Akut inmeli hastalarda modifiye mann yutma değerlendirme testinin Türkçeye uyarlanması: Geçerlik ve güvenirlik çalışması

Objective: The aim of the dysphagia screening test is to identify as many cases as possible before aspiration occurs. In Türkiye, there is a need for a practical and non-invasive screening test that evaluates swallowing pre-skills apart from comprehensive clinical tests. For this purpose, the Turkish validity and reliability of the Modified Mann Assessment of Swallowing Ability (MMASA) test were examined. Material and Methods: The test was translated into Turkish, and its content validity index was calculated. Then, the test was re-translated to English, and its compliance with the original version was evaluated. The generated Turkish MMASA (TR-MMASA) test was applied to 90 patients with acute stroke. Similar scale validity was evaluated by checking its compliance with the Turkish Mann Assessment of Swallowing Ability (T-MASA) test. The test-retest and interrater reliability methods were used for reliability analysis. Internal consistency (IC) and item-total correlation were examined. Results: Reliability was calculated according to intraclass correlation (ICC) coefficients (ICC=0.92, ICC=0.97). IC and item-total correlation coefficients were examined (Cronbach’s alpha=0.91). For convergent and discriminant validity, T-MASA test was applied, and the Spearman’s rho correlation coefficient was examined (r=0.88). As a result of the receiver operating characteristic analysis, the sensitivity (87%), specificity (88%), positive predictive value (0.77), negative predictive value (0.93), positive likelihood ratio (7.14) and negative likelihood ratio (0.14) percentages of the test were found valid. Conclusion: TR-MMASA test was found to be a valid and reliable screening test for bedside clinical evaluation in patients with acute stroke.Amaç: Disfaji tarama testinde amaç, aspirasyon meydana gelmeden olabildiğince çok riskli vakayı belirlemektir. Türkiye’de kapsamlı klinik testlerin dışında yutma ön becerilerini değerlendiren pratik ve girişimsel olmayan bir tarama testine ihtiyaç duyulmaktadır. Bu amaçla çalışmada, Modifiye Mann Yutma Yeteneği [Modified Mann Assessment of Swallowing Ability (MMASA)] testi, Türkçeye uyarlanarak geçerlik ve güvenirliği incelenmiştir. Gereç ve Yöntemler: Test, ilk olarak Türkçeye çevrilerek sonrasında kapsam geçerlik indeksi hesaplanmıştır. İngilizceye geri çevirisi yapılarak orijinal hâliyle olan uyumuna bakılmıştır. Oluşturulan Türkçe MMASA (TRMMASA) testi, akut inmeli 90 hastaya uygulanmıştır. Benzer ölçüt geçerliliği için Türkçe Mann Yutma Yeteneği Değerlendirmesi [Turkish Mann Assessment of Swallowing Ability (T-MASA)] testi kullanılmıştır. Güvenirlik analizi için test-tekrar test ve klinisyenler arası güvenirlik yöntemleri uygulanmıştır. İç tutarlılık ve madde-toplam madde korelasyonu incelenmiştir. Bulgular: Güvenirlik, sınıf içi korelasyon katsayısına [intraclass correlation coefficients (ICC)] göre (ICC=0,92, ICC=0,97) hesaplanmıştır. İç tutarlılık ve madde-toplam madde korelasyon katsayıları incelenmiştir (Cronbach alfa=0,91). Yakınsak ve ayırt edici geçerlik için T-MASA testi uygulanarak Spearman rho korelasyon katsayısı bulunmuştur (r=0,88). Alıcı işletim karakteristiği analizi sonuçlarına göre duyarlılık (%87), özgüllük (%88), pozitif öngörü değeri (0,77), negatif öngörü değeri (0,93), pozitif olabilirlik oranı (7,14) ve negatif olabilirlik oranı (0,14) tespit edilmiştir. Sonuç: TR-MMASA testi, akut inmeli hastalarda yatak başı klinik değerlendirme için geçerli ve güvenilir bir tarama testi olarak bulunmuştur

