Denise Brandão de Oliveira e Britto

The faculty of language

Rev Soc Bras Fonoaudiol. 2007;12(4):343-5 (1) Pós-graduanda em Lingüística e Língua Portuguesa pela Pontifícia Universidade Católica de Minas Gerais – PUC-Minas – Belo Horizonte (MG), Brasil; Professora da Pontifícia Universidade Católica de Minas Gerais – PUCMinas – Belo Horizonte (MG), Brasil. Endereço para correspondência: Denise Brandão de Oliveira e Britto. R. Desembargador Jorge Fontana, 250/1201, bloco 1, Belvedere, Belo Horizonte – MG, CEP 30320-670. E-mail: denisebrandao@pucminas.br The faculty of language

Relato de caso: descrição da evolução da comunicação alternativa na pragmática do adulto portador de autismo

TEMA: alguns pacientes portadores de autismo necessitam do apoio de metodos alternativos de comunicacao para se interagir e comunicar de forma eficaz. A comunicacao alternativa e/ou suplementar (CAS) promove possibilidades comunicativas atraves da utilizacao integrada de simbolos, recursos, estrategias e tecnicas. PROCEDIMENTOS: os objetivos deste estudo foram descrever os efeitos da utilizacao simultânea de dois metodos alternativos de comunicacao, para a ampliacao das habilidades pragmaticas de um adulto portador de autismo. A pesquisa e um estudo de caso do tipo longitudinal, de um individuo de 20 anos, diagnosticado com autismo. Os recursos comunicativos utilizados pelo sujeito foram avaliados, por meio da prova de pragmatica do teste de linguagem infantil ABFW, antes e depois da utilizacao, ao longo de nove meses, dos metodos de comunicacao alternativa: PECS - Adaptado e Fala Sinalizada. Os dados coletados antes e apos o uso dos recursos da comunicacao alternativa foram comparados quali-quantitativamente. RESULTADOS: os dados coletados mostraram que houve aumento do numero de atos comunicativos e funcoes comunicativas, e que o percentual do espaco comunicativo ocupado pelo sujeito aumentou apos os procedimentos realizados com o uso dos programas de comunicacao alternativa. CONCLUSAO: concluiu-se que houve progresso no perfil pragmatico da comunicacao com o uso concomitante dos dois metodos de comunicacao alternativa, uma vez que as interacoes sociais do sujeito aumentaram.

A prevalência do uso de sonda nasogástrica em bebês portadores de fissura de lábio e/ou palato

PURPOSE: To investigate the prevalence of the use of nasogastric tube in babies with cleft lip and/or palate, and to correlate its use with type of cleft, maternity hospital (private or public) and city of origin, and age at the first visit to a cleft center. METHODS: The sample consisted of data collected from 137 babies of both genders with cleft lip and/or palate, without any other associated anomalies, born full-term, who attended their first consultation at a specialized cleft center with ages between zero and 12 months (median=33 days). Statistical analyses used the coefficient of contingency test (p<0,05). RESULTS: From the subjects, 61% were male and 39% were female; 51% presented cleft lip and palate, 35% cleft palate, and 14% cleft lip. Regarding place of birth, 36% were born in private and 64% in public maternity hospitals; 60% were born in the city of Belo Horizonte (Minas Gerais, Brazil), 15% in other cities of the metropolitan area, and 25% in other cities at the state of Minas Gerais (Brazil). The use of nasogastric tube was reported in 23% of the cases. There was no association between the type of cleft or maternity and the use of the tube, but the later was more frequent within the metropolitan area (p=0,007). CONCLUSION: The prevalence of the use of nasogastric tube in babies with cleft lip and/or palate was considered high since they were born full-term and without any other associated anomalies that would indicate the need of the tube. The use of nasogastric tube was more frequent in babies born at the metropolitan area of Belo Horizonte, when compared to other cities in the state of Minas Gerais (Brazil).

