اثر تمرينات زمان‌ بندي بر شدت لكنت و زمان‌ بندي حركتي كودكان مبتلا به لكنت

Effects of Timing Training on Stuttering Severity and Motor Timing in Children Who Stutter

زمينه و هدف: لكنت در اثر تخريب كنترل فضايي و زماني حركات لازم جهت توليد روان گفتار به وجود مي‌آيد. افرادي كه لكنت دارند، در كنترل تغييرپذيري، سرعت و زمان بندي نسبي حركات گفتاري خود در موقع صحبت كردن روان، متفاوت عمل مي‌كنند. شواهد فيزيولوژيكي نشان دادند كه ساز و كارهاي كنترل حركتي براي توليد گفتار و حركت اندام‌ها زير بناي عصبي مشتركي دارند. بنابراين هدف از پژوهش حاضر تعيين تأثير تمرينات زمان‌بندي بر زمان‌بندي حركتي و شدت لكنت كودكان مبتلا به لكنت بوده است. روش‌بررسي: اين تحقيق از نوع نيمه‌تجربي با طرح پيش‌آزمون و پس‌آزمون و گروه كنترل بود. شركت‌كنندگان در اين تحقيق چهارده كودك شهر اصفهان (ده پسر و چهار دختر) با محدودهٔ سني 4تا6 سال بودند كه به‌صورت دردسترس انتخاب شده و به‌طور تصادفي در دو گروه تجربي و كنترل تقسيم شدند. گروه تجربي به‌مدت هشت هفته تمرينات زمان‌بندي را انجام داد. از آزمون‌هاي شدت لكنت و آداسيتي به‌ترتيب جهت سنجش شدت لكنت و زمان‌بندي حركتي استفاده شد. داده‌ها با استفاده از تحليل كوواريانس تجزيه‌و‌تحليل شدند. يافته‌ها: يافته‌ها نشان داد كه پس از هشت هفته تمرينات زمان‌بندي، شدت لكنت (0٫018=p) و زمان‌بندي حركتي كودكان (0٫001>p) گروه تجربي درمقايسه با گروه كنترل به‌طور معناداري بهبود يافته است. نتيجه‌گيري: به‌نظر مي‌رسد ارتباط قوي ميان سيستم‌هاي زباني و حركتي وجود داشته و تمرينات زمان‌بندي ممكن است روش تمريني مفيدي براي كاهش شدت لكنت در كودكان مبتلا به لكنت باشد.

Background & Objectives: Stuttering is caused by the destruction of spatial and temporal control of the movements necessary to produce speech fluency. People who stutter act differently in control of the variability, speed and timing of speech movements at the time of speaking fluently. Physiological evidence suggests that the mechanisms of motor control for speech production and limb movements have the same nervous structures. Accordingly, in the present study, the researchers decided to use a motor timing intervention program assuming that by practicing this task, people who stutter can get the timing or ability to synchronize themselves with each move or the ability to accurately repeat the motor task with the rhythm. In addition, with the help of intrinsic (or emergent) timing processes, they can also transfer this probable improvement of timing stability during the implementation of motor tasks assignments to oral–motor tasks. Methods: A quasi–experimental study with a pre–test post–test design was conducted on 14 children (10 boys and 4 girls) ranged between 4–6 years of age. The participants were recruited conveniently and assigned randomly to two groups of experimental and control. The experimental group underwent an eight–week sequential motor timing training. The Audacity and Stuttering Severity Instrument–Fourth Edition tests were used in order to measure the stuttering severity and motor timing, respectively. The data were analyzed using the covariance analysis. Results: Analysis of covariance showed that by controlling the effect of pre–test, there was a significant difference between the mean scores of motor timing and the stuttering severity of children in both groups, and the average scores of motor timing (p<0.001) and stuttering severity (p=0.018) in the experimental group were significantly lower than the control group. Conclusion: Based on the findings of this study, timing training improved mental timing and, as a result, stuttering severity decreased in children who stutter. In these children, speech and non–speech movements control processes had the same nervous structure. Weakness in the speech and non– speech abilities of people who stutter may therefore be due to defect in the timing mechanisms and impact of timing training on the mental timing or in fact same intrinsic (or emergent) timing processes improved the speech and reducing stuttering severity in these children.