Haydée Fiszbein Wertzner

Características fonológicas de crianças com transtorno fonológico com e sem histórico de otite média

PURPOSE: To verify the number of types, the total occurrence and the mean of phonological processes in phonologically disordered children with and without otitis background. METHODS: The subjects were 44 children diagnosed with phonological disorder, half of them with otitis background and half without any history of otitis, from the Laboratory of Phonology of the Speech and Language Pathology Course of the Medical School USP-SP. The imitation and picture naming tests (Wertzner, 2000) were carried out in order to analyze the phonological processes. RESULTS: In the otitis group, the most occurring phonological process in the imitation test was the fricative devoicing and in the picture naming, the liquid simplification. In the group of children with no otitis background, the cluster reduction and the fricative devoicing were the most used processes in the picture naming and in the imitation tests, respectively. Only the cluster reduction in the picture naming test had differences between both groups. There was no statistical difference regarding the mean of phonological processes types. CONCLUSION: Although some children with phonological disorder might present otitis media, the analysis did not allow the identification of a linguistic marker that can differentiate children with and without otitis background.

Phonological performance measured by speech severity indices compared with correlated factors

CONTEXT AND OBJECTIVE Some factors seem to influence speech impairment among phonologically disordered children. The aim was to compare severity indices with some correlated factors. DESIGN AND SETTING Observational, analytical and cross-sectional study conducted within the Language-Speech-Hearing Sciences Course, Universidade de São Paulo. METHOD Fifty phonologically disordered children with ages ranging from 4 to 11 years took part. The indices were calculated from phonology tests and were correlated with anamnesis and audiological data. Students t test and Spearmans correlation were used to compare percentages of consonants correct (PCC) and process density index (PDI) for children with and without otitis, upper respiratory histories and audiological abnormalities, with regard to whether or not they were comprehended during assessment, their ages when they started to speak and their ages at the assessment. RESULTS The higher the age at the assessment was, the higher the PCC (imitation: 0.468; naming: 0.431; Spearmans correlation) and the lower the PDI (imitation: 0.459; naming: 0.431); the later the child started to speak, the lower the PCC (imitation p = 0.064; naming p = 0.050) and the higher the PDI (imitation p = 0.067; naming p = 0.042). There were differences between groups with and without upper respiratory history (PCC: imitation p = 0.016, naming p = 0.005; PDI: imitation p = 0.014, naming p = 0.008). There was no difference between the groups regarding otitis, comprehension during the assessment and audiological data. CONCLUSIONS Children with upper respiratory histories who began to speak later presented more severe speech impairment indices.

Análise acústica das consoantes líquidas do Português Brasileiro em crianças com e sem transtorno fonológico

ABSTRACT Purpose: To describe and compare the F1, F2 and F3 formants of the liquids /l, , / produced by children with and withoutphonological impairment. Methods: Fifty nine children were separated into three groups: Control Group (CG), with absence ofdisorders in speech and language development; Experimental Group 1 (EG1), with presence of the process of liquids simplificationand/or cluster simplification; and Experimental Group 2 (EG2), with liquid simplification and any other processes. Children wererequested to repeat the syllables la, li, lu; a, i, u and a, i, u and the words /se’bola/, /’lama/, /’miu/, /aka’E/, /i’afa/,/pa’asu/. Data were stored and analyzed in the Computerized Speech Laboratory. Statistical analyses were provided. Results: Regarding the formants, the CG showed great differences between the three studied sounds. Between-groups analysis showed thatF3 presented the greatest modifications. Distorted sounds did not present significant differences between EG1 and EG2 and thesubstituted ones showed differences in F3 only for the consonant //.

