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Yıl:2009; Cilt: 19; Sayı: 3>> Özet
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Klinik Psikofarmakoloji Bülteni; 2009;19(3):246-253
Gelişimsel kekemeliğe tedavi yaklaşımları: Çocuk psikiyatristlerinin bakış açıları
T Türkbay, A Cöngöloğlu, M Çiyiltepe, İ Durukan, K Karabekiroğlu
Tümer Türkbay, Gülhane Askeri T?p Akademisi, Çocuk Psikiyatrisi AD, Ankara-Turkey
Amaç: Kekemelik, genellikle konuşmanın akışında aksamaların olduğu bir iletişim bozukluğudur. Gelişimsel kekemeliğin nedenlerine yönelik birçok kuram ileri sürülmesine karşın, yeterince açıklama getirilememiştir. Gelişimsel kekemeliğin kesin tedavisi yoktur, tedavi yaklaşımlarının çoğu konuşma akıcılığındaki düzensizliklerin azaltılmasına yardımcı olmaya yöneliktir. Gelişimsel kekemeliğin tedavisine yönelik profesyonellerin yaklaşım ve tutumlarında fikir birliği yoktur. Bu çalışmada, gelişimsel kekemeliğe yönelik tedavi yaklaşımları hakkındaki ülkemizdeki çocuk psikiyatrisi uzmanlarının görüşlerinin araştırılması amaçlanmıştır. Yöntem: Veriler 38 çocuk psikiyatri uzmanına, çok seçenekli sorular ve varsayımsal çerçevede vaka senaryosu içeren anket uygulanarak elde edilmiştir. Verilere tanımlayıcı analiz uygulanmıştır. Bulgular: Çocuk psikiyatristlerinin %43.3'ü okul öncesi dönemde gelişimsel kekemeliğe müdahale edilmemesi görüşündeydi. %65.7'i en azından başlangıçta ?bekle ve gör? stratejisini tercih ediyordu. Çocuk psikiyatristlerinin büyük bir kısmı, birincil olarak anne-babanın hedeşendiği dolaylı müdahale lehinde görüş bildirdi. Sedatif antihistaminikler ve seçici serotonin geri alım inhibitörleri sık olarak tercih edilen ilk seçenek ilaçlardı (sırasıyla %36.8 ve %34.2). Risperidon ise %15.8 oranında ilk seçenek olarak tercih ediliyordu. Çocuk psikiyatristlerin çoğu, akıcı konuşmayı destekleyici aygıtlara aşina değillerdi ve alternatif tıp yaklaşımlarının etkisiz oldukları görüşündeydiler. Tartışma: Gelişimsel kekemeliğin tedavi yaklaşımlarına yönelik çocuk psikiyatristlerinin görüşleri heterojen tablo sergilemektedir. Türkiye'de ki çocuk psikiyatristleri daha konservatif tedavi yaklaşımlarını tercih etmektedir. Gelişimsel kekemeliğin tedavisinde çocuk psikiyatristlerinin konuşma terapistleri ile yoğun işbirliği önemlidir.
The management of developmental stuttering: child psychiatrists? perspectives
Objective: Stuttering is a communication disorder
generally characterized by involuntary disruptions in the
flow of speech. Various theories have been offered to
explain developmental stuttering, but its causes are not
well understood. There is no known cure for
developmental stuttering, though many treatment
approaches help children reduce the number of
dysfluencies in their speech. There is no common
consensus on approaches and attitudes of professionals
towards management of developmental stuttering. This
nationwide survey of child psychiatrists was conducted to
assess child psychiatrists? views about management
approaches to developmental stuttering.
Method: Data obtained from 38 respondents who were
the child psychiatry specialists using a specific
questionnaire including items formatted as multiplechoice
questions and a case scenario with a hypothetical
frame. Descriptive analysis was applied to the data.
Results: Of the child psychiatrists, 43.3% agreed that early
developmental stuttering should be ignored. 65.7% of
them preferred at least initially, a ?wait and see? strategy.
An appreciable majority of the child psychiatrists were in
favor of the indirect therapy, which is aimed primarily at
the parents. Sedative antihistamines and selective
serotonin reuptake inhibitors were preferred frequently
used as first-choice drug class (36.8% and 34.2%,
respectively) while risperidone was prescribed as a firstchoice
drug by 15.8 percent. Most of the child psychiatrists
were not familiar with anti-stuttering devices, and
alternative medicine was considered as non-effective and
not helpful.
Discussion: Child psychiatrists show a heterogeneous
picture regarding their views on therapeutic approaches in
developmental stuttering. Child psychiatrists in Turkey
prefer more conservative approaches. It is important that
child psychiatrists work in extensive collaboration with
speech pathologists for treating developmental stuttering.

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