Fernanda Dreux Miranda Fernandes

Características do sistema estomatognático de crianças respiradoras orais: enfoque antroposcópico

BACKGROUND the use of anthroposcopy in the assessment of posture and morphology of the stomatognathic system of mouth breathing children. AIM to describe the postural and morphologic characteristics of the stomatognathic system of mouth breathing children, according to age. METHOD participants were 100 children, of both genders, with ages ranging from 7 to 11 years and 11 months, leukoderms, in mixed dentition and with the diagnosis of mouth breathing. The investigated postural and morphologic characteristics of the stomatognathic system were labial and lingual resting position, possibility of labial occlusion, hyperfunction of the mentalis muscle during labial occlusion, bite and morphology of the lower lip, cheeks and hard palate, using the anthroposcopy methodology. RESULTS the results referring to the characterization of the studied population, according to the most frequent otorhinolaryngologic diagnosis, was of enlarged pharyngeal and palatine tonsils. A statistically significant difference was found between the percentages of each otorhinolaryngologic diagnosis, according to age. The results of the characteristics of the stomatognathic system indicated that the most common aspects in the studied sample were: half-open lips when in the resting position, tongue lowered on the mouths floor in the resting position, possibility of labial occlusion, hyperfunction of the mentalis muscle during labial occlusion, alterations of bite, labioverted, symmetry of the cheeks and alteration of the hard palate. All of the studied characteristics presented the same frequency with the increase in age, with no statistically significant difference. CONCLUSION mouth breathing children presented pathologic adaptations in the postural and morphological characteristics of the stomatognathic system. This suggests the importance of early diagnosis in order to avoid orofacial alterations.

Amostra de filmagem e análise da pragmática na síndrome de Down

BACKGROND: assessing language development is a complex task that requires practical and theoretical knowledge about the investigated issues. It is also important to take into account data gathering and analysis methodology, in order to achieve consistent and reliable results that mirror the subjects reality. AIM: considering the purpose of obtaining the maximum data in minimum time, without jeopardizing their quality and effectiveness, our aim is to identify the better samples size and moment of videotaped interaction to study the pragmatic abilities of children with Down syndrome. METHOD: the communicative profile of 25 children with Down syndrome aged between 2 and 7 years were determined as proposed by Fernandes (2004). Data obtained through samples of 15 and 30 minutes were analyzed and compared. The situation analyzed provided interaction between the child and a speech-and language-therapist in play situations. To determine the statistical significance of data the tests Friedman, Wilcoxon and confidence interval were applied with a significance level of 0.05 (5%). CONCLUSION: there were no significant differences related to the obtained samples with different videotaped duration for pragmatic analysis of the communication of children with Down syndrome.

Relação entre os aspectos sócio cognitivos e perfil funcional da comunicação em um grupo de adolescentes do espectro autístico

BACKGROUND Issues concerning language development and their relation with social cognitive aspects give direction to the clinical practice when assisting the population with the diagnosis within the autistic spectrum. The deficits or differences in this development can result in different ways of analyzing and counseling this population. Adolescence becomes a question mark in this analysis since, in most cases, researches address only early childhood. The speech pathologist must assess the relationship between language abilities and communicative competence. Language abilities refer to the possibilities to understand and formulate spoken or written symbolic systems, whereas the communicative competence refers to the ability to use language as an effective tool to interact with other people in several social contexts. PURPOSE To verify the development of the functional communicative profile and of the social cognitive aspects of adolescents, who attend a specialized institution and who have a psychiatric diagnosis within the autistic spectrum in three different situations of communication during a 12 months period and to study the relation between these variables in the same situations, during the same period of time. METHOD Subjects of this study were five adolescents with ages between 12 and 17 years. Two recording sets, with a 12 month interval, were obtained for each subject. Each recording set was composed by three 30 minutes videotaped situations of different interactive contexts: Situation I--individual language therapy; Situation II--child in a group with coordinator; Situation III--child in a group without coordinator. RESULTS Differences exist between the subjects in the three studied situations regarding the social cognitive performance and the functional communicative profile. CONCLUSION There is a relationship between the development of the social cognitive aspects and the functional communicative profile in the three situations of communication for the studied period.

