Tiago Mendonça Attoni

Processamento auditivo, reflexo acústico e expressão fonológica

Estima-se que haja uma estreita relacao entre o acometimento nas habilidades do processamento auditivo, do reflexo acustico e na fala. OBJETIVO: O presente estudo e retrospectivo. Avaliar estas tres vertentes em criancas com e sem desvio fonologico e ver se ha relacao entre elas. MATERIAL E METODO: Neste estudo participaram 46 criancas, 24 sem comprometimento de fala e 22 com desvio fonologico. Todas as criancas foram submetidas a testes do processamento auditivo e pesquisa dos limiares do reflexo acustico DESENHO CIENTIFICO: Transversal e contemporâneo. RESULTADOS: Todas as criancas com desvio fonologico apresentaram alteracoes no processamento auditivo e nos limiares do reflexo acustico. O mesmo nao ocorreu com as criancas tidas como normais para o desempenho de fala. CONCLUSAO: Alteracoes no processamento auditivo e nos limiares do reflexo acustico estao intimamente ligados as dificuldades de fala.

Avaliação do processamento auditivo e da discriminação fonêmica em crianças com desenvolvimento fonológico normal e desviante

UNLABELLED Auditory processing and phonemic discrimination are essential for communication. TYPE OF STUDY Retrospective. AIM To evaluate auditory processing and phonemic discrimination in children with normal and disordered phonological development. MATERIAL AND METHODS An evaluation of 46 children was carried out: 22 had phonological disorders and 24 had normally developing speech. Diotic , monotic and dichotic tests were applied to assess auditory processing and a test to evaluate phonemic discrimination abilities. DESIGN Cross-sectional, contemporary. RESULTS The values of normally-developing children were within the normal range in all auditory processing tests; these children attained maximum phonemic discrimination test scores. Children with phonological disorders performed worse in the latter, and presented disordered auditory processing. CONCLUSION Auditory processing and phonemic discrimination in children with phonological disorders are altered.

Processamento auditivo e consciência fonológica em crianças com aquisição de fala normal e desviante

BACKGROUND Auditory processing (AP) and phonological awareness (PA) in children with and without phonological disorders. AIM To compare the performance of children with and without phonological disorders in a PA test; to verify the possible relationship between performances in distinct tasks of this test with the performance in the AP evaluation. METHOD Participants were 44 children with and without the diagnosis of phonological disorder, aged between 5:0 and 7:0 years, of both genders. After speech samples were gathered, subjects were divided into two groups: a study group (SG), composed by children with phonological disorders, and a control group (CG) with children without phonological disorders. PA was assessed through the Protocol Task Awareness Test (PTAT), and through the simplified AP evaluation (screening)--Disyllabic change--Staggered Spondaic Word (SSW), dichotic listening test and the binaural fusion test. RESULTS In both PA and AP assessments, children of the CG obtained better results. When correlating the results of AP and PA, a greater number of correlations were observed for the SG. CONCLUSION A significant relationship between the performance in the AP evaluation and success in PA tasks exists for children with phonological disorders.

Onset complexo pré e pós-tratamento de desvio fonológico em três modelos de terapia fonológica

PURPOSE: To examine the occurrence of complex onset pre- and post-treatment in children treated with three different models of phonological therapy. METHODS: Twenty-one subjects with phonological disorder participated in the study, 16 boys and five girls, with ages varying between four years and seven years and eleven months. The children were divided into three groups of seven subjects, according to the therapy models used: Modified Cycles Model, Maximum Opposition Model and ABAB-Withdrawal and Multiple Probes Model. Data from initial and final evaluations of the phonological system were analyzed, regarding the total production of complex onsets and of production of complex onsets with /l/ and /r/. These were classified as: not acquired, from 0 to 39%; partially acquired, from 40 to 69%; and acquired, from 70 to 100%. Statistical analyses were carried out. RESULTS: Regarding the total number of occurences of complex onsets, there was a difference between pre- and post-therapy means of not acquired and acquired complex onsets in the Modified Cycles Model and in the Maximum Opposition Model; in the ABAB-Withdrawal and Multiple Probes Model, this difference was found only for acquired complex onsets. The same was veryfied for complex onsets with /r/. With regards to complex onsets with /l/, differences were found only in the Modified Cycles Model, between not acquired and acquired complex onsets. A different classification of not acquired and acquired complex onsets was observed, in all models, between pre- and post-treatment. CONCLUSION: The three models of phonological therapy were effective for the treatment of complex syllabic onset structure.

