Ana Maria Schiefer

Avaliação comportamental do processamento auditivo em indivíduos gagos

BACKGROUND: the behavioral auditory processing (AP) evaluation allows the investigation of neuroaudiological processes involved in speech fluency processing. AIM: the purpose of this study was to describe the results obtained in the AP evaluation in stutterers, comparing the type of AP disorder with the severity of stuttering. METHOD: 56 subjects, 49 male and 7 female, ranging in age from 4 to 34 years, were referred from the speech-language clinic of UNIFESP to the AP evaluation. All patients were submitted to the following evaluations: audiological, speech and language. Disfluency was classified according to the protocol proposed by Riley (1994) which includes the following stuttering severity levels: very mild, mild, moderate, severe and very severe. Behavioral AP tests were selected and analyzed according to the patients age and to the proposal of Pereira & Schochat (1997). RESULTS: subjects with ages between 4 to 7 years and between 12 to 34 years presented mostly mild stuttering, subjects between 8 to 11 years presented mostly moderate stuttering. From the total of 56 individuals who were evaluated, 92.85% presented AP disorders. The most common auditory processing disorders were supra-segmental and decoding. No statistical differences were found considering the results of the AP evaluation and the severity of stuttering for none of the age groups. CONCLUSION: the AP evaluation indicated deficits for most of the participants of all age groups, however no correlations were observed with the severity of stuttering.

O efeito do feedback auditivo atrasado na gagueira

Purpose To verify the effect of delayed auditory feedback and altered frequency in the stuttering severity, by means of the SpeechEasy®device. Methods Sixteen 17 to 49 year-old men and women who stuttered were selected. Schooling ranged from High School to Undergraduate degree. Subjects were distributed in 2 groups: G1 with 8 people who stuttered and had speech therapy using the SpeechEasy®device and G2 with 8 people who stuttered and had therapy without the device. All the subjects underwent conventional speech-language-hearing evaluation, specific stuttering evaluation, basic hearing evaluation and speech training with or without the device. Obtained data was submitted to appropriate statistical analysis. Results There was a significant decrease in the stuttering severity level and in atypical disfluencies rate, in groups G1 and G2, in the final assessment when compared to the initial one. Conclusion There was an improvement of stuttering level with speech training in both groups, with a tendency of G1, which made use ofSpeechEasy® device to present higher reduction in the disfluencies rate and bigger gain in articulatory rate and information production rate.

Processamento auditivo em gagos: análise do desempenho das orelhas direita e esquerda

OBJETIVO: Comparar a diferenca entre as orelhas nos testes comportamentais do processamento auditivo e os resultados de sujeitos com diferentes graus de gravidade de gagueira em cada teste do processamento auditivo. METODOS: Cinquenta e seis individuos, com idades entre quatro e 34 anos, foram encaminhados pelo Ambulatorio de Avaliacao Fonoaudiologica da UNIFESP para avaliacao comportamental do processamento auditivo. Todos os pacientes foram submetidos a avaliacao de audicao, fala e linguagem. A disfluencia foi classificada segundo o protocolo de Riley (1994), o qual preve os seguintes graus de gravidade da gagueira: muito leve, leve, moderado, severo e muito severo. Os testes para avaliacao do processamento auditivo foram selecionados e analisados de acordo com a idade do paciente e a proposta de Pereira & Schochat (1997). RESULTADOS: Observamos prevalencia da gagueira de grau leve nas faixas etarias de quatro a sete anos e de 12 a 34 anos de idade, e de grau moderado nos individuos de oito a 11 anos de idade. Dos 56 individuos avaliados 92,85% apresentaram alteracao do processamento auditivo. Houve diferenca estatisticamente significante entre as orelhas direita e esquerda na etapa de atencao direcionada do teste dicotico nao verbal, em todas as faixas etarias estudadas. Nao foram encontradas diferencas significativas entre os graus de gravidade da gagueira em nenhum dos testes de processamento auditivo. CONCLUSOES: A orelha direita apresentou melhor desempenho do que a esquerda nos diferentes testes comportamentais. O grau de gravidade da gagueira nao interferiu no resultado de cada teste.

