Relaciones entre problemas fonoarticulatorios y variables temperamentales en niños de cuatro añosun estudio de la intervención con praxias

Resumen

The development of language and speech directly influences communication and the skills to interact with others, allows the development of thought, improves or increases learning and, therefore, influences the child's behavior. During the acquisition of language, problems may arise in the phonoarticulatory development. The articulatory disorder is the difficulty in pronouncing or correctly forming one or more sounds, which occur later than expected in typical development. Its intervention has traditionally been focused on solving the articulatory problem, treating it in part with oromotor exercises, defined as the accomplishment of programmed and intentionally organized and coordinated movements, since they involve training to execute and articulate learned movements with the lips, tongue , jaw and facial gestures. The treatment has generally been multidimensional, including breathing, blowing, auditory discrimination, oromotor exercises and language integration (repeated, induced and spontaneous). However, the efficiency of oromotor exercises in the treatment of articulatory problems has been questioned, some authors affirming that they are useful while others claiming that they are useless. Given this open debate, we considered investigating its effectiveness and deepening in the knowledge of articulatory disorders in relation to individual differences in temperament. Thus, the general aim of this study was to analyze the usefulness of training in oromotor exercises as an instrument for the treatment of articulatory problems, in addition to knowing if these problems are linked to individual temperamental differences and, in particular, to inhibitory control. 122 4-year-old children with typical development were initially evaluated with the Induced Phonological Registry of Monfort and Juárez (2006). 52 children had unacquired phonemes and were divided into two randomized groups (experimental and control). An intervention was carried out with oromotor exercises with the experimental group in 2 weekly sessions of 30 minutes for three months. The parents answered the brief version of the Child Behavior Questionnaire (CBQ) (Putnam and Rothbart , 2006), to measure child's temperament. Finally, the "Simon says" test of the Inhibitory Control Battery of Kochanska (1997) was applied. After the intervention, the Induced Phonological Registry was re-administered. To analyze the effects of the intervention, a Generalized Linear Model of "repeated measures" was chosen. Results and conclusions: the results of our study do not show significant differences between the experimental and control groups when oromotor exercises are used with children with typical development who do not have acquired all the phonemes. Thus, these results show that these exercises are not useful for improving the articulation of phonemes in children with a typical development. The second objective was to find out which phonemes were most influenced by oromotor exercises. For this purpose, we carefully analyze the collected data, first checking the isolated phonemes, also the phonemes in inverses and the consonant groups with /l/ and with /r/. Again, no significant differences were obtained between the experimental and control groups. The third objective was to analyze if the effect of the oromotor exercises varied depending on severity, for this two types were differentiated, one moderate (from 2 to 6 unacquired phonemes) and another serious (from 7 phonemes onwards), and significant differences were found between the moderate and severe groups, since the serious ones improved more than the moderate ones, but it was not due to the treatment with oromotor exercises. The fourth aim was to analyze whether individual differences in temperament were related to articulatory problems. The results of the CBQ show that, considering the extreme values, children with greater positive emotionality have fewer phonoarticulatory problems. These children are more sociable and enjoy interacting and communicating with other children, which seems to contribute to their speech learning. The fifth objective was to study whether the capacity for inhibitory control was related to articulatory problems. In the "Simon says" test we found no relationship with articulatory alterations. However, there was a relationship between the measure of inhibitory control measured through CBQ and articulatory problems, when subjects with extreme values were considered. Results indicate that children who are high in inhibitory control have more phonoarticulatory disorders. In conclusion, the results point to the lack of effectiveness of oromotor exercises for intervention in phonoarticulatory problems and to the influence of individual differences in temperament in language development.