Lourdes Bernadete Rocha de Souza

Cochlear implanted children present vocal parameters within normal standards

OBJECTIVE to compare acoustic and perceptual parameters regarding the voice of cochlear implanted children, with normal hearing children. METHOD this is a cross-sectional, quantitative and qualitative study. METHODS Thirty six cochlear implanted children aged between 3 y and 3 m to 5 y and 9 m and 25 children with normal hearing, aged between 3 y and 11 m and 6 y and 6 m, participated in this study. The recordings and the acoustics analysis of the sustained vowel/a/and spontaneous speech were performed using the PRAAT program. The parameters analyzed for the sustained vowel were the mean of the fundamental frequency, jitter, shimmer and harmonic-to-noise ratio (HNR). For the spontaneous speech, the minimum and maximum frequencies and the number of semitones were extracted. The perceptual analysis of the speech material was analyzed using visual-analogical scales of 100 points, composing the aspects related to the overall severity of the vocal deviation, roughness, breathiness, strain, pitch, loudness and resonance deviation, and instability. This last parameter was only analyzed for the sustained vowel. RESULTS The results demonstrated that the majority of the vocal parameters analyzed in the samples of the implanted children disclosed values similar to those obtained by the group of children with normal hearing. CONCLUSION implanted children who participate in a (re) habilitation and follow-up program, can present vocal characteristics similar to those vocal characteristics of children with normal hearing.

Frequência fundamental, tempo máximo de fonação e queixas vocais em mulheres com obesidade mórbida

Background Obese people have abnormal deposition of fat in the vocal tract that can interfere with the acoustic voice. Aim To relate the fundamental frequency, the maximum phonation time and voice complaints from a group of morbidly obese women. Methods Observational, cross-sectional and descriptive study that included 44 morbidly obese women, mean age of 42.45 (±10.31) years old, observational group and 30 women without obesity, control group, with 33.79 (±4.51)years old. The voice recording was done in a quiet environment, on a laptop using the program ANAGRAF acoustic analysis of speech sounds. To extract the values of fundamental frequency the subjects were asked to produce vowel [a] at usual intensity for a period in average of three seconds. After the voice recording, participants were prompted to produce sustained vowel [ a] , [ i] and [ u] at usual intensity and height, using a stopwatch to measure the time that each participant could hold each vowel. Results The majority, 31(70.5%), had vocal complaints, with a higher percentage for complaints of vocal fatigue 20(64.51%) and voice failures 19(61.29%) followed by dryness of the throat in 15 (48.38%) and effort to speak 13(41.93%). There was no statistically significant difference regarding the mean fundamental frequency of the voice in both groups, but there was significance between the two groups regarding maximum phonation. Conclusion Increased adipose tissue in the vocal tract interfered in the vocal parameters.

Tradução e adaptação transcultural do Northwestern Dysphagia Patient Check Sheet para o português brasileiro

PURPOSE To present the translation and cross-cultural adaptation of the Brazilian version of the Northwestern Dysphagia Patient Check Sheet (NDPCS). METHODS The translation to Portuguese was performed by two Brazilian bilingual speech language pathologists, followed by a back translation conducted by a bilingual native speaker of the original language. Afterwards, the three versions were compared by a committee of three speech language pathologists. Initially, the final translated version of the NDPCS was applied with 35 volunteers aged between 62 and 92 years old (74.77±7.08), who had no dementia or complaints of swallowing disorder. After some adjustments, the instrument was applied with other 27 volunteers aged between 60 and 87 years old (76.56±7.07) with the same profile. RESULTS There was divergence in semantic equivalence in relation to one item, which was modified in the translated version. The tasks requested for observation during deglutition were adapted in relation to the solid food and the volumes used in pudding and liquid consistencies. The instrument maintained the same structure as the original version, with five categories and into 28 items, three brief variables, and four closures. CONCLUSION The equivalence between the original and the translated version of the NDPCS was preserved after its translation and adaptation to Brazilian Portuguese. The validation process of the psychometric properties of the instrument is in progress.

Autopercepção da deglutição em pacientes com doença tireoidiana benigna não cirúrgica

Purpose To verify the frequency of swallowing complaints in patients with benign nonsurgical thyroid disease and compare the self-perception of swallowing disorder intensity between different types of thyroid disease. Methods The study sample comprised 39 women aged 19-58 years (38.54 ± 10.74) with hypothyroidism (n=22; 56.4%) or thyroid nodules (n=17; 43.6%). Presence and type of swallowing complaint and self-perception of swallowing disorder intensity were investigated by means of self-ratings recorded on a 100-millimeter visual analog scale. The data were analyzed by descriptive measures and the Mann-Whitney nonparametric test was used to compare the self-perception of swallowing disorder intensity between both clinical diagnoses of thyroid disease. The level of 5% was adopted for statistical significance. Results Twenty-six (66.7%) individuals reported the following swallowing complaints: pharyngolaryngeal stasis sensation (37.15%), chocking (34.29%), and odynophagia (28.57%). The mean value of self-perception of swallowing disorder intensity by the visual analog scale was 59.35 (± 27.38) millimeters. No difference in self-perception was reported between the clinical diagnoses of thyroid disease. Conclusion In this sample, swallowing complaint was frequently observed in patients with benign nonsurgical thyroid disease. Moderate self-perception of swallowing disorder intensity was reported regardless of the clinical diagnosis of thyroid disease.