Disfluências e velocidade de fala em produção espontânea e em leitura oral em indivíduos gagos e não gagos

PURPOSE: To investigate and characterize temporal parameters of speech in spontaneous situation and in oral reading in people who stutter and who do not stutter, and investigate the relation among these variables. METHODS: Thirty participants aged between 17 and 59 years, with a minimum of 08 years of scholar education, constituted the Study Group, composed by 15 people who stutter and the Control Group with 15 people who did not stutter. Subjects on the Control and Study Group were matched by gender, age and education level. After anamnesis it was made: brief neuropsychological assessment, specific stuttering assessment and specific oral reading assessment. Disfluencies were analyzed and it was calculated speech rate on spontaneous production and oral reading. RESULTS: There were more disfluencies in spontaneous speech than in text oral reading in both groups. As to speech rate, in the Control Group, pseudoword and text reading were positively correlated, and in the Study Group, all variables were positively correlated. CONCLUSION: Speech rate and disfluencies analysis characterized both groups, either in spontaneous speech and reading situations which evidenced performance profiles differentiated by speech rate, frequency and disfluency typology. Investigation showed that people who stutter present lower values of speech rate, as well as higher occurrence of disfluencies, either on spontaneous speech and oral reading, in comparison to people who do not stutter.

Temporal processing and long-latency auditory evoked potential in stutterers

INTRODUCTION Stuttering is a speech fluency disorder, and may be associated with neuroaudiological factors linked to central auditory processing, including changes in auditory processing skills and temporal resolution. OBJECTIVE To characterize the temporal processing and long-latency auditory evoked potential in stutterers and to compare them with non-stutterers. METHODS The study included 41 right-handed subjects, aged 18-46 years, divided into two groups: stutterers (n=20) and non-stutters (n=21), compared according to age, education, and sex. All subjects were submitted to the duration pattern tests, random gap detection test, and long-latency auditory evoked potential. RESULTS Individuals who stutter showed poorer performance on Duration Pattern and Random Gap Detection tests when compared with fluent individuals. In the long-latency auditory evoked potential, there was a difference in the latency of N2 and P3 components; stutterers had higher latency values. CONCLUSION Stutterers have poor performance in temporal processing and higher latency values for N2 and P3 components.

Comparison of pausing behavior in children who stutter and children who have Asperger syndrome.

PURPOSE The objective of this research was to compare the number and types of grammatical and non-grammatical silent pauses presented by stutterers and subjects with Asperger syndrome in their narratives. METHOD Ten children who stutter and four participants with Asperger syndrome (mean ages of both groups 10 years) were assessed at the Speech and Language Disorders Department of the Universidade Federal de São Paulo/Brasil. They narrated a story based on a pre-selected sequence of pictures. They were filmed and their productions were analyzed using version 5.0.47 of Praat (http://www.fon.hum.uva.nl/praat/download_win.html). Silent intervals in the speech that ranged from 0.25 to 4s were considered pauses. The pauses were classified as grammatical and non-grammatical, depending on the words that preceded and followed them. RESULTS Both groups presented grammatical and non-grammatical pauses and the former predominated. The children with Asperger syndrome produced a greater number of pauses than the stutterers. EDUCATIONAL OBJECTIVES The reader will be able to: (1) characterize the use of pauses in the oral narrative; (2) distinguish a grammatical pause from a non-grammatical pause regarding the use and function; (3) recognize the pattern of pause found in the two populations.

