Maria de Lourdes Merighi Tabaquim

Study of the stress of parents of patients with cleft lip and palate in a surgical process

Familias com filhos afetados por fatores geneticos ou teratogenicos envolvendo sequelas estruturais, funcionais, esteticas e psicologicas, como nas fissuras labiopalatinas, sao vulneraveis a diferentes graus estressores. Este estudo teve por objetivo investigar o nivel de estresse de pais e maes antes e apos a intervencao cirurgica de filhos com fissura labiopalatina. Participaram 14 pais de criancas com Fissura Transforame Incisivo Uni e Bilateral, de ambos os sexos, na faixa etaria de 21 a 53 anos, integrantes do programa de intervencao cirurgica do Hospital de Reabilitacao de Anomalias Craniofaciais da Universidade de Sao Paulo. Foram utilizados os instrumentos: 1) de Identificacao; 2) Questionario de Ansiedade; 3) Questionario da Imagem Corporal; e 4) Reconhecimento dos sinais de estresse. Os resultados permitiram concluir que os sujeitos, pais e responsaveis dos pacientes com fissura labiopalatina, em situacao cirurgica, mostraram niveis mais elevados de estresse no periodo de pre-cirurgia, com qualidade alterada dos aspectos autonomicos do organismo, alem de reacoes corporais significativamente insatisfatorias.

Avaliação das habilidades cognitivas, da comunicação e neuromotoras de crianças com risco de alterações do desenvolvimento

The objective of this study was to assess the functional and neuropsychomotor skills of children who presented a clinical history of a risk for developmental alterations during their first year of life in the motor, cognitive, linguistic and psychosocial areas. Sixty children were assessed and classified into two groups: the Experimental Group (GI), made up of 30 children ranging from zero to two years and eleven months old, of both sexes, with a history of peri-, pre- and postnatal intercurrences and/or neuropsychomotor delay; the Control Group (GII), made up of 30 children without any history of developmental alterations, and matched according to sex and age. When the two groups (GI and GII) were compared, the results revealed a statistically significant difference in GI in the motor, language and cognitive areas. In the comparative analysis between the different areas, those that revealed the biggest detriment were the language and motor skills, followed by the cognitive skills. The psychosocial area was the least compromised and in the comparison between the two groups the scores were not statistically significant. This shows the influence of risk factors in the developmental process and the importance of an early follow-up with those children that reveal a history of intercurrences.

Avaliação do desenvolvimento cognitivo e afetivo-social de crianças com perda auditiva

PURPOSE: the objective of this study was to evaluate the level of cognitive, affective and social development of children diagnosed with hearing loss. METHOD: the study included 50 children diagnosed with hearing loss, with a mean age of 16.1 months, both genders. We applied a semi-structured interview with parents for the life history of the child, Scale Development and Behavioral Assessment Scale Reaction Baby Retraction. RESULTS: the study identified 80% of children with bilateral profound hearing loss. Quotient of normal development occurred in 76% of the sample and the most affected functions were language and personal-social. The affective and interactional levels adjustment were characterized by the alarm reactions for personal problems and social interaction. CONCLUSION: the dephased verbal and nonverbal competences showed implications on cognitive development, suggesting the hearing loss condition and associated risk factors, with limited situational communicative exchanges that promote the development of adaptive skills and increased the self-esteem on the relationships.

Concepção de professores do ensino fundamental sobre a dislexia do desenvolvimento

A dislexia e um disturbio especifico de aprendizagem, de origem constitucional, caracterizado por dificuldades na decodificacao de palavras simples isoladas e causado pela deficiencia no processamento da informacao fonologica. Os professores geralmente sao os primeiros a observar as dificuldades da crianca dislexica nas fases iniciais da alfabetizacao, porem, a falta de conhecimento necessario sobre o transtorno inviabiliza a conducao da situacao de forma a tornar menos arduo o enfrentamento das dificuldades na aprendizagem. O objetivo deste estudo foi caracterizar o nivel de informacao sobre a dislexia de 27 professores de lingua portuguesa da 5a a 8a serie do ensino fundamental, sendo 17 da rede estadual e 10 da particular. Os resultados revelaram desconhecimento sobre os aspectos etiologico-causais da dislexia: 29,6% dos participantes desconsideram os aspectos geneticos, hereditarios e neurologicos como causa do transtorno e 33,3% desconsideraram esses mesmos aspectos como fator predisponente. O estudo concluiu que o nivel de informacao dos docentes participantes foi insuficiente para identificar sinais de risco para o transtorno dislexico.