Processamento auditivo em crianças com fala normal e desviante

UNLABELLED Phonological speech disorders are characterized by abnormal development towards the adult target pattern; its etiology is unknown. It is thought the this condition results from auditory processing disorders involving the abilities required for human beings to understand what is heard. AIM To investigate the relationship between auditory processing and the acquisition of disordered or normal speech, drawing comparisons between these profiles. MATERIAL AND METHOD A prospective, contemporary, cross-sectional study comprising a sample of 44 subjects aged 5 to 7 years; two groups were formed: a study group (SG) comprising children with disordered speech acquisition, and a control group (CG) consisting of children with normal speech acquisition. A simplified evaluation of auditory processing was undertaken: the PSI test in Portuguese; the speech-in-noise test; the binaural fusion test; the dichotic digit test; and the staggered spondaic word test (SSW). RESULTS There was a statistically significant difference between the two groups; the SG scored worse than the CG in all the tests. The PSI test only - with a 100% success rate - scored equally in both groups. CONCLUSION Auditory processing may affect speech development.

Investigação e análise do reflexo acústico contralateral em crianças com desvio fonológico

UNLABELLED Much has been studied on the role of the acoustic reflex in the communication process. AIM To examine the responses of the contralateral acoustic reflex in children with normal hearing and phonological disorders. To investigate the relationship of the level of severity of phonological disorder. To measure the chances of it affecting all the frequencies tested. MATERIALS AND METHODS The study was based on the analysis of medical charts from 70 children with phonological disorders, and 24 females and 46 males, aged between 5 and 7 years. Audiological tests were analyzed to exclude children with hearing loss, evaluation of the contralateral acoustic reflex and the level of severity of phonological disorder. STUDY DESIGN Prospective. RESULTS All children showed change in the contralateral acoustic reflex. There was no significant relationship between the level of severity of phonological disorders and changes in the acoustic reflex for both genders. Female children showed no statistically significant value in the relationship between the frequencies, except at 500 Hz. Male children had more significant relationship in the association between changes in frequencies tested. CONCLUSION It is believed that children with phonological disorders exhibit changes in the contralateral acoustic reflex.

O processamento auditivo e a combinação de traços distintivos na aquisição de fala em crianças com desvios fonológicos

OBJETIVO: Investigar a relacao entre as habilidades auditivas e as combinacoes de tracos presentes na fala de criancas com desvios fonologicos. METODOS: Participaram da pesquisa 22 criancas com diagnostico de desvio fonologico, com idades entre 5 e 7 anos e de ambos os generos. Foi feita a coleta dos dados de fala por meio do teste Avaliacao Fonologica da Crianca. A combinacao de tracos foi observada mediante o Modelo Implicacional de Complexidade de Tracos (MICT). Os tracos adquiridos consideraram uma producao correta acima de 80%. Foram aplicados ainda os testes: Avaliacao Simplificada do Processamento Auditivo (triagem), Teste Dicotico de Dissilabos Alterados (SSW), Teste Dicotico de Digitos, Teste de Fusao Binaural, Teste de Fala no Ruido e o Teste de Logoaudiometria Pediatrica (PSI). RESULTADOS: Todas as criancas obtiveram 100% de exito no PSI. Nos testes de fala no ruido e de fusao binaural, bem como na triagem, os sujeitos tambem obtiveram medias altas. Os testes SSW e Dicotico de Digitos mostraram escores baixos. A combinacao de tracos que se mostrou mais alterada foi a [+aproximante,+continuo], que esta na composicao do fonema /r/, seguida de [coronal,+continuo]/(-anterior), que compoem os fonemas /ʃ,ʒ/. CONCLUSAO: Os resultados obtidos nos testes SSW e Dicotico de Digitos mostraram haver alteracao nas habilidades de ordenacao temporal complexa e figura-fundo, bem como memoria sensorial defasada. Ao relacionar com os tracos, estas alteracoes encontradas podem comprometer a aquisicao destes tracos descritos.