"Sesbilim" ve "Sesbilgisi" Terimleri Üzerine

Sesbilim ve sesbilgisi disiplinlerinin içerikleri, ilgi alanları hakkında kuşkusuz pek çok şey bilinmektedir. Ancak bu iki disiplin için Türkçe'de kullanılan terimlerin birbirine karıştırıldığı, değişik araştırmacıların farklı kullanımları gözlenmektedir. Sözgelimi, ülkemizde bir grup araştırmacı "phonetics" karşılığı "sesbilim" (örneğin, Selen, 1979; Demircan, 1979; Aksan, 1980; Konrot, 1984; Topbaş, 1991), "phonology" karşılığı "sesbilgisi" (örneğin, Konrot, 1984; Topbaş, 1991) ya da "görevsel/gelişmeli sesbilim" (örneğin, Aksan, 1978, 1980; Demircan, 1979) kullanmaktadır. Diğer bir grup araştırmacının da "phonetics" karşılığı "sesbilgisi", "phonology” karşılığı "sesbilim" (örneğin, Vardar, 1980; Demirezen, 1990) terimlerini kullandıkları dikkat çekmektedir. Bu nedenle bu yazıda daha sonraki yazılarımıza temel oluşturmak amacıyla "sesbilim (phonetics)" ve "sesbilgisi (phonology)" disiplinlerinin ilgi alanları, bu iki alanın bağdaşık ve ayrı yönleri üzerinde durulacaktır

Türkiye’de çocukluk çağı dil bozukluğuna ilişkin toplumsal farkındalık: Betimsel çalışma

Objective: Childhood language impairment (CLI), also known as developmental language disorder, adversely affects children’s expressive and/or receptive language development. Although relatively significant action has been taken to raise public awareness about other developmental disorders in Turkey, limited attention has been paid to CLI. Moreover, no previous study has been conducted about awareness of the Turkish population about CLI. Material and Methods: We carried out the Turkish version of a survey developed by Working Group 3 of COST Action IS1406 to estimate public awareness of CLI regarding its nature, causes and the problems associated with it. Data were collected in the form of face-to-face interviews. The sample included 87 participants from socio-economically diverse districts of İstanbul, Turkey, determined on the basis of the Human Development Index. Results: A significantly lower number of the participants reported having heard of CLI compared to autism, attention-deficit/hyperactivity disorder and speech disorder. Another finding was that women with children reported having heard of CLI significantly more than those without children. It was also observed that the participants had inadequate knowledge of the problems that individuals with CLI have and of its causes. Conclusion: The current findings highlight the need to take more action to raise public awareness about CLI in Turkey.Amaç: Çocukluk çağı dil bozukluğu (ÇÇDB), diğer adıyla gelişimsel dil bozukluğu, çocukların alıcı ve/veya ifade edici dil gelişimini olumsuz yönde etkilemektedir. Türkiye’de diğer gelişimsel bozukluklara ilişkin toplumsal farkındalığın artırılmasına yönelik ciddi çalışmalar yapılmış olmakla birlikte ÇÇDB’ye yönelik çalışmalar sınırlı kalmıştır. Ayrıca Türkiye’de ÇÇDB’ye ilişkin toplumsal farkındalık üzerine yapılmış bir çalışma bulunmamaktadır. Gereç ve Yöntemler: Bu çalışmada ÇÇDB’nin doğası, sebepleri ve ÇÇDB ile ilişkilendirilen sorunlara ilişkin toplumsal farkındalığı ölçmek amacıyla COST Aksiyonu IS1406 3. Çalışma Grubu tarafından geliştirilen anketin Türkçe versiyonu uygulanmıştır. Veriler yüz yüze gerçekleştirilen mülakatlar ile toplanmıştır. İstanbul’un sosyoekonomik açıdan farklı ilçelerinden 87 katılımcı örneklemi oluşturmuş olup bu ilçeler İnsani Gelişme Endeksi kullanılarak belirlenmiştir. Bulgular: Otizm, dikkat eksikliği hiperaktivite bozukluğu ve konuşma bozukluklarına kıyasla anlamlı oranda daha az katılımcı ÇÇDB terimini duyduğunu belirtmiştir. Çalışmanın bir diğer bulgusu, çocuğu olmayan kadınlara kıyasla çocuğu olan kadınlar arasında ÇÇDB teriminin daha fazla duyulmuş olmasıdır. Ayrıca çalışma örnekleminin, ÇÇDB’si olan bireylerin yaşadıkları sorunlar ve ÇÇDB’nin sebeplerine dair yetersiz bilgi sahibi olduğu gözlenmiştir. Sonuç: Çalışmanın bulguları, Türkiye’de ÇÇDB’ye ilişkin toplumsal farkındalığın artırılması için harekete geçilmesi gerektiğini göstermektedir

