Habilidades de praxia verbal e não-verbal em indivíduos gagos
Verbal and non-verbal praxic abilities in stutterers
Natália Casagrande Brabo; Ana Maria Schiefer
Resumo
Objetivo: caracterizar as habilidades de praxias verbal e não-verbal em indivíduos gagos adultos.
Métodos: para esta pesquisa foram selecionados 40 indivíduos maiores de 18 anos, de ambos os sexos: 20 gagos adultos e 20 sem queixas de comunicação. Para a avaliação das praxias foram submetidos ao Protocolo de Avaliação da Apraxia Verbal e Não-verbal (Martins e Ortiz, 2004).
Resultados: em relação às habilidades de praxia verbal, houve diferença estatisticamente significante quanto ao número de disfluências típicas e atípicas manifestadas pelos dois grupos estudados. A repetição de frase foi o único tipo de disfluência típica que apresentou diferença estatisticamente significante entre os grupos. Bloqueio, repetição de sílaba e prolongamento foram as disfluências atípicas que apresentaram diferença estatisticamente significante entre os grupos. Em relação às habilidades de praxia não-verbal, não foi encontrada diferença estatisticamente significante entre os grupos no desempenho dos movimentos de lábios, língua e mandíbula, isolados e em sequência.
Conclusão: os indivíduos gagos adultos apresentaram número de disfluências típicas e atípicas significantemente maior que os indivíduos não gagos (praxia verbal). Os indivíduos gagos não se diferenciaram dos não gagos quanto às habilidades de praxia não-verbal, contrariando os que acreditam que a instalação precoce da gagueira afeta a praxia não-verbal.
Palavras-chave
Abstract
Purpose: to characterize the verbal and non-verbal praxic abilities in adult stutterers.
Methods: for this research, 40 over 18-year old men and women were selected: 20 stuttering adults and 20 without communication complaints. For the praxis evaluation, they were submitted to "Protocolo de Avaliacao da Apraxia Verbal e Nao-verbal" (Martins and Ortiz, 2004).
Results: regarding the abilities of verbal praxis, there was a statistically significant difference of number of typical and atypical disfluencies showed by the two studied groups. Phrase repetition was the only type of typical disfluency which showed a statistically significant difference between the groups. Blocking, syllable repetition and prolonging were the atypical disfluencies which showed a statistically significant difference between the groups. Regarding the non-verbal praxic abilities, a statistically significant difference was not found between the groups in the performance of lip, tongue and jaw movements, isolated and in sequence.
Conclusion: the adult stutterers showed a significantly higher number of typical and atypical disfluencies than non-stutterers (verbal praxis). Stutterers do not differ from non-stutterers in their non-verbal praxic abilities. This finding contradicts those who believe that early stuttering affects non-verbal praxis.
Keywords
Referências
1. Suresh R, Ambrose N, Roe C, Pluzhnikov A, Wittke-Thompson JK, Thompson JK, Ng MCY, et al. New complexities in the genetics of stuttering: significant sex-specific linkage signals. Am J Hum Genet. 2006; 78(4):554-63.
2. Riaz N, Steinberg S, Ahmad J, Pluzhnikov A, Riazuddin S, Cox NJ, et al. Genomwide significant linkage to stuttering on chromosome 12. Am J Hum Genet. 2005; 76(4):647-51.
3. Viswanath N, Lee HS, Chakraborty R. Evidence for a major gene influence on persistent developmental stuttering. Hum Biol. 2004; 76(3):401-12.
4. Ludlow CL, Loucks T. Stuttering: a dynamic motor control disorder. J Fluency Disord. 2003; 28(4):273-95.
5. Andrade CRF, Cervone LM, Sassi FC. Relationship between the stuttering severity index and speech rate. São Paulo Med J. 2003; 121(2):81-4.
6. Britto Pereira MM. Análise linguística da gagueira. São Paulo: Ed. AM3 Artes, 2003 p.23.
7. Rodrigues N. Neurolinguística dos distúrbios da fala. 3. ed. São Paulo: Cortez EDUC; 1999.
8. Dewey D. What is developmental dyspraxia? Brain Cognit. 1995; 29(3):254-74.
9. Meyer PG. Tongue lip and jaw differentiation and its relationship to orofacial myofunctional treatment. Int J Orofacial Myology. 2000; 26:44-52.
