Leticia Correa Celeste

Expressão de certeza e dúvida na gagueira: estudo dos aspectos temporais da fala

PURPOSE: to examine the role of speech temporal organization on the expression as for the attitudes of certainty and doubt in the group of adults who stutter, comparing such analysis with a group of speech-fluent adults. METHOD: we analyzed 24 individuals, 12 with stuttering (SG1 and SG2) and 12 without stuttering (CG). Samples were collected with a corpus of 10 key phrases that were produced in the neutral form, expressing doubt and certainty, totaling 840 utterances. The acoustic analysis was performed using Praat and the following parameters were analyzed: time and speech rate and articulation, presence and duration of pauses and disfluencies, duration of vowels in pre-tonic and tonic syllables and occurrence of post-tonic vowel. Statistical analysis was performed by using Kruskall Wallis and chi-square tests, with a significance level of 95%. RESULTS: the expression of doubt has the lowest rate of articulation in the control group, followed by neutral and certainty expressions, with statistically significant differences. Also in the control group, there was presence of pauses and disfluencies only in the expression of doubt. In the experimental group, the largest difference was found in the vowel duration of the stressed syllable. CONCLUSION: generally speaking, CG varied more its temporal organization in order to express attitudes. However, it is also possible to note a trend in the group of people who stutter. As for the speech rate, by removing the pauses and disfluencies, we see that both GE1 and GE2 differentiate certainty, faster articulating each syllable.

Metodologias de análise da velocidade de fala: um estudo piloto

PURPOSE To describe the performance of fluent adults in different measures of speech rate. METHODS The study included 24 fluent adults, of both genders, speakers of Brazilian Portuguese, who were born and still living in the metropolitan region of Belo Horizonte, state of Minas Gerais, aged between 18 and 59 years. Participants were grouped by age: G1 (18-29 years), G2 (30-39 years), G3 (40-49 years), and G4 (50-59 years). The speech samples were obtained following the methodology of the Speech Fluency Assessment Protocol. In addition to the measures of speech rate proposed by the protocol (speech rate in words and syllables per minute), the rate of speech into phonemes per second and the articulation rate with and without the disfluencies were calculated. We used the nonparametric Friedman test and the Wilcoxon test for multiple comparisons. Groups were compared using the nonparametric Kruskal Wallis. The significance level was of 5%. RESULTS There were significant differences between measures of speech rate involving syllables. The multiple comparisons showed that all the three measures were different. There was no effect of age for the studied measures. These findings corroborate previous studies. CONCLUSION The inclusion of temporal acoustic measures such as speech rate in phonemes per second and articulation rates with and without disfluencies can be a complementary approach in the evaluation of speech rate.

O impacto do contexto da disfluência na organização temporal de consoantes na gagueira

Purpose To analyze and compare the voice onset time (VOT) in Brazilian Portuguese speakers who stutter and those who do not, focusing on three different moments of speech: fluent, pre-dysfluent and post-dysfluent environments. Methods Twenty participants (n=10 with stuttering and n=10 without stuttering) were recorded. The data were transcribed and segmented for acoustic analysis, and it was extracted tokens of Brazilian Portuguese voiceless stops /p/, /t/ and /k/. Tokens were classified according to whether they were produced by people who stutter (PWS) or by people who do not stutter (PWnS), and according to their environment in speech (i.e., in fluent speech, pre-dysfluency, and post-dysfluency). For comparisons within groups it were used the Friedman and Wilcoxon tests, and the Mann-Whitney test was used in intergroup comparisons. Statistical analyses were executed using SPSS 14.0 with the significance level set at α=0.05. Results VOT in stuttering and non-stuttering speakers differed most in the environment of pre-dysfluencies, during which stuttering speakers show significantly longer VOT than speakers who do not stutter. After passing through a moment of dysfluency, however, stuttering speakers’ VOT returns to measures similar to non-stuttering speakers’. Conclusion In pre-dysfluent and post-dysfluent speech, PWS produces longer VOT than PWnS. In the fluent speech of PWS, the stops behave differently. The implications of these results for speech motor control are discussed.