Provas de nomeação e imitação como instrumentos de diagnóstico do transtorno fonológico

BACKGROUND: phonological disorder. AIM: to verify the association between the phonological performance in picture naming and imitation tasks, assessing the occurrence of phonological processes and using the severity indexes of Percentage of Correct Consonants and Phonological Density Index. METHOD: participants of this research were 50 phonologically disordered children, with no history of prior speech-language therapy and with ages between 4:0 and 12 years. RESULTS: The analysis of the phonological processes indicated that the non-productive processes were more frequent than the productive ones, not only in the imitation task but also in the picture naming task. It was observed that in both tasks, most participants presented the phonological processes of cluster reduction, liquid simplification and final consonant deletion, independently of their productivity. When comparing both tasks, there was an association and agreement regarding the number of participants who presented phonological processes as well as a correlation regarding the total number of phonological processes; there was no evidence of differences concerning the averages of the phonological processes observed in the imitation and picture naming tasks; a negative correlation was observed between the severity indexes Percentage of Correct Consonants and Phonological Density Index; moreover, these values presented a strong correlation in both tests, indicating that they detect similar severity levels. CONCLUSION: the study verified an association and agreement between the picture naming and imitation tasks, not only for the number of participants who presented phonological processes, but also for the number of phonological processes, thus indicating the importance of using structured tests for the diagnosis of phonological disorder. Furthermore, for the severity indexes, Percentage of Correct Consonants and Phonological Density Index, a high correlation was observed between the tasks, indicating that both tasks are useful instruments in detecting phonological disorder.

Gravidade do distúrbio fonológico: julgamento perceptivo e porcentagem de consoantes corretas

TEMA: disturbio Fonologico. OBJETIVO: aplicar o indice de gravidade de Porcentagem de Consoantes Corretas (PCC) e verificar a correlacao entre este indice e o aplicado perceptivamente pelos juizes. METODO: calculou-se o indice de gravidade PCC de 50 sujeitos diagnosticados com disturbio fonologico, apos 60 juizes ouviram as provas de fonologia de cada sujeito e julgaram perceptivamente a gravidade. RESULTADO: o indice PCC aplicado aos sujeitos obteve uma variacao entre 40% e 98%, com uma classificacao predominante da populacao nos graus leve e levemente moderado. CONCLUSAO: existe correlacao entre o julgamento perceptivo dos juizes e os valores do indice PCC.

O aspecto familial e o transtorno fonológico

BACKGROUND Phonological disorder. AIM To verify the phonological processes used by phonologically disordered children with and without family history of speech and language disorders; the association between the phonological processes; the difference between the Percentage of Correct Consonants-Revised (PCC-R) severity index regarding family history. METHOD Participants were 104 subjects--25 phonologically disordered children--with no history of previous speech-language therapy, living with their biological parents and siblings. The material used was a child development questionnaire and the phonology tests of the Teste de Linguagem Infantil-ABFW. RESULTS Liquid simplification was the most observed process independently of family history; the phonological process of devoicing was mostly observed when the family members presented phonological disorders; the phonological process observed in children are, in general, different from those presented by the family nucleus, and those that are similar do not determine characteristics of family history since they are processes frequently observed in subjects with phonological disorders; the PCC-R severity index did not differentiate types of phonological disorders regarding family history. CONCLUSION This research shows characteristics that indicate that family history of speech and language disorder is associated to phonological disorders. The knowledge about the childs family history facilitates the planning and execution of early intervention actions, preventing the aggravation of phonological disorders. The PCC-R severity index does not differentiate types of phonological disorders regarding family history.

Analysis of fundamental frequency, jitter, shimmer and vocal intensity in children with phonological disorders

UNLABELLED Phonological Disorder is a disturbance of primary manifestation of undefined causes that makes speech become unintelligible. The analysis of vocal parameters becomes important in the process of diagnosis of this disorder, since voice disorders could interfere in the production of speech sounds. AIM The objective of this study was to verify vocal characteristics related to the intensity and fundamental frequency--F0--and their disturbance indexes--jitter and shimmer--in children with phonological disorders. STUDY DESIGN Clinical prospective with transversal cohort. MATERIAL AND METHOD There were 40 children, 20 of them with phonological disorders and 20 with no speech and language disturbances. Phonological exams with the ABFW infantile language test and spontaneous speech were applied. The Computer Speech Lab was used to record and perform acoustic analyses of the vowels /a/, /e/, /i/, through the vocal parameters: fundamental frequency, intensity, jitter and shimmer. RESULTS F0--vowel /e/ was smaller, on average, in the Phonological Disorder Group and it was 126 Hz in the Control Group. To shimmer and jitter there was no evidence that the means of the Phonological Disorder Group were different from the ones of the Control Group (p= 0.191, p= 0.865, respectively). As for intensity, there was evidence that the average did not differ in the Phonological Disorder Group and the Control Group (p= 0.002). CONCLUSION The frequency of the vowel /e/ was smaller in the Phonological Disorder Group. There was difference between the two groups regarding the means of intensity of vowels /a/, /e/ and /i/, smaller in the Phonological Disorder Group. No differences between the groups were found regarding the averages of jitter and shimmer.

