magistrsko delo
Neža Mulej (Avtor), Irena Hočevar-Boltežar (Mentor), Jerneja Novšak Brce (Komentor)

Povzetek

Prezgodnji porod ali rojstvo pred dopolnjenim 37. tednom gestacije je tudi v Sloveniji, kjer se letno rodi približno 7 % nedonošenčkov, naraščajoč pojav. K dodatnemu tveganju razvojnih odstopanj nedonošenčkov prispeva tudi nizka porodna teža (< 2500 g) in motnje hranjenja in požiranja. V teoretičnem delu so opisane značilnosti pojava prezgodnjega rojstva, možne posledice nedonošenosti na otrokov razvoj, značilnosti bolnišnične oskrbe nedonošenčkov in posebnosti kasnejšega spremljanja njihovega razvoja. Podrobneje smo raziskovali medsebojni vpliv nizke porodne teže, motenj hranjenja in požiranja do drugega leta ter odstopanja govorno-jezikovnega razvoja. V empiričnem delu so predstavljene značilnosti posameznega nedonošenega otroka z obdobja novorojenčka, malčka in predšolskega otroka. V raziskavo je bilo vključenih 117 nedonošenčkov s porodno težo do 1500 g, rojenih v Porodnišnici v Ljubljani med letoma 2013 in 2015. Njihov razvoj smo raziskovali na podlagi podatkov iz Enote za intenzivno terapijo in nego novorojencev (EINT), osnovnih podatkov kontrolnega pregleda po odpustu iz porodnišnice pri povprečni starosti dveh let ter z dvema avtorskima vprašalnikoma. Prvi vprašalnik je bil namenjen pridobivanju podatkov otroka z njegovega zadnjega sistematskega zdravniškega pregleda pri povprečni starosti 5,5 leta, drugi vprašalnik pa pridobivanju podatkov o govorno-jezikovnem razvoju otroka s strani otrokovega logopeda. Prejeli smo 50 izpolnjenih vprašalnikov od pediatrov ter 19 izpolnjenih vprašalnikov od logopedov. Z raziskavo smo ugotovili pomembno pogostejša odstopanja na Denverskem razvojnem presejalnem testu ob zadnjem kontrolnem pregledu v porodnišnici (n = 117) pri otrocih z motnjami hranjenja in požiranja po odpustu iz porodnišnice kot pri otrocih brez teh motenj (p = 0,01) in povezavo med Denverskim presejalnim razvojnim testom pri dveh letih ter oceno pediatrov o odstopanju govora in jezika pri zadnjem sistematskem pregledu (p = 0,02). Povezanosti odstopanj govora in jezika na Denverskem razvojnem presejalnem testu z nizko gestacijsko starostjo (p = 0,11) ali z nizko težo ob rojstvu (p = 0,05) nismo potrdili. Pri nadaljnjem spremljanju nedonošenčkov pri povprečni starosti 5,5 leta (n = 50) so pediatri pri 34 % otrok poročali o odstopanjih glede razvoja govora in jezika, ki so bila povezana z odstopanjem splošnega razvoja (p < 0,01), psihičnega razvoja (p < 0,01), grobe (p = 0,04) in fine motorike (p < 0,01), prisotnostjo nevroloških motenj (p = 0,04) ter motenj aktivnosti in pozornosti (p = 0,02). Ocena pediatrov o odstopanju govora in jezika ni bila povezana z otrokovim spolom in značilnostmi otrokove družine, po katerih smo poizvedeli v vprašalniku. Pridobljeni podatki od logopedov (n = 19) kažejo, da je 83,3 % otrok logopeda prvič obiskalo pred 5. letom, 44,4 % pa pred 3. letom. Logopedi so pri obravnavanih nedonošenih otrocih navajali odstopanja govorno-jezikovnega izražanja (94,7 %), govorno-jezikovnega razumevanja (36,8 %), fonološkega zavedanja (57,9 %) in sociopragmatičnih spretnosti (42,1 %). Izključno artikulacijske težave so bile prisotne le pri 26,3 % nedonošenčkov, težave na vseh štirih omenjenih področjih pa pri 42,1 %. Logoped sodeluje pri ocenjevanju in obravnavi nedonošenčkov, kar od njega zahteva poglobljeno razumevanje njihovih razvojnih in zdravstvenih posebnosti. S pomočjo ugotovitev o razvoju in obravnavi nedonošenih otrok z nizko porodno težo ter motnjami hranjenja in požiranja smo prispevali k boljšemu razumevanju njihovih značilnosti in potreb, oblikovali idejno izhodišče za nadaljnje raziskovanje in izpostavili pomen vključevanja logopedske pomoči pri zgodnji obravnavi motenj hranjenja in požiranja ter govorno-jezikovnih odstopanjih.

