Hızlı Bozuk Konuşma Üzerine Bir İnceleme Çalışması

Year 2021, Volume: 4 Issue: 3, 362 - 379, 30.12.2021

Evrim Gerçek Ahsen Erim Merve Sapmaz Atalar İrem Özkaraalp Beyza Pehlivan

Abstract

Amaç: Bu çalışmada dil ve konuşma bozuklukları alanında yer alan ve akıcılık bozuklukları şemsiyesi altında bulunan HBK’nin tanımı, kapsamı, özellikleri, değerlendirilmesi ve terapisindeki güncel bilgilerin sentezlenmesi amaçlanmıştır. Böylece klinik ve araştırma alanında HBK’ye dikkat çekilmesi sağlanacaktır. Yöntem: Bu çalışmada geleneksel derleme yöntemi kullanılmıştır. İnceleme kapsamında; HBK’de görülen konuşma akıcısızlıkları, dilsel-motor özellikler, etiyoloji, eşlik eden bozukluklar, HBK’nin değerlendirilmesi ve terapisine ilişkin alanyazın incelemesi gerçekleştirilmiştir. Bulgular: Yapılan incelemeler sonucunda, HBK’de konuşma hızının ötesinde akıcısızlık özellikleri, dil ve iletişim gibi diğer becerilerin de etkilendiği görülmüştür. Bunun yanı sıra HBK’nin diğer dil ve konuşma bozukluklarına ek olarak da görülebildiği, nadiren izole olarak görüldüğüne dair bulgular olduğu; HBK’nin etiyolojsi ile ilgili birçok farklı görüş ileri sürülmüş olup bunlarla birlikte bozukluğun nörolojik ve genetik temellerinin bulunduğuna dair pek çok kanıt temeli olduğu da görülmüştür. HBK’si olan bireylerde çeşitli becerilerde meydana gelen etkilenmelerin, bu bozukluğun çalışılması zor alanlardan biri olmasına neden olabildiği belirlenmiştir. Bu nedenle ayrıcı tanı içeren bir değerlendirmenin yapılması, terapi hedeflerini belirlemeye de yardımcıdır. Sonuç: HBK değerlendirmelerinde; konuşma hızının yanı sıra konuşmadaki akıcısızlık özellikleri, dil ve sesletim becerileri, dinleme ve anlatım becerileri, sözel olmayan iletişim becerileri, motor koordinasyon, işitsel ve görsel algı, bilişsel ve entelektüel beceriler, farkındalık ve kendini izleme gibi çok çeşitli becerilerin incelenmesi önerilmektedir. Birçok alanı etkilemesi nedeni ile çalışılması zor bir bozukluk olan HBK’de terapi genel olarak tanımlama, farkındalık, hız-sesletim-dil becerilerinin çalışılması ve izleme-takip aşamalarından oluşmaktadır. Bunlarla birlikte, HBK ‘kimsesiz çocuk’ benzetmesi ile anılmaktadır. Çünkü hem dil ve konuşma terapisi alanında hem de bozukluğu yaşayan bireyler arasında HBK’ye ilişkin farkındalığın oldukça düşük olduğu belirtilmektedir.

Keywords

akıcılık bozuklukları, akıcısız konuşma, akıcısızlık tipleri, hızlı bozuk konuşma, konuşma anlaşılırlığı

A Review on Cluttering

Abstract

Purpose: Cluttering is a fluency disorder characterized by a variety of features such as low speech intelligibility, speed of speech perceived as too fast or irregular, inappropriate prosody and the presence of disfluencies. In this study, the purpose was to synthesize the definition, scope, characteristics, assessment and current information on therapy of cluttering, which is under the umbrella of fluency disorders in the field of speech and language pathology. The aim is also to draw attention to cluttering in terms of clinical practice and research. Method: The traditional compilation method was used in this study. A literature review was conducted on speech fluency, linguistic-motor features, etiology, accompanying disorders, assessment and therapy of cluttering. Results: Beyond the speed of speech, other skills such as disfluencies, language and communication skills are also affected in cluttering. In addition, there have been findings showing that cluttering can be seen in addition to other speech and language disorders and is rarely seen in isolation. It can also be seen together with attention deficit and hyperactivity disorder and specific learning disorder. In addition, auditory processing disorders, apraxia, and autism spectrum disorders are among the disorders that can often coexist with cluttering. It has also been stated that cluttering can be seen together with genetic origin syndromes such as Down syndrome, Tourette's syndrome and Fragile X syndrome. Many different views have been put forward regarding the etiology of cluttering, but it has also been seen that there is a lot of evidence base that the disorder has neurological and genetic bases. It has been determined that the effects of cluttering that occur in various skills of individuals with cluttering may cause this disorder to be one of the difficult disorders to study. Therefore, performing an assessment leading to differential diagnosis also helps to determine the therapy goals. Conclusion: In cluttering, in addition to speed of speech it is recommended to examine a wide variety of skills such as disfluencies in speech, language and pronunciation skills, listening and expression skills, non-verbal communication skills, motor coordination, auditory and visual perception, cognitive and intellectual skills, awareness and self-monitoring while performing the assessment procedures. Cluttering is also a disorder that is difficult to treat because it affects many developmental areas and skills of the individual. Therapy generally consists of identification, awareness, speed-pronunciation-language skills and monitoring-follow-up stages. In addition, cluttering is reffered to as the "orphan" disorder because it is often stated that awareness of cluttering is quite low both in the field of speech and language therapy and among individuals with cluttering.

Keywords

cluttering, disfluent speech, disfluency types, fluency diorders, speech intelligibility

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