Brasília Maria Chiari

Prevalência de desordens de fala em escolares e fatores associados

OBJECTIVE To assess prevalence of speech disorders in schoolchildren and its associated factors. METHODS Cross-sectional study comprising a random sample of 1,810 schoolchildren attending the first grade in public schools in a city of Southern Brazil, in 2001. Schoolchildren aged between five and 11 years were evaluated using a previously validated speech screening test for phonetic and/or phonologic disorders. Data on school failure, gender, age and maternal and paternal schooling were collected to test associations. Associations between variables were analyzed using the Chi-square test. RESULTS The prevalence of speech disorders in the children studied was 24.6% and they were more prevalent in younger children aged five and six compared to children aged ten or more. Speech disorders prevalence around five years old was 57% and between eight and ten years old was 42%. Speech disorders frequency was similar in both sexes. The prevalence of disorders was associated to maternal and paternal schooling, 79.5% and 78.6%, respectively, when parents had less then one year of study. CONCLUSIONS The prevalence of speech disorders among schoolchildren studied was higher than that described in the literature. Parental schooling was a major factor associated to these disorders.

Uma breve revisão histórica sobre a construção dos conceitos do Autismo Infantil e da síndrome de Asperger

The aim of this study was to review historically the concepts of Autism and Asperger syndrome. Through literature review, the authors evidence the changes on theoretical concepts and clinical descriptions of Autism and Asperger syndrome with time.

Humanização das práticas do profissional de saúde: contribuições para reflexão

This article intends to contribute with some reflections about contemporary clinical approach concerning humanized health assistance based on the review of literature indexed and published in Brazil at BVS and Scielo between 1987 and 2007, including some authors referred in these studies and published in the same period, when considered essential to consubstantiate the discussions presented. Matters are also discussed regarding humanized health care based on public policies and health related professional practices, as well as the possibilities for extending discussions related to the need of inclusion of theses principles in various stages of the health professional background, from undergraduate studies. In addition, some propositions are presented to contribute with the education of the healthcare professional, as well as subsidies for the reflection related to curricular proposals and opportunities offered by university professors, who may strongly influence the professional education and, further, with the health assistance and health services practices.Este artigo se propoe a contribuir com subsidios para a reflexao da atuacao clinica contemporânea sob a otica da humanizacao da atencao a saude a partir de revisao da literatura indexada e publicada no Brasil nas bases de dados da biblioteca virtual em saude (BVS) e Scielo entre 1987 e 2007, bem como autores citados nestes estudos e publicados no mesmo periodo, quando considerado essencial para consubstanciar as discussoes apresentadas. Tambem sao discutidas questoes ligadas a humanizacao da saude a partir da concepcao da humanizacao como politica de saude e como pratica profissional, assim como possibilidades de ampliacao da discussao da necessidade de incorporar tais premissas nas diversas etapas da formacao dos alunos de graduacao no que concerne ao tema. Alem disso, sao apresentadas proposicoes para contribuir a formacao do profissional ligado ao setor saude desde a graduacao, bem como subsidios para a reflexao sobre as propostas curriculares e oportunidades oferecidas pelos professores universitarios, os quais podem influir fortemente na formacao profissional e, posteriormente, com o funcionamento e com as praticas vigentes nos servicos de saude.

Linguagem expressiva de crianças nascidas pré-termo e termo aos dois anos de idade

BACKGROUND expressive language of pre-term children. AIM to compare the expressive vocabulary of two year-old children born prematurely, to that of those born at term. METHODS the study sample was composed by 118 speech-language assessment protocols, divided in two groups: the pre-term group (PTG) composed by 58 underweight premature children followed by a multi-professional team at the Casa do Prematuro (House of Premature Children) at Unifesp, and the full-term group (FTG) composed by 60 full-term born children. In order to evaluate the expressive language of these children, the Lave - Lista de Avaliação do Vocabulário Expressivo (Assessment List of the Expressive Vocabulary) was used. The Lave is an adaptation of the LDS - Language Development Survey - for the Brazilian Portuguese Language. The Lave investigates the expressive language and detects delays in oral language. RESULTS children born underweight and prematurely present a greater occurrence of expressive language delay, 27.6%. These pre-term children present significantly lower expressive vocabulary and phrasal extension than children of the same age born at full-term in all semantic categories. Family income proved to be positively associated to phrasal extension, as well as to gestational age and weight at birth; thus indicating the effect of these adverse conditions still during the third year of age. The audiological status was associated to word utterances in the PTG. CONCLUSION children born prematurely and underweight are at risk in terms of vocabulary development; this determines the need for speech-therapy intervention programs.BACKGROUND: expressive language of pre-term children. AIM: to compare the expressive vocabulary of two year-old children born prematurely, to that of those born at term. METHODS: the study sample was composed by 118 speech-language assessment protocols, divided in two groups: the pre-term group (PTG) composed by 58 underweight premature children followed by a multi-professional team at the Casa do Prematuro (House of Premature Children) at Unifesp, and the full-term group (FTG) composed by 60 full-term born children. In order to evaluate the expressive language of these children, the Lave - Lista de Avaliacao do Vocabulario Expressivo (Assessment List of the Expressive Vocabulary) was used. The Lave is an adaptation of the LDS - Language Development Survey - for the Brazilian Portuguese Language. The Lave investigates the expressive language and detects delays in oral language. RESULTS: children born underweight and prematurely present a greater occurrence of expressive language delay, 27.6%. These pre-term children present significantly lower expressive vocabulary and phrasal extension than children of the same age born at full-term in all semantic categories. Family income proved to be positively associated to phrasal extension, as well as to gestational age and weight at birth; thus indicating the effect of these adverse conditions still during the third year of age. The audiological status was associated to word utterances in the PTG. CONCLUSION: children born prematurely and underweight are at risk in terms of vocabulary development; this determines the need for speech-therapy intervention programs.