Análise acústica e índice de estimulabilidade sons líquidos do português brasileiro

PURPOSE: to describe the acoustic characteristics obtained from the acoustic analysis (AA) and the stimulability index (SI) of the liquids [[l/]; [[r/]; [[lh/]. METHODS: we analyzed the speech production elicited by imitation from two twin adolescents aged 11:6 years-old, showing the phonological process of liquid simplification. Their productions were acoustically analyzed before the stimulability test application. RESULTS: the two subjects correctly produced the sound [[l/]. Subject 1 was not stimulable to the sound [[r/] and his production was substituted by [[l/] independently of the subsequent vowel. Subject 2 was stimulable to the sound [[l/] and produced it correctly only in one of the imitations task when combined with the vowel /a/. The AA showed that the sound [[l/] was produced in different ways when production was either correct or substituted by [[r/]. Both subjects were stimulable to [[lh/]. AA showed statistical differences when the [[lh/] was followed by the vowels /a/ and /u/. The vowel /i/ was the only sound that did not facilitate the production of [[lh/] for the subject 2. CONCLUSION: the combined use of both procedures was effective in identifying motor and acoustical speech problems and helped to find out some parameters that tend to facilitate the acquisition of a sound.

Análise da freqüência fundamental, jitter, shimmer e intensidade vocal em crianças com transtorno fonológico

Phonological Disorder is a disturbance of primary manifestation of undefined causes that makes speech become unintelligible. The analysis of vocal parameters becomes important in the process of diagnosis of this disorder, since voice disorders could interfere in the production of speech sounds. AIM: The objective of this study was to verify vocal characteristics related to the intensity and fundamental frequency -F0- and their disturbance indexes - jitter and shimmer - in children with phonological disorders. STUDY DESIGN: clinical prospective with transversal cohort. MATERIAL AND METHOD: There were 40 children, 20 of them with phonological disorders and 20 with no speech and language disturbances. Phonological exams with the ABFW infantile language test and spontaneous speech were applied. The Computer Speech Lab was used to record and perform acoustic analyses of the vowels /a/, /e/, /i/, through the vocal parameters: fundamental frequency, intensity, jitter and shimmer. RESULTS: F0 - vowel /e/ was smaller, on average, in the Phonological Disorder Group and it was 126 Hz in the Control Group. To shimmer and jitter there was no evidence that the means of the Phonological Disorder Group were different from the ones of the Control Group (p= 0.191, p=0.865, respectively). As for intensity, there was evidence that the average did not differ in the Phonological Disorder Group and the Control Group (p= 0.002). CONCLUSION: The frequency of the vowel /e/ was smaller in the Phonological Disorder Group. There was difference between the two groups regarding the means of intensity of vowels /a/, /e/ and /i/, smaller in the Phonological Disorder Group. No differences between the groups were found regarding the averages of jitter and shimmer.

Speech Inconsistency Index in Brazilian Portuguese-Speaking Children

Objective: Speech inconsistency is characterised by variable productions of the same lexical items within the same context. This study aimed to describe inconsistencies among Brazilian Portuguese (BP)-speaking children with and without phonological disorder (PD) as well as the effectiveness of a speech inconsistency test (SIT). Methods: The study sample included children between 5 years 0 months (5;0 years) and 10;10 years of age, both genders, 51 children with PD and 50 without speech-language disorders. The SIT includes 25 pictures, each named 3 times in different sequences within the same session. Results: The inconsistency average of children with PD (27.4%) was higher than that of typically developing children (9.8%). Linear regression showed age and gender effects, receiver operating characteristic curves were built for speech inconsistency with combined gender and age cutoff values. Inconsistent subjects among typically developing children included 2 younger boys and 2 older girls. Inconsistencies were found among children with PD, including 10 boys up to 7;6 years and 11 over this age, and 7 girls up to 7;6 years and 6 over this age. Conclusion: Speech inconsistency in BP-speaking children seems to be an effective measure for differentiating children with PD from those with typically developing phonology.