Lenisa Brandão

Semiotic Inspection of a Game for Children with Down Syndrome

There are not many initiatives in the area of gamedevelopment for children with special needs, specially childrenwith Down syndrome. The major purpose of our research isto promote cognitive development of disabled children in thecontext of inclusive education. In order to do so, we addressaspects of interaction, communication and game design instimulating selected cognitive abilities. By using a Human-Computer Interaction method based on the Inspection ofEvaluation, it was possible to study and understand userinteraction with the interface and thus examine the positiveaspects as well as the communicability problems found withthe JECRIPE game - a game developed specially for childrenwith Down syndrome in pre-scholar age.

JECRIPE: stimulating cognitive abilities of children with Down Syndrome in pre-scholar age using a game approach

Digital games are usually developed to provide fun for people of all ages. Although games have been mostly used for entertainment purposes, they have great potential as an intervention tool in health care. Digital games can be applied in health care helping users to learn or to experience something in a fun way. However, there are important issues to be considered to achieve this goal, specially in the development of applications for people with special needs. In this work, we are concerned specifically with Down syndrome needs, and we present an unhackneyed game for children with Down syndrome between 3 to 7 years old. Children in pre-scholar age need to be stimulated considering different cognitive areas. The stimulation of such cognitive areas can provide good results in the development over the years. Given the current demand and absence of games that fulfill Down syndrome special needs, we developed JECRIPE. JECRIPE is a digital game that stimulates the specific cognitive abilities: imitation, perception, fine motor skills, hand-eye coordination and receptive and expressive verbal language. This paper describes how these cognitive areas are used to stimulate children with Down syndrome in pre-scholar age and some technical issues in the development of the game.

Doença de Alzheimer e a aplicação de diferentes tarefas discursivas

People with Alzheimer’s disease (AD) have discourse deficits which demand evaluation and intervention. For this reason, it is important to understand the different demands of different discourse tasks. This article reviews the main studies on the discourse of people with Alzheimer’s disease, describing the performance of such population in discourse tasks which are classified according to their input style. Studies which used neutral input, naturalistic conversations, directive and facilitative input, and tasks which used visual stimuli to elicit narrative and descriptive discourse were described. Differences between discourse tasks focusing on preserved and affected discourse abilities in people with Alzheimer’s disease were discussed. Finally, research on discourse tasks for those with Alzheimer’s disease and their application in the evaluation and intervention of communication in AD is considered.

Doença de alzheimer: cognição e discurso narrativo com apoio em figuras

Purpose to investigate discourse in Alzheimer’s disease (AD) using a picture narrative task; to examine possible difficulties in the expression of knowledge and the relationship between discourse and cognition. Methods the design of the study was transversal, using quantitative comparison of groups. The clinical sample consisted of eighteen subjects with AD, eight of them with moderate cognitive decline (GDS 4) and ten with moderate-severe cognitive decline (GDS 5); the control group consisted of sixteen subjects without neurological or psychiatric disorders. All were matched for gender, native language, age and education and subjects underwent cognitive assessments. The discourse task consisted of a picture narrative of the tale “Little Red Riding Hood.” Results participants with AD had lower overall coherence scores and more difficulties in the expression of knowledge than subjects without AD. Discourse deficits correlated with performance on cognitive measures. The GDS 4 and GDS 5 groups differed in local coherence scores. Conclusion discourse of subjects with AD was characterized by failure in coherence and informativeness, which related strongly with their cognitive deficits.

Discourse intervention strategies in Alzheimer's disease: Eye-tracking and the effect of visual cues in conversation

Objective The goal of this study was to investigate whether on-topic visual cues can serve as aids for the maintenance of discourse coherence and informativeness in autobiographical narratives of persons with Alzheimers disease (AD). Methods The experiment consisted of three randomized conversation conditions: one without prompts, showing a blank computer screen; an on-topic condition, showing a picture and a sentence about the conversation; and an off-topic condition, showing a picture and a sentence which were unrelated to the conversation. Speech was recorded while visual attention was examined using eye tracking to measure how long participants looked at cues and the face of the listener. Results Results suggest that interventions using visual cues in the form of images and written information are useful to improve discourse informativeness in AD. Conclusion This study demonstrated the potential of using images and short written messages as means of compensating for the cognitive deficits which underlie uninformative discourse in AD. Future studies should further investigate the efficacy of language interventions based in the use of these compensation strategies for AD patients and their family members and friends.

Proposta de um protocolo de análise conversacional de comunicação suplementar e alternativa

Purpose: to propose an assessment of communication that includes the conversational analysis of children who have cerebral palsy, with complex communication needs and their interlocutors. Methods: a propositional study type of a speech language and hearing science assessment tool whose methodological flowchart was divided into five phases. Results: the final version of the protocol consisted of fifty-four items divided into three parts: (a) communicative means, acts of speech, topic maintenance and dialogue turn-taking, common to the dyads; (b) acts of child speech, use of resource, thematic maintenance and dialogue turn-taking and (c) speaker speech acts, encouragement of the use of the communication resource, theme maintenance and dialogue turn-taking. All assessment items receive a score by the assessment record according to presented linguistic behavior. Conclusion: this study showed the development and creation of a conversation evaluation protocol for children with cerebral palsy and their interlocutors. It can be used to evaluate the means, the communicative acts and adjacent-pairs observed in conversational contexts, leading the initial clinical speech language and hearing assessment process to the introduction, maintenance and general use of the Augmentative and Alternative Communication with different interlocutors and environments.