Correlação entre voz, autoavaliação vocal e qualidade de vida em voz de professoras

PURPOSE: to evaluate vocal quality and voice-related quality of life in 1st to 5th grade female teachers, to check vocal self-assessment, and to correlate those findings. METHOD: an observational cross-sectional study on the correlation with seventy-three 1st to 5th grade teachers in state public elementary schools in the city of Maceio/AL. An objective questionnaire was used in order to characterize the said sample. An auditory perceptual analysis of the voices was conducted and the voice-related quality of life questionnaire (V-RQOL) was administered. The sample was described by using descriptive statistics. The Spearmans rank correlation coefficient was used to assess the correlation among auditory perceptual analysis, self-assessment, and voice-related quality of life scores. RESULTS: teachers suffered from moderate vocal deviation in sustained phonation and mild to moderate deviation in connected speech. Most teachers deemed their voices to be good (37%) and acceptable (43.8%). As to vocal complaints, hoarseness was the most cited (91.8%). Total scores for V-RQOL showed moderate impact of the voice on quality of life, and only the vocal self-assessment issue had any correlation to V-RQOL scores. V-RQOL domains showed significant correlations amongst themselves. CONCLUSION: the population in the study suffered from vocal deviation and its impact on quality of life, although most of them were pleased with their voices. Nothing, but the vocal assessment topic had any correlation with the V-RQOL scores, implying that the worse is the vocal self-assessment, the worse is the voice-related quality of life scores.

Testes de rastreamento x testes de diagnóstico: atualidades no contexto da atuação fonoaudiológica

BACKGROUND Evaluation instruments, properties, selection indicators, application and validation of screening and diagnostic tests. AIM To present some concepts concerning screening and diagnostic tests and their application according to a specific purpose. To present a few practical examples of the application of these instruments related to human communication, as well as to present validation criteria of tests in the population and criteria used for the rational selection of screening or diagnostic instruments in health programs and health services based on epidemiological concepts indexed in Scielo, Lilacs or Medline up to January 2007. CONCLUSION Diagnostic instruments differ from screening instruments in their objectives and eligibility criteria. Sensibility and specificity are two important indicators to be considered when choosing an instrument for screening or diagnosis. Reproducibility, time required to complete the evaluation and previous preparation of patients, if needed, are also indicators to be considered when choosing an instrument. Publication and information exchange regarding the properties of evaluation instruments, used for diagnosis or screening, related to the Speech, Language and Hearing Sciences must be systematically stimulated. Besides that, improving the knowledge about methodologies and evaluation instruments under different perspectives contribute to the better use of human and financial resources. Furthermore, the elaboration of studies that promote the correct validation of screening and diagnostic instruments used in human communication disorders contributes to the increase in knowledge in the field of Speech, Language and Hearing Sciences and, indirectly, to the acknowledgement of this science, based on technical-scientific evidence, in health promotion.

Níveis de compreensão de leitura em escolares

BACKGROUND: important reading performance measurements are related to how and to what extent a child understands a written text. AIM: to study the performance of primary school (Ensino Fundamental) students in reading comprehension tasks according to the variables grade and type of school. METHOD: 160 students from the 3rd to the 6th grades were screened and later evaluated based on the retelling and question answering about a given text. RESULTS: students of the 5th and 6th grades of private schools presented a better performance on issues related to implicit information when compared to students of public schools. The overall analysis of the educational level revealed, through the retelling task, a better performance of the 6th grade students in terms of the number of present macro propositions and a low performance of the 5th grade students in terms of the achieved comprehension level, in both types of school. When answering text-derived questions, the 4th, 5th and 6th grade students performed better than the 3rd grade students regarding explicit questions. When considering implicit questions, the 4th grade students performed better than all the other grades, in both types of school. These results gave evidence to the influence of the different texts used in each grade. CONCLUSION: the 5th and 6th grades from private schools were the only grades that performed better when compared to public schools in general, regarding answering implicit knowledge questions. All students achieved some level of reading comprehension.

