maguire GA, Riley GD, Franklin DL, Gottschalk LA. Risperidone for the treatment of stuttering. J Clin Psychopharmacol 2000; 20:479-482
  • 26. Rosenberger PB, Wheelden JA, Kalotkin M. The effect of haloperidol on stuttering. Am J Psychiatry 1976; 133:331-334
  • 27. Wells PG, Malcolm MT. Controlled trial of the treatment of 36 stutterers. Br J Psychiatry 1971; 119:603-604
  • 28. Cocores J, Dackis C, Davies R, Gold M. Propranolol and stuttering [Letter to the editor]. Am J Psychiatry 1986; 143:1071-1072
  • 29. Costa AD, Kroll RM. Sertraline in stuttering. J Clin Psychopharmacol 1995; 15:443-444
  • 30. Kumar A, Balan S. Fluoxetine for persistent developmental stuttering. Clin Neuropharmacol. 2007; 30:58-59
  • 31. Brady JP. The pharmacology of stuttering: a critical review. Am J Psychiatry 1991; 148:1309-1316
  • 32. Gardner DM, Baldessarini RJ, Waraich P. Modern antipsychotic drugs: a critical overview. CMAJ 2005; 172:1703-1711
  • 33. Kroll R, Beitchman JH. Stuttering. In: Sadock B.J., Sadock V.A., editors. Kaplan & Sadock’s Comprehensive Textbook of Psychiatry, 7th ed. Philadelphia: Lippincott Williams and Wilkins, 2000
  • 34. Debney S, Druce T. Intensive fluency programme long-term follow- up. Poster Presentation ASHA conference, 1987
  • 35. Ingham RJ, Kilgo M, Ingham JC, Moglia RA, Belknap H, Sanchez T. Evaluation of a stuttering treatment based on reduction of short phonation intervals. J Speech Lang Hear Res 2001; 44:1229-1244
  • 36. Onslow M, Costa L, Andrews C, Harrison E, Packman A. Speech outcomes of a prolonged-speech treatment for stuttering. J Speech Hear Res 1996; 39:734-749
  • 37. Cooper EB. The chronic preservatives stuttering syndrome; incurable stuttering. J Fluency Disord 1987;12:381-388
  • 38. Lincoln MA, Onslow M. Long-term outcome of early intervention for stuttering. Am J Speech Lang Pathol 1997; 6:51-58
  • 39. Jones M, Onslow M, Packman A, Williams S, Ormond T, Schwarz I, Gebski V. Randomised controlled trial of the Lidcombe programme of early stuttering intervention. BMJ 2005; 331:659
  • 40. Ladouceur R, Martineau G. Evaluation of regulated breathing method with and without parental assistance in the treatment of child stutterers. J Behav Ther Exp Psychiatry 1982; 13:301-306
  • 41. ASHA. Stuttering: benefits of speech-language pathology services. http://www.asha.org/public/speech/disorders/StutteringSLPbenefits .htm., 2008
  • 42. Craig AR, Kearns M. Results of a traditional acupuncture intervention for stuttering. J Speech Hear Res 1995; 38:572-578
APA TÜRKBAY T, CÖNGÖLOĞLU A, ÇİYİLTEPE M, DURUKAN İ, Karabekiroglu K (2009). The management of developmental stuttering: Child psychiatrists' perspectives. , 247 - 254.
Chicago TÜRKBAY Tümer,CÖNGÖLOĞLU Ayhan,ÇİYİLTEPE MÜZEYYEN,DURUKAN İbrahim,Karabekiroglu Koray The management of developmental stuttering: Child psychiatrists' perspectives. (2009): 247 - 254.
MLA TÜRKBAY Tümer,CÖNGÖLOĞLU Ayhan,ÇİYİLTEPE MÜZEYYEN,DURUKAN İbrahim,Karabekiroglu Koray The management of developmental stuttering: Child psychiatrists' perspectives. , 2009, ss.247 - 254.
AMA TÜRKBAY T,CÖNGÖLOĞLU A,ÇİYİLTEPE M,DURUKAN İ,Karabekiroglu K The management of developmental stuttering: Child psychiatrists' perspectives. . 2009; 247 - 254.
Vancouver TÜRKBAY T,CÖNGÖLOĞLU A,ÇİYİLTEPE M,DURUKAN İ,Karabekiroglu K The management of developmental stuttering: Child psychiatrists' perspectives. . 2009; 247 - 254.
IEEE TÜRKBAY T,CÖNGÖLOĞLU A,ÇİYİLTEPE M,DURUKAN İ,Karabekiroglu K "The management of developmental stuttering: Child psychiatrists' perspectives." , ss.247 - 254, 2009.
ISNAD TÜRKBAY, Tümer vd. "The management of developmental stuttering: Child psychiatrists' perspectives". (2009), 247-254.
APA TÜRKBAY T, CÖNGÖLOĞLU A, ÇİYİLTEPE M, DURUKAN İ, Karabekiroglu K (2009). The management of developmental stuttering: Child psychiatrists' perspectives. Klinik Psikofarmakoloji Bülteni, 19(3), 247 - 254.
Chicago TÜRKBAY Tümer,CÖNGÖLOĞLU Ayhan,ÇİYİLTEPE MÜZEYYEN,DURUKAN İbrahim,Karabekiroglu Koray The management of developmental stuttering: Child psychiatrists' perspectives. Klinik Psikofarmakoloji Bülteni 19, no.3 (2009): 247 - 254.
MLA TÜRKBAY Tümer,CÖNGÖLOĞLU Ayhan,ÇİYİLTEPE MÜZEYYEN,DURUKAN İbrahim,Karabekiroglu Koray The management of developmental stuttering: Child psychiatrists' perspectives. Klinik Psikofarmakoloji Bülteni, vol.19, no.3, 2009, ss.247 - 254.
AMA TÜRKBAY T,CÖNGÖLOĞLU A,ÇİYİLTEPE M,DURUKAN İ,Karabekiroglu K The management of developmental stuttering: Child psychiatrists' perspectives. Klinik Psikofarmakoloji Bülteni. 2009; 19(3): 247 - 254.
Vancouver TÜRKBAY T,CÖNGÖLOĞLU A,ÇİYİLTEPE M,DURUKAN İ,Karabekiroglu K The management of developmental stuttering: Child psychiatrists' perspectives. Klinik Psikofarmakoloji Bülteni. 2009; 19(3): 247 - 254.
IEEE TÜRKBAY T,CÖNGÖLOĞLU A,ÇİYİLTEPE M,DURUKAN İ,Karabekiroglu K "The management of developmental stuttering: Child psychiatrists' perspectives." Klinik Psikofarmakoloji Bülteni, 19, ss.247 - 254, 2009.
ISNAD TÜRKBAY, Tümer vd. "The management of developmental stuttering: Child psychiatrists' perspectives". Klinik Psikofarmakoloji Bülteni 19/3 (2009), 247-254.