VOCAL COMPLAINT, AUDITORY-PERCEPTUAL ASSESSMENT OF VOICE AND VOCAL SELF-ASSESSMENT IN WOMEN WITH MORBID OBESITY

Background : Obese people often have altered breathing patterns and therefore may experience difficulties in voice production. Aim : To verify the presence of vocal complaints and the correlation between the auditory-perceptual analysis of voice and vocal self-assessment of a group of women with morbid obesity before and after bariatric surgery. Methods : A longitudinal, exploratory, descriptive study of 21 morbidly obese women aged between 28 and 68 years, assessed before and after bariatric surgery, was performed. The women filled out a form containing identification data and type of vocal complaint. Perceptual evaluation of voice and vocal self-assessment were performed using a visual analog scale. For perceptual assessment of voice the women were asked to say three sentences from the Consensus Auditory-Perceptual Evaluation of Voice. Results : Of the 21 patients, 14 (66.6%) reported vocal complaints, of which 10 (71%) vocal fatigue, eight (57.14%) voice failures and seven (50%) vocal effort. All participants reported improvements in the voice after surgery, irrespective of having reported vocal complaints before surgery. There was no correlation between vocal self-assessment and auditory-perceptual assessment of the voice before or after the procedure. There was no correlation between vocal self-assessment and perceptual evaluation of the voice before surgery. Conclusion : Obesity interfered with voice production and influenced negative perception and therefore vocal complaints. Complaints about vocal production cannot be perceived by a speech therapist with the same impact as by patients, as both employ different criteria for vocal evaluation. Vocal self-assessment is an important tool in voice evaluation.

Body mass index and acoustic voice parameters: is there a relationship?

INTRODUCTION Specific elements such as weight and body volume can interfere in voice production and consequently in its acoustic parameters, which is why it is important for the clinician to be aware of these relationships. OBJECTIVE To investigate the relationship between body mass index and the average acoustic voice parameters. METHODS Observational, cross-sectional descriptive study. The sample consisted of 84 women, aged between 18 and 40years, an average of 26.83 (±6.88). The subjects were grouped according to body mass index: 19 underweight; 23 normal ranges, 20 overweight and 22 obese and evaluated the fundamental frequency of the sustained vowel [a] and the maximum phonation time of the vowels [a], [i], [u], using PRAAT software. The data were submitted to the Kruskal-Wallis test to verify if there were differences between the groups regarding the study variables. All variables showed statistically significant results and were subjected to non-parametric test Mann-Whitney. RESULTS Regarding to the average of the fundamental frequency, there was statistically significant difference between groups with underweight and overweight and obese; normal range and overweight and obese. The average maximum phonation time revealed statistically significant difference between underweight and obese individuals; normal range and obese; overweight and obese. CONCLUSION Body mass index influenced the average fundamental frequency of overweight and obese individuals evaluated in this study. Obesity influenced in reducing maximum phonation time average.

Profile of phonological awareness in bilingual and monolingual children

PURPOSE To compare the performance of phonological awareness skills in bilingual and monolingual students of both genders. METHODS This research presents an observational, cross-sectional descriptive study conducted with 17 students from the 3rd grade, aged between seven years and 8 years and 11 months, with similar socioeconomic level, from two private schools, being one a monolingual school, and the other a bilingual one. Children at risk for auditory deprivation of any degree, those with learning difficulties, and children enrolled in the school less than two years were excluded from the research. A total of nine bilingual and eight monolingual students was tested using the Phonological Awareness Profile test. RESULTS The results showed that 64.7% of the 17 students tested reached the performance expected for their age, and 35.3% performed above expectation, being 83.3% of the latter bilingual students. The bilingual children presented better performance in the sequential rhyme skill and in the total test score, and the male bilingual children presented better performance in the phoneme addition skill. There was no statistically significant difference when comparing the performance of bilingual and monolingual female students. CONCLUSION Bilingual children had greater command of phonemic awareness skill. Male bilingual children showed better performance when compared to their monolingual peers than female bilingual students.

Perfil das habilidades de consciência fonológica em crianças bilíngues e monolíngues

PURPOSE To compare the performance of phonological awareness skills in bilingual and monolingual students of both genders. METHODS This research presents an observational, cross-sectional descriptive study conducted with 17 students from the 3rd grade, aged between seven years and 8 years and 11 months, with similar socioeconomic level, from two private schools, being one a monolingual school, and the other a bilingual one. Children at risk for auditory deprivation of any degree, those with learning difficulties, and children enrolled in the school less than two years were excluded from the research. A total of nine bilingual and eight monolingual students was tested using the Phonological Awareness Profile test. RESULTS The results showed that 64.7% of the 17 students tested reached the performance expected for their age, and 35.3% performed above expectation, being 83.3% of the latter bilingual students. The bilingual children presented better performance in the sequential rhyme skill and in the total test score, and the male bilingual children presented better performance in the phoneme addition skill. There was no statistically significant difference when comparing the performance of bilingual and monolingual female students. CONCLUSION Bilingual children had greater command of phonemic awareness skill. Male bilingual children showed better performance when compared to their monolingual peers than female bilingual students.