Ana Paula Ramos de Souza

Fonoaudiólogo e agente comunitário de saúde: uma experiência educativa

PURPOSE: To analyze the efficacy of a formation process regarding Speech-Language and Hearing Sciences developed with Community Health Agents, based on the theoretical concept of radical education in health. METHODS: Initially, a group of five community agents from a Family Health Program Unit was submitted to a semi-structured collective interview. Then, through the focal group technique, a process of radical education in health was carried out, totalizing eight sessions of approximately 90 minutes each. In the final phase, the group received an informative written material regarding Speech-Language and Hearing Sciences, human communication, its disorders and ways of prevention. RESULTS: During the initial interview, the group showed knowledge predominantly related to clinical practice, especially on speech, writing and learning disorders, deafness and bedridden patients. The educative process began with the representation of the traditional model of health education and, throughout the sessions, with the dialogue development, it assumed the radical model in health, besides the centralization in the model of health prevention. Only one health agent read the written material. CONCLUSION: The educational process was effective to treat the subjects proposed by the group and allowed the individual empowerment.

O grupo na fonoaudiologia: origens clínicas e na saúde coletiva

BACKGROUND: the group in speech therapy. PURPOSE: to review the researches about the effectiveness of group therapy in collective health, and more specifically in speech therapy and in psychology under the Brazilian reality. CONCLUSION: the group was an efficient and efficacy intervention strategy, in all cases, because of its theatrical assumptions.

Associação entre indicadores de risco ao desenvolvimento infantil e estado emocional materno

PURPOSE: to analyze the association between depression and anxiety maternal emotional states, whether combined or isolated and its relation with child development risk in children with zero to four month old. METHOD: this is an observational, analytic and a cohort research. We utilized the Beck Depression and Anxiety Inventories and Child Development Index Risks Inventory for data collection with 182 pairs of mother-child as for their interaction. RESULTS: the percentage of babies with at least one development risk and maternal and maternal anxiety emotional states when combined (34,2%; p<0,001) was significantly higher than with mothers without altered emotional states. There was a significant correlation between depression and anxiety (G= 0,83; p< 0,01e), that shows that mothers with higher degrees of depression also have anxiety states. CONCLUSION: there was association between maternal depression and anxiety and presence of risk for child development, a fact that shows the need for public health programs in order to care and to treat such pairs, when needed.

Análise da associação entre tipos de aleitamento, presença de risco ao desenvolvimento infantil, variáveis obstétricas e socioeconômicas

PURPOSE: To investigate the association among types of breastfeeding, presence of child development risk, socioeconomic and obstetric variables. METHODS: The sample was composed of 182 mother-child dyades. Data were collected through an initial interview about breastfeeding; obstetric, socioeconomic, demographic and psychosocial aspects; and mother-child interaction analysis by the Child Development Risk Inventory. The data were organized in categories related to breastfeeding, presence or absence of child development risk, obstetric and socioeconomic variables, and were analyzed in Statistica 9.0 software for statistical analysis. RESULTS: The mixed breastfeeding type shows statistical correlation between presence of child development risk as well as to variables such as prematurity, low weight, birth intercurrences and mothers domestic profession. CONCLUSION: The results show that factors such as low weight, prematurity and presence of birth intercurrences can be associated to mixed breastfeeding, even if the mothers present physical and time availability for breastfeeding. These variables can be associated to mother-child initial interactions detected by Child Development Risk Inventory.

Abordagem terapêutica grupal com mães de crianças portadoras de distúrbios de linguagem

The aim of this study was to investigate the efficiency of a group therapy approach with mothers of subjects with language impairment to promote changes in the dialogic interaction of the mother-child dyad. Four mother-child dyads participated in this study. The procedures were an initial interview with the mothers and filming of the dyads engaged in an interaction situation before and after therapeutic intervention, in order to interpret the mothers speech and the dialogic activity, as well as to verify the efficacy of group sessions. Group therapy consisted of eight meetings with the mothers, in which varied issues regarding child development were discussed. The results showed that the intervention improved mother-child interaction. The group therapy approach not only helped mothers in their role, welcoming their demands, but was also an important alternative in clinics of the public health system, since it can reduce the waiting time for Speech-Language Pathology assistance.