Caracterização do padrão de fechamento velofaríngeo em pacientes com fissura palatina

Purpose: To characterize the velopharyngeal closure pattern in patients submitted to cleft palate surgery and its relation with gender, age, cleft type, and diagnosis of velopharyngeal function. Methods: Retrospective study based on 89 nasopharyngoscopy studies of operated cleft palate patients with ages between 4 and 47 years (mean=17.32±10.50). Data were analyzed regarding gender, age range (4 to 8, 9 to 12, 13 to 18 and >18 years), cleft type (postforamen or transforamen), diagnosis of velopharyngeal function (adequate, borderline, and inadequate), and velopharyngeal closure patterns (coronal, circular, circular with Passavant’s ridge, and sagittal). Results were statistically analyzed. Results: In the study sample, 59.55% of the patients were women; 39.33% were above 18 years of age; 44.94% had post-foramen cleft and 55.06%, transforamen cleft; 14.61% showed adequate, 53.93% borderline, and 31.46% inadequate velopharyngeal closure. With regards to the velopharyngeal closure pattern, 37.08% of the subjects presented coronal closure; 33.71%, circular closure, 15.73% circular with Passavant’s ridge; and 13.48%, sagittal closure pattern. There was a relation between pattern of closure and diagnosis of velopharyngeal function (p=0.05). Conclusion: Most of the sample presented coronal pattern of velopharyngeal closure, followed by circular, circular with Passavant’s ridge and sagittal patterns. There was no relationship between closure pattern and the variables gender, age, and cleft type, but there was a related influence to the diagnosis of velopharyngeal function.

Análise de parâmetros perceptivo-auditivos e acústicos em indivíduos gagos

PURPOSE: To analyze auditory-perceptual and acoustic parameters of the voices of adult stutterers. METHODS: Fifteen male stutterers in the age range from 21 to 41 years (mean 26.6 years), attended at the institutions Speech-Language Pathology Clinical Center in the period from February 2005 to July 2007, were analyzed. The auditory-perceptual parameters analyzed were vocal quality, type of voice, resonance, vocal tension, speech rate, pneumo-phonic coordination, vocal attack and pitch range; the acoustic parameters analyzed were fundamental frequency and its variability during spontaneous speech. RESULTS: The auditory-perceptual analysis showed that the most frequent characteristics among the subjects were normal vocal quality (60%), altered resonance (66%), vocal tension (86%), altered vocal attack (73%), normal speech rate (54%), altered pitch range (80%) and altered pneumo-phonic coordination (100%). However, only the presence of vocal tension and the altered pneumo-phonic coordination and pitch range were statistically significant in the stutterers studied. In the acoustic analysis, fundamental frequency varied from 125,54 to 149,59 Hz, and the variability of the fundamental frequency ranged from 16 to 21 halftones, or from 112,50 to 172,40 Hz. CONCLUSION: The auditory-perceptual parameters that were significantly frequent among stutterers were: presence of vocal tension, altered pneumo-phonic coordination, and altered pitch range. Therefore, it is important to evaluate the vocal aspects of these patients, for the fluency disorders might undermine some vocals parameters, causing dysphonia.

Variações semânticas nos enunciados de crianças em processo de desenvolvimento da linguagem oral: estudo preliminar

PURPOSE: to analyze the semantics of the statement of changes were in the process of development of language. METHODS: the study included 10 children in the process of development of language, between three and four years, without complaint and / or hearing and cognitive impairments. Data collection was performed through the observation and recording, audio and video, playful interaction situations RESULTS: in the statements of children aged 3 years, it was observed that there was a higher occurrence of super-extension only in relation to sub-extension (p=0,039) and that there was a trend to higher incidence when compared with the proximity phonologic (p=0,053), deitic (p=0,053) and relation of contiguity (p=0,083). In the statements of children aged 4 years, there was a higher occurrence of periphrasis in relation to sub extension (p=0,012) and proximity phonologic (p=0,012). There was no difference between the semantic changes studied between the ages of 3 and 4 years. CONCLUSION: the variations were most frequent semantic super-extension and periphrasis.