Fonoaudiologia e autismo: resultado de três diferentes modelos de terapia de linguagem

BACKGROUND language and communication disorders are essential features of the autistic spectrum disorders, and are part of the diagnostic criteria. AIM to verify the existence of observable differences in the functional communicative profile and in the social cognitive performance of autistic children and adolescents receiving language therapy in three different situations. Assessment focused on the period of modified intervention and on the following period. METHOD subjects were children and adolescents with psychiatric diagnosis within the autistic spectrum. Participants were divided in three groups according to the intervention received during a period of six months. RESULTS determined observable differences, but not statistically significant. The group that presented the most progress was the one in which the subjects received therapy in pairs. The fact that none of groups presented a decrease in their progress indicators, as well as the fact that in a few situations the number of subjects who presented progress increased after this period was not expected. CONCLUSION the results of the present study reinforce that the procedures used to determine the individual abilities and inabilities were useful in planning the intervention procedures.BACKGROUND: language and communication disorders are essential features of the autistic spectrum disorders, and are part of the diagnostic criteria. AIM: to verify the existence of observable differences in the functional communicative profile and in the social cognitive performance of autistic children and adolescents receiving language therapy in three different situations. Assessment focused on the period of modified intervention and on the following period. METHOD: subjects were children and adolescents with psychiatric diagnosis within the autistic spectrum. Participants were divided in three groups according to the intervention received during a period of six months. RESULTS: determined observable differences, but not statistically significant. The group that presented the most progress was the one in which the subjects received therapy in pairs. The fact that none of groups presented a decrease in their progress indicators, as well as the fact that in a few situations the number of subjects who presented progress increased after this period was not expected. CONCLUSION: the results of the present study reinforce that the procedures used to determine the individual abilities and inabilities were useful in planning the intervention procedures.

Qualidade de vida dos cuidadores de crianças com transtorno do espectro autístico

OBJETIVO: Avaliar a qualidade de vida dos cuidadores de criancas incluidas no espectro autistico e determinar se ha algum tipo de relacao entre os diferentes dominios e aspectos demograficos como escolaridade e classe social. METODOS: Foram sujeitos 150 cuidadores de criancas pertencentes ao espectro autistico, com idades entre 24 e 65 anos, os quais responderam as questoes feitas por meio do instrumento de avaliacao da qualidade de vida WHOQOL-bref, elaborado pelo Programa de Saude Mental da Organizacao Mundial de Saude, composto de 26 questoes, divididas em quatro dominios (Fisico, Psicologico, Relacoes Sociais, e Meio Ambiente). RESULTADOS: Os dados revelaram diferencas significantes entre todos os dominios. O unico dominio do questionario de qualidade de vida que mostrou correlacao estatisticamente significante com todas as variaveis demograficas foi o dominio Meio Ambiente. CONCLUSAO: Fatores como acesso a lazer, saude e transporte tem papel importante na qualidade de vida percebida por pais de criancas do espectro autistico.

Análise das funções comunicativas expressas por terapeutas e pacientes do espectro autístico

ABSTRACT BACKGROUND: communicative functions used by language therapists and patients. AIM: to analyze the communicative functions used by language therapists and patients of the autistic spectrum. METHOD: the communicative functions expressed by six therapists in interaction with six patients each were analyzed, constituting 36 profiles of communicative functions expressed by the dyad therapist-patient. All therapists were part of a Training Program in Childhood Psychiatric Disorders and the patients were diagnosed within the autistic spectrum. Data were gathered using the transcriptions of a videotaped therapy session and these were analyzed according to the criteria suggested by Fernandes (2000). The communicative functions were divided in two different ways: interpersonal and non-interpersonal, and instrumental, regulatory, interactive, personal, heuristic and imaginative. RESULTS: the comparison between the functions used by the language therapists and the patients indicated a statistically significant difference in use of the following functions: request of social routine, request of information, request of action, comment, recognition of other, exclamation, non-focused, exploratory, exhibition, play and reactive. There was also a statistically significant difference between the use of interpersonal, non-interpersonal, regulatory, interactive, personal and heuristic communicative functions. CONCLUSION: the functional communicative profile of language therapists is different from the one presented by their patients when comparing each communicative function and when the communicative functions are grouped (interpersonal and non-interpersonal, and instrumental, regulatory, interactive, personal, heuristic and imaginative). Therapists use communicative functions to fill in the communicative space and to make requests. This finding agrees with the findings of previous studies.