Speech-language pathology clinical evaluation, integrality and humanization: general perspectives and some thoughts

Clinical evaluation is an important instrument for the speech-language pathologist (SLP) successful approach. The aims of this article are: to present some issues concerning the SLPs assessment and approach; contribute to the discussions about SLPs clinical practice; provide some input to the considerations about the individual approach that is possible to each SLP, for better interpersonal contact with the patients and their families in accordance with their peculiarities and demands. With SLP assessment it is possible to achieve a functional communication diagnosis and design an intervention plan. Several studies published in other health related sciences show evidence on the need to review the way the relations between health professionals, patients and their families have been established. Clinical assessment has enormous importance in the SLP approach and constitutes one of the first contacts of the patient and their family with the SLP. Therefore, it is important that these questions are considered in this initial stage of the SLP clinical performance. So, it is crucial that the evaluation management and its correlates receive more attention by SLP undergraduate students, professors and tutors. Also, evaluations of the speech-language and audiology treatment progress must be considered at all times.

Verificação do desempenho de crianças deficientes auditivas oralizadas em teste de vocabulário

TEMA: vocabulario expressivo de criancas deficientes auditivas oralizadas. OBJETIVO: verificar o desempenho de um grupo de criancas com perda de audicao em um teste de vocabulario expressivo. METODO: o Teste de Linguagem Infantil ABFW - Vocabulario foi aplicado em 21 criancas portadoras de deficiencia auditiva de grau moderadamente severo a profundo divididas em tres grupos, conforme suas idades: 3 anos a 4 anos e 11 meses, 5 anos a 6 anos e 11 meses e 7 anos a 8 anos e 11 meses. Estas criancas utilizavam predominantemente o codigo linguistico oral para se comunicar. RESULTADOS: os individuos pertencentes aos diferentes grupos etarios forneceram mais respostas corretas e processos de substituicao ao nomearem as figuras solicitadas do que nao designaram. Em geral, as criancas com idades entre 7 anos a 8 anos e 11 meses demonstraram melhor desempenho do que aquelas com idades entre 3 anos a 4 anos e 11 meses e 5 anos a 6 anos e 11 meses, cujos comportamentos foram semelhantes. CONCLUSAO: as criancas demonstraram melhores desempenhos nos campos conceituais animais, meios de transporte e formas e cores; as criancas mais velhas mostraram maior conhecimento dos vocabulos na maioria dos campos conceituais. Ao verificar o desempenho destas criancas no Teste de Linguagem Infantil ABFW - Vocabulario, foi possivel concluir que tal verificacao permitiu a identificacao dos campos conceituais em que as criancas possuem maior ou menor dominio, assim como o reconhecimento dos recursos que os sujeitos deficientes auditivos utilizam na tentativa de nomear. Estas informacoes permitem que o fonoaudiologo enfatize os campos conceituais menos conhecidos pelas criancas e abordem os tracos e atributos dos objetos ja conhecidos por elas, antes de apresenta-lo.

Impacto vocal de professores

RESUMO Objetivo: analisar o impacto vocal nas atividades diarias em professores do ensino medio. Correlacionar os achado da auto-percepcao do problema vocal com os aspectos: efeitos no traba-lho, na comunicacao diaria, na comunicacao social e na sua emocao. Metodo: a amostra foi cons-tituida por 107 professores, sendo 86 com queixa e 21 sem queixa, selecionados em escolas da rede particular de ensino de Maceio-AL. Cada professor respondeu individualmente o protocolo Perfil Participacao em Atividades Vocais na presenca da pesquisadora, assinalando suas respostas em uma escala visual que varia de 0 a 10. O protocolo e composto por 28 questoes com a presenca inte-grada em cinco aspectos englobados para avaliar a qualidade de vida e o resultado de tratamentos vocais. O protocolo oferece, ainda, dois escores adicionais: pontuacao de limitacao nas atividades (PLA) e de restricao de participacao (PRP). Resultados: na comparacao dos grupos com e sem queixa vocal foram verificados que todos os resultados foram estatisticamente significantes (p<0,001) e, em todos os aspectos os maiores escores foram do grupo com queixa vocal. A PLA foi de 33,27, em um total de 100 pontos e a PRP foi de 20,46, em um total de 100 pontos e a pontuacao da media dos aspectos foi de 79,50, em um total de 280 pontos. Conclusao: a media dos aspectos analisados foi de 79,50 pontos verificando-se que os professores se sentem limitados no exercicio da sua profis-sao, porem nao restritos a exerce-la. Quanto a correlacao dos aspectos todos foram estatisticamente significantes, demonstrando fidedignidade. Os escores adicionais PLA e PRP apresentaram valores que reforcam a limitacao em exercer a docencia.DESCRITORES: Voz; Qualidade de Vida; Docentes; Atividades Cotidianas