Importance of Speech Disorders in Cleft Lip and Palate Patients, Assessment of Speech Therapy and Evaluation of Distraction Osteogenesis: Two Case Reports

The aim of this study is to spotlight on; what should be taken into consideration during and after surgery to prevent and/or to correct speech pathologies of the CLP patients, insufficiency of the treatment without speech therapy, and remarkable changes achieved with speech therapy. For this purpose, 21 years old female patient with late operated soft palate cleft, suffering from only her speech problems, and a 21 years old female patient with bilateral CLP operated in early ages, but had oronasal fistula and, suffering from her speech, aesthetic and functional problems are presented. The first patient was treated by a specialist speech therapist. After eight months of rehabilitation, it was observed that articulation errors of the patient were reduced and speech comprehensibility was improvedIn the second case, the maxilla was advanced with “Posterior Maxillary Segmental Sagittal Distraction”. After the distraction period patient's profile was improved. The existing velopharyngeal insufficiency did not increase after distraction and positive improvement was observed in speech mimics. Correction of aesthetics and occlusion alone in the CLP patients is not sufficient and it is not possible to expect correction of speech with improvement of the peripheral structures. Without “speech therapy” it is not possible to correct or optimize speech

Tutorial:Speech assessment for multilingual children who do not speak the same language(s) as the speech-language pathologist

Purpose: The aim of this tutorial is to support speech language pathologists (SLPs) undertaking assessments of multilingual children with suspected speech sound disorders, particularly children who speak languages that are not shared with their SLP. Method: The tutorial was written by the International Expert Panel on Multilingual Children’s Speech, which comprises 46 researchers (SLPs, linguists, phoneticians, and speech scientists) who have worked in 43 countries and used 27 languages in professional practice. Seventeen panel members met for a 1-day workshop to identify key points for inclusion in the tutorial, 26 panel members contributed to writing this tutorial, and 34 members contributed to revising this tutorial online (some members contributed tomore than 1 task). Results: This tutorial draws on international research evidence and professional expertise to provide a comprehensive overview of working with multilingual children with suspected speech sound disorders. This overview addresses referral, case history, assessment, analysis, diagnosis, and goal setting and the SLP’s cultural competence and preparation for working with interpreters and multicultural support workers and dealing with organizational and government barriers to and facilitators of culturally competent practice. Conclusion: The issues raised in this tutorial are applied in a hypothetical case study of an English-speaking SLP’s assessment of a multilingual Cantonese-and English-speaking 4-year-old boy. Resources are listed throughout the tutorial.Australian Research Council: FT0990588United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute on Deafness & Other Communication Disorders (NIDCD

