Marizete Ilha Ceron

Análise comparativa da eficiência de três diferentes modelos de terapia fonológica

BACKGROUND phonological therapy in children with phonological disorders. AIM to verify changes in the phonological system of children with phonological disorders, based on the comparison of number of acquired phonemes, number of sounds in the phonetic inventory and altered distinctive features, before and after therapy, and to verify differences between therapy models: Modified Cycles, Maximal Oppositions and ABAB--Withdrawal and Multiple Probes. METHOD the research group was composed of 21 subjects, 15 male and 6 female, with phonological disorders, who had already completed speech-language treatment. The initial and final phonological assessments were compared taking into consideration the number of phonemes in the phonological systems, the number of sounds in the phonetic inventory and the altered distinctive features. Phonological changes that resulted from the application of the three therapeutic models were also compared. RESULTS statistically significant differences were observed between the initial and final assessments in all of the three therapeutic models considering the number of acquired phonemes and the altered distinctive features, whereas in the phonetic inventory a statistically significant difference was observed only between the ABAB--Withdrawal and Multiple Probes and the Maximal Oppositions model. No statistical difference was observed between the therapy models. CONCLUSION the three therapy models were effective in the treatment of children with phonological disorders, once all of the children presented improvement of their phonological system, phonetic inventory and altered distinctive features. No significant statistical difference was found between the models

Eficácia da terapia para desvios fonológicos com diferentes modelos terapêuticos

BACKGROUND phonological therapy. AIM to evaluate the effectiveness of three different therapy models regarding changes in the phonological system of subjects with different phonological disorder (PD) severity levels. METHOD the research group was composed by 66 subjects, 43 males and 23 females, with ages between 4:4 and 8:2 years, who were part of a school clinic database. All subjects were evaluated, before and after a period of 15 to 25 sessions of phonological therapy, using the Childs Phonological Assessment. Based on this assessment, the severity level of the PD was determined using the Percentage Consonants Correct - PCC, and by calculating the number of Non-Acquired Segments -NAS and the percentage of Acquired Segments (AS) after treatment. The subjects were treated using the following approaches: ABAB-Withdrawal and Multiple Probes, Modified Maximum Opposition and Modified Cycles Models. For the statistical analysis the T-Test was used with a significance level of 5%. RESULTS the statistical analysis indicated an increase in the PCC and in the percentage of AS, as well as a reduction in the number of NAS for all groups. These results were statistically significant for the majority of the groups. CONCLUSION the results indicate that the three therapy approaches were effective in the treatment of children with PD, and were effective in treating different severity levels. Besides that, most of the changes occurred in the phonological system of the groups with more severe PD.

Estudo sobre os ambientes favoráveis à produção da líquida não-lateral /r/ no tratamento do desvio fonológico

Os ambientes favoraveis sao contextos facilitadores para a aquisicao do segmento tratado. Eles podem ser analisados sob os seguintes aspectos: tonicidade, contexto antecedente e vogal seguinte. O objetivo deste relato de caso foi analisar a influencia das variaveis linguisticas (ambiente favoravel) no tratamento de um sujeito com desvio fonologico evolutivo. Participou do estudo um sujeito com desvio fonologico, com idade de 6:8 no inicio do tratamento, do sexo masculino, tratado pelo Modelo ABAB-Retirada e Provas Multiplas. Foram analisados os dados de fala pre e pos-tratamento e as Provas Alvo Basicas do primeiro ciclo de tratamento. Nas palavras-alvo selecionadas para terapia, foram analisadas as aquisicoes quanto ao alvo de tratamento, a liquida nao-lateral /r/, e os ambientes favoraveis a aquisicao no que se refere a tonicidade e aos contextos (antecedente e seguinte). Observou-se que o /r/, nas palavras-alvo selecionadas, nao era encontrado em ambientes mais favoraveis; em geral, encontrava-se em ambiente neutro ou menos favorecedor. No entanto, verificou-se generalizacao no que se refere a aquisicao da liquida nao-lateral /r/ em Onset Medial, e a producao do fonema nas palavras-alvo selecionadas foi efetiva, destacando-se as producoes das palavras [ba´rata], [ko´ruZa] e [mo´ragu], que apresentaram maior numero de ocorrencias.

