Maysa Luchesi Cera

Análise fonológica dos erros da apraxia adquirida de fala

BACKGROUND the phonological characterization of the errors present in the speech of individuals with speech apraxia can elucidate several aspects of this disorder and consequently lead to the development of effective therapeutic interventions. Generally, studies that have characterized the errors present in speech apraxia were developed in other languages other than the Brazilian Portuguese (BP). The existing national literature about this theme is based on these studies. AIM to present the phonological analysis of the errors present in the speech of individuals with speech apraxia, speakers of the BP language. METHOD 20 adults with speech apraxia were evaluated. The analysis of phonological errors, such as substitution and omission was made. RESULTS a few of the most affected phonemes in the speech of apraxic individuals (/b/, /lambda / e /3 /), speakers of the BP language, were different from those usually described in international studies. CONCLUSION results suggest that the errors present in the speech of apraxic individuals can suffer the influence of language once the most frequent errors found in the present study were different from those described in the international literature.

Aphasia and herpes virus encephalitis: a case study

CONTEXT Meningoencephalitis early in life, of any etiology, is a risk factor for development of subsequent sequelae, which may be of physical, psychiatric, behavioral or cognitive origin. Anomia is a language abnormality frequently found in such cases, and other language deficits are rarely described. The aim of this study was to describe the cognitive and linguistic manifestations following a case of herpetic meningoencephalitis in a 13-year-old patient with eight years of schooling. CASE REPORT The patient underwent a speech-language audiology assessment nine months after the neurological diagnosis. The battery of tests included the Montreal-Toulouse Language Assessment test protocol (MT Beta-86, modified), the description from the Cookie Theft task of the Boston Diagnostic Aphasia Examination (BDAE), an informal assessment of the patients logical and mathematical reasoning, and the neuropsychological subtests from the WAIS-III scale, which assess working memory. The patient presented mixed aphasia, impairment of short-term memory and working memory, and dyscalculia. This case also presented severe cognitive and linguistic deficits. Prompt diagnosis is crucial, in order to enable timely treatment and rehabilitation of this neurological infection and minimize the cognitive deficits caused by the disease.

Phonological analysis of substitution errors of patients with apraxia of speech

The literature on apraxia of speech describes the types and characteristics of phonological errors in this disorder. In general, phonemes affected by errors are described, but the distinctive features involved have not yet been investigated. Objective To analyze the features involved in substitution errors produced by Brazilian-Portuguese speakers with apraxia of speech. Methods 20 adults with apraxia of speech were assessed. Phonological analysis of the distinctive features involved in substitution type errors was carried out using the protocol for the evaluation of verbal and non-verbal apraxia. Results The most affected features were: voiced, continuant, high, anterior, coronal, posterior. Moreover, the mean of the substitutions of marked to markedness features was statistically greater than the markedness to marked features. Conclusions This study contributes toward a better characterization of the phonological errors found in apraxia of speech, thereby helping to diagnose communication disorders and the selection criteria of phonemes for rehabilitation in these patients.

Manifestações da apraxia de fala na doença de Alzheimer

PURPOSE: To identify praxic speech manifestations in patients diagnosed with different stages of Alzheimers disease, and to verify similarities among their occurrences. METHODS: Participants were 90 patients with Alzheimers, 30 in each stage of the disease (mild, moderate and severe), who were assessed using the following instruments: Clinical Dementia Rating (CDR), Mini-Mental State Examination (MMSE), Lawton Instrumental Activities of Daily Living, and the Assessment Protocol of Verbal and Orofacial Apraxia. Sixty six female subjects and 24 male subjects were assessed; mean age was 80.2±7.2 years, and mean level of education was 4.2±3.5 years. RESULTS: In the mild stage, the proportions of trial-and-error, repetition and addition were similar, as well as omission, substitution and self-correction. In the moderate stage, the following items were similar: trial-and-error and repetition, substitution, omission and addition, and self-correction. In the severe stage, all manifestations were similar, except addition. The error type addition differentiated the patients regarding the stages of the disease. CONCLUSION: Patients in the three stages of Alzheimers disease showed distinct patterns of verbal praxic manifestations.