Original ArticleAuditory processing in children with normal and disordered speech

UNLABELLED Phonological speech disorders are characterized by abnormal development towards the adult target pattern; its etiology is unknown. It is thought the this condition results from auditory processing disorders involving the abilities required for human beings to understand what is heard. AIM To investigate the relationship between auditory processing and the acquisition of disordered or normal speech, drawing comparisons between these profiles. MATERIAL AND METHOD A prospective, contemporary, cross-sectional study comprising a sample of 44 subjects aged 5 to 7 years; two groups were formed: a study group (SG) comprising children with disordered speech acquisition, and a control group (CG) consisting of children with normal speech acquisition. A simplified evaluation of auditory processing was undertaken: the PSI test in Portuguese; the speech-in-noise test; the binaural fusion test; the dichotic digit test; and the staggered spondaic word test (SSW). RESULTS There was a statistically significant difference between the two groups; the SG scored worse than the CG in all the tests. The PSI test only - with a 100% success rate - scored equally in both groups. CONCLUSION Auditory processing may affect speech development.

Discriminação fonêmica, processamento auditivo e reflexo acústico em crianças com desenvolvimento de fala normal e desviante

Este estudo teve por objetivo avaliar a capacidade de discriminacao fonemica, as habilidades do processamento auditivo e os limiares do reflexo acustico em criancas com desvio fonologico e analisar uma possivel associacao entre estas vertentes. Alem disso, os resultados foram comparados ao de criancas sem alteracoes fonologicas. A amostra foi composta por 46 criancas, sendo 24 com desenvolvimento de fala normal e 22 com desenvolvimento de fala desviante, com idades compreendidas entre 5:0 e 7:4. Na avaliacao de discriminacao fonemica foi utilizado o Teste de Figuras para Discriminacao Fonemica. Para as avaliacoes do processamento auditivo foram utilizados a Avaliacao Simplificada do Processamento Auditivo, Teste Pediatrico de Inteligibilidade de Fala (PSI), Teste Fala com Ruido, Teste de Dissilabos Alternados (SSW) e o Teste Dicotico de Digitos. Os limiares do reflexo acustico foram mensurados pelo imitanciometro nas frequencias de 500, 1000, 2000 e 4000 Hz. Para o tratamento estatistico foi utilizado o programa SAS user´s guide: statistical, Analysis System Institute, Inc., Cary, NC, 2001; teste de correlacao de coeficientes de Pearson, considerando-se p<0,05. Os resultados indicaram que criancas com desvio fonologico apresentam deficits na capacidade de discriminacao fonemica, alteracoes em habilidades do processamento auditivo e reflexos acusticos fora dos padroes de normalidade. A conclusao deste estudo e que alteracoes na discriminacao fonemica, no processamento auditivo e reflexo acustico estao associados ao desvio fonologico e possivelmente podem ser responsaveis pelo seu aparecimento.

A generalização estrutural silábica no tratamento do desvio fonológico

, Marcia Keske-Soares RESUMOObjetivo: analisar a generalizacao estrutural silabica no tratamento realizado. Metodos: a amostra constituiu-se de sete sujeitos, com idades de 4:0 e 7:0 anos, selecionados atraves do banco de dados da amostra do Centro de Estudos da Linguagem e Fala (CELF) de uma instituicao de ensino superior. Os sujeitos selecionados haviam passado por avaliacoes fonoaudiologicas, apresentando alteracao somente no nivel fonologico (A1), que havia sido realizada durante a composicao do banco de dados. Os pacientes foram posteriormente tratados com o /r/ em Onset Medial pelo Modelo ABAB–Retirada e Provas Multiplas, por um ciclo de nove sessoes terapeuticas, durante nove semanas. Para a analise da generalizacao estrutural silabica, foram comparados os dados do sistema fonologico obtidos na avaliacao fonologica inicial e na Prova de Generalizacao 1 (PG1). Resultados: o S1 percorreria duas metas, mas houve generalizacao em apenas uma; o S2 nao houve generalizacao em nenhuma das duas metas indicadas; o S3 e o S4 percorreram as quatro metas que seriam indicadas, e o S5 per-correu as 3 metas propostas. Conclusao: a analise permitiu verificar de forma detalhada as metas de generalizacao.DESCRITORES: Fala; Transtornos da Articulacao; Fonoterapia