Ključne besede

nedonošenček;razvojna odstopanja;govorno-jezikovni razvoj;nizka porodna teža;motnje hranjenja in požiranja;logoped;

Podatki

Jezik: Slovenski jezik
Leto izida:
Tipologija: 2.09 - Magistrsko delo
Organizacija: UL PEF - Pedagoška fakulteta
Založnik: [N. Mulej]
UDK: 616.32-008.1(043.2)
COBISS: 153066499 Povezava se bo odprla v novem oknu
Št. ogledov: 26
Št. prenosov: 3
Ocena: 0 (0 glasov)
Metapodatki: JSON JSON-RDF JSON-LD TURTLE N-TRIPLES XML RDFA MICRODATA DC-XML DC-RDF RDF

Ostali podatki

Sekundarni jezik: Angleški jezik
Sekundarni naslov: Development of premature babies with feeding and swallowing disorders and low birth weight
Sekundarni povzetek: Premature births, or births before 37 weeks of gestation, are a growing phenomenon, including in Slovenia, where about approximately 7 % of newborns are born prematurely. Low birth weight (< 2500 g) and feeding and swallowing disorders pose an additional risk for the developmental abnormalities. The theoretical part of this thesis describes the characteristics of the occurrence of premature birth, the possible consequences of preterm birth for the child's development, the characteristics of hospital care of premature babies and the specifics of subsequent monitoring of their development. We studied the mutual influence of low birth weight, feeding and swallowing disorders, and atypical speech and language development. In the empirical part, the characteristics of individual preterm infants from the neonatal, toddler, and preschool periods are presented. 117 premature children with birth weight less than 1500 g born in Ljubljana Maternity Hospital between 2013 and 2015 were included in the research. Their development was studied using data from the Neonatal Intensive Care Unit and baseline data from the follow-up examination after the discharge from the maternity hospital at an average age of two years, as well as two questionnaires. With the first questionnaire, we collected the data about the child from their last physical examination at an average age of five and a half years, while the other aimed to obtain the data about the child's speech and language development from their speech and language pathologists (SLP). We received 50 completed questionnaires from the pediatricians and 19 completed questionnaires from SLPs. The study revealed that children with feeding and swallowing disorders were significantly more likely to have deviations in the Denver Developmental Screening Test at the last follow-up visit at the maternity hospital (n = 117) than children without these disorders (p = 0.01). We also observed a correlation between the Denver Developmental Screening Test administered at the age of two, and the pediatricians' assessment of atypical speech and language development at the last physical examination (p = 0.02). The correlation between speech and language deviations in the Denver Developmental Screening Test and low gestational age (p = 0.11) or low birth weight (p = 0.05) was not confirmed. During the follow-up examinations of premature children at an average age of five and a half years (n = 50), pediatricians reported atypical speech and language development in 34% of children, which were correlated to the deviations in general development (p < 0.01), psychological development (p < 0.01), gross (p = 0.04) and fine motor skills (p < 0.01), the presence of neurological disorders (p = 0.04), and activity and attention disorders (p = 0.02). The pediatricians' assessments of atypical speech and language were not related to the child's gender or the characteristics of the child's family, which were asked about in the questionnaire. Data obtained from the SLPs (n = 19) showed that 83.3 % of the children visited a SLP for the first time before the age of five and 44.4 % before the age of three. SLPs reported deviations in expressive language (94.7 %), receptive language (36.8 %), phonological awareness (57.9 %), and sociopragmatic skills (42.1 %) in the treated premature children. Articulation problems exclusively occurred in 26.3 % of premature babies, whereas problems in all four mentioned areas were observed in 42.1 %. A speech and language pathologist (SLP) participates in the assessment and treatment of premature babies, which requires a deep understanding of their developmental and health specifics. With the help of findings on the development and treatment of premature children with low birth weight and feeding and swallowing disorders, we have contributed to a better understanding of their characteristics and needs, provided a conceptual starting point for further research, and highlighted the importance of including the SLP into the early treatment of feeding and swallowing disorders, and speech and language disorders.
Sekundarne ključne besede: premature babies;developmental deviations;speech and language development;low birth weight;feeding and swallowing disorders;speech and language pathologist;Govorna terapija;Univerzitetna in visokošolska dela;
Vrsta dela (COBISS): Magistrsko delo/naloga
Študijski program: 0
Konec prepovedi (OpenAIRE): 1970-01-01
Komentar na gradivo: Univ. v Ljubljani, Pedagoška fak., Logopedija in surdopedagogika
Strani: 1 spletni vir (1 datoteka PDF (103 str.))
ID: 18957934