Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Konuşma Sesi Bozukluğu Olan Çocuklarda Aile Katılımlı Çoklu Karşıtlık Müdahalesinin Değerlendirilmesi: Tanımlayıcı Araştırma
Evaluation of Parent Involvement Multiple Oppositions Intervention for Children with Speech Sound Disorders: Descriptive Research
Beyza Nur DÜKARa , Melike KALAYb , Özge SERTc
aAnadolu Üniversitesi Sağlık Bilimleri Fakültesi, Dil ve Konuşma Terapisi Bölümü, Eskişehir, Türkiye
bSerbest Dil ve Konuşma Terapisti, Trabzon, Türkiye
cSerbest Dil ve Konuşma Terapisti, İzmir, Türkiye
Turkiye Klinikleri J Health Sci. 2024;9(2):266-73
doi: 10.5336/healthsci.2023-98084
Article Language: TR
Full Text
ÖZET
 Amaç: İleri derecede konuşma sesi bozukluğu ve fonem yığılması olan çocuklarda etkililiği kanıtlanmış terapi yaklaşımlarından birisi çoklu karşıtlık müdahalesidir. Bu yaklaşımın haftada 3 gün yoğun şekilde uygulandığında etkili olduğu kanıtlanmıştır. Ancak dünya genelinde ve Türkiye koşullarında, dil konuşma terapistlerinin bir vakayı bu kadar yoğun çalışma fırsatları yoktur. Bu çalışmada, fonem yığılması olan ve yoğun terapi alması gereken çocuklara uygulanan aile katılımlı çoklu karşıtlık müdahale yaklaşımının etkililiğini belirlemek amaçlanmıştır. Gereç ve Yöntemler: Bu amaç kapsamında, çalışmaya 4-6 arasında olan orta ve ileri derece fonolojik bozukluk tanısı almış; müdahale kriterlerini karşılayan 3 katılımcı ve katılımcıların ebeveynleri dâhil edilmiştir. Katılımcılar, 8 hafta boyunca, 45 dk'lık terapi almış olup, ebeveynler hem terapileri izlemişler hem de düzenli olarak ev ödevlerini yapmışlardır. Terapi uygulamasının etkililiği, katılımcılara uygulanan Türkçe sesletim-sesbilgisi testinin sesletim alt testi, işitsel ayırt etme alt testi, doğru ünsüz yüzdesi hesaplama, fonolojik farkındalık testi ile değerlendirilmiştir. Bunlara ek olarak günlük aktivite ve katılım süreçlerindeki değişimi izlemek için Bağlam İçi Anlaşılabilirlik Ölçeği uygulanmıştır. Bulgular: Yapılan müdahaleden sonra tüm katılımcıların test puanlarında artış olduğu, müdahale hedeflerinin yanı sıra çalışılmayan seslerin de fonetik dağarcığa eklendiği, fonolojik farkındalık becerilerinde ilerleme olduğu görülmüştür. Sonuç: Haftada bir kez aile katılımı ile uygulanan aile katılımlı çoklu karşıtlık müdahale yaklaşımının, orta-ileri derecede fonolojik bozukluğu olan çocukların fonolojik sisteminde ilerlemeler sağladığı görülmektedir. Bu bulgular, ebeveynlerin fonolojik müdahaleyi yetkin şekilde günlük hayatta da devam ettirebileceklerini ve aileleri fonolojik müdahale süreçlerine dâhil etmenin önemi göstermektedir.

Anahtar Kelimeler: Konuşma sesi bozukluğu; çoklu karşıtlık yaklaşımı; aile katılımı
ABSTRACT
 Objective: The effectiveness of multiple opposition intervention has been proven by many studies in children with severe phonological disorder and phoneme collapse. When we look at the studies showing the effectiveness of this intervention, it is seen that this intervention is successful with intensive therapies three times a week. However, speech and language therapists do not have the opportunity to see a client so intensely in the world and in Türkiye. In this study, it was examined whether the multiple opposition intervention is effective when the family is actively included in the therapy processes of children who need intensive therapy. Material and Methods: Three children with moderate-to-severe phonological disorders aged 4-6 and their parent participated in the study. During the intervention process, the participants attended one 45-min clinic- based session for 8 weeks. Their parents also attended traning session and completed home practise on the other days The participants' pre- and post-intervention developments were evaluated with the articulation sub-test and auditory discrimination sub-test of Turkish articulation and phonology test, correct consonant percentage calculation, phonological awareness test, and the In-Context Intelligibility Scale was applied to see the family perception. Results: After the intervention, it was observed that all participants' test scores increased, non-trained sounds were added to participants the phonetic vocabulary as well as the intervention goals, and there was an improvement in their phonological awareness skills. Conclusion: Combined parent- and speech-language pathologist delivered multiple opposition intervention is effective for children with moderate-to-severe phonological disorder. The findings indicate that parents can be trained to competently and confidently deliver phonological intervention.

Keywords: Speech sound disorders; multiple opposition intervention; family involvement
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