Erissandra Gomes

Hipersensibilidade auditiva no transtorno do espectro autístico

BACKGROUND auditory hypersensitivity in the autistic spectrum disorder has been described in the literature since the very first reports. However, this symptom has not been sufficiently explored, especially regarding possible causes, diagnosis and consequences. AIM to study sensory-perceptual abnormalities in the autistic spectrum disorder, emphasizing auditory hypersensitivity and to discuss their effects in speech therapy based on the literature found until September 2007 in the following database: Scielo, Lilacs, Web of Science, and Medline. CONCLUSION sensory-perceptual abnormalities are present in approximately 90% of individuals with autism; no theory has been found to explain this fact. Although the cause of auditory hypersensitivity remains unknown, it is the most common sensory-perceptual abnormality--its prevalence ranges between 15% to 100%. A few rare studies exist on behavioral, electroacoustic and electrophysiological hearing evaluation of autistic children; these studies discuss auditory hypersensitivity. The early diagnosis of this alteration is considered relevant for the possible identification of atypical sensorial markers, especially in hearing and for the better understanding of their impact on the development of communication in autistic individuals.

Auditory hypersensitivity in children and teenagers with autistic spectrum disorder

OBJECTIVE To verify if the clinical behavior of auditory hypersensitivity, reported in interviews with parents/caregivers and therapists/teachers of 46 children and teenagers suffering from autistic spectrum disorder, correspond to audiological findings. METHOD The clinical diagnosis for auditory hypersensitivity was investigated by means of an interview. Subsequently, a test of the acoustic stapedial reflex was conducted, and responses to intense acoustic stimulus in open field were observed. RESULTS Of the 46 subjects, 11 (23.9%) were clinically diagnosed as oversensitive to sound and only 2 showed discomfort when exposed to intense acoustic stimulus in open field. There was no statistically significant difference for the test of the ipsilateral acoustic stapedial reflex between the groups. CONCLUSION Behavioral manifestations to sounds are not associated to hypersensitivity of the auditory pathways, but instead these are associated to difficulties in the upper processing, involving systems that usually are impaired in autistic spectrum patients, such as the limbic system.

Influência da consciência fonológica na escrita de pré-escolares

PURPOSE: to analyze the influence of the phonological awareness on preschool children writing. METHODS: a randomized comparison study in which 57 children were evaluated in two aspects, namely: the level of phonological awareness (through CONFIAS protocol of phonological awareness) and the level of writing (through word dictation). They were split, randomly, in two different groups: the intervention group (30 children) and the control group (27 children). The age group was from 5 years and 1 month to 6 years and 6 months old. In the intervention group a schedule of 10 play sessions was set up based on phonological awareness activities. Meanwhile, the other group did not have any special activities. Thereafter, all subjects were again assessed with the same tests. RESULTS: in the initial evaluation, 92.6% and 93.4% of the children in the control group and intervention group, respectively, were in the pre-syllabic writing level. Both groups had similar scores in the phonological awareness test, 26 points in the control group and 24 in the intervention group. Although, in the final evaluation 36.7% of the subjects on the intervention group achieved the syllabic level of writing and 10% reached the syllabic-alphabetical level of writing (P<0.0001); against, just 14.8% and 3.7%, respectively, on the control group (P=0.056). As long as the phonological awareness is concerned the children on the intervention group had an even more dramatic progress, they went from 24 points in the first evaluation to 37 points in the final (P<0.0001). Meanwhile, the subjects in the control group went from 26 to 28 points in the final evaluation. CONCLUSION: the phonological awareness practice interfered in the writing level development.

Condições iniciais no aleitamento materno de recém-nascidos prematuros

PURPOSE: To describe the breastfeeding initial conditions for premature infants. METHODS: The sample consisted on 26 mother/baby dyads. The babies had an average of 36.1 weeks corrected gestational age and were hospitalized in a Neonatal Intensive Care Unit in Southern Brazil. Data was collected from medical records, and the observation of the dyads was conducted during feeding, using the Observation and Evaluation of the Breastfeeding Protocol. Favorable and unfavorable behaviors were registered regarding position, responses, suction, affection and anatomy of the breast. After the observation, a questionnaire was applied to the mothers. RESULTS: The best results refer to the position of mother/child and affection and the poorer ones to the infant responses. Statistically significant correlations by the Spearman Correlations Coefficient were observed between some items of the protocol and other study variables. CONCLUSION: Most premature infants from this sample presented a satisfactory initiation on analyzed aspects referring to breastfeeding. Still, we emphasize the need of practices for breastfeeding effectiveness and its encouragement in this population.