Dialogia mãe-filho em contextos de depressão materna: revisão de literatura

TEMA: o presente estudo analisou a producao cientifica dos ultimos cinco anos sobre a depressao materna, em particular as repercussoes da depressao na interacao mae-filho e as suas implicacoes para o desenvolvimento infantil. OBJETIVO: verificar as repercussoes da depressao materna na interacao mae-filho, e examinar suas implicacoes para o desenvolvimento da crianca, especialmente o de linguagem. CONCLUSAO: a revisao de literatura realizada demonstra que a depressao materna afeta nao so a mae, mas tambem o desenvolvimento global do bebe. Os estudos apontaram que os efeitos da depressao materna podem resultar negativamente no desenvolvimento da crianca, potencializando desordens linguisticas, comportamentais, afetivas, cognitivas e sociais. Portanto, a depressao materna, em um determinado momento apos o nascimento, pode interferir no estabelecimento do vinculo mae-bebe e, por isso, deve ser tratada o mais precocemente possivel.

Fatores de risco psíquico ao desenvolvimento infantil: implicações para a fonoaudiologia

BACKGROUND: psychical risk factors to child development and implications on speech-language and hearing therapy. PURPOSE: to study, through a theoretical review, the psychical risks to the child development, emphasizing the risks for language acquisition, and discuss the implications on the speech-language and hearing therapy performance for precocious age. CONCLUSION: through reviewed literature, we evidenced that children who live with biological and especially psychic risks, during their first years, are more inclined to develop problems that may come to affect their development. So, we consider the need for speech-language and hearing therapy to be linked to a constant observation of the psychical risk factors to the child development and language acquisition, being this professional able to take part in the precocious detection and stimulation under a promotional perspective.

Desempenho por tarefa em consciência fonológica: gênero, idade e gravidade do desvio fonológico

PURPOSE: to check the relationship between the performance in the different phonological awareness skills and degree of phonological disorder and analyze the interference of gender and age in the performance of the subjects in the analyzed tasks. METHODS: 32 children, with ages between 4:1 and 7:8 years, with phonological disorders, 12 female and 20 male, were evaluated. All subjects were assessed using the Child Phonological Evaluation proposed by Yavas et al. (1991). The severity of the disorder was determined by the Percentage of Correct Consonants, classifying the phonological disorder as severe, moderate-severe, mild-moderate and mild. After that, we applied the proof of phonological awareness, proposed by Capovilla and Capovilla (1998). RESULTS: it was observed that there are no significant differences in the performance of phonological awareness considering the gender variable. In terms of age, there were significant differences for the phonemic synthesis, syllabic segmentation and transposition tasks between the groups of higher and younger than six years. The synthesis, manipulation and transposition tasks did not differentiate the subjects nor about the degree of phonological disorder or syllabic and phonemic dominion. CONCLUSION: the oldest children showed better performance in the phonological awareness-related tasks. Segmentation tasks showed a tendency for difference among the degrees of phonological disorder to be investigated in future studies.

Diálogo de pais e bebês em situação de risco ao desenvolvimento

Purpose to investigate the enunciative relationships which are established between parents and children who have risk factors for infant developmental problems, especially the effects of the risks during the language acquisition process. Methods the sample consisted of study of three children who present risks for development, who were observed from 0 to 18 months through the Clinical Risk Indicators in Child Development, and through filmed samples with parents and children interaction. The data analysis considered the enunciative approach by Carmen Silva (2007, 2009) and the psychoanalytic approach. Results by analyzing the three cases, it was possible to evidence that all of them presented difficulties of mother-baby separation, what reflected in the language semantization process, when the number of interlocutors became higher. However, the subjects evidenced the possibility of language semiotic domain, observing the three enunciative mechanisms proposed by Silva (2007). Conclusions the study evidenced that the difficulties of mother-baby separation and the weak entrance of the paternal function have made the position of the children in the language more difficult, because the children are dependant of parents’ speech for their own productions.

Dialogia e função materna em casos de limitações práxicas verbais

The current study analyzed possible relation between the dialogic interaction of the duo mother-child with praxic limitations and the exercise of maternal function. It tries, specifically, to categorize the types of dialogic interactions found, to analyze the interference or not of praxic limitation of children on the interpretation process by the mother and the reflexes of maternal function over the mother-child dialog. Five mother-child diad took part on the study, with the interaction of these duos being filmed, on which the play, the relation mother-child, as well the exercise of maternal function were filmed. Precarious bonds on the relation mother-child, difficulty on the exercise of maternal function, directive, intrusive or apathetic and away mothers were observed. For subjects, children of mothers that could evolve on the exercise of maternal function, cases which the bond had a significant improvement, it was observed a greater language evolution. The dialogic analyzes demonstrated that verbal dyspraxia doesn’t prevent the interpretation process, it can only limit it. However, the exercise of maternal function seems to have a more important effect on the mother-child dialog.