Ana Paola Nicolielo

Desempenho escolar de crianças com Distúrbio Específico de Linguagem: relações com habilidades metafonológicas e memória de curto prazo

PURPOSE: To describe the performance of children with Specific Language Impairment (SLI) in tests of reading, writing, arithmetic, phonological awareness and auditory sequential memory abilities, as well as to verify whether there is a positive association between the tests that evaluate school learning and those that evaluate information processing. METHODS: Twenty children with SLI diagnosis and ages between 7 and 12 years, were submitted to the School Performance Test (Teste de Desempenho Escolar - TDE) and two tests that evaluate information processing (Phonological Abilities Profile and the subtest of Auditory Sequential Memory of the Illinois Test of Psycholinguistic Abilities- ITPA). RESULTS: The majority of the subjects presented deficits in all the tests. The analysis of the associations among the groups performance in the different tests showed that metalinguistic skills were significantly associated with the reading (p=0.02) and writing (p=0.02) abilities. In turn, the auditory sequential memory ability presented statistically significant association only with arithmetic ability (p=0.0003). CONCLUSION: The majority of the evaluated children showed deficits in their school performance, as well as in the abilities of phonological awareness and short term memory. It was found positive associations between the short term memory and the arithmetic tests, and between the phonological awareness and the reading and writing tests. In this context, it is emphasized the use of intervention programs based on Psycholinguistic Models, that suggest the use of individual strategies for the development of metalinguistic skills.

Relações entre processamento fonológico e linguagem escrita nos sujeitos com distúrbio específico de linguagem

PURPOSE: to check the occurrence of alterations in language skills and writing skills of Phonological Processing (PP) in children with SLI, compare the performance between children with SLI and Typical Language Development on the different abilities of PP; check for association between PP and skills of written language in children with SLI. METHOD: 40 subjects, 20 with SLI (EG) and 20 with TLD (CG) aged between 7 and 10 year old for both genders. To assess the abilities of PP we applied the following tests: proof of non word repetitions to assess phonological working memory (PWM), Rapid Automated Naming test (RAN) for evaluating Lexical Access (LA) and Phonological Abilities Profile for assessing phonological awareness (PA). Writing and reading were evaluated using the subtests present in Test for Analising Reading and Writing Skills (dictation and spontaneous writing, reading text and reading comprehension, respectively). For statistical analysis we used the Chi-Square test, with significance level < 0.05. RESULTS: an association between performance on tests of reading and writing and performance on tests of PP was confirmed. CONCLUSION: there is an association between performance in reading and writing tests of PP which suggests that the difficulties in the abilities referring to PF may explain the difficulties of written language regarding these subjects.

Fatores interferentes na alimentação de crianças de 17 a 25 meses de uma creche municipal

RESUMOObjetivo: verificar fatores interferentes no padrao de alimentacao de criancas de 17 a 25 meses. Metodos: dados de avaliacoes fonoaudiologicas de todas as criancas do bercario (n=14) de uma creche no municipio de Bauru/SP. Aplicacao de questionario aos pais a respeito das condicoes de saude geral e desenvolvimento neuromotor, aleitamento natural ou artificial, habitos orais e proble-mas respiratorios. Analisou-se a morfofuncionalidade dos constituintes do sistema estomatognatico e caracteristicas clinico-fisiologicas da mastigacao e degluticao. A analise estatistica foi descritiva. Resultados: constatou-se alteracao em diversos aspectos da saude nas criancas (92,8%); presenca de ma oclusao (28,6%); alteracoes morfologicas para labio (21,4%) e lingua (21,4%); alteracoes de tonicidade de bochechas (57,1%), mento (21,4%) e labios (42,8%); respiracao oral ou orona-sal (42,8%); alteracoes na mastigacao (35,7%) e na degluticao de solido (50%) e liquido (42,8%). Conclusao: para esse grupo, a presenca de habitos orais, assim como as alteracoes morfologicas e de tonicidade influenciam o padrao de alimentacao das criancas analisadas, evidenciando a necessi-dade de prevenir e detectar precocemente tais fatores para que a alimentacao nas criancas ocorra de forma adequada, promovendo assim condicoes de saude para um desenvolvimento higido. DESCRITORES: Comportamento Alimentar; Crianca; Desenvolvimento Infantil; Promocao da Saude

Habilidades de consciência fonológica em crianças de escolas pública e particular durante o processo de alfabetização

PURPOSE: To verify and compare phonological awareness (PA) abilities of public and private school children in the literacy process. METHODS: A test of phonological awareness (PA) was applied in 70 children in the first grade of elementary school (35 students from public school and 35 from private school) at the beginning (pretest) and end (posttest) of the school year. RESULTS: All children showed improvement in their performance when compared pre and posttest. In the pretest, the best scores were observed in the syllable level and in rhymes; however, comparing the pre with the posttests, the phonemic level showed the most significant improvement rates in the whole sample. The private school children had higher scores in most tests applied, as well as a higher total number of points compared to public school children in the pre and posttest. There was a decrease in the difference of the PA performance between schools at the end of the school year. CONCLUSION: All children showed improvement in PA skills with literacy process, although children from private schools had better performance, especially in the pretest, which can be a sign of the socioeconomic influence in the development of these skills. Syllabic and rhymes skills were developed before the literacy process and phonemic awareness skills were developed concurrently with this process. Also this study lays emphasis on the importance of the instruction in public schools in reducing the discrepancy between the abilities of these schools at the end of the school year, in this sample.

