Giriş:Oral-motor egzersizler (OME) duyusal uyarmayı ya da dudak, çene, dil, velum, larenks ve solunum kaslarının hareketini içeren egzersizlerdir. OME farklı bozukluk türlerinde terapi amaçlı uygulanmaktadır. Prematüre bebeklerin oral-motor becerilerinin gelişiminde, nöromotor bozukluklarda dil lateralizasyonu, dudak kontrolü, çiğneme becerisi, yutma becerisi, salya kontrolü, çene stabilizasyonu, ısırma, kaşıkla beslenme, bardaktan su içme gibi becerilerin geliştirilmesinde oldukça etkilidir. OME konuşma sesi bozukluklarının terapilerinde de kullanılmaktadır. ASHA’nın kanıta dayalı uygulamalarında OME’nin konuşma sesi bozukluğu üzerinde bir etkisi görülmemiştir.Amaç:Araştırma kapsamında özel eğitim öğretmenlerine (ÖE) ve dil ve konuşma terapistlerine (DKT) OME’yi terapilerinde kullanıp kullanmadıkları, hangi bozukluk ve/veya engel grubunda ne amaçla kullandıkları, ne tür egzersizleri uyguladıkları, hangi terapi materyallerini kullandıkları ve OME’nin vakalar üzerindeki etkisi sorulmuştur. Yöntem:Bu araştırma DKT’den ve ÖE’den alınan cevaplara göre, OME’nin terapi etkililiğini belirleme amacıyla yapılan bir tarama çalışmasıdır. 29 uzman DKT ve 29 ÖE’den alınan geri dönütlerle toplamda 58 adet anket formu toplanmıştır. Bulgular: Araştırma bulgularında bazı bölümlerde istatistiksel olarak belirgin fark olsa da bazı durumlarda istatistiksel olarak bir fark görülmemiştir. Sonuç:Araştırma sonucunda DKT’nin ve ÖE’nin OME’yi bazı yerlerde benzerlik gösterse de farklı amaçlarla, farklı bozukluk türlerinde kullandıkları görülmüştür. Ayrıca OME’ye dair bilgiye DKT’nin ÖE’den daha çok hakim olduğu görülmüştür.
Anahtar Kelimeler
oral motor egzersiz, özel eğitim öğretmeni, dil ve konuşma terapisti, terapi etkililiği
Referanslar
Anuk İnce, D., Tugcu, A. U., Ecevit, A., Ciyiltepe,
M., Kurt, A., Abbasoglu, A., Tekindal, M.A. & Tarcan A. (2015). Goniometer
measurements of oral labial angle and evaluation of oral motor reflexes in
preterm infants: Comparison to findings in term infants. Journal of Child Neurology, 30(12)1-6.
Arvedson,
J. C. (2000). Evaluation of children with feeding and swallowing problems. Language, Speech and Hearing Services in
Schools, 31: 28–41.
ASHA’s National Center for Evidence-Based Practice in
Communication Disorders (2007). American Speech-Language-Hearing Association
Annual Convention, Convention Presentation, Boston, MA.
Bahr,
D. C. (2010). Oral motor assessment and
treatment: Ages and stages. Boston, MA: Allyn and Bacon.
Bahr,
D. C. (2008, November). The oral motor debate: where do we go from here? Poster
presented at the annual meeting of the American Speech-Language-Hearing
Association, Chicago, IL.
Bernstein,
N. A. (1967). The Co-ordination and Regulation of Movements. Pergamon; Oxford,
United Kingdom.
Bunton K. (2008 November). Speech versus non-speech:
Different tasks, different neural organization. Seminers in Speech Language, 29(4):
267-275.
Caruso, A. J. & Strand, E. A. (1999). Clinical Management of Motor Speech
Disorders in Children. New York, Thieme Publishers.
Clark, H. M. (2003). Neuromuscular treatments for
speech and swallowing. American Journal
of Speech Language Pathology, 12,
400-415.
Dworkin,
J. P. & Culatta RA (1985). Oral structural and neuromuscular
characteristics in children with normal and disordered articulation. Journal of Speech and Hearing Disorders,
50, 150-156.
Erkin,
G., Kaçar, S., & Özel, S. (2005). Serebral Palsili hastalarda
gastrointestinal sistem ve beslenme problemleri. Türk
Fiziksel Tıp Rehabilitasyon Dergisi, 51(4):150-155.
