Helena Bolli Mota

A terapia em consciência fonológica no processo de alfabetização

BACKGROUND Phonological awareness and literacy. AIM to verify the influence of phonological awareness therapy in the literacy process. METHOD 46 children were submitted to an assessment involving the reading and writing of words and non-words and of phonological awareness. The experimental group was submitted to therapy. RESULTS Therapy had a positive influence in the performance of the children in the experimental group (76.47%) regarding tasks of phonological awareness and regarding their performance in reading and writing; only literate children were able to perform tasks involving phonemic awareness. CONCLUSION Phonological awareness therapy facilitates the acquisition of the alphabetic code.

Memória de trabalho, consciência fonológica e hipótese de escrita

BACKGROUND Working memory, phonological awareness and spelling hypothesis. AIM To verify the relationship between working memory, phonological awareness and spelling hypothesis in pre-school children and first graders. METHOD Participants of this study were 90 students, belonging to state schools, who presented typical linguistic development. Forty students were preschoolers, with the average age of six and 50 students were first graders, with the average age of seven. Participants were submitted to an evaluation of the working memory abilities based on the Working Memory Model (Baddeley, 2000), involving phonological loop. Phonological loop was evaluated using the Auditory Sequential Test, subtest 5 of Illinois Test of Psycholinguistic Abilities (ITPA), Brazilian version (Bogossian & Santos, 1977), and the Meaningless Words Memory Test (Kessler, 1997). Phonological awareness abilities were investigated using the Phonological Awareness: Instrument of Sequential Assessment (CONFIAS - Moojen et al., 2003), involving syllabic and phonemic awareness tasks. Writing was characterized according to Ferreiro & Teberosky (1999). RESULTS Preschoolers presented the ability of repeating sequences of 4.80 digits and 4.30 syllables. Regarding phonological awareness, the performance in the syllabic level was of 19.68 and in the phonemic level was of 8.58. Most of the preschoolers demonstrated to have a pre-syllabic writing hypothesis. First graders repeated, in average, sequences of 5.06 digits and 4.56 syllables. These children presented a phonological awareness of 31.12 in the syllabic level and of 16.18 in the phonemic level, and demonstrated to have an alphabetic writing hypothesis. CONCLUSION The performance of working memory, phonological awareness and spelling level are inter-related, as well as being related to chronological age, development and scholarity.

Análise comparativa da eficiência de três diferentes modelos de terapia fonológica

BACKGROUND phonological therapy in children with phonological disorders. AIM to verify changes in the phonological system of children with phonological disorders, based on the comparison of number of acquired phonemes, number of sounds in the phonetic inventory and altered distinctive features, before and after therapy, and to verify differences between therapy models: Modified Cycles, Maximal Oppositions and ABAB--Withdrawal and Multiple Probes. METHOD the research group was composed of 21 subjects, 15 male and 6 female, with phonological disorders, who had already completed speech-language treatment. The initial and final phonological assessments were compared taking into consideration the number of phonemes in the phonological systems, the number of sounds in the phonetic inventory and the altered distinctive features. Phonological changes that resulted from the application of the three therapeutic models were also compared. RESULTS statistically significant differences were observed between the initial and final assessments in all of the three therapeutic models considering the number of acquired phonemes and the altered distinctive features, whereas in the phonetic inventory a statistically significant difference was observed only between the ABAB--Withdrawal and Multiple Probes and the Maximal Oppositions model. No statistical difference was observed between the therapy models. CONCLUSION the three therapy models were effective in the treatment of children with phonological disorders, once all of the children presented improvement of their phonological system, phonetic inventory and altered distinctive features. No significant statistical difference was found between the models

Habilidades de memória de trabalho e o grau de severidade do desvio fonológico

BACKGROUND Working memory. AIM To verify the performance of working memory abilities and their relation with the severity of phonological disorders. METHOD 45 children, with ages between 5.0 and 7.11 years, with evolutional phonological disorders (EFD), 17 female and 18 male, were evaluated. All subjects were assessed using the Child Phonological Evaluation proposed by Yavas et al. (1991). The severity of the disorder was determined by the Percentage of Correct Consonants (PCC) proposed by Shriberg and Kwiatkowski (1982), classifying the phonological disorder as severe, moderate-severe, average-moderate and average. After that, subtest 5 of the Psycholinguistic Abilities Test (ITPA--Bogossian & Santos, 1977) and the non-word repetition test (Kessler, 1997) were applied. RESULTS After analyzing the data according the statistical tests of Kruskal Wallis and Duncan, it was verified that the performance of moderate-severe and severe individuals in the non-word repetition test was inferior to that of average-moderate and average individuals. However, performance results in the digit repetition test did not present a positive correlation with severity. CONCLUSION The performance of phonological memory has a relation with the severity of phonological disorders. This allows us to accept the idea that the phonologic memory is related to speech production. Regarding the central executor, the results indicate that the performance in digit repetition, used to assess the central executor, did not present a correlation with the severity of the disorder. This can be justified by the fact that the central executor is more directly related to vocabulary acquisition and is responsible for processing and storing information.