Um caso de bilingüismo: a construção lexical, pragmática e semântica

PURPOSE: to report on speech therapy performance in a precocious bilingualism case. METHODS: report of a male patient case, bilingual since his childhood. Referred to a speech therapy attendance, with the age of two years and four months, with a familiar complaint about his non-verbally communication. Description through assessment data and speech language therapy for three months. RESULTS: the speech language therapy assessment, based on informal observation, found out some elementary intentional aspects of communication forms, characterizing a simple lateness of language, having the bilingualism as a cause. The therapy adapted and changed itself according to the patient evolutions. The patient gained development related with the use of Portuguese in pragmatic, semantics and lexical aspects, achieving the main purpose of interventions. CONCLUSION: the speech language therapy was efficient, contributing to afford a better quality of communication and speech to the patient, essentially with regards to the use of Portuguese language.

Sinais clínicos de disfagia em lactentes com bronquiolite viral aguda

Objective: To determine the occurrence of clinical signs of dysphagia in infants with acute viral bronchiolitis, to compare the respiratory parameters during deglutition, and to ensure the intra- and inter- examiners agreement, as well as to accomplish intra and interexaminators concordance of the clinical evaluation of the deglutition. Methods: This was a cross-sectional study of 42 infants aged 0-12 months. The clinical evaluation was accompanied by measurements of respiratory rate and pulse oximetry. A score of swallowing disorders was designed to establish associations with other studied variables and to ensure the intra- and interrater agreement of clinical feeding assessments. Caregivers also completed a questionnaire about feeding difficulties. Significance was set at p<0.05. Results: Changes in the oral phase (prolonged pauses) and pharyngeal phase (wheezing, coughing and gagging) of swallowing were found. A significant increase in respiratory rate between pre- and post-feeding times was found, and it was determined that almost half of the infants had tachypnea. An association was observed between the swallowing disorder scores and a decrease in oxygen saturation. Infants whose caregivers reported feeding difficulties during hospitalization stated a significantly greater number of changes in the swallowing evaluation. The intra-rater agreement was considered to be very good. Conclusions: Infants with acute viral bronchiolitis displayed swallowing disorders in addition to changes in respiratory rate and measures of oxygen saturation. It is suggested, therefore, that infants displaying these risk factors have a higher probability of dysphagia.Objective:To determine the occurrence of clinical signs of dysphagia in infants with acute viral bronchiolitis, to compare the respiratory parameters during deglutition, and to ensure the intra- and inter- examiners agreement, as well as to accomplish intra and interexaminators concordance of the clinical evaluation of the deglutition.Methods:This was a cross-sectional study of 42 infants aged 0-12 months. The clinical evaluation was accompanied by measurements of respiratory rate and pulse oximetry. A score of swallowing disorders was designed to establish associations with other studied variables and to ensure the intra- and interrater agreement of clinical feeding assessments. Caregivers also completed a questionnaire about feeding difficulties. Significance was set at p<0.05.Results:Changes in the oral phase (prolonged pauses) and pharyngeal phase (wheezing, coughing and gagging) of swallowing were found. A significant increase in respiratory rate between pre- and post-feeding times was found, and it was determined that almost half of the infants had tachypnea. An association was observed between the swallowing disorder scores and a decrease in oxygen saturation. Infants whose caregivers reported feeding difficulties during hospitalization stated a significantly greater number of changes in the swallowing evaluation. The intra-rater agreement was considered to be very good.Conclusions:Infants with acute viral bronchiolitis displayed swallowing disorders in addition to changes in respiratory rate and measures of oxygen saturation. It is suggested, therefore, that infants displaying these risk factors have a higher probability of dysphagia.

Analysis of sound pressure levels emitted by children's toys

OBJECTIVE To verify the levels of sound pressure emitted by non-certified childrens toys. METHODS Cross-sectional study of sound toys available at popular retail stores of the so-called informal sector. Electronic, mechanical, and musical toys were analyzed. The measurement of each product was carried out by an acoustic engineer in an acoustically isolated booth, by a decibel meter. To obtain the sound parameters of intensity and frequency, the toys were set to produce sounds at a distance of 10 and 50cm from the researchers ear. The intensity of sound pressure [dB(A)] and the frequency in hertz (Hz) were measured. RESULTS 48 toys were evaluated. The mean sound pressure 10cm from the ear was 102±10 dB(A), and at 50cm, 94±8 dB(A), with p<0.05. The level of sound pressure emitted by the majority of toys was above 85dB(A). The frequency ranged from 413 to 6,635Hz, with 56.3% of toys emitting frequency higher than 2,000Hz. CONCLUSIONS The majority of toys assessed in this research emitted a high level of sound pressure.OBJECTIVE:To verify the levels of sound pressure emitted by non-certified childrens toys. METHODS: Cross-sectional study of sound toys available at popular retail stores of the so-called informal sector. Electronic, mechanical, and musical toys were analyzed. The measurement of each product was carried out by an acoustic engineer in an acoustically isolated booth, by a decibel meter. To obtain the sound parameters of intensity and frequency, the toys were set to produce sounds at a distance of 10 and 50cm from the researchers ear. The intensity of sound pressure [dB(A)] and the frequency in hertz (Hz) were measured. RESULTS:48 toys were evaluated. The mean sound pressure 10cm from the ear was 102±10 dB(A), and at 50cm, 94±8 dB(A), with p<0.05. The level of sound pressure emitted by the majority of toys was above 85dB(A). The frequency ranged from 413 to 6,635Hz, with 56.3% of toys emitting frequency higher than 2,000Hz. CONCLUSIONS: The majority of toys assessed in this research emitted a high level of sound pressure.

