Dil ve Konuşma Bozukluklarında Koruyucu Yaklaşımlar
Özet
Dil ve Konuşma Bozukluklarında Koruyucu Yaklaşımlar, Dil ve Konuşma Terapistlerinin (DKT) geleneksel müdahale rollerinin ötesinde üstlendikleri önleyici sorumlulukları ve bu hizmetlerin önemini kapsamlı bir şekilde ele almaktadır. Koruyucu hizmetler birincil, ikincil ve üçüncül olmak üzere üç basamakta yapılandırılmakta ve tedavi süreçlerine kıyasla ciddi bir ekonomik ve sosyal avantaj sunmaktadır. Pediatrik grupta gelişimsel dil bozuklukları, konuşma sesi sorunları, disleksi, kekemelik, ses ve yutma bozukluklarına yönelik biyolojik, medikal, ailesel ve çevresel risk faktörlerinin erkenden tanınması hayati önem taşımaktadır. Buna karşılık, ebeveyn etkileşim duyarlılığı, zengin ev okuryazarlık ortamı ve oyun fırsatları gibi unsurlar koruyucu faktörler olarak bu risklerin olumsuz etkilerini hafifletmektedir. Koruyucu yaklaşımlar kapsamında yaygın tarama programları, okul ortamlarında kullanılan Müdahaleye Yanıt Modeli, gerekli durumlarda sağlanan medikal ve cerrahi destekler öne çıkmaktadır. Ayrıca, ses hijyeni eğitimlerinin verilmesi, aile merkezli dil stratejilerinin uygulanması ve toplum ile disiplinler arası profesyonellerin farkındalık düzeylerinin artırılması bozuklukların sıklığını, yaygınlığını ve uzun vadeli etkilerini azaltmaktadır. Sonuç olarak, multidisipliner bir yaklaşımla yürütülen bu koruyucu hizmetler, bireysel tam iyi olma durumunu desteklemekte ve toplumsal sağlık maliyetlerini optimize etmektedir.
Preventive Approaches in Speech and Language Disorders comprehensively addresses the preventive responsibilities assumed by Speech and Language Therapists (SLTs) beyond traditional intervention roles and underscores the significance of these services. Preventive services are structured into three levels—primary, secondary, and tertiary—offering substantial economic and social advantages compared to treatment. In the pediatric population, early detection of biological, medical, familial, and environmental risk factors for developmental language disorders, speech sound disorders, dyslexia, stuttering, and voice/swallowing disorders is vital. Conversely, components such as parental interaction responsiveness, rich home literacy environments, and daily play opportunities act as protective factors that mitigate these risks. Key preventive strategies include widespread screening programs, the Response to Intervention Model utilized in educational settings, and necessary medical or surgical supports. Furthermore, implementing vocal hygiene training, parent-implemented language strategies, and increasing awareness among families and multidisciplinary professionals effectively reduces the incidence, prevalence, and long-term severity of these communication disorders. In conclusion, these preventive services, managed through a multidisciplinary framework, promote individual well-being and optimize public health outcomes.
Referanslar
Konrot A. In: Topbaş S, editor. Dil ve Kavram Gelişimi. Kök Yayıncılık; 227-249, 2011.
Dil ve Konuşma Terapistleri Derneği (DKTD) [homepage on the Internet]. (2020). [updated 2021 May 13; cited 2021 April 12]. Dil ve Konuşma Terapisti Kimdir?. Available from: https://www.dktd.org/tr/files/download/p1e8tpiusl15n41h7pq2n1ib35u34.pdf .
American Speech-Language-Hearing Association (ASHA) [homepage on the Internet]. (1991). [updated 2021 May 13; cited 2021 April 12]. Prevention of Communication Disorders. Available from: https://www.asha.org/policy/ps1988-00228/ .
Paul R, Norbury CF. Language Disorders from Infancy through Adolescence. 4th ed. Elseiver; 2012.
Delgado CE, Vagi SJ, Scott KG. Early risk factors for speech and language impairments. Exceptionality. 2005; 13(3): 173-191.
Stanton-Chapman TL, Chapman DA, Bainbridge NL, Scott KG. Identification of early risk factors for language impairment. Res Dev Disabil. 2002; 23(6): 390-405.
Campbell TF, Dollaghan CA, Rockette HE, Paradise JL, Feldman HM, Shriberg LD, et al. Risk factors for speech delay of unknown origin in 3‐year‐old children. Child Dev. 2003; 74(2): 346-357.
