Inaê Costa Rechia

Dialogia e função materna em casos de limitações práxicas verbais

The current study analyzed possible relation between the dialogic interaction of the duo mother-child with praxic limitations and the exercise of maternal function. It tries, specifically, to categorize the types of dialogic interactions found, to analyze the interference or not of praxic limitation of children on the interpretation process by the mother and the reflexes of maternal function over the mother-child dialog. Five mother-child diad took part on the study, with the interaction of these duos being filmed, on which the play, the relation mother-child, as well the exercise of maternal function were filmed. Precarious bonds on the relation mother-child, difficulty on the exercise of maternal function, directive, intrusive or apathetic and away mothers were observed. For subjects, children of mothers that could evolve on the exercise of maternal function, cases which the bond had a significant improvement, it was observed a greater language evolution. The dialogic analyzes demonstrated that verbal dyspraxia doesn’t prevent the interpretation process, it can only limit it. However, the exercise of maternal function seems to have a more important effect on the mother-child dialog.

Processos de substituição e variabilidade articulatória na fala de sujeitos com dispraxia verbal

The aim of the present study was to analyze the role of linguistic variables in the occurrence of substitution processes in the speech of subjects with verbal dyspraxia (VD). Therefore, it was carried out the phonological analysis of the speech of seven subjects with ages ranging from 2:6 (years:months) to 4:2 and diagnostic hypothesis of VD. The occurrences of usual and idiosyncratic substitution processes, assimilations and articulatory variability were statistically analyzed using the computational package VARBRUL. The variable word length was statistically significant for the occurrence of assimilations and unusual substitutions, indicating that trisyllabic and polysyllabic variants favored the highest occurrence of a process. Stress was statistically significant for the occurrence of articulatory variability and usual substitutions, showing that a process had higher probability of occurring in tonic and post-tonic syllables (syllables within the metrical foot of the accent), respectively. The class of sounds was significant for the use of usual substitutions by the subjects studied, occurring when the segments are liquid and fricative phonemes. Finally, the syllabic structure was statistically significant for idiosyncratic substitutions. The positions of final coda and simple medial onset were the most susceptible to the occurrence of a substitution process. The data of this study suggest that substitutions, in general, tend to occur in words with more than two syllables, in liquid and fricative targets, within the metrical foot of the accent (in post-tonic and tonic syllables), in simple medial onset and final coda positions.

Terapia fonoaudiológica em três casos do espectro autístico

O objetivo deste trabalho foi analisar as estrategias terapeuticas fonoaudiologicas em linguagem a partir da visao dialetica em sua eficacia e efetividade para que os sujeitos funcionem na linguagem; explicitar alguns dos movimentos terapeuticos necessarios para a manutencao do topico discursivo e de papeis dialogicos pelos sujeitos durante a conversacao. Foi realizada analise qualitativa da interacao dialogica, antes e apos tres meses de terapia de linguagem de base dialetica, por meio de filmagem e transcricao da interacao linguistica e nao-linguistica em 45 minutos de sessao, de tres sujeitos do espectro autistico entre seis e oito anos de idade. Os sujeitos ampliaram sua participacao dialogica em situacoes de interacao verbal, apresentando progressos no funcionamento da linguagem. Desta forma, e possivel afirmar a eficacia e efetividade da abordagem na terapeutica de linguagem em sujeitos do espectro autistico, pois permite perceber o avanco no funcionamento da linguagem. Os movimentos terapeuticos consistem em ancorar as enunciacoes dos sujeitos atribuindo sentido e mantendo o topico de discurso.

Intensive care unit: results of the Newborn Hearing Screening

INTRODUCTION Procedures for extending the life of newborns are closely related to potential causes of hearing loss, justifying the identification and understanding of risk factors for this deficiency. OBJECTIVE To characterize the population, analyze the frequency of risk factors for hearing loss, and assess the audiological status of infants attended in a Newborn Hearing Screening program (NHS). METHODS This was a retrospective study that analyzed medical records of 140 patients from a neonatal intensive care unit, identifying the frequency of risk factors for hearing loss and audiological status, utilizing transient otoacoustic emissions and brainstem auditory evoked potential (BAEP). RESULTS Prematurity was present in 78.87% of cases; 45% of the infants were underweight and 73% received ototoxic medication. Audiologically, 11.42% failed the NHS, and 5% of cases failed retest; of these, one had results compatible with hearing loss on BAEP. CONCLUSION A higher rate of low birth weight, and prematurity was observed in infants who underwent screening and had an audiological diagnosis by the third month of life. Only one newborn presented a change in audiological status. The authors emphasize the importance of auditory monitoring for all infants, considering this as a high-risk sample for hearing loss.