EVOLUÇÃO DO PROCESSO TERAPÊUTICO FONOAUDIOLÓGICO NO DISTÚRBIO ESPECÍFICO DE LINGUAGEM (DEL): RELATO DE CASO

The aim of this study was to describe the clinical course of a nine years girl diagnosed with SLI attended the Clinic of Child Language, FOB-USP. Longitudinal carried out was realized, through analysis of medical records and filming. The speech and language therapy began when the child was five years and presented the initial complaint of phonological alterations and impairments in the speech intelligibility. It was found phonological processes not expected for age, alterations in semantic, syntactic and pragmatic and in auditory perceptual processes. The receptive language was preserved. The intervention focused on the organization of linguistics subsystems, mainly the information processing skills. After 12 months, there was evolution of the aspects, except the phonological, with less significant evolution. Activities directed to written language were included when the child started primary school. After 42 months of intervention, there was evolution of phonological aspect. However, this evolution is not observed in spontaneous speech. Alterations in these aspects exert great influence on the performance of written language. The phonological awareness skill is adequate, however, there is difficulty in converting phoneme/grapheme, resulting in performance very short in written language. There is impairment in the linguistic information processing, and persisting alterations, common in the frames of SLI, which lead to gaps in the literacy process. To conduct the therapeutic process is necessary to understand the nature of language difficulties, developing specific strategies geared mainly to linguistic information processing and learning, providing skills and empowering the individual to active participation in school and social settings.

Processamento fonológico em crianças com distúrbio específico de linguagem

OBJETIVO: comparar o desempenho de criancas com Disturbio Especifico de Linguagem e com Desenvolvimento Tipico de Linguagem em relacao as habilidades de memoria fonologica, acesso lexical e consciencia fonologica. METODOS: 40 sujeitos (20 com diagnostico de disturbio - Grupo de Estudo e 20 sem disturbio - Grupo Controle) de 7 e 10 anos de idade, ambos os generos, pareados de acordo com a idade cronologica e serie escolar. Aplicou-se: Prova de Fonologia do Teste de Linguagem Infantil ABFW; Prova de nao palavras da prova de Memoria de Trabalho Fonologica; Perfil de Habilidades Fonologicas e Teste de Nomeacao Automatica Rapida - RAN. Realizaram-se analises estatisticas descritivas e inferenciais, utilizando o teste Qui Quadrado (significância menor ou igual a 0,05). RESULTADOS: houve diferenca estatistica entre os grupos nas habilidades do processamento fonologico. O grupo experimental apresentou desempenho significantemente pior comparado ao Grupo Controle. Apenas a prova de nomeacao rapida de objetos nao apresentou diferenca estatistica significante entre os grupos. CONCLUSAO: a grande maioria das criancas com DEL apresentaram alteracao nas habilidades do PF, sendo a diferenca de desempenho em comparacao com criancas com DTL estatisticamente significante.

Evolução comunicativa em gemelares com atraso no desenvolvimento da linguagem

The theme of this study is the communicative behavior of twins with language disorders before and after speech therapy. Data from two pairs of male twins with a diagnosis of language delay were analyzed (monozygotic – S1/S2, dizygotic – S3/S4). Data were collected in assessments made pre and post speech-language audiology intervention through: semi-structured interviews with the parents, observation of communicative behavior, and language and development scale test. The speech-language audiology intervention lasted for 34 months for S1/S2 (from two years and five months to five years and three months) and 17 months for S3/S4 (from three years and seven months to five years and four months). More severe pre, peri and post natal complications with a greater psychomotor and communicative impairment were observed in the pre speech-language audiology intervention assessment. S3/S4 showed less severe pre, peri and post natal complications and development delay occurring only in language. The age of the children in post intervention assessment was similar, however, the pair S1/S2 showed a more damaged global and communicative development, even having received a longer speech-language audiology intervention. S3 showed a performance approximate to the typical development and S4 had difficulties just concerning phonology and pragmatics. The experiences of twins, differentiated as to interpersonal circumstances, lead to atypical language development, due to the reduced objective need of linguistic interaction. The post natal complications in S1/S2 exacerbated the delay in child development, encompassing the communicative development.

INTERVENÇÃO FONOAUDIOLOGICA BASEADA NA PERSPECTIVA COMPORTAMENTAL EM TRANSTORNO GLOBAL DO DESENVOLVIMENTO (TGD): RELATO DE CASO

The aim of this study was to describe a process of speech-language therapy focused on the adequacy of language skills, cognitive and social abilities with child with a language disorder as part of a Pervasive Developmental Disorder (PDD) under the behavioral approach. The child in question was female and was diagnosed in a Clinic of Speech-Language Pathology in a university and referred to the neurological diagnosis at 2 years of age. Soon after the diagnosis, the individual language intervention begin based on a behaviorist perspective of more traditional base; however, throughout the process, being reported here the first two years of intervention and presented data from the revaluation speech-language at the beginning of the third year of intervention. As a result of the intervention, there was improvement in receptive and expressive language, and the child presented evolution as the behavioral aspect and the acquisition of communicative skills, involving verbal responses to actions. Additionally, increased eye contact and attention span and aspects related to the symbolism. The case was described with a concern to make it clear that it is not always easy to identify the best therapeutic approach for these children early in the process, and decisions about the appropriate approach should be constantly rethought not only because on the diagnosis itself but also the manifestations of general and specific symptoms – which vary according to children´s development and progress of the intervention. These decisions should be guide by the experience of the professional, but also in the expectation and limit of each family.