Jornal da Sociedade Brasileira de Fonoaudiologia最新文献

Purpose: To verify the use of conjunctions in narratives, and to investigate the influence of stimuli's complexity over the type of conjunctions used by children with specific language impairment (SLI) and children with typical language development.

Methods: Participants were 40 children (20 with typical language development and 20 with SLI) with ages between 7 and 10 years, paired by age range. Fifteen stories with increasing of complexity were used to obtain the narratives; stories were classified into mechanical, behavioral and intentional, and each of them was represented by four scenes. Narratives were analyzed according to occurrence and classification of conjunctions.

Results: Both groups used more coordinative than subordinate conjunctions, with significant decrease in the use of conjunctions in the discourse of SLI children. The use of conjunctions varied according to the type of narrative: for coordinative conjunctions, both groups differed only between intentional and behavioral narratives, with higher occurrence in behavioral ones; for subordinate conjunctions, typically developing children's performance did not show differences between narratives, while SLI children presented fewer occurrences in intentional narratives, which was different from other narratives.

Conclusion: Both groups used more coordinative than subordinate conjunctions; however, typically developing children presented more conjunctions than SLI children. The production of children with SLI was influenced by stimulus, since more complex narratives has less use of subordinate conjunctions.

Purpose: To investigate the social-cognitive performance of children with diagnostics of autism spectrum disorder (ASD), mental disability (MD) and hearing impairment (HI) in two different communicative situations.

Methods: Participated in this study 30 children ages between 3 and 12 years starting speech language therapy processes, divided in three groups: Group 1 - ten children with diagnoses included in the Autism Spectrum Disorders (ASD); Group 2: ten children diagnosed with mental disabilities (MD) and Group 3: ten children diagnosed with hearing impairment (HI). The subjects were assessed in two different communicative situations (group and individual therapy situation) for 12 months.

Results: Data regarding the performance of the three groups in the two situations show that G3 had better absolute performance when compared with other groups, with the variable symbolic play as an important differential criterion for the three groups.

Conclusion: We conclude that the social-cognitive performance can be used as an auxiliary tool for intervention, helping the identification of variables that could interfere in the communicative performance.

Purpose: To analyze the effectiveness of stimulability as a complementary task to the diagnosis of speech sound disorders (SSD), and to describe the performance of children with absent sounds from the phonetic inventory according to stimulable absent sounds, severity, gender, age, and occurrence of different phonological processes.

Methods: Participants were 130 male and female children with ages between 5 years and 10 years and 10 months, divided into two groups: Research Group (RG), comprising 55 children with SSD; and Control Group (CG), composed of 75 children with no speech and language disorders. Based on participants' performance on the Phonology test, the severity of the disorder was calculated through the Percentage of Consonants Correct - Revised (PCC-R), and the phonetic inventory was verified. The stimulability test was applied to each absent sound from the phonetic inventory, based on the imitation of single words. The RG was subdivided into RG1 (27 children who presented absent sounds) and RG2 (28 children with complete inventory).

Results: None of the CG children presented absent sounds in the phonetic inventory, while 49% of the RG1 subjects presented absent sounds. There was absence of most language sounds. PCC-R means were lower for RG1, indicating higher severity. In the RG1, 22 children were stimulable, while five were not stimulable to any absent sound. There was association between the most occurring phonological processes and the need for stimulability assessment, indicating that the difficulty to produce absent sounds reflects difficulty with phonological representation. Stimulability is influenced by age, but not by gender.

Conclusion: The stimulability test is effective to identify stimulable children among those who present absent sounds from their phonetic inventory. Children with SSD and absent sounds have lower PCC-R, and therefore present more severe disorder. Most of the children with absent sounds are stimulable, but may not be stimulable for complex syllable structures or articulatory gestures. The difficulty to produce absent sounds reflects phonological representation deficit. Speech production is influenced by maturation in both boys and girls.

Purpose: To explore which measures could predict the persistency of developmental language impairment (DLI) based on the association between the initial language assessment and the therapeutic prognosis of the child.

Methods: In this retrospective study, the records of 42 children with diagnosis of DLI were analyzed. Participants' age varied from 21 to 63 months at the first language assessment, which included vocabulary, phonology, pragmatics and fluency tests. The performance of subjects in each test was scored from 0 to 4, based on the severity of the deficits, and the maximum score corresponded to age-adequate performance. As prognostic measure, we accounted the length of therapy (in sessions) of patients who were discharged, were referred to another service (because the deficits had become very mild), or remained in therapy (persistent language difficulties).

Results: There was association between initial assessment (normal or mild alterations for vocabulary and pragmatics abilities) and prognosis (<135 therapeutic sessions). Vocabulary was the only variable able to predict the length of therapy. Being classified as severe in this measure caused the estimate of treatment to increase, in average, 112 sessions.

Conclusion: The first vocabulary assessment can contribute to predict the child's therapeutic prognosis. This finding is clinically and scientifically relevant to Speech-Language Pathology, since it offers an auxiliary resource to the prognosis and therapeutic planning in cases of DLI.

Purpose: To compare the results obtained in the Autism Behavior Checklist with those obtained in the Childhood Autism Rating Scale to identify and characterize children with Autism Spectrum Disorders.