Vídeo educativo: estratégia de treinamento para cuidadores de crianças com fissura labiopalatina

Objective To check the knowledge informal caregivers of children with cleft lip and palate acquire about the postoperative care of cheiloplasty and palatoplasty through the use of an educational video. Methods Randomized clinical trial conducted with 80 caregivers of children with cleft lip and palate, arranged into two groups: experimental (G1) and control (G2). Data collection occurred during the child’s hospital stay, in three stages, using a structured questionnaire and an educational video developed and validated for this study. Results There was evidence of improvement in the acquisition of knowledge about postoperative care in both groups (p <0.001), but it was higher in G1 compared to G2. Conclusion The educational video was shown to be effective to train caregivers of children with cleft lip and palate after cheiloplasty and palatoplasty.

Syntactic Awareness and Text Production in Brazilian Portuguese Students with Learning Disabilities

Aims: This study compared the syntactic awareness and textual production skills of school children and teenagers with and without learning disabilities (LD) and related their performances in both skills. Methods: The study group consisted of 15 children with an LD and 15 without language and learning alterations. To compare the performance of both groups, data were statistically analyzed using Fishers exact test, and the association between the evidence in each group was demonstrated by Spearmans correlations, with a significance level of 5% (p < 0.05). Results: Most subjects with LD showed a lower performance in tests of syntactic awareness and textual production. Statistical analysis indicated a significant difference in the performance of children with and without language disorders for both tested skills. A positive relationship was found between the childrens performance in the test of textual production and the tasks of syntactic awareness. Conclusion: Our findings suggest that the ability to judge and correct grammatical structures can be an important factor in the development of the skills used to produce a text.

Klinefelter syndrome: a speech-language and neuropsychological assessment

Corresponding address: Dionísia Aparecida Cusin Lamônica Rua: Via Puccini, n0 1-16, Bairro Tivolli CEP: 17053-095 Bauru, São Paulo, Brasil E-mail: dionelam@uol.com.br ABSTRACT The Klinefelter syndrome is a chromosomal aneuploidy caused by additional X chromosomes in men. The diagnosis is made by clinical observation and karyotype examination. Besides other characteristics, the phenotype involves infertility, hypogonadism, gynecomastia, and cognitive alterations, mainly in the language domain. This paper describes the case of a teenager with Klinefelter syndrome and history of difficulties in the learning process, behavioral and communication problems. The ethical guidelines were followed in the present report. The cognitive-communicative, pragmatic and syntactic profile was drawn from the speech and neuropsychological evaluations. The speech-language assessment showed deficits in expression and comprehension. Difficulties were also found in phonological awareness, mathematical operations, reading and writing, access to the lexicon, alterations in pragmatics and occasionally, in syntactics. The neuropsychological evaluation indicated impairments in tasks that require the identification of similarities, establishment of cause-effect relationships and analogies, demonstrating a compromised reasoning for logical operations, with intellectual level incompatible with the chronological age. This interdisciplinary clinical study favors intervention approaches in rehabilitation, to maximize the potential of the individuals affected, contributing to improve their quality of life.

Study of Burden Among Caregivers of Children with Cleft Lip and Palate

espanolResumen: La salud fisica y psicologica de los cuidadores de ninos con fisura labiopalatina puede ser fuertemente influenciado por el estado y el comportamiento del nino, y por la demanda de atencion prestada en el tratamiento. Este estudio tuvo como objetivo identificar los niveles de sobrecarga de estos cuidadores. Participaron 100 cuidadores de ninos que estaban en el periodo perioperatorio de queiloplastia y/o palatoplastia. Fue utilizada como instrumento la Escala Burden Interview. Los datos fueron analizados cuantitativamente. Niveles leves y moderados-graves fueron identificados en el 43% de la muestra. Se observo que las madres de ninos en edad alrededor de doce meses tuvieron sobrecarga significativamente mayor. Los resultados fueron indicativos de una mayor demanda de cuidados para el nino en esta fase de desarrollo, debido a la busqueda de autonomia en la locomocion, la exploracion de los objetos en el entorno circundante, con continuas solicitaciones de interaccion comunicativa y afectivo-sociales, juntamente con la referencia de mayor apego (el cuidador), lo que puede haber contribuido a una sobrecarga mayor. portuguesResumo: A saude psicologica e fisica dos cuidadores das criancas com fissura labiopalatina pode ser fortemente influenciada pela condicao e comportamento da crianca e pela demanda de cuidados dispensados no tratamento. Este estudo objetivou identificar os niveis de sobrecarga nesses cuidadores. Participaram 100 cuidadores cujos filhos se encontravam no periodo perioperatorio de queiloplastia e/ou palatoplastia. A Escala Burden Interview foi utilizada como instrumento. Os dados foram analisados quantitativamente. Foram identificados niveis moderados e moderados-severos de sobrecarga em 43% da amostra. Observou-se que maes de criancas com idade em torno de 12 meses apresentaram sobrecarga significativamente maior. Os resultados foram indicativos de maior exigencia de cuidados com a crianca nessa fase do desenvolvimento, decorrente da busca de autonomia na locomocao, exploracao de objetos no ambiente proximo, com solicitacoes continuas de interacao comunicativa e afetiva-social junto a referencia de maior apego (o cuidador), o que pode ter contribuido para uma maior sobrecarga. EnglishAbstract: The psychological and physical health of caregivers of children with cleft lip and palate can be strongly influenced by the child’s condition and behavior, and care required by the treatment. This study’s objective was to identify overload levels among these caregivers. A total of 100 caregivers, whose children were in the perioperative period of cheiloplasty and/or palatoplasty, were interviewed using the Scale Burden Interview. The data were analyzed quantitatively. Moderate and moderate severe burden levels were identified in 43% of the sample. The mothers of children aged around 12 months presented significantly higher overload. The results indicate that children in this developmental stage present greater care demand because they seek autonomy in locomotion, explore objects in their surrounding environment, and continually request communicative and affective-social interaction with their reference to greater attachment (the caregiver), which may have contributed to higher burden.