Sunderajan T, Kanhere SV. Speech and language delay in children: Prevalence and risk factors. J Family Med Prim Care. 2019; 8(5): 1642-1646.
Korpilahti P, Kaljonen A, Jansson-Verkasalo E. Identification of biological and environmental risk factors for language delay: The Let's Talk STEPS study. Infant Behav Dev. 2016; 42: 27-35.
Bettio CDB, Bazon MR, Schmidt A. Risk and protective factors for language development delay. Psicol Estud. 2019; 24:1-15.
Wren Y, Miller LL, Peters TJ, Emond A, Roulstone S. Prevalence and predictors of persistent speech sound disorder at eight years old: Findings from a population cohort study. J Speech Lang Hear Res. 2016; 59(4): 647-673.
Hayiou‐Thomas ME, Carroll JM, Leavett R, Hulme C, Snowling MJ. When does speech sound disorder matter for literacy? The role of disordered speech errors, co‐occurring language impairment and family risk of dyslexia. J Child Psychol Psychiatry. 2017; 58(2): 197-205.
Paracchini S, Scerri T, Monaco AP. The genetic lexicon of dyslexia. Annu. Rev. Genom. Hum. Genet. 2007; 8 (1): 57–79.
Snowling MJ, Gallagher A, Frith U. Family risk of dyslexia is continuous: Individual differences in the precursors of reading skill. Child Dev. 2003; 74 (2): 358–373.
van Bergen E, van der Leij A, de Jong PF. The intergenerational multiple deficit model and the case of dyslexia. Front Hum Neurosci. 2014; 8: 1-13.
Dilnot J, Hamilton L, Maughan B, Snowling MJ. Child and environmental risk factors predicting readiness for learning in children at high risk of dyslexia. Dev Psychopathol. 2017; 29(1): 235-244.
Carroll JM, Mundy IR, Cunningham AJ. The roles of family history of dyslexia, language, speech production and phonological processing in predicting literacy progress. Dev Sci. 2014; 17 (5): 727–742.
Bishop DV, Snowling MJ. Developmental dyslexia and specific language impairment: Same or different? Psychol. Bull. 2004; 130: 858–886.
Duff FJ, Reen G, Plunkett K, Nation K. Do infant vocabulary skills predict school-age language and literacy outcomes? J Child Psychol Psychiatry. 2015; 56 (8): 848–856.
Ergül C, Ökcün-Akçamuş MÇ, Akoğlu G, Bahap-Kudret Z, Kılıç-Tülü B, Demir E, Okşak FE. Türkçe konuşan çocuklarda fonolojik işlemleme becerileri ilk okuma performansını yorduyor mu? Boylamsal sonuçlar. Hacettepe Üniversitesi Eğitim Fakültesi Dergisi. 2020. Erken Görünüm. http://www.efdergi.hacettepe.edu.tr/yonetim/plugins/uploads/files/3525-published.pdf .
Guitar B. Stuttering: An integrated approach to its nature and treatment. 4th ed. Baltimore: Lippincott Williams & Wilkins; 2014.
Carding PN, Roulstone S, Northstone K. The prevalence of childhood dysphonia: a cross-sectional study. ALSPAC Study Team. J Voice. 2006; 20(4): 623-630.
Sederholm E, McAllister A, Dalkvist J, Sundberg J. Aetiologic factors associated with hoarseness in ten-year-old children. Folia Phoniatr Logop. 1995; 47(5): 262-78.
Tavares ELM, Brasolotto A, Santana MF, Padovan CA, Martins RHG. (2011). Epidemiological study of dysphonia in 4-12 year-old children. Braz. J. Otorhinolaryngol. 2011; 77(6): 736-746.
Prasse JE, Kikano GE. An overview of pediatric dysphagia. Clin. Pediatr. 2009; 48(3): 247-251.
Sharp HM, Hillenbrand K. Speech and language development and disorders in children. Pediatr Clin North Am. 2008; 55(5): 1159–73.
Skarżyński H, Piotrowska A. Prevention of communication disorders–screening pre-school and school-age children for problems with hearing, vision and speech: European Consensus Statement. Med Sci Monit. 2012; 18(4): SR17-21.
Nelson HD, Nygren P, Walker M, Panoscha R. Screening for speech and language delay in preschool children: Systematic evidence review for the US Preventive Services Task Force. Pediatrics. 2006; 117 (2): 298–319.