Language and communication non-pharmacological interventions in patients with Alzheimer's disease: a systematic review. Communication intervention in Alzheimer

ABSTRACT Alzheimers disease considerably compromises communication skills. Language changes become more prominent as the disease progresses. Deterioration of language and cognition reduces the ability of holding conversations, which has a negative impact on social interaction. OBJECTIVE: To conduct a systematic review of the literature for articles reporting interventions focused on the language and communication of people with Alzheimers disease (AD) without use of medication. METHODS: We performed a search using the keywords Alzheimers disease, language, communication, cognition, cognitive intervention, rehabilitation and therapy, and their corresponding Portuguese and Spanish terms, on the SciELO, LILACS, PubMed and PsychINFO databases. We analyzed intervention studies published from 1993 to 2016 that involved stimulation of language skills and/or communication with pre-and post-intervention quantitative results, and whose samples included at least 50% with a diagnosis of probable AD. Studies were analyzed and classified into four levels of evidence, according to the criteria described in the literature. RESULTS: Twenty-eight articles were included. The majority of the designs had medium-to-low scientific evidence. Most interventions showed benefits for at least one language or communicative skill. Eight types of interventions emerged from the analysis of the studies. Further research with higher levels of evidence is recommended in the investigation of interventions focused on language and communication skills of patients with dementia. CONCLUSION: Studies with high levels of evidence on the topic investigated are only being conducted on a small scale. Two intervention techniques seem potentially effective: lexical-semantic approaches and interventions that work with different cognitive skills (including language).

A warning to the Brazilian Speech-Language Pathology and Audiology community about the importance of scientific and clinical activities in primary progressive aphasia.

This article aims to warn the Brazilian Speech-Language Pathology and Audiology scientific community about the importance and necessity of scientific and clinical activities regarding Primary Progressive Aphasia. This warning is based on a systematic literature review of the scientific production on Primary Progressive Aphasia, from which nine Brazilian articles were selected. It was observed that there is an obvious lack of studies on the subject, as all the retrieved articles were published in medical journals and much of it consisted of small samples; only two articles described the effectiveness of speech-language therapy in patients with Primary Progressive Aphasia. A perspective for the future in the area and characteristics of Speech-Language Therapy for Primary Progressive Aphasia are discussed. As a conclusion, it is evident the need for greater action by Speech-Language Pathology and Audiology on Primary Progressive Aphasia.

Neuropsychological profile of an adult with Chorea-Acanthocytosis: a case study

Este estudio tiene como objetivo describir el perfil neuropsicologico de un adulto con Corea-acantocitosis. Esta enfermedad se caracteriza por una demencia subfrontocortical, sintomas neuropsiquiatricos, deterioro cognitivo, movimientos orobucofaciais coreicos, laceraciones en la lengua, comportamiento estereotipado, cambios de personalidad, convulsiones, degeneracion de los ganglios basales y presencia de acantocitos en frotis sanguineo periferico. Los datos neuropsicologicos muestran deficit en la atencion enfocada, memoria verbal, memoria visual, planificacion y flexibilidad cognitiva presentes en esta condicion. En las tareas que evaluan las habilidades de teoria de la mente, el paciente presento dificultad para inferir las acciones, intenciones y estados de los demas. Las diferencias en la evaluacion de este caso, en comparacion con los casos descritos en la literatura se refieren a deficiencias en la teoria de la mente, discurso narrativo, interpretacion de los actos indirectos del discurso y la prevalencia de la repeticion en la adquisicion de una nueva informacion, no examinadas en los estudios previos. Se espera con este estudio proporcionar informacion para una mejor comprension de los aspectos neuropsicologicos de la enfermedad, asi como permitir el desarrollo de propuestas de intervencion neuropsicologica. Palabras clave: Corea-acantocitisis, Neuroacantocitosis, cognicion, evaluacion neuropsicologica, Teoria de la Mente, estudio de caso.

Perfil neuropsicológico de un adulto con Corea-Acantocitosis: un estudio de caso

Este estudio tiene como objetivo describir el perfil neuropsicologico de un adulto con Corea-acantocitosis. Esta enfermedad se caracteriza por una demencia subfrontocortical, sintomas neuropsiquiatricos, deterioro cognitivo, movimientos orobucofaciais coreicos, laceraciones en la lengua, comportamiento estereotipado, cambios de personalidad, convulsiones, degeneracion de los ganglios basales y presencia de acantocitos en frotis sanguineo periferico. Los datos neuropsicologicos muestran deficit en la atencion enfocada, memoria verbal, memoria visual, planificacion y flexibilidad cognitiva presentes en esta condicion. En las tareas que evaluan las habilidades de teoria de la mente, el paciente presento dificultad para inferir las acciones, intenciones y estados de los demas. Las diferencias en la evaluacion de este caso, en comparacion con los casos descritos en la literatura se refieren a deficiencias en la teoria de la mente, discurso narrativo, interpretacion de los actos indirectos del discurso y la prevalencia de la repeticion en la adquisicion de una nueva informacion, no examinadas en los estudios previos. Se espera con este estudio proporcionar informacion para una mejor comprension de los aspectos neuropsicologicos de la enfermedad, asi como permitir el desarrollo de propuestas de intervencion neuropsicologica. Palabras clave: Corea-acantocitisis, Neuroacantocitosis, cognicion, evaluacion neuropsicologica, Teoria de la Mente, estudio de caso.