Terapia fonológica: a generalização dentro de uma classe de sons e para outras classes de sons

PURPOSE: to compare the generalization inside of a sound class and for other sound classes in the treatment of subjects with different severity levels of phonological disorders submitted to the Modified Cycles Model, ABAB-Withdrawal and Multiple Probes and Maximum Opposition Model. METHODS: 21 children with phonological disorder, 11 males and 10 females, with average age 5:7, were their speech data analyzed through the phonological assessment. From the contrastive analysis we calculated the Percentage of Correct Consonants (Shriberg & Kwiatkowski, 1982) and the subjects were classified in the different severity levels of phonological disorders: severe, moderate-severe, mild-moderate and mild. Six subjects were submitted to the treatment with Modified Cycles Model, eight to the ABAB-Withdrawal and Multiple Probes Model, and seven to the Modified Maximum Opposition Model. After this was compared the generalization inside of a sound class and for other sound classes among three therapy models for each severity level of phonological disorder. RESULTS: the generalization inside a sound class occurred in all studied models. ABAB-Withdrawal and Multiple Probes Model were effective for all severity groups and the Modified Maximum Opposition were more effective for the severe and moderate-severe groups. In the generalization for other sound classes, the subjects treated with ABAB-Withdrawal and Multiple Probes Model showed a major generalization in different severity levels of phonological disorder. CONCLUSION: all the subjects showed evolution in all kinds of generalization studied in three different therapeutic models.

Terapia fonológica: a generalização a itens não utilizados no tratamento (outras palavras)

PURPOSE: to check the generalization to non used items during treatment (other words) obtained in the three different models of therapy in subjects with different degrees of phonological disorder severity. METHODS: the studied group was composed by twenty-one subjects, eleven males and ten females, with average age when of the beginning of treatment 5:7. Speech data were analyzed through the performance of the phonological assessment. After the phonological assessment, the percentage of correct consonants proposed by Shriberg & Kwiatkowski (1982) was calculated and the subjects were then classified in the degrees of phonological disorder severity: severe, moderate-severe, mild-moderate and mild disorder. Six subjects were submitted to the Modified Cycles Model, eight to the ABAB-Withdrawal and Multiple Probes Model and seven to the Modified Maximum Opposition Model. A comparison was made on the generalization to non used items during treatment (other words) among three models of therapy within each degree of phonological disorder severity. RESULTS: Among the subjects with severe, moderate-severe and mild disorder, three subjects that presented the major generalization to non used items during treatment, all treated with ABAB-Withdrawal and Multiple Probes Model. Of the subjects with mild-moderate disorder, were treated with the Modified Maximum Opposition Model those that showed the major generalization. CONCLUSION: all the subjects showed gains in the phonological system and as for the generalization to non used items during treatment (other words), but ABAB-Withdrawal and Multiple Probes and Modified Maximum Opposition Models were more effective.

Terapia fonológica considerando as variáveis linguísticas

The aim of this study was to analyze the acquisition of the non-lateral liquid /r/ in two children with phonological disorders, taking into consideration the words hierarchy proposed in a previous study, as well as the generalization obtained. The facilitating linguistic variables for the acquisition of the target sound /r/ in medial onset were considered to the selection of target words, based on syllable tonicity and the preceding and following environments to the non-lateral liquid. It was observed a better development in subject 1, who was treated with words belonging to the more favorable context, as compared to the subject 2, who was treated with the less favorable contexts. The choice of target words for therapy based on facilitating linguistic variables proved to be important to acquisition of /r/ as well as for the occurrence of generalizations.

Modelo de oposições múltiplas modificado: abordagem baseada em traços distintivos

The aim of this study was to propose an approach based on distinctive features for the Multiple Oppositions Model, and to test its application on a Brazilian Portuguese speaker. The model was used with a male subject with moderate-severe phonological disorder and six years and six months old. After phonological evaluation the target sounds were selected. The initial phonological system was considered, as well as the altered distinctive features ([+voiced], [+sonant], [+approximant], [coronal/±anterior], [-continuous]). The features with more alterations were [+voiced, +sonant, +approximant], justifying the choice of the following target sounds for treatment: /r/ x /l/ x // x // x /z/,in medial onset. Based on the application of this model in English speakers, some necessary procedures were introduced, such as: choice of the target-sounds based on the altered distinctive features, and the structure of therapy session. At the end, the subject was reassessed, in order to verify the phonological system acquisitions. After ten speech-language therapy sessions, the subject acquired the phonemes /l, , , z/, generalizing them to other word positions (/l/ and // in initial onset). It was also verified the occurrence of generalization for the same class and other classes of sounds (/b/, /d/, /g/, /v/). However, the phoneme /r/ was not acquired. This proposal proved to be effective, for the subject showed improvement on his phonological system with few therapeutic sessions. It was possible to observe that the Multiple Oppositions Model, when applied using the approach based on distinctive features, is effective, because it favored many phonological changes.