Heineman KA, Bolanos H, Griffin JS. In: Ryan CS, editor. Learning Disabilities An International Perspective. IntechOpen; 99-114, 2017.
Speech-Language SLP’s Role in Tiers of RtI [homepage on the Internet]. [updated 2021 May 13; cited 2021 April 12]. Available from: https://www.dist102.k12.il.us/_theme/files/Curriculum/RTI/SLPsRoleRTITiers2011.pdf .
Tomblin, JB., Harrison, M., Ambrose, SE., Walker, EA., Oleson, JJ, & Moeller MP. Language outcomes in young children with mild to severe hearing loss. Ear Hear. 2015; 36(01): 76S-91S.
Nagarajan R, Savitha VH, Subramaniyan B. Communication disorders in individuals with cleft lip and palate: An overview. Indian J Plast Surg. 2009; 42(Suppl): S137-S143.
Yolal Duru Y, Erim A, Küçük EN. Anneler ve okul öncesi öğretmenlerin gecikmiş konuşmaya yönelik bilgi düzeylerinin karşılaştırılması. Dil, Konuşma ve Yutma Araştırmaları Dergisi. 2020; 3(1): 61-90.
Uysal AA, Tura G. Öğretmen adaylarının çocuklardaki dil ve konuşma bozukluklarına yönelik tutum ve bilgilerinin değerlendirilmesi. Kocaeli Üniversitesi Eğitim Dergisi. 2018; 1(1): 13-22.
Millard SK, Zebrowski P, Kelman E. Palin parent–child interaction therapy: The bigger picture. Am J Speech Lang Pathol. 2018; 27(3S): 1211-1223.
Starkweather CW, Gottwald SR. The demands and capacities model: Response to Siegel. J Fluency Disord. 2000; 25(4): 369-375.
Aydın Uysal A, Erim A. İlköğretim öğretmenlerinin kekemelik ve akran zorbalığına yönelik farkındalık düzeyleri. In: 10. Ulusal Odyoloji ve Konuşma Bozuklukları Kongresi; 2020 December 25-27; İstanbul. p. 66.
Moharir M, Barnett N, Taras J, Cole M, Ford-Jones EL, Levin L. Speech and language support: How physicians can identify and treat speech and language delays in the office setting. Paediatr. Child Health. 2014; 19(1): 13-18.
Maviş İ. Perspectives on public awareness of stroke and aphasia among Turkish patients in a neurology unit. Clin Linguist Phonet. 2007; 21(1): 55-70.
Bolbol SA, Zalat MM, Hammam RA, Elnakeb NL. Risk factors of voice disorders and impact of vocal hygiene awareness program among teachers in public schools in Egypt. J Voice. 2017; 31(2): 251-e9.
Pasa G, Oates J, Dacakis G. The relative effectiveness of vocal hygiene training and vocal function exercises in preventing voice disorders in primary school teachers. Logoped Phoniatr Vocol. 2007; 32(3): 128-140.
Broaddus-Lawrence PL, Treole K, McCabe RB, Allen RL, Toppin L. The effects of preventive vocal hygiene education on the vocal hygiene habits and perceptual vocal characteristics of training singers. J Voice. 2000; 14(1): 58-71.
Nawka T, Obrębowski A, Pruszewicz A. In: am Zehnhoff-Dinnesen A, Wiskirska-Woznica B, Neumann K, Nawka T, editors. Prevention of Voice Disorders. Phoniatrics I: Fundamentals-Voice Disorders-Disorders of Language and Hearing Development. Springer; 431-435, 2018.
Scrimgeour K, Meyer SE. Effectiveness of a hearing conservation and vocal hygiene program for kindergarten children. Special Services in the Schools. 2002; 18(1-2): 133-150.
Lu D, Yiu EML, Dai Pu HY, Ma EPM. Parental knowledge, attitudes, and practices about vocal hygiene for their children in Chengdu, a city from China. Medicine. 2019; 98(16): 1-9.
Levickis P, McKean C, Wiles A, Law J. Expectations and experiences of parents taking part in parent–child interaction programmes to promote child language: a qualitative interview study. Int J Lang Commun Disord. 2020; 55(4): 603-617.
Pepper J, Weitzman E. It takes two to talk: A practical guide for parents of children with language delays. 4th ed. The Hanen Centre; 2004.