Methods: Participants were 28 children with psychiatric diagnosis within the autism spectrum that were enrolled in language therapy in a specialized service. These children were assessed according to the Autism Behavior Checklist and Childhood Autism Rating Scale criteria, based on information obtained with parents and therapists, respectively. Data were statistically analyzed regarding the agreement between responses. Results indicating high or moderate probability of autism in the Autism Behavior Checklist were considered concordant with the results indicating mild-to-moderate or severe autism in the Childhood Autism Rating Scale. Results indicating low probability of autism in the Autism Behavior Checklist and without autism in the Childhood Autism Rating Scale were also considered concordant.

Results: There was agreement on most of the responses. Cases in which there was disagreement between results obtained on both protocols corroborate literature data, showing that the instruments may not be sufficient, if applied alone, to define the diagnosis.

Conclusion: The Childhood Autism Rating Scale may not effectively diagnose autistic children, while the Autism Behavior Checklist may result in over- diagnose, including within the autism spectrum children with other disorders. Therefore, the associated use of both protocols is recommended.

Purpose: To verify the applicability of a software in the (re)habilitation of hearing impaired children.

Methods: The sample comprised 17 children with hearing impairment, ten with cochlear implants (CI) and seven with hearing aids (HA). The Software Auxiliar na Reabilitação de Distúrbios Auditivos - SARDA (Auxiliary Software for the Rehabilitation of Hearing Disorders) was used. The training protocol was applied for 30 minutes, twice a week, for the necessary time to complete the strategies proposed in the software. To measure the software's applicability for training the speech perception ability in quiet and in noise, subjects were assessed through the Hearing in Noise Test (HINT), before and after the auditory training. Data were statistically analyzed.

Results: The group of CI users needed, in average, 12.2 days to finish the strategies, and the group of HA users, in average 10.14 days. Both groups presented differences between pre and post assessments, both in quiet and in noise. Younger children showed more difficulty executing the strategies, however, there was no correlation between age and performance. The type of electronic device did not influence the training. Children presented greater difficulty in the strategy involving non-verbal stimuli and in the strategy with verbal stimuli that trains the sustained attention ability. Children's attention and motivation during stimulation were fundamental for a successful auditory training.

Conclusion: The auditory training using the SARDA was effective, providing improvement of the speech perception ability, both in quiet and in noise, for the hearing impaired children.

Purpose: To develop a simple and quick-to-apply procedure for pitch-matching scanning that contains vocal imitation tasks of musical sounds of different tones and the temporal ordination of three different tones; to verify its applicability, by comparing the performance of musicians and non-musicians.

Methods: Participants were 32 adults of both genders without vocal, hearing and/or auditory processing complaints. They were equally divided into two groups: musicians group--MG and non-musicians group--NMG. All participants underwent the Pitch-matching Scanning that included musical stimuli compatible with men and women singing vocal range gathered into two types of tasks: isolate tones and three-tone sequences. Participants were instructed to listen to them and to reproduce them vocally. Voice samples were recorded, analyzed acoustically, and right and wrong matches for the two tasks were characterized. The variables regarding the comparison between groups and types of tasks were statistically analyzed.

Results: A difference was found between groups, and the MG presented greater number of right matches in both tasks.

Conclusion: The Pitch-matching Scanning was developed and was sensitive to evaluate and compare the performance between groups. Thus, it can be used as a tool for pitch-matching tracking. Musicians presented better performance than non-musicians in the Pitch-matching Scanning.

Purpose: To perform a systematic analysis of the research regarding vocal characteristics of hearing impaired children or adults with cochlear implants.

Research strategy: A literature search was conducted in the databases Web of Science, Bireme, and Universidade de São Paulo's and CAPES' thesis and dissertations databases using the keywords voice, voice quality, and cochlear implantation, and their respective correspondents in Brazilian Portuguese.

Selection criteria: The selection criteria included: title consistent with the purpose of this review; participants necessarily being children or adults with severe to profound pre-lingual or post-lingual hearing loss using cochlear implants; and data regarding participants' performance on perception and/or acoustic analysis of the voice.

Results: Twenty seven papers were classified according to the levels of evidence and quality indicators recommended by the American Speech-Language-Hearing Association (ASHA). The designs of the studies were considered of low and medium levels of evidence. Six papers were classified as IIb, 20 as III, and one as IV.

Conclusion: The voice of hearing impaired children and adults with cochlear implants has been little studied. There is not an effective number of studies with high evidence levels which precisely show the effects of the cochlear implantation on the quality of voice of these individuals.

Purpose: To analyze the hearing aid satisfaction after one, three and six months of use.

Methods: Longitudinal study with 22 elderly individuals who participated in a selection and adaptation process for sound amplification devices in a high complexity health service. The study was carried out at the institution on the day of hearing aid fitting and on the follow-up appointments after one, three and six months of fitting. The data is part of the application of the Satisfaction with Amplification in Daily Life (SADL) questionnaire. In order to assess the consistency of the items composing the positive effects category of the SADL survey after one, three and six months of hearing aid use, the Cronbach's coefficient alpha was used.

Results: There were improvements to the SADL scores in the period between the first use of the hearing aid and the following six months. Cronbach's coefficient alpha was calculated excluding questions 9 and 10, simultaneously. The coefficient values were 0.75 after a month, 0.69 after three months, and 0.81 after six months. Questions 9 (Do you feel more confident when you use hearing aids?) and 10 (The sounds that you hear with your hearing aids are normal?) created inconsistency in the assessment after one and three months of amplification use.

Conclusion: The results obtained with the SADL indicate a high level of satisfaction. The averages for positive effects, negative effects, and global score were different after one, three and six months of hearing aid use.