Çocukluk Çağı Dil Bozuklukları Değerlendirme ve Müdahalesinde Türkiye ve Amerika’nın Karşılaştırılması

Year 2019, Volume: 2 Issue: 2, 146 - 173, 08.09.2019

Özlem Oğuz , İrem Özkaraalp , Ahsen Erim , Rumeysa İnan Şeyda Nur Başaran

Abstract

Giriş
& Amaç: Çocukluk çağı dil bozukluklarında ayırıcı
tanı ve erken müdahale oldukça önem taşımaktadır. Dil terapilerinde çok çeşitli
yaklaşımlar kullanılmakta ve her ne kadar yaklaşımlar arasında farklı
sınıflamalar yapılıyor olsa da genel sınıflama klinisyen merkezli, çocuk
merkezli ya da hibrit yaklaşımlar şeklinde yapılmaktadır. Dil ve konuşma
terapistliği mesleğinin daha yeni olduğu Türkiye ile mesleğin daha eski bir
geçmişe sahip olduğu Amerika’da kullanılan değerlendirme ve müdahale yaklaşımları
ile birlikte mesleğin çalışma alanlarına yönelik yapılacak karşılaştırmanın hem
uygulama hem araştırma alanına katkılar sağlayacağı düşünülmektedir. Bu
gereksinimle bu çalışmada Türkiye ve Amerika’da yaşayan dil ve konuşma
terapistlerinin ‘Özgül Dil Bozukluğu (ÖDB)’ ve ‘Gecikmiş Dil ve Konuşma (GDK)’
vakalarının değerlendirme ve müdahale süreçlerinde kullandıkları yöntemlerin karşılaştırılması
amaçlanmaktadır. Yöntem: Çalışmada betimsel araştırma modeli kullanılmış
olup verilerin toplanması amacıyla araştırmacılar tarafından 8 soruluk Türkçe
ve İngilizce iki eşdeğer anket hazırlanmıştır. Çalışmada çeşitli kurumlarda
hizmet veren Türkiye’den 56; Amerika’dan 128 toplamda 184 dil ve konuşma
terapisti (DKT) katılımcı yer almıştır. Anketler katılımcılara çevrimiçi
yollarla ulaştırılmıştır. Verilerin analizi için SPSS-20 paket programı
kullanılmıştır. Bulgular
ve Sonuç: Çalışma
bulgularına göre Türkiye ve Amerika’da GDK ve/veya ÖDB
şüphesiyle başvuran kişilerin yönlendirildiği uzmanların farklılık gösterdiği görülmüştür.
Amerika’da
değerlendirme için yönlendirmenin dil ve konuşma terapistinden farklı olarak
ağırlıklı olarak psikoloğa, takibinde ise özel eğitim uzmanına yapıldığı dikkat
çekmektedir. Türkiye’de ise öncelik çocuk psikiyatristine verilmektedir. Türkiye
ve Amerika’daki DKT’lerin GDK ve/veya ÖDB’ye sahip bireyleri değerlendirirken
kullandıkları değerlendirme araçları karşılaştırıldığında iki grup arasında
istatistiksel olarak anlamlı bir fark bulunamamıştır. Türkiye’de
ÖDB ve GDK müdahale süreçlerinde en çok kullanılan yaklaşımlar Fonolojik
Farkındalık Yaklaşımı (x̄=2,78)
ve etkileşim temelli yaklaşımlardan
biri olan Floortime (x̄=2,48) iken; Amerika’da Oyun Temelli Yaklaşım (Play Based Approach) (x̄=2,90) ve
Kolaylaştırıcı Görsel Stratejiler (Visual Strategies
to Facilitate) (x̄=2,81)
yaklaşımları olmaktadır. Her iki
ülke için de en az kullanılan yaklaşım ‘Yazma Laboratuvarı Yaklaşımı (The Writing Lab)’dır.

Keywords

gecikmiş dil, özgül dil bozukluğu, dil ve konuşma terapisi, müdahale, değerlendirme, karşılaştırma

Assessment and Intervention in Childhood Language Disorders: A Comparison of Practices in Turkey and the USA

Abstract

Introduction: Differential
diagnosis and early intervention are quite important in childhood language
disorders. A wide variety of approaches can be used in language therapies and
these approaches are divided into such classes as clinician-centered,
child-centered or hybrid approaches. It is thought that the comparison about
the assessment and treatment techniques for delayed language and Specific
Language Impairment between the USA and Turkey where speech and language
therapy field does not have an old history may contribute to both practice and
research. For that reason, it was aimed to compare the methods and approaches
of assessment and treatment in cases of delayed language and specific language
impairment between speech and language therapists who live in the USA and
Turkey in this study. Method:
The descriptive research model was used in this study and two equivalent
questionnaires of eight questions related to assessment and treatment procedures
in Turkish and English were prepared by the researchers in order to collect the
data. 56 participants from Turkey and 128 participants from the USA, 184
participants in total, participated to the study. The corresponding author prepared
the English version of the survey. The questionnaires were delivered to the
participants online.  SPSS-20 package
program was used for the data analysis. Results
& Conclusion: According to the
findings, speech and language therapists work mostly at the rehabilitation centers
in Turkey (32,14 %) while the speech and language therapists work mostly in
schools (57 %) in the USA. It was found that there is no speech and language
therapist who works in schools in Turkey, as there is no available position for
speech and language therapists at schools in Turkey. The findings show that
there are differences between the USA and Turkey about referenced experts/
professionals in cases of delayed language and specific language impairment
referrals. It is noteworthy that in the USA reference for evaluation is mainly
directed to psychologist and as a second professional to special education
experts apart from speech and language therapist. Although referenced experts
show variety in Turkey, reference is done most commonly to child psychiatrists.
When the assessment tools for delayed language and Specific Language Impairment
between the USA and Turkey were compared, there were no statistically
significant differences between the two groups. Both groups prefer informal observation
during assessment process. Survey
findings also indicate that the most commonly used approaches for Specific
Language Impairment and language delay were Phonological Awareness Approach
(x̄=2,78) and Floortime, which
is one of Relationship Based Approaches (x̄=2,48) in Turkey while the
Play Based Approach (x̄=2,90)
and Visual Strategies to
Facilitate Approach were the most preferred ones in
the USA. (x̄=2, 81). The least used approach for both
countries was the Writing Lab Approach. In the intervention sessions of delayed
language and Specific Language Impairment, the speech and language therapists
in Turkey chose toys as materials (55, 3 %) while the ones in the USA mostly preferred
books (36, 2 %) besides other variable options such as flashcards, games,
pictures, videos, Ipad and core boards. 

Keywords

Delayed language, Specific Language Impairment, developmental language disorder, speech and language therapy, treatment, assessment, comparison

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