Differential diagnosis of functional speech sound disorders

Motnje govorjenih glasov (MGG) so najpogostejše motnje, s katerimi se srečujejo logopedi v praksi. Med njimi prevladujejo idiopatske oz. funkcionalne MGG (FMGG), ki so vse prej kot homogena skupina motenj. Uporaba neustreznih in nepoenotenih terminov ter netočen opis govorno-jezikovnih težav otrok s FMGG kažeta na nepoznavanje podskupin motnje. Raziskave kažejo večjo osredotočenost logopedov na otrokovo zmožnost izreke posameznih soglasnikov v besedah kot na ocenjevanje fonoloških kompetenc in zmožnosti ter določanje prisotnosti fonoloških procesov. V slovenskem prostoru torej narašča potreba po diferencialni diagnostiki FMGG, saj vsaka podskupina te motnje predstavlja implikacijo za drugo vrsto terapije. Podskupine so tuji raziskovalci začeli preučevati s pomočjo kvalitativne analize govornih napak in kognitivno-jezikovnih zmožnosti v ozadju. V raziskavi smo uporabili dva testa – Tripozicijsko oceno artikulacije in Instrument za ocenjevanje fonološkega razvoja v slovenščini (presejalni preizkus), s katerima smo opisali fonološke sisteme otrok s FMGG, starih med 41 in 69 let. Predstavljeni so kvantitativni (PCC, PVC, št. fonoloških procesov) kot tudi kvalitativni podatki (opis fonetičnega inventarja, fonoloških procesov). Od 23 vključenih otrok je imel 1 artikulacijsko motnjo, 4 kombinirano artikulacijsko-fonološko motnjo in 18 fonološko motnjo. Glede na model diferencialne diagnostike jih je imelo 8 zaostanek v fonološkem razvoju (od tega 1 pridruženo artikulacijsko motnjo), 12 smo jih diagnosticirali s konsistentno fonološko motnjo (1 s pridruženo artikulacijsko motnjo), ostala 2 pa sta z nekonsistentno rabo nenavadnih fonoloških procesov izkazala prisotnost nekonsistentne fonološke motnje, oba s pridruženo artikulacijsko motnjo. Rezultati se ne ujemajo popolnoma z rezultati študij iz tujih jezikovnih okolij, kar lahko pripišemo majhnemu vzorcu ter pomanjkanju raziskav in norm s področja fonološkega razvoja slovensko govorečih otrok. Raziskava je vzpodbuda za dodatno raziskovanje na področju fonološkega razvoja in FMGG, ustreznejšo diferencialno diagnostiko, uporabo učinkovitejših pristopov v terapiji in poenotene terminologije.Speech sound disorders (SSD) are the most common disorders encountered by speech-language pathologists in practice. Among them, idiopathic or functional SSDs prevail, and they are anything but a homogeneous group of disorders. The use of inappropriate and inconsistent terms and inaccurate descriptions of the speech-language difficulties of children with functional SSDs indicate a lack of understanding of the disorder\u27s subgroups. Studies show that the focus is more on a child\u27s ability to articulate individual consonants in words than on assessing phonological competence and determining the presence of phonological processes. Therefore, there is an increasing need for differential diagnosis of functional SSDs in the Slovenian context, as each subgroup of this disorder represents an implication for another type of therapy. Foreign researchers have begun to study these subgroups using qualitative analysis of speech errors and their underlying cognitive-linguistic abilities. In this research, two tests were used: the Three-Position Articulation Assessment and the An Instrument for Evaluation of Slovenian Phonological Development: Screener. These tests were used to describe the phonological systems of children with functional SSD aged between 41 and 69 years. The study presents both quantitative data (PCC, PVC, number of phonological processes) and qualitative data (description of phonetic inventory, phonological processes). Of the 23 children included, one had an articulation disorder, four had a combined phonological-articulation disorder, and 18 had a phonological disorder. According to the differential diagnosis model, 8 children showed a phonological delay (including one with an associated articulation disorder), 12 were diagnosed with consistent phonological disorder (one with an associated articulation disorder), and the remaining two children showed presence of inconsistent use of atypical phonological processes, indicating inconsistent phonological disorder, both with an associated articulation disorder. The results are not fully consistent with studies conducted in foreign language environments due to a small sample size and a lack of research and norms related to phonological development in Slovene-speaking children. This study serves as an incentive for further research in the field of phonological development and functional SSD, for more appropriate differential diagnosis and therapy, and for the use of standardized terminology