Fields,
D. & Polmanteer, K. (2002). Effectiveness of Oral Motor Techniques in
Articulation and Phonology Therapy. American Speech-Language-Hearing
Association Annual Convention, Atlanta, GA.
Gommerman,
S., & Hodge M. (1995). Effects of oral-motor therapy on swallowing and
sibilant production. International
Journal of Orofacial Myology, 21,
9-22.
Goozée,
J., Murdoch, B., Ozanne, A., Cheng, Y., Hill, A. & Gibbon F. (2007).
Lingual kinematics and coordination in speech-disordered children exhibiting
differentiated versus undifferentiated lingual gestures. International Journal of Language and Communication Disorders, 5,
1-22.
Hodge,
M.M., Salonka, R. V. & Kollias, S.
(2005). Use of nonspeech oral-motor exercises in children’s speech therapy.
Poster session presented at American Speech-Language-Hearing Association Annual
Convention, San Diego, CA.
Joffe,
V & Pring T. (2008). Children with phonological problems: A survey of
clinical practice. International Journal
of Language and Communication Disorders, 43(2), 154–164.
Kayıhan,
H. Oral
defans, I. Yutma Bozuklukları Kongresi, Ankara 8 Aralık, 2004.
Kumin, L. (1994). Intelligibility of speech in
children with Down Syndrome in natural settings: Parents' perspective. Perceptual and Motor Skills: 78(1), 307-313.
Kummer,
A. (2016). To clip or not to clip? That’s the question. Presented at the annual
convention of The American Speech-Language-Hearing Association. Philadelphia,
PA.
Lof,
G.L. & Watson M. M. (July 2008). A
Nationwide Oral Motor Exercise Survey. Language, Speech and Hearing Services in
Schools, 39: 392-407.
Lof,
G. L. (2008). Controversies surrounding nonspeech oral motor exercises for
childhood speech disorders. Seminars in Speech and Language, 29, 276-83.
Lof, G. L. (2010). Five reasons why
nonspeech oral motor exercises (NSOME) do not work. Perspectives on School Based Issues, 11, 109-117.
Manno,
C. J., Fox, C., Eicher, P. S. & Kerwin M.L. E. (2005 Fall). Early Oral-Motor Interventions for Pediatric
Feeding Problems:What, When and How? JEBI:
2(3), 152
Marshalla,
P. (2008). Oral Motor Treatment vs. Non-speech Oral Motor Exercises. Oral Motor Institute, 2(2). Retrieved
from www.oralmotorinstitute.org.
McCauley,
R., & Strand, E. (2008). Treatment of childhood apraxia of speech: Clinical
decision making in the use of nonspeech oral motor exercise. Seminars in Speech and Language, 29(4), 284-293.
McCauley,
R., Strand, E,, Lo., G., Schooling, T. & Frymark, T. (2009). Evidence-based
systematic review: Effects
of non-speech oral motor exercises on speech. American Journal of
Speech-Language Pathology, 18, 343-360.
Mcleod
S. & Baker E. (2004) Current clinical practice for children with speech
impairment. In B. E. Murdoch, J., Goozee, B. M. Whelan and K. Docking (eds),
26th World Congress of The International Association of Logopedics and
Phoniatrics (Brisbane: University of Queensland).
Molnar,
G. E. & Alexander, M. A. (1999). Pediatric Rehabilitation, Third Edition,
Phidelphia: Hanley-Belfus Inc..
Overland,
L. & Merkel-Walsh, R. (2013). A sensory-motor approach to feeding.
Charleston, SC: TalkTools.
Ruscello,
D. (2008). Oral motor treatment issues related to children with developmental
speech sound disorders. Language, Speech
and Hearing Services in Schools, 39, 380-391.
Tecklin, J. S. (1999)
Pediatric Physical Theraphy, Third Edition, Phidelphia: Lippincott Williams
& Wilkins.
Topbaş, S. (2011). Dil ve Kavram Gelişimi, Kök
Yayıncılık, Ankara.
Tremblay, S., Houle, G.
& Ostry, D. J. (2008). Specificity of speech motor learning. Journal of Neuroscience, 28(10):2426–2434.
Weismer, G. (2006).
Philosophy of research in motor speech disorders. Clinical Linguistics Phonetics, 20(5):315–349.
Ygual-Fernandez, A. &
Cervera-Merida, J. F. (2016). Non-speech oral motor treatment efficacy for
children with developmental speech sound disorders. Revista de Neurologica,62(1), 59-64.