Analysis of error type and frequency in apraxia of speech among Portuguese speakers

Most studies characterizing errors in the speech of patients with apraxia involve English language. Objectives To analyze the types and frequency of errors produced by patients with apraxia of speech whose mother tongue was Brazilian Portuguese. Methods 20 adults with apraxia of speech caused by stroke were assessed. The types of error committed by patients were analyzed both quantitatively and qualitatively, and frequencies compared. Results We observed the presence of substitution, omission, trial-and-error, repetition, self-correction, anticipation, addition, reiteration and metathesis, in descending order of frequency, respectively. Omission type errors were one of the most commonly occurring whereas addition errors were infrequent. These findings differed to those reported in English speaking patients, probably owing to differences in the methodologies used for classifying error types; the inclusion of speakers with apraxia secondary to aphasia; and the difference in the structure of Portuguese language to English in terms of syllable onset complexity and effect on motor control. Conclusions The frequency of omission and addition errors observed differed to the frequency reported for speakers of English.

Interdisciplinary Therapy for patients with dementia

Patients with dementia require rehabilitation involving several health professionals, where interdisciplinary care can further enhance the routine of patients and their families. Objective To compare the functional performance of elderly with dementia before and after an interdisciplinary intervention program provided by a healthcare service of medium complexity. Methods Three cases with clinically-confirmed dementia enrolled on an interdisciplinary rehabilitation program were reported. The following instruments were applied: Mini Mental-State Exam, Clinical Dementia Rating, Geriatric Depression Scale, Lawton & Brody Index, and the Functional Independence Measure for adults (FIM). The therapeutic strategies were individualized and designed based on patient performance on the FIM, according to the criteria of the Classification of Functionality, Disability and Health, implemented at the house of therapy of the Center for Integrated Rehabilitation together with provision of guidance. Results A reduction in functional dependence was observed after intervention, evidenced by less supervision needed to carry out Activities of Daily Living. Conclusion The three patients benefited from the interdisciplinary intervention.

Speech and orofacial apraxias in Alzheimer's disease – CORRIGENDUM

The authors of the recent article by Cera et al. (published online 7th June 2013) regret that the following information was omitted from the manuscript in error: The authors gratefully acknowledge the funding for this project provided by the State of Sao Paulo Research Foundation (FAPESP 2008/52670-1) and the National Council for Scientific and Technological Development (CNPq 132979/2008-0). The authors are grateful to the participants for their time and effort.

Apraxia of speech and orofacial apraxia in Alzheimer's disease

icantly reduced ability to detect simple emotional cues and difficulty identifying simple and paradoxical sarcasm on the TASIT; reduced ability to identify risk and failure to modify decision making on the IGT; and increasedmean reaction times on the set-switching task. Performance on these tasks was not uniformly correlated across the FTD cohort. Conclusions: Our findings provide further evidence that the capacity to evaluate one’s own behavior, the capacity to evaluate others’ behavior and the capacity to switch between behavioral sets are impaired in FTLD. The application of tests sensitive to these functions could provide new biomarkers of complex behavioral functions in FTLD.

Disartria na doença de Wilson: análise de dois casos em fases distintas

TEMA: disartria na Doenca de Wilson. PROCEDIMENTOS: estudo de caso de dois pacientes com o diagnostico da doenca, ambos adultos jovens, do sexo feminino e com seis anos de escolaridade. Quatro fonoaudiologas realizaram a avaliacao perceptivo-auditiva de modo independente, na qual foram investigados os seguintes parâmetros: tipo de voz, loudness, pitch, ataque vocal, instabilidade fonatoria e ressonância. O grau de alteracao de cada parâmetro foi mensurado atraves de uma escala analogico-visual. Alem disso, foram obtidas medidas de inteligibilidade por transcricao ortografica. A analise acustica foi realizada por meio do programa Praat, com a obtencao de medidas de frequencia fundamental, de perturbacao e ruido e medidas temporais. RESULTADOS: a fala de ambos os pacientes foi caracterizada por: reducao do tempo maximo de fonacao, voz soprosa e tensa, ataques vocais aspirados, instabilidade vocal, aumento de shimmer e proporcao ruido-harmonico, hipernasalidade, reducao da diadococinesia oral, da inteligibilidade e da velocidade da fala. Os resultados obtidos sugeriram que o paciente que cursa com a Doenca de Wilson ha mais tempo, apresentou prejuizo mais acentuado na maioria dos parâmetros perceptuais e acusticos analisados. CONCLUSAO: foram identificadas manifestacoes comuns entre os casos, as quais podem constituir-se em tracos caracteristicos da fala de pacientes disartricos com Doenca de Wilson. Todavia, diferencas tambem foram evidenciadas, as quais podem estar relacionadas ao tempo de evolucao da doenca.