Potenciais evocados auditivos corticais em neonatos nascidos a termo e pré-termo

Purpose To measure the exogenous components of the cortical auditory evoked potential (CAEP) in term and preterm newborns and compare them considering the variables latency and amplitude. Methods This is a cross-sectional, prospective, comparative, contemporary study. One hundred twenty-seven newborns were evaluated; 96 of these were included in the study after analysis of the exams by three referees. Participants were divided into two groups: Term Group: 66 infants and Preterm Group: 30 neonates. The recordings of CAEP were performed using surface electrodes with newborns comfortably positioned in the lap of their mothers and/or guardians in natural sleep. To this end, binaural verbal stimuli were presented with /ba/ as the frequent stimulation and /ga/ the rare stimulus, at an intensity of 70 dB HL, through insert earphones. The presence or absence of exogenous components and the latency and amplitude of P1 and N1 were analyzed in both groups. Pertinent tests were used in the statistical analysis of data. Results The latency of the waves P1 and N1 was smaller in participants in the Term Group. However, there were no statistically significant differences in the amplitude of P1 and N1 between the groups. No difference between the groups was found when comparing the presence and absence of the components P2 and N2. Conclusion It is possible to measure the CAEP in term and preterm neonates. There was influence of the maturational process only on the measure of latency of the components P1, binaurally, and N1, in the left ear, which were smaller in participants in the Term Group.

Categorias enunciativas na descrição do funcionamento de linguagem de mães e bebês de um a quatro meses

OBJECTIVE To present categories which explain the language functioning between infants and their mothers from Benvenistes concept of semiotic system, and verify whether such categories can be described numerically. METHOD Four mother-infant dyads were monitored in three stages. The first study consisted of a qualitative analysis of the transcribed video recordings conducted in each stage. We intended to identify the enunciative principles associated with the relationship between the semiotic system of the infants body and their mothers language, namely, the principles of interpretancy and homology. The other study was conducted by means of a descriptive numerical analysis of the enunciative categories and the infant caregiver scale of behavior, using the ELAN software (EUDICO Linguistic Anotador). RESULTS Mutuality in mother-infant interactions was observed in most of the scenes analyzed. Productive enunciative categories demonstrated in the infants demand/mothers interpretation relation was identified in homology and interpretancy. It was also possible to use these categories to describe the mother-infant interactions numerically. In addition, other categories emerged because there are other subtypes of maternal productions not directly related to infant demand. This shows that infants are exposed to language of heterogeneous characteristics. CONCLUSION The concept of semiotic system allowed the proposition of language functioning categories identifiable in the mother-infant relationship. Such categories were described numerically.

Efeitos da prematuridade na aquisição da linguagem e na maturação auditiva: revisão sistemática

Purpose To verify which damages prematurity causes to hearing and language. Research strategies We used the decriptors language/linguagem, hearing/audicao, prematurity/prematuridade in databases LILACS, MEDLINE, Cochrane Library and Scielo. Selection criteria randomized controlled trials, non-randomized intervention studies and descriptive studies (cross-sectional, cohort, case-control projects). Data analysis The articles were assessed independently by two authors according to the selection criteria. Twenty-six studies were selected, of which seven were published in Brazil and 19 in international literature. Results Nineteen studies comparing full-term and preterm infants. Two of the studies made comparisons between premature infants small for gestational age and appropriate for gestational age. In four studies, the sample consisted of children with extreme prematurity, while other studies have been conducted in children with severe and moderate prematurity. To assess hearing, these studies used otoacoustic emissions, brainstem evoked potentials, tympanometry, auditory steady-state response and visual reinforcement audiometry. For language assessment, most of the articles used the Bayley Scale of Infant and Toddler Development. Most studies reviewed observed that prematurity is directly or indirectly related to the acquisition of auditory and language abilities early in life. Conclusion Thus, it could be seen that prematurity, as well as aspects related to it (gestational age, low weight at birth and complications at birth), affect maturation of the central auditory pathway and may cause negative effects on language acquisition.Purpose To verify which damages prematurity causes to hearing and language. Research strategies We used the decriptors language/linguagem, hearing/audição, prematurity/prematuridade in databases LILACS, MEDLINE, Cochrane Library and Scielo. Selection criteria randomized controlled trials, non-randomized intervention studies and descriptive studies (cross-sectional, cohort, case-control projects). Data analysis The articles were assessed independently by two authors according to the selection criteria. Twenty-six studies were selected, of which seven were published in Brazil and 19 in international literature. Results Nineteen studies comparing full-term and preterm infants. Two of the studies made comparisons between premature infants small for gestational age and appropriate for gestational age. In four studies, the sample consisted of children with extreme prematurity, while other studies have been conducted in children with severe and moderate prematurity. To assess hearing, these studies used otoacoustic emissions, brainstem evoked potentials, tympanometry, auditory steady-state response and visual reinforcement audiometry. For language assessment, most of the articles used the Bayley Scale of Infant and Toddler Development. Most studies reviewed observed that prematurity is directly or indirectly related to the acquisition of auditory and language abilities early in life. Conclusion Thus, it could be seen that prematurity, as well as aspects related to it (gestational age, low weight at birth and complications at birth), affect maturation of the central auditory pathway and may cause negative effects on language acquisition.