Influência do ambiente hospitalar nos aspectos relacionados ao aleitamento materno

PURPOSE: To investigate the influence of hospital environment on aspects related to breastfeeding and communication on the mother/newborn interaction during the breastfeeding process. METHODS: This consisted on a cross-sectional study composed by 34 dyads: 18 in rooming and 16 in intermediate/medium care units of a public hospital. Each dyad was observed at the time of breastfeeding, and data were analyzed considering the aspects standardized by UNICEF for breastfeeding. Verbal and nonverbal communication modes were observed. RESULTS: Comparison of variables showed significant associations between hospital environment and the position of the mother in relation to the newborn and mother stimulation and vocalization to the neonate, with favorable percentage for the dyad that was in rooming. The other variables did not differ. CONCLUSION: Important conditions for the establishment of breastfeeding and communication between mother and newborn are influenced by the location of the dyad, especially the hospital environment.

Análise dos níveis de pressão sonora emitidos por brinquedos infantis

OBJECTIVE To verify the levels of sound pressure emitted by non-certified childrens toys. METHODS Cross-sectional study of sound toys available at popular retail stores of the so-called informal sector. Electronic, mechanical, and musical toys were analyzed. The measurement of each product was carried out by an acoustic engineer in an acoustically isolated booth, by a decibel meter. To obtain the sound parameters of intensity and frequency, the toys were set to produce sounds at a distance of 10 and 50cm from the researchers ear. The intensity of sound pressure [dB(A)] and the frequency in hertz (Hz) were measured. RESULTS 48 toys were evaluated. The mean sound pressure 10cm from the ear was 102±10 dB(A), and at 50cm, 94±8 dB(A), with p<0.05. The level of sound pressure emitted by the majority of toys was above 85dB(A). The frequency ranged from 413 to 6,635Hz, with 56.3% of toys emitting frequency higher than 2,000Hz. CONCLUSIONS The majority of toys assessed in this research emitted a high level of sound pressure.OBJECTIVE:To verify the levels of sound pressure emitted by non-certified childrens toys. METHODS: Cross-sectional study of sound toys available at popular retail stores of the so-called informal sector. Electronic, mechanical, and musical toys were analyzed. The measurement of each product was carried out by an acoustic engineer in an acoustically isolated booth, by a decibel meter. To obtain the sound parameters of intensity and frequency, the toys were set to produce sounds at a distance of 10 and 50cm from the researchers ear. The intensity of sound pressure [dB(A)] and the frequency in hertz (Hz) were measured. RESULTS:48 toys were evaluated. The mean sound pressure 10cm from the ear was 102±10 dB(A), and at 50cm, 94±8 dB(A), with p<0.05. The level of sound pressure emitted by the majority of toys was above 85dB(A). The frequency ranged from 413 to 6,635Hz, with 56.3% of toys emitting frequency higher than 2,000Hz. CONCLUSIONS: The majority of toys assessed in this research emitted a high level of sound pressure.

Síndrome de Beckwith-Wiedmann: relato de caso da intervenção fonoaudiológica

TEMA: descrever a evolucao de um caso de Sindrome de Beckwith-Wiedmann com macroglossia submetido a fonoterapia quanto aos aspectos estruturais e miofuncionais do sistema estomatognatico. PROCEDIMENTOS: inicialmente foram coletados os dados do prontuario e foi realizada a entrevista inicial com a mae. Apos, a paciente, com 1 ano e 2 meses de idade, foi submetida a avaliacao fonoaudiologica clinica e foram realizados exames complementares (avaliacao otorrinolaringologica, exame videofluoroscopico e avaliacao audiologica). Apos seis meses de terapia miofuncional com a utilizacao de tecnicas passivas, foi realizada uma reavaliacao. RESULTADOS: na avaliacao fonoaudiologica inicial observou-se flacidez de labios e bochechas; ausencia de vedamento labial; lingua com tensao diminuida, hemi-hipertrofia direita e acentuada projecao anterior; dificuldades na mastigacao e na degluticao de alimentos solidos. Decorridos seis meses de terapia miofuncional, constatou-se maior rigidez da musculatura de labios e bochechas, posteriorizacao da lingua com aumento da tensao muscular, e desempenho adequado na mastigacao e degluticao de alimentos solidos. CONCLUSAO: a intervencao fonoaudiologica precoce, baseada em tecnicas de terapia miofuncional, apresentou resultados considerados satisfatorios para este caso de Sindrome de Beckwith-Wiedmann com macroglossia.