Logopedski pristupi u rehabilitaciji jezično govornih teškoća kod djece s cerebralnom paralizom

master's thesis

• Title (english): Approaches in rehabilitation of speech and language difficulties in children with cerebral palsy
• Author: Nikolina Gelo
• Mentor: Emica Farago (mentor)
• Committee member: Emica Farago (predsjednik povjerenstva)
• Committee member: Draženka Blaži (član povjerenstva)
• Committee member: Ana Bonetti (član povjerenstva)
• Granter: University of Zagreb; Faculty of Education and Rehabilitation Sciences; Zagreb
• Defense date and country: 2016-06-21, Croatia
• Scientific / art field, discipline and subdiscipline: SOCIAL SCIENCES; Speech Therapy

Abstract

Cerebralna paraliza predstavlja jedan od najčešćih motoričkih odstupanja u dječjoj dobi.
Definira se kao skup promjenjivih, ali trajnih poremećaja pokreta, položaja i držanja tijela
nastalih prenatalnim, perinatalnim ili postnatalnim oštećenjem mozga, malformacijom
nezrelog mozga ili mozga u razvoju. Zahvaća dvoje do troje na 1000 živorođene djece.
Klinička slika cerebralne paralize je raznolika. Čine je brojni poremećaji i teškoće od kojih se
posebno ističu komunikacijske, jezične i govorne teškoće. Komunikacijske teškoće su
prisutne u čak 42 %, a govorne u 36 % slučajeva djece s cerebralnom paralizom. Postoje i
podaci koji govore o tome kako su jezično-govorne teškoće prisutne u oko 31 do 88 %
slučajeva djece s cerebralnom paralizom. Naime, što su govorne teškoće težeg stupnja, to će i
jezična proizvodnja biti više narušena, a sam jezik je važan kako bi uopće moglo doći do
razmjene željene poruke, odnosno komunikacije s okolinom u kojoj se djeca nalaze.
Navedeno jasno ukazuje na važnost uloge logopeda. Radom će se stoga nastojati dati pregled i
opsežniji opis, no i kritički osvrt na učinkovitost nekih pristupa koje logoped može koristiti u
rehabilitaciji tih teškoća i to korištenjem izvora literature koji obuhvaćaju novije spoznaje.
Tako je unutar rada ponajprije opisana klinička slika cerebralne paralize, zatim su opisane i
iznad spomenute komunikacijske, jezične i govorne teškoće, a tek je nakon toga naglasak
stavljen na same pristupe. Pregledom literature izdvojeno je i opisano njih pet: asistivna
tehnologija, potpomognuta komunikacija, interakcijski trening za komunikacijske partnere
djece s cerebralnom paralizom, PROMPT pristup i sustavni pristup. Uočeno je kako su
najveću učinkovitost pokazali pristup potpomognute komunikacije, PROMPT pristup i
sustavni pristup, a nešto je manja učinkovitost preostalih dvaju pristupa. Oni pristupi koji nisu
navedeni i opisani u radu su pristupi koji nisu toliko zastupljeni u literaturi. Štoviše, za mnoge
od njih još nisu provedena istraživanja koja bi jasnije ukazala na učinkovitost njihove
primjene u radu s upravo ovom populacijom. Stoga je istaknuta potreba za provođenjem
takvih istraživanja, kao i onih vezanih uz ove koji su navedeni u radu s obzirom na to da su
neki od njih pokazali određene nedostatke i ograničenja koja nipošto ne bi smjela biti
zanemarena.

Abstract (english)

Cerebral palsy is one of the most common motor disabilities in early childhood. It is defined
as a set of varying, but permanent disorders of movement, position and posture. These
disorders result from prenatal, perinatal or postnatal brain damage, malformation of immature
brain or from disturbances that occured in the developing fetal or infant brain. Prevalence of
cerebral palsy is 2 to 3 per 1000 live births. The clinical picture of cerebral palsy is very
complicated. It consists a lot of disorders and difficulties of which the most important are
communication, language and speech difficulties. Communication difficulties are present in
42 % of children with cerebral palsy and speech difficulties are present in 36 % of children
with cerebral palsy. There are data that suggest that speech and language difficulties are
present in approximately 31 – 88 % of children with cerebral palsy. In fact, if speech
difficulties are severe, language production will be more disrupted. Language is very
important because it allows the exchange of messages between children and their
conversation partners. Therefore, this paper will tend to provide an comprehensive overview,
description and the critical review on the effectiveness of some approaches that speech
language pathologist can use in rehabilitation of communication, language and speech
difficulties in children with cerebral palsy. Thus, in this paper are described clinical picture of
cerebral palsy and above mentioned communication, language and speech difficulties. Of
course, particular emphasis is placed on the approaches. These approaches are: assistive
technology, alternative and augmentative communication, interaction training for
conversation partners of children with cerebral palsy, PROMPT approach and systems
approach.
After literature review it is noted that the highest efficiency demonstrate alternative and
augmentative communication, PROMPT approach and systems approach. Two remaining
approaches are less effective. Those approaches that are not mentioned and described in this
paper are approaches that are less represented in the literature. Moreover, for many of them
there are no studies which demonstrate the effectiveness of their application in work with this
population. Therefore, the need of those studies is big, as well as the need of those studies
related with approaches that are mentioned in this paper. Namely because some of them
showed certain limitations that should not be ignored.

• Keywords: cerebralna paraliza; logopedski pristupi u rehabilitaciji; komunikacijske teškoće; jezične teškoće; govorne teškoće
• Keywords (english): cerebral palsy; SLP approaches in rehabilitation; communication difficulties; language difficulties; speech difficulties
• Language: croatian
• URN:NBN: urn:nbn:hr:158:779126
• Study programme: Title: Speech and Language Pathology; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra logopedije (magistar/magistra logopedije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-09-02 10:14:54