Terapia fonológica: a generalização para outra posição na palavra

PURPOSE: to analyze the efficacy in the three models of therapy with phonological basement in subjects with different degrees of phonological disorder severity. METHODS: the subjects in this research were 21 children, eleven males and ten females, with age mean: 5:7. Speech data were analyzed through the performance of the phonological assessment. After the phonological assessment, the percentage of correct consonants proposed by Shriberg & Kwiatkowski (1982) was calculated and the subjects were then classified in the severity degrees regarding the phonological disorder in: severe, moderate-severe, mild-moderate and mild disorder. Six0 subjects were submitted to the Modified Cycles Model, 8 to the ABAB-Withdrawal and Multiple Probes Model and 7 to the Modified Maximum Opposition Model. Making the comparison the generalization to other position in the word among three models of therapy within each degree of phonological disorder severity. RESULTS: the generalization to other position in the word occurred in all the studied models, however, ABAB-Withdrawal and Multiple Probes Model were more effective to the group with severe disorder; the Modified Maximum Opposition Model to the group with moderate-severe and mild-moderate disorder; and the Modified Maximum Opposition and the ABAB-Withdrawal and Multiple Probes Models to the group with mild disorder. CONCLUSION: all the subjects showed gains in the phonological system and relation to generalization of the other positions in the word, but the ABAB-Withdrawal and Multiple Probes and Modified Maximum Opposition Models were more effective.

Escolha dos sons-alvo para terapia: análise com enfoque em traços distintivos

The targets of the treatment can facilitate or difficult acquisitions in the phonological inventory. This study had the aim to verify the effectiveness of the therapy proposed by the Multiple Oppositions Model, taking into consideration the target sounds chosen, as well as to analyze the acquired sounds and the distinctive features, based on the target sounds. The researched group comprised five children with phonological disorder, with an average age of 6;1 (years;months). Speech-language pathology and complementary evaluations were carried out. After the assessments, the subjects underwent speech therapy using the Multiple Oppositions Model. After treatment, another evaluation was carried out, in order to compare the therapeutic evolution and the effectiveness of the chosen sound targets for each subject. The phonological inventory and the number of altered distinctive features before and after therapy were compared for each subject, as well as the distinctive features focused during therapy. The subjects who added more phonemes to their phonological inventory were the ones that most decreased the number of altered distinctive features. It can be concluded that the Multiple Oppositions Model provided improvements on the phonological inventory that were related to the characteristics of the target sounds selected for each subject. The subjects whose target sounds contemplated the work with the majority of the altered distinctive features and the most complex sounds in the phonological hierarchy presented greater acquisitions in their phonological inventories.

Mudanças fonológicas obtidas no tratamento de sujeitos comparando diferentes modelos de terapia

BACKGROUND There are many options of phonological disorder treatments that aim at improving childrens communication. AIM To analyze the Percentage of Consonants Correct-Revised, the number of acquired phonemes in the phonological system and the types of generalizations obtained in treatment, comparing different therapy models in subjects with different severity levels of phonological disorder. METHOD Participants were 21 children, mean age 5:7 years. All subjects underwent speech, language and hearing evaluations and additional exams. Children were then divided into groups according to therapy model and severity level of phonological disorder. The Percentage of Consonants Correct-Revised, the number of acquired phonemes and the types of generalizations were analyzed and compared within and between each therapeutic model, considering pre and post therapy evaluations. RESULTS It was possible to observe improvement in the three analyzed therapy models. When comparing the therapy models, the greater improvement in percentage terms was observed for the ABAB-Withdrawal and Multiple Probes Model and the Maximal Oppositions Model, even though the statistical analysis indicated no significant difference. CONCLUSION The three therapy models were effective for the treatment of children with phonological disorder because they all of them provided an increase in the Percentage of Consonants Correct-Revised, in the number of acquired phonemes and in the types of analyzed generalizations.