Estudo sobre os ambientes favoráveis à produção da líquida não-lateral /r/ no tratamento do desvio fonológico

Os ambientes favoraveis sao contextos facilitadores para a aquisicao do segmento tratado. Eles podem ser analisados sob os seguintes aspectos: tonicidade, contexto antecedente e vogal seguinte. O objetivo deste relato de caso foi analisar a influencia das variaveis linguisticas (ambiente favoravel) no tratamento de um sujeito com desvio fonologico evolutivo. Participou do estudo um sujeito com desvio fonologico, com idade de 6:8 no inicio do tratamento, do sexo masculino, tratado pelo Modelo ABAB-Retirada e Provas Multiplas. Foram analisados os dados de fala pre e pos-tratamento e as Provas Alvo Basicas do primeiro ciclo de tratamento. Nas palavras-alvo selecionadas para terapia, foram analisadas as aquisicoes quanto ao alvo de tratamento, a liquida nao-lateral /r/, e os ambientes favoraveis a aquisicao no que se refere a tonicidade e aos contextos (antecedente e seguinte). Observou-se que o /r/, nas palavras-alvo selecionadas, nao era encontrado em ambientes mais favoraveis; em geral, encontrava-se em ambiente neutro ou menos favorecedor. No entanto, verificou-se generalizacao no que se refere a aquisicao da liquida nao-lateral /r/ em Onset Medial, e a producao do fonema nas palavras-alvo selecionadas foi efetiva, destacando-se as producoes das palavras [ba´rata], [ko´ruZa] e [mo´ragu], que apresentaram maior numero de ocorrencias.

Os caminhos da fonoaudiologia no Sistema Único de Saúde - SUS

BACKGROUND: the ways of the speech-language therapy in the Unique System of Health - SUS. PURPOSE: to accomplish a brief report about the health questions evolution in Brazil and speech-language therapy service evolution in the Public System, in addition to carry through a quick analysis on the concern of research in this area. CONCLUSION: speech-language therapy service has been presenting significant advances in the Unique System of Health. Since its insertion in SUS, between the decades of 70 and 80, many conceptions and practices have been reevaluated. However, it is necessary to have acquaintance on this step so that we can make it to advance each time more. We believe that this service deserves important attention from the actions of public health and that scientific evidences are necessary in order to prove the significance of this work.

Vocabulário expressivo de crianças com diferentes níveis de gravidade de desvio fonológico

PURPOSE: to relate task performance of expressive vocabulary with the deviation severity, the age range and the reference values of the vocabulary testing used. METHODS: the sample was made up of 17 subjects with phonological deviation, with ages ranging between 3 years 5 months and 8 years 2 months. They were divided into four groups, based on the PCC analysis and classification regarding the severity grade according to Shriberg and Kwiatkowski (1982). This result allows for classifying the deviation into: severe, moderately-severe, medium-moderated and medium. The Test for Young Children ABFW - Vocabulary was applied. An analysis took place for correlation among age, severity grade for the phonological deviation and reference results of the vocabulary testing. RESULTS: children with minor phonological deviation severity obtained better results than the others, despite the majority of these results not being significant. Younger children showed lower performance than expected. CONCLUSIONS: it is possible to think that the severity of phonological deviation may influence the performance of children in this sample in the expressive vocabulary test.

Generalização baseada nas relações implicacionais obtida pelo modelo "ABAB-Retirada e Provas Múltiplas"

ABStRACt Purpose: To analyze the generalization based on the implicational relationships obtained by the “ABAB Withdrawal and Multiple Probes Model” in children with different severity degrees of phonological deviation. Methods: Speech data analysis of eight subjects with phonological deviations. Evaluations of receptive and expressive language, oral sensory-motor oral system, psychomotricity, hea-ring discrimination and phonology were carried out, in addition to audiological, otorhinolaryngological and neurological evaluations. Next, the severity degree of the phonological deviation was determined, and the treatment was initiated, using the “ABAB Withdrawal and Multiple Probes Model”. Results: Generalizations based on implicational relationships were observed. Conclusions: The “ABAB Withdrawal and Multiple Probes Model” was effective in the treatment of subjects with phonological deviation. The generalization based on implicational relationships coincided, partly, with the Implicational Model of Features Complexity.

Habilidades em consciência fonológica de sujeitos após realização de terapia fonológica

BACKGROUND phonological awareness abilities of children with a history of speech-language disorders. AIM to compare the phonological awareness abilities of individuals who recovered from phonological disorders after having gone through speech-language treatment with that of individuals with typical phonological development. METHOD participants of this study were eighteen individuals, nine in the experimental group and nine in the control group. Both groups had their phonological awareness abilities evaluated through the Metalinguistic Sequential Evaluation Instrument Confias. RESULTS significant statistical differences were observed between the groups in terms of the following performances: rhyme identification, rhyme production, syllable exclusion, on all of the activities involving syllables and on the activities involving phoneme exclusion, phoneme segmentation, and phoneme transposition, on all of the activities involving phonemes and also on all of the activities involving phonological awareness. The control group presented a better performance in all of the activities. CONCLUSIONS even after speech therapy the experimental group presented a worse performance in terms of the phonological awareness abilities.

Análise da eficácia terapêutica em três modelos fonológicos de abordagem contrastiva

BACKGROUND Phonological therapy in subjects with phonological disorders. AIM To compare the efficacy of three contrastive approach models in three different severities of phonological disorder. METHOD Participants of the study were nine subjects with phonological disorders, with ages ranging between 4:2 and 6:6 years. All subjects were evaluated prior to and after phonological therapy. Three groups, with three subjects each, were determined for treatment. Each group presented one individual with severe, one with moderate-severe and one with mild-moderate phonological disorder. Each group was treated using a different therapy model--Minimal Opposition, Maximal Oppositions/Empty Set and Multiple Opposition. Results were analyzed according to the Friedman Test, considering p < 0.05; a descriptive analysis was also performed among the models. RESULTS There was no statistical difference among the models considering the severity of phonological disorder. The Minimal and Maximal Oppositions/Empty Set approaches favored a greater number of sound acquisitions in the phonetic inventory of subjects with severe and moderate-severe disorder. On the other hand, the Multiple Oppositions approach favored a better performance of sound acquisition in the phonological system and a decrease in the impaired distinctive features in severe and moderate-severe disorder. CONCLUSION The models of therapy were effective in the treatment of different severities of phonological disorders observing the best performance in children with severe and moderate-severe disorder.