Rapid Naming in Brazilian Students with Dyslexia and Attention Deficit Hyperactivity Disorder

Introduction: The effective development of reading and writing skills requires the concerted action of several abilities, one of which is phonological processing. One of the main components of phonological processing is rapid automatized naming (RAN)—the ability to identify and recognize a given item by the activation and concomitant articulation of its name. Objective: To assess the RAN performance of schoolchildren with dyslexia and attention deficit hyperactivity disorder (ADHD) compared with their peers. Methods: In total, 70 schoolchildren aged between 8 and 11 years participated in the study. Of these, 16 children had a multiprofessional diagnosis of ADHD while 14 were diagnosed with dyslexia. Matched with these groups, 40 schoolchildren with no history of developmental impairments were also evaluated. The RAN test was administered to assess the length of time required to name a series of familiar visual stimuli. The statistical analysis was conducted using measures of descriptive statistics and the 2-sample t-test at the 5% significance level. Results: The performance of the group with dyslexia was inferior to that of the control group in all tasks and the ADHD group had inferior performance for color and letters-naming tasks. The schoolchildren with dyslexia and those with ADHD showed very similar response times. Age was an important variable to be analyzed separately. As they aged, children with typical language development had fast answers on colors and digits tasks while children with dyslexia or ADHD did not show improvement with age. Conclusions: The schoolchildren with dyslexia took longer to complete all tasks and ADHD took longer to complete digits and objects tasks in comparison to their peers with typical development. This ability tended to improve with age, which was not the case, however, with schoolchildren who had ADHD or dyslexia.

Processamento fonológico em indivíduos com transtorno de Déficit de Atenção e Hiperatividade

Purpose to analyze e to describe the skills’ performance of the phonological processing components in subjects with Attention Deficit - Hyperactivity Disorder (ADHD). Methods it is a descriptive analytical study of the evaluation data of the phonological processing skills of 45 subjects, with ages between 7 and 16 years, with a multiprofessional diagnosis of ADHD. All data was obtained from the medical records of the subjects evaluated by the Laboratorio de Estudo dos Transtornos de Aprendizagem (LETRA) of Hospital das Clinicas da Universidade Federal de Minas Gerais (UFMG), between the years of 2008 and 2011. The analyzed results include the Phonological Awareness test, proposed by the battery of tests BELEC, the Rapid Serial Naming (RAN) test and Auditory Memory test. Two variables were considered in this analysis: the age and the presence or absence of associated comorbidities. The test used to the sample characterization was the nonparametric of Mann Whitney. Results groups tend to differentiate themselves when the age variable is analyzed, on the Phonological Awareness tests and RAN. When the comorbidity variable was analyzed, the Phonological Awareness was more influenced by the presence of comorbidities. On the Auditory Memory skills, by the same light, there were no differences between the groups. Conclusion the largest deficit in phonological processing was observed in phonological awareness skills, according to the age and comorbidity variables, followed by the lexicon’s access skills, according to the age variable. About the Working Memory, there was no significance.

Fluency profile: comparison between Brazilian and European Portuguese speakers

The purpose of the study was to compare the speech fluency of Brazilian Portuguese speakers with that of European Portuguese speakers. The study participants were 76 individuals of any ethnicity or skin color aged 18-29 years. Of the participants, 38 lived in Brazil and 38 in Portugal. Speech samples from all participants were obtained and analyzed according to the variables of typology and frequency of speech disruptions and speech rate. Descriptive and inferential statistical analyses were performed to assess the association between the fluency profile and linguistic variant variables. We found that the speech rate of European Portuguese speakers was higher than the speech rate of Brazilian Portuguese speakers in words per minute (p=0.004). The qualitative distribution of the typology of common dysfluencies (p<0.001) also discriminated between the linguistic variants. While a speech fluency profile of European Portuguese speakers is not available, speech therapists in Portugal can use the same speech fluency assessment as has been used in Brazil to establish a diagnosis of stuttering, especially in regard to typical and stuttering dysfluencies, with care taken when evaluating the speech rate.

Parâmetros prosódicos de leitura em escolares do segundo ao quinto ano do ensino fundamental

Purpose Characterize and compare melodic variation and reading speed and verify their evolution throughout the development of schooling. Methods The reading of 78 Elementary School (2nd to 5th grade) students was analyzed using the Praat program with regards to the parameters of melodic variation (F0) and reading speed (Duration). Statistical measures (mean and standard deviation) were taken and the Student´s t-test was applied at significance level of 5%. Results Melodic variation and reading speed increased as schooling progressed, especially during 5th grade. Conclusion Melodic variation increases as schooling progresses, mainly during 5th grade. First minute of reading analysis is sufficient to assess reading speed, not being necessary to analyze the full text.