10. Bloodstein O. A handbook on stuttering. San Diego: Singular; 1995.p.181-6.
11. Riley GD. Stuttering severity instrument for children and adults - SSI. Austin: Texas; 1994.
12. Andrade CRF, Zuckiewicz DV, Sassi FC. Seis parametros da fluencia. Rev Soc Bras Fonoaudiol. 2000; 5(7):59-64.
13. Martins FC, Ortiz KZ. Proposta de protocolo para avaliação da apraxia de fala. Fono Atual. 2004; 7(30):53-61.
14. Juste F, Andrade CR. Typology of speech disruptions and grammatical classes in stuttering and fluent children. Pró-Fono. 2006; 18(2):129-40.
15. Anderson JD, Conture EG. Language abilities of children who stutter: a preliminary study. J Fluency Disord. 2005; 25(4):283-304.
16. Carlo EJ, Watson JB. Disfluencies of 3- and 5-year old Spanish-speaking children. J Fluency Disord. 2003; 28(1):37-53.
17. Max L, Caruso AJ, Gracco VL. Kinematic analyses of speech, orofacial nonspeech, and finger movements in stuttering and nonstuttering adults. J Speech Lang Hear Res. 2003; 46(1):215-32.
18. Loucks TMJ, De Nil LF, Sasisekaran J. Jaw-phonatory coordination in chronic developmental stuttering. J Commun Disord. 2007; 40(3):257-72.
19. Tremblay S, Shiller DM, Ostry DJ. Somatosensory basis of speech production. Nature. 2003; 423:866-9.
20. Loucks TMJ, De Nil LF. Oral kinesthetic deficit in adults who stutter: a target-accuracy study. J Motor Behav. 2006; 38(3):238-46.
21. Max L, Caruso AJ, Gracco VL. Kinematic analyses of speech, orofacial non-speech and finger movements in stuttering and non-stuttering adults. J Speech Lang Hear Res. 2003; 46(1):215-32.
22. Max L, Gracco VL. Coordination of oral and laryngeal movements in the perceptually fluent speech of adults who stutter. J Speech Lang Hear Res. 2005; 48(3):524-42.
23. Watkins RV, Johnson BW. Language abilities in children who stutter: toward improved research and clinical applications. Lang Speech Hear Serv Sch. 2004; 35(1):82-9.
24. Subramanian A, Yairi E, Amir O. Second formant transitions in fluent speech of persistent and recovered preschool children who stutter. J Commun Disord. 2003; 36(1):59-75.
25. Subramanian A, Yairi E. Identification of traits associated with stuttering. J Commun Disord. 2006; 39(3):200-16.
26. Max L, Yudman EM. Accuracy and variability of isochronous rhythmic timing across motor systems in stuttering versus nonstuttering individuals. J Speech Lang Hear Res. 2003; 46(1):146-63.
27. Loucks TMJ, De Nil LF. Anomalous sensorimotor integration in adults who stutter: a tendon vibration study. Neurosci Letters. 2006; 402(1-2):195-200.
28. Felicio CM, Freitas RLG, Vitti M, Regalo SC. Comparison of upper and lower lip muscle activity between stutterers and fluent speakers. Int J Pediatr Otorhinolaryngol. 2007; 71(8):1187-92.
29. Aram DM, Horwitz SJ. Sequential and non-speech praxic abilities in developmental verbal apraxia. Dev Med Child Neurol. 1983; 25(2):197-206.
30. Farias SR, Ávila CRB, Vieira MM. Relação entre fala, tônus e praxia não-verbal do sistema estomatognático em pré-escolares. Pró-Fono. 2006; 18(3):267-76.
31. Ingham RJ, Ingham JC, Finn P, Fox PT. Towards a functional neural systems model of developmental stuttering. J Fluency Disord. 2003; 28(4):297-317.
32. Preibisch C, Raab P, Neumann K, Euler HA, Von Gudenberg AW, Gall V, et al. Event-related fMRI for the suppression of speech-associated artifacts in stuttering. Neuroimage. 2003; 19(3):1076-84.
33. Van Borsel, Achten J, Satens EP, Lahort P, Voet T. fMRI of developmental stuttering: a pilot study. Brain Lang. 2003; 85(3):369-76.
34. De Nil LF, Kroll RM, Lafaille SJ, Houle S. A positron emission tomography study of short- and long-term treatment effects on functional brain activation in adults who stutter. J Fluency Disord. 2003; 28(4):357-80.
35. Preibisch C, Neumann K, Raab P, Euler HA, Von Gudenberg AW, Lanfermann H, et al. Evidence for compensation for stuttering by the right frontal operculum. Neuroimage. 2003; 20(2):1356-64.
Submetido em:
31/03/2009
Aceito em:
10/10/2009