Potencial evocado auditivo cortical em neonatos a termo e pré-termo: gênero e indicadores de risco para deficiência auditiva

Purpose To investigate the exogenous potential in normal hearing neonates born at full term and preterm, correlating them to gender and to the presence of risk indicators for hearing impairment (IRDA). Methods 96 of 127 newborns were considered after judges’ analysis. Sixty six were born at term and 30 preterm in a public hospital. All neonates had result “pass” in neonatal hearing screening. The exam records were conducted with newborns, in natural sleep, through positioned electrodes: the active on the forehead (Fz), the ground (Fpz) on the forehead and the reference ones on the left (M1) and right (M2) mastoid. Verbal stimuli were presented binaurally. The frequent stimulus was /ba/ and /ga/ was the rare stimulus, in intensity of 70 dBHL, through insert earphones. The oddball paradigm was respected. The presence or absence of exogenous potential was analyzed. For data analysis, statistical tests were used. Results There was a statistically significant difference in the values of female gender components related to N1-P2 amplitude in the left ear. There was no significant difference between the IRDAs presence and components absence. Conclusion It was verified that the cortical auditory evoked potentials in neonates present higher amplitude values in the preterm group in females, and no statistically significant difference related to latency. However, regarding the presence of IRDAs and absence of components, it was not found significant connection.

Auditory maturation and psychological risk in the first year of life

PURPOSE To assess the potential association between psychological risk and limited auditory pathway maturation. METHODS In this longitudinal cohort study, 54 infants (31 non-risk and 23 at-risk) were assessed from age 1 to 12 months. All had normal hearing and underwent assessment of auditory maturation through cortical auditory evoked potentials testing. Psychological risk was assessed with the Child Development Risk Indicators (CDRIs) and PREAUT signs. A variety of statistical methods were used for analysis of results. RESULTS Analysis of P1 and N1 latencies showed that responses were similar in the both groups. Statistically significant differences between-groups were observed only for the variables N1 latency and amplitude at 1 month. Significant maturation occurred in both groups (p<0.05). There was moderate correlation between P1 latency and Phase II CDRIs, which demonstrates that children with longer latencies at age 12 months were more likely to exhibit absence of these indicators in Phase II and, therefore, were at greater psychological risk. The Phase II CDRIs also correlated moderately with P1 and N1 latencies at 6 months and N1 latencies at 1 month; again, children with longer latency were at increased risk. CONCLUSION Less auditory pathway maturation correlated with presence of psychological risk. Problems in the mother-infant relationship during the first 6 months of life are detrimental not only to cognitive development, but also to hearing. A fragile relationship may reflect decreased auditory and linguistic stimulation.

Dialogy and matern function in cases of verbal praxic limitation

The current study analyzed possible relation between the dialogic interaction of the duo mother-child with praxic limitations and the exercise of maternal function. It tries, specifically, to categorize the types of dialogic interactions found, to analyze the interference or not of praxic limitation of children on the interpretation process by the mother and the reflexes of maternal function over the mother-child dialog. Five mother-child diad took part on the study, with the interaction of these duos being filmed, on which the play, the relation mother-child, as well the exercise of maternal function were filmed. Precarious bonds on the relation mother-child, difficulty on the exercise of maternal function, directive, intrusive or apathetic and away mothers were observed. For subjects, children of mothers that could evolve on the exercise of maternal function, cases which the bond had a significant improvement, it was observed a greater language evolution. The dialogic analyzes demonstrated that verbal dyspraxia doesn’t prevent the interpretation process, it can only limit it. However, the exercise of maternal function seems to have a more important effect on the mother-child dialog.