Aleitamento materno exclusivo em bebês com fissura de lábio e/ou palato

Purpose: To investigate exclusive breastfeeding in infants with cleft lip and/or palate and its association with the type of cleft. Methods: Data recorded by the pediatrician during the first consultation were obtained from 137 clinical charts. The sample consisted of the pediatric records of infants of both genders, with cleft lip and/or palate, born full term and without any other associated anomalies, who arrived for the first consultation between zero and 12 months of age. Data were statistically analyzed. Results: There was predominance of complete cleft lip and palate in male infants. Subjects’ mean age was 53 days, with median of 33 days on the date of first consultation. Exclusive breastfeeding occurred in 7.3% of the total sample – 6.57% in cleft lip group, 0.73% in the cleft palate, and none in the complete cleft lip and palate group. There was significant association between type of cleft and breastfeeding. Conclusion: Exclusive breastfeeding is present in only a small part of the total sample of infants with cleft lip and/or palate, and is frequent in infants with incomplete cleft lip.

Cleft palate: regional prevalence in the State of Minas Gerais in a specialized reference center

Objective: to identify the origin and some clinical, epidemiological parameters of patients seeking a cleft lip and palate specialized center in Belo Horizonte and who reside within the State of Minas Gerais. Material and methods: the sample was composed of 308 patients residing in Minas Gerais who arrived at the center without prior surgical treatment. The information was obtained from a secondary database containing the medical records of these patients. Data were analyzed according to the meso-region of the Minas Gerais State and the patients’ city of origin (Campo das Vertentes, Central Mineira, Jequitinhonha, Noroeste de Minas, Norte de Minas, Oeste de Minas, Sul/Sudoeste de Minas, Triângulo Mineiro/Alto Paranaiba, Vale do Mucuri, Vale do Rio Doce, and Zona da Mata). The following variables were analyzed: gender, age at the time of treatment, and type of cleft. Results: no statistical predominance was observed in any gender. We observed a statistically significant occurrence for “up to one year” (69%) in relation to the age when treatment was sought. Cleft lip was the most frequent type of cleft (36%). Among the 308 patients from meso-regions in Minas Gerais, the majority was concentrated in the Central region while the Triângulo Mineiro/Alto Paranaiba region comprised the smallest number of patients. Conclusion: the origin of the largest number of patients seeking a cleft lip and palate specialized center care in Belo Horizonte is in the Central region of Minas Gerais.

Trabalho, educação continuada e renda do profissional fonoaudiólogo atuante em audiologia

Purpose: to investigate the formation pattern and performance of the audiologist in Audiology in the 6th Region, besides analyzing job satisfaction, and to verify the relationship between the degree of professional development and the degree of satisfaction with the speech therapist monthly income – salary. Methods: cross-sectional study with audiologists enrolled in the 6th Region Regional Speech Council, through the application of a questionnaire to analyze the variables: education, professional activity areas, salary and satisfaction with the profession, in the period of May to October 2012. Results: 857 audiologists were investigated. Of these, 63.8% work in Audiology, 53.7% graduated in Minas Gerais, 51.4% have specialization and 5.5% are masters, which was associated statistically with higher wage income (p <0.05) . With regard to the source of income, 84.1% reported having in Speech Therapy your only source of income and most receive from 2 to 5 minimum wages. Most work with occupational audiology. The ENT is the professional who most directs patients. From those investigated, 54.1% are not satisfied with their profession. There was a significant relationship between job satisfaction and income. Conclusion: there was little integration of the speech therapist in the areas of expertise, central auditory processing test, vestibular rehabilitation, hearing conservation program and labyrinthine tests. The importance of continuing studies is emphasized to assist in employability on the labor market and improve professional skills. It is evident the need to integrate academic and professional training.