Habilidades fonológicas em crianças com gagueira

Objetivo : estudar as caracteristicas de desenvolvimento fonologico de criancas gagas e nao-gagas, e investigar possivel associacao entre a presenca de gagueira e a de processos fonologicos.Metodos : foram selecionadas 20 criancas (10 gagas), do sexo feminino e masculino, entre 04 a 08 anos de idade, pareadas por sexo e idade. As criancas do grupo de estudo tiveram diagnostico de Gagueira e foram classificadas quanto a gravidade da patologia por meio do Stuttering Severity Instrument-3. Foram excluidas aquelas que apresentaram evidencia de surdez, doencas neurologicas e/ou psiquiatricas. As criancas de ambos os grupos foram submetidas a avaliacao fonoaudiologica e a aplicacao das provas de Fonologia do Teste de Linguagem Infantil- ABFW.Resultados : no grupo de estudo foram observados 60% de processos fonologicos nao esperados para a idade, enquanto que no grupo controle foram apenas 10%. As diferencas entre os grupos nao foram estatisticamente significantes quanto a incidencia de processos fonologicos. Ha indicios de que o grupo de criancas gagas esteja mais predisposto a presenca de pelo menos um processo fonologico.Conclusao : conclui-se que a metodologia utilizada na investigacao dos processos fonologicos foi eficaz, mas devido a amostra reduzida nao foi possivel o aprofundamento da questao, ou seja, verificar se ha uma diferenciacao no desempenho de criancas gagas quanto aos processos fonologicos quando comparadas com as nao-gagas.

Pesquisa do efeito de supressão e do processamento auditivo em indivíduos que gaguejam

Purpose To verify the auditory processing abilities and occurrence of the suppression effect of Otoacoustic Emissions (OAE) in individuals who stutter. Methods The study sample comprised 15 adult individuals who stutter, aged 18-40 years, with stuttering severity ranging from mild to severe, paired according to gender, age, and schooling with individuals without speech complaint or disorder. All participants underwent conventional clinical evaluation, specific stuttering assessment, and basic (audiometry, imitanciometry, and measurement of acoustic reflexes) and specific (auditory processing evaluation and measurement of suppression effect of OAEs) audiological assessments. Data were statistically analyzed with application of the Fishers Exact Test and the Mann-Whitney Test. Results The group of individuals who stutter (Study Group - SG) presented higher incidence of auditory processing disorders. The auditory processing assessments used to differentiate the groups of stutterers and non-stutterers (Control Group - CG) were the Nonverbal Dichotic Test and the Frequency Pattern Test. The SG presented higher incidence of absence of suppression effect of OAEs, indicating abnormal functioning of the efferent medial olivocochlear system. Conclusion The auditory processing abilities investigated in this study differentiate individuals who stutter from non-stutterers, with greater changes in the first. Functioning of the efferent medial olivocochlear system showed a deficit in stutterers, indicating difficulties in auditory discrimination, especially in the presence of noise.

Compreensão oral e leitora e consciência sintática nas alterações de leitura e escrita

Objetivo: investigar a presenca de deficits de habilidades metassintaticas em escolares com dificuldades de aprendizagem e analisar possiveis correlacoes entre essas habilidades e as de leitura e a compreensao oral. Metodos: foram avaliadas 29 criancas, indicadas por seus professores, por nao apresentarem queixas relacionadas a aprendizagem escolar - Grupo I (GI) e com queixas de comunicacao, oral e/ou mediada pela escrita, que constituiram o Grupo II (GII). As idades das criancas variaram entre 9 anos e 11 anos e 7 meses, de 4o e 5o ano do Ensino Fundamental. As criancas foram avaliadas por meio de testes de compreensao oral, consciencia sintatica e morfossintatica, taxa e acuracia de leitura e compreensao leitora. Para a analise estatistica foram utilizados: teste nao parametrico de Mann-Whitney, para caracterizacao da amostra e comparacao dos grupos com e sem queixa escolar quanto as variaveis, e Coeficiente de correlacao de Spearman, usado para medir o grau de associacao entre as variaveis em cada grupo. Resultados: observaram-se diferencas significantes entre os grupos, nas tarefas de compreensao oral, consciencia sintatica e morfossintatica, de maneira geral, taxa e acuracia de leitura e na prova de compreensao leitora, com melhor desempenho do do GI em todas as tarefas. Conclusao: com estes resultados, enfatiza-se a relevância da estimulacao de habilidades metassintaticas para o desenvolvimento da leitura e a inclusao de provas metassintaticas na avaliacao da leitura, tanto quanto a utilizacao de atividades metassitaticas como recurso terapeutico.