“Il ruolo del counseling familiare nella gestione delle disfluenze in età prescolare”

INTRODUCTION Parents are the most important conversational partner for pre-school children. So many clinicians stress the importance of including parents of disfluent children in the intervention process. The ways of parental involvement depends on a proper theory or working model which characterizes disfluency in interactionist terms and as being multifactorial and dynamic in nature. As a consequence the parent’s role main topics could be:-management of communicative interactions; -flexible assumption of a variety of roles throughout the intervention process; - determination on individual basis of nature and scope of parents involvement in fluency intervention throughout the course of therapy. METHODOLOGY The Authors compared the difluency evolution in four homogeneous groups at the aim of evaluating the parent’s role in the treatment of childhood disfluency. The subjects were 11 children (11 male and 3 female), aged from 4.8 to 5.3 years, showing atypical disfluency. The speech fluency had been videotaped in three contests (free playing, picture describing, building play). The disfluent children were assigned to the following four groups:-group 1= parental counseling (90 minutes/week) + direct fluency intervention (90 minutes/week); -group 2 = parental counseling (180minutes/week); -group 3 = direct fluency intervention; -group 0= no intervention. The direct fluency intervention was carried out combining different methods: -“Emotions and Comunication” method (Marletta-Pacifico,1993); -“Space-time method” (Terzi,1976); -“Modeling therapy” (Gregory 1979); - Traditional logopedic exercices. The parental counseling was carried out following Gregory’s directions and was acted in several steps: -listening phase; - information phase; -carryng out and checking up. RESULTS AND CONCLUSION The following results have been pointed out 18 months post-treatment: -in group 1 the several kinds of speech atypical disfluency were absent and the percentage of repetitions was below 3%; - in group 2 the fluency disorders significantly decreased although 3-4% of syllable and words repetitions and 4-5 of phoneme repetitions were recorded; - in group 3 repetitions (3-7%) and prolongations (2-3%) were pointed out, while blocks and visible tensions were absent; - in group 0 all the atypical kinds of disfluency were still present and the frustrating speech-relaxed experiences were increased. In conclusion, the abstention from early intervention in children showing atypical disfluency gave rise to a negative evolution. The complete approach (parental counseling and direct fluency intervention) achieved the best results. The parental counseling demonstrated to be more effective than intervention in the treatment of disfluency in pre-school children.