Famílias com crianças autistas na literatura internacional

This article reviewed the 39 papers published in the last five years in three journals (Journal of Autism and Developmental Disorders, Focus on Autism and Other Developmental Disorders and Autism) about families with autistic children. It points out to five main issues that were studied: stress and emotional disorders, support groups and quality of life, characteristics of the families, familys perspectives about the autistic child, and intervention results.

Children with autism spectrum disorders

Rev Soc Bras Fonoaudiol. 2009;14(1):148-9 (1) Livre-Docente; Professora do Curso de Fonoaudiologia do Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Faculdade de Medicina da Universidade de São Paulo – USP – São Paulo (SP), Brasil. Endereço para correspondência: Fernanda Dreux Miranda Fernandes. R. Cipotânea, 51, Cidade Universitária, São Paulo – SP, CEP 05360-160. E-mail: fernandadreux@usp.br Children with autism spectrum disorders

Medidas antropométricas orofaciais de crianças paulistanas e norte-americanas: estudo comparativo

BACKGROUND Anthropometric orofacial measurements of children from Sao Paulo and from North America. AIM To describe the anthropometric orofacial measurements of children from Sao Paulo and to compare the obtained means to the North American norms. METHOD Participants were 254 children, leukoderm, in mixed dentition period, with ages ranging from 7 to 11 years and 11 months, with no history of speech, language and hearing disorders or treatment. The investigated anthropometric orofacial measurements were the height of the upper lip, the height of lower lip, the length of the philtrum and the height of lower face. In order to obtain these measurements, an electronic digital sliding caliper Starrett Series 727 was used. RESULTS The obtained data for the height of the upper lip, the height of the lower lip and the height of the lower face are below the means described for North American children. When considering the length of the philtrum, similar results were found between the research sample and North American children. CONCLUSION The results of the measurements of the present sample referring to the height of the upper lip, the height of the lower lip and height of the lower face are below the values reported for North American children. The North American norms are not valid for the children of our population, except for the length of the philtrum.

Avaliação da comunicação no espectro autístico: interferência da familiaridade no desempenho de linguagem

OBJETIVO: Analisar a interferencia da familiaridade da situacao de avaliacao na funcionalidade da comunicacao de sujeitos com diagnostico incluido no Espectro Autistico, buscando o melhor procedimento para avaliacao da comunicacao desta populacao. METODOS: Participaram da presente pesquisa 18 sujeitos com diagnostico incluido nos Disturbios do Espectro Autistico, com idades entre tres anos e 11 meses e 17 anos e 11 meses, com media etaria de oito anos e nove meses (DP: 3,6 anos). Inicialmente foi realizada a filmagem da interacao de cada participante com sua terapeuta em situacao rotineira de avaliacao (Situacao Familiar), semelhante as sessoes semanais de atendimento, e nas sessoes seguintes foi realizada outra filmagem de cada sujeito em interacao com uma fonoaudiologa nao-familiar, com materiais ludicos pre-determinados (Situacao Nao-Familiar). Os dados de interacao foram transcritos e analisados e as variaveis foram selecionadas a partir do protocolo do Perfil Funcional da Comunicacao (PFC). RESULTADOS: A comparacao entre as situacoes demonstrou diferenca apenas para quatro variaveis (23%), dentre as dezessete analisadas; tres dessas mostraram resultado superior na Situacao Familiar: atos comunicativos expressados por minuto, numero de respostas e porcentagem de utilizacao da funcao comunicativa Nao-Focalizada, e uma delas se mostrou superior na Situacao Nao-Familiar: porcentagem de utilizacao da funcao comunicativa Jogo. CONCLUSAO: A interferencia da familiaridade da situacao comunicativa no desempenho comunicativo de sujeitos autistas e minima, sendo que o procedimento de avaliacao nos mesmos moldes da Situacao Familiar mostrou-se ligeiramente melhor para a avaliacao da comunicacao dessa populacao.