Treinamento da performance comunicativa em universitários da área da saúde

Introdução: A expressão do conhecimento é um desafio na vida dos alunos no ensino superior. Objetivo: Avaliar a eficácia da intervenção fonoaudiológica por meio do programa Treinamento da Performance Comunicativa (TAPCo) para universitários. Métodos: Participaram desta pesquisa 26 universitários de ambos os gêneros e de quatro diferentes cursos da área da saúde. A pesquisa foi realizada em seis etapas, a saber: registro audiovisual de uma apresentação oral dos discentes antes do treinamento; treinamento das habilidades comunicativas por meio do programa TAPCo; registro audiovisual após o treinamento; tabulação dos dados obtidos pelos pesquisadores; avaliação randomizada e cega dos 26 discentes, por três fonoaudiólogas não participantes da pesquisa, de forma qualitativa; autoavaliação dos participantes. O TAPCo foi composto por oito sessões de treinamento, que envolveram os seguintes aspectos: vestuário, expressão corporal e facial, fala e voz. Resultados: Houve melhora, com diferença estatisticamente significativa, em todos os aspectos treinados, de acordo com a autoavaliação. Quanto à avaliação qualitativa das juízas, observou-se que a classificação predominante foi boa, em todos os aspectos avaliados. No aspecto vestuário, houve maior presença do indicador indiferente. O aspecto fala e voz apresentou a maior predominância da qualificação excelente. Conclusão: Tanto as avaliações das juízas, quanto as autoavaliações, mostraram a eficiência do TAPCo para o treinamento de estudantes universitários. Embora a autoavaliação tenha apresentado algumas divergências em relação à avaliação das juízas, esse procedimento se mostrou uma excelente ferramenta de acompanhamento da evolução do TAPCo.

Apresentação de um Protocolo Assistencial para Pacientes com Distúrbios da Deglutição

Purpose: to describe the implementation process of a Clinical Practice Protocol for Patients with Swallowing Disorders (CPSD) in a public hospital of high technological density in the Federal District of Brazil. Methods This is an Experience Report study which describes the implementation process of a Clinical Practice Protocol for Patients with Swallowing Disorders in a public hospital of high technological density in the Federal District. Results The protocol was implemented in three stages: Stage 1 - literature search on the procedures that characterize the best propaedeutic and therapeutic practices; Stage 2 - discussion with a multidisciplinary team about the adjustments needed to implement the CPSD; and Stage 3 - Final proposal for the protocol implementation considering the particularities of the service. Conclusion The final proposal of the Clinical Practice Protocol for Patients with Swallowing Disorders (CPSD) provides a predefined, systematic method to monitor patients with swallowing disorders in high technological density health facilities. In addition to being inexpensive, the CPSD fosters decision-making, favors early detection of disorders, and assists managers with evaluating the quality of the service offered.PURPOSE To describe the implementation process of a Clinical Practice Protocol for Patients with Swallowing Disorders (CPSD) in a public hospital of high technological density in the Federal District of Brazil. METHODS This is an Experience Report study which describes the implementation process of a Clinical Practice Protocol for Patients with Swallowing Disorders in a public hospital of high technological density in the Federal District. RESULTS The protocol was implemented in three stages: Stage 1 - literature search on the procedures that characterize the best propaedeutic and therapeutic practices; Stage 2 - discussion with a multidisciplinary team about the adjustments needed to implement the CPSD; and Stage 3 - Final proposal for the protocol implementation considering the particularities of the service. CONCLUSION The final proposal of the Clinical Practice Protocol for Patients with Swallowing Disorders (CPSD) provides a predefined, systematic method to monitor patients with swallowing disorders in high technological density health facilities. In addition to being inexpensive, the CPSD fosters decision-making, favors early detection of disorders, and assists managers with evaluating the quality of the service offered.

Mapeamento da fonoaudiologia educacional no Brasil : formação, trabalho e experiência profissional

Purpose To map the profile of Brazilian Speech Therapists who report acting in Educational Speech Therapy, with regard to aspects related to training, performance and professional experience. Methods Retrospective study, based on secondary database analysis of the Federal Council of Hearing and Speech Sciences on the questionnaires reporting acting with Educational Environment. Results 312 questionnaires were completed, of which 93.3% by women aged 30-39 years. Most Speech Therapists continued the studies, opting mostly for specialization. Almost 50% of respondents, have worked for less than six years with the speciality, most significantly in the public service (especially municipal) and private area. Conclusion The profile of the Speech Therapists active in the Educational area in Brazil is a professional predominantly female, who values to continue their studies after graduation, looking mostly for specialization in the following areas: Audiology and Orofacial Motor. The time experience of the majority is up to 10 years of work whose nature is divided mainly in public (municipal) and private schools. The performance of Speech Therapists in the Educational area concentrates in Elementary and Primary school, with varied workload.