Moyamoya disease: impact on the performance of oral and written language

Moyamoya disease is an unusual form of occlusive, cerebrovascular disorder that affects the arteries of the central nervous system, causing acquired language alterations and learning difficulties. The study aim was to describe the oral/written language and cognitive skills in a seven-year-and-seven-month-old girl diagnosed with Moyamoya disease. The assessment consisted of interviews with her parents and application of the following instruments: Observation of Communicative Behavior, Peabody Picture Vocabulary Test, Academic Performance Test, Profile of Phonological Awareness, Raven’s Progressive Matrices Test, Special Scale, Wechsler Intelligence Scale for Children, Bender Visual Motor Gestalt Test, and Wisconsin Card Sorting Test. Two episodes of stroke in the left and right temporal-parietal and left frontal areas occurred until the age of six years and five months. Revascularization surgery and medication treatment were conducted. The audiologic and ophthalmologic assessments indicated normality. At the time of the study, the girl was attending the second grade of elementary school. She presented changes in oral and written language (syllabic-alphabetic), non-naming of all graphemes, low arithmetic and writing means, reading skill below first grade level and psycholinguistic delay, and pre-school level phonological processing skills. The psychological evaluation indicated satisfactory intellectual level; however, it also showed cognitive performance impairment in verbal and execution tasks and limitations on graphic-perceptual-motor skills and sequential logic organization. The stroke episodes influenced the performance of learning processes, affecting the analysis, integration, and interpretation of relevant visual and auditory information.Moyamoya disease is an unusual form of occlusive, cerebrovascular disorder that affects the arteries of the central nervous system, causing acquired language alterations and learning difficulties. The study aim was to describe the oral/written language and cognitive skills in a seven-year-and-seven-month-old girl diagnosed with Moyamoya disease. The assessment consisted of interviews with her parents and application of the following instruments: Observation of Communicative Behavior, Peabody Picture Vocabulary Test, Academic Performance Test, Profile of Phonological Awareness, Ravens Progressive Matrices Test, Special Scale, Wechsler Intelligence Scale for Children, Bender Visual Motor Gestalt Test, and Wisconsin Card Sorting Test. Two episodes of stroke in the left and right temporal-parietal and left frontal areas occurred until the age of six years and five months. Revascularization surgery and medication treatment were conducted. The audiologic and ophthalmologic assessments indicated normality. At the time of the study, the girl was attending the second grade of elementary school. She presented changes in oral and written language (syllabic-alphabetic), non-naming of all graphemes, low arithmetic and writing means, reading skill below first grade level and psycholinguistic delay, and pre-school level phonological processing skills. The psychological evaluation indicated satisfactory intellectual level; however, it also showed cognitive performance impairment in verbal and execution tasks and limitations on graphic-perceptual-motor skills and sequential logic organization. The stroke episodes influenced the performance of learning processes, affecting the analysis, integration, and interpretation of relevant visual and auditory information.

Attentional function and cognitive flexibility on students with cleft fissure

Interfering factors at general child including those with cleft lip and palate at school stage attention can do harm in learning. Objective: Identify the cognitive competences of attention and flexibility on students with cleft fissure and low academic performance. Participants were 45 students, both genders, 8 to 10 years old, which are attending between the 3rd and 5th grade of the public school and compose three groups: GI, with cleft lip and palate and low academic performance; GII, without development changes, but with low academic performance; and, GIII, as control group, without any changes at their development. The resources used were: Raven Test, Progressive Matrices; Scholar Development Test, and, the Wisconsin CardSorting, Some results are: Intellectual resources appeared in the middle and above it in all groups. In academic skills, the GI group had the lowest performance at writing activity, but the same group presented better reading performance compared to GII. In arithmetic activities, the difference occurred only when both groups were compared to GIII. Attentional and cognitive flexibility performance, with the average rating, occurred in 73% of GI, and 100% on the other groups. It was concluded that the impaired academic activities did not constitute direct relationship with optimized performance in executive cognitive functions at the groups complaining about low academic performance, with and without cleft lip and palate, although the last one has had the most impaired performance.