Sesbilgisi Açısından Dil Edinim Süreci

Dilbilimsel çözümleme bugün dil ve konuşma bozukluklarının tanılanması ve terapisi sürecinde oldukça yaygın olarak kullanılan bir yöntemdir. Çocuğun iletişim engeli ne olursa olsun eğer konuşma üretimi etkileniyorsa, sesbilgisel (fonolojik) çözümleme ve değerlendirme tanılamada kullanılması zorunlu bir yöntem olarak karşımıza çıkmaktadır. İletişim engelinin türüne göre terapistin yanıtlamakla yükümlü olduğu pek çok sorudan en önemlileri çocuğun dilinin ses sistemini nasıl kullanabildiği, ve çocuğun konuşma üretiminin normalden nasıl sapma gösterdiğine ilişkindir. Yanıtlan ise güncelliğini korumakta olan "çocuk ana dilinin ses sistemini nasıl ediniyor?" sorusu ile bir bütünlük taşımaktadır. Eğitimci/terapist ancak bu yolla çocuğun konuşma gelişimi ve düzeyi hakkında kestirimde bulunabilir

How aware is the public of the existence, characteristics and causes of language impairment in childhood and where have they heard about it? A European survey

Public awareness of language impairment in childhood (Developmental Language Disorder (DLD)) has been identified as an important determiner of research and clinical service delivery, yet studies directly assessing public awareness are lacking. This study surveyed awareness across 18 countries of Europe.Method: A questionnaire developed by an international team asked whether respondents had heard of language impairment affecting children, what they thought its manifestations and causes were and where they had heard of it. Respondents were also asked whether they had heard of autism, dyslexia, ADD/ADHD and speech disorder. The questionnaire was administered to members of the public in 18 European countries. A total of 1519 responses were obtained, spanning 6 age groups, 4 educational level groups and 3 income level groups. Results: Across all but one country, significantly fewer people had heard of language impairment than any of the other disorders (or 60 % compared to over 90 % for autism). Awareness tended to be lowest in Eastern Europe and greatest in North-Western Europe, and was influenced by education level, age and income level. People in countries with overall low and overall high awareness differed in their views on manifestations and causes. People had heard of language impairment and autism the same way most frequently through the media, including Internet, and less frequently through their child's school or a medical professional. Discussion: The study confirms that awareness of language impairment and knowledge of the breadth of its manifestations are low. It also suggests opportunities for how to increase awareness, including greater media coverage of language impairment and more efficient use of venues such as schools and healthcare. Ways in which cultural and linguistic differences may influence public awareness efforts are discussed, including the translatability of clinical labels and scientific terms. These may impact the acceptance of a common term and definition across all countries. As awareness campaigns are gaining momentum, the findings of this study can serve as a baseline against which to compare future findings.COST (European Cooperation in Science and Technology, European Union

The social and cultural context of intervention for children with developmental language disorder

The activity of working group 3 of COST Action IS1406 was concerned with whether and how social and cultural factors impact children’s access to language services, whether the services offered fit their needs and are consistent with the types of services their families consider appropriate. To this end, working group 3’s portion of the practitioner survey examined the impact on service delivery of demographic factors, such as place of residence and income level, the impact of social factors such as parental views on child development, language impairment and child-rearing practices and the impact of situational factors such as migration. Finally, working group 3 examines the implications of cultural competency for workforce development

Comparing measures of spontaneous speech of Turkish-speaking children with and without language impairment

Children with language impairments (LIs) have deficits in one or more ofthe language areas, including phonology, syntax, morphology, semanticsand pragmatics. In Turkey, identification of children with LI has recentlybeen raised as an important issue. Speech-language therapy (SLT) is ayoung profession in Turkey, although it is growing rapidly (Topbaş, 2006).As part of the new professional law establishing SLT, regulations setforth by the Ministry of Health (2011) in cooperation with the Ministryof National Education (MoNE, 2014) included obligations to offer SLTservices to individuals with speech-language impairments. Until a decadeago, the identification of children with LIs (including those who wouldnow be diagnosed with specific language impairment [SLI]) was left to theintuition of doctors or other professionals’ opinions. Language disorderswere (a) included along with developmental disabilities occurring secondaryto hearing impairment, mental retardation, learning disabilities, autism andother organic, neurological or psychiatric disorders; or (b) denied altogether,often by taking a wait-and-see approach for many years. No doubt, manychildren were inappropriately underdiagnosed or unattended