CoDAS最新文献

Purpose: To assess the safety and immediate effect of photobiomodulation of low-level laser in vocally healthy women.

Methods: Experimental research in 36 vocally healthy women aged 18 to 45 years, with skin phototype I to III and body mass index below 25. Participants were randomized to form four groups: Group 1: placebo laser photobiomodulation followed by voiced tongue trill technique (VTTT); Group 2: 3 J infrared laser per point (total 21 J) followed by VTTT; Group: 3: 6 J infrared laser per point (total 42 J) followed by VTTT; and Group 4: 9 J infrared laser per point (total 63 J) followed by VTTT. The following outcomes were assessed: auditory-perceptual evaluation, acoustic analysis (jitter, shimmer, amplitude perturbation quotient [APQ], noise-to-harmonic ratio, period perturbation quotient, cepstral peak prominence, and cepstral peak prominence smoothed), and self-perceived phonatory effort. All participants' records were taken before and immediately after the experiments.

Results: There was no significant difference in voice quality, acoustic parameters, or self-perceived phonatory discomfort between intervention moments in the placebo, VTTT + 3 J, and VTTT + 6 J groups in the intragroup comparison. G4 (VTTT + 9 J) decreased shimmer and APQ aperiodicity measures (respective p-values: 0.033; 0.044).

Conclusion: Results indicate aperiodicity measures improved with VTTT preceded by 9 J low-level laser application per point, commending this irradiation dosimetry as a possible energy for voice therapy in light-skinned and normal-BMI women. There was no evidence of worsened measures or in-creased discomfort with this resource, indicating it is safe for clinical practice.

Purpose: To validate the internal structure of the Speech-Language Pathology Script Concordance Test (FonoTCS), which will be developed in a virtual, open-access format, to be used in the assessment of clinical reasoning among young professionals and students of speech-language pathology with a generalist background, speakers of Brazilian Portuguese.

Methods: This is a study to validate the internal structure of the instrument. Twenty-five specialist speech-language pathologists, with more than 10 years of generalist clinical experience, and 35 students summoned for Enade participated. Both groups evaluated the 30 clinical cases with 120 items from FonoTCS. For the final selection of specialists who made up the sample, judges whose evaluations showed Z2 results >2 and Z<-2 distant from the modal response were removed. For the selection of items present in the final format of the test, those that remained had a Pearson correlation between the transformed scores of students for a given item and the sum of the transformed scores for all items, with a value greater than 0.05. The Cronbach's Alpha test was applied to measure the internal consistency of FonoTCS, and the score of each item was defined based on the aggregated score method.

Results: The responses of 13 specialists were considered for the definition of the final test score. The final instrument had 88 items distributed across 28 clinical cases. The internal consistency was 0.903 with a 95% confidence interval expressed by 0.86|---|0.95. These values indicate a high internal consistency among the items of FonoTCS.

Conclusion: FonoTCS is valid and reliable for use in evaluating the clinical reasoning of young professionals and speech-language pathology students with generalist training, who are Brazilian Portuguese speakers.

Purpose: This study aimed to assess the contributions of the DHACA method to expressive communication development in children with autism spectrum disorder (ASD).

Methods: This longitudinal case series study had a sample of 12 children with ASD, nonverbal or minimally verbal communication, and support level one or two. Data were collected by applying the ACOTEA-R Protocol by analyzing videos recorded during intervention sessions before and after using the DHACA. Participants underwent 20 individual speech-language-hearing sessions with the DHACA.

Results: After the intervention with the ACOTEA-R, 10 of the 12 children improved their overall expressive communication skills. Concerning the communicative profile, initially, 10 children were nonverbal and 2 were minimally verbal. After the intervention, 7 evolved to a verbal pattern, whereas 5 remained nonverbal. The progress of the following communication skills stands out: use of sentences with four or more words, naming objects, social expressions, greeting people, and making comments. Moreover, 8 of the 12 participants advanced to the third skill in the DHACA, characterized by request with lexical and morphosyntactic expansion.

Conclusion: The children's speech and use of the communication book indicated progress in their expressive communication development after intervention with the DHACA.

Purpose: To analyze swallowing in older adults with dementia through clinical evaluation at a referral center for elderly healthcare.

Methods: Retrospective, cross-sectional, observational study with older people, stratified by the Clinical Dementia Rating (CDR). Characterization was based on data extracted from medical records, including functional, cognitive, and mood assessments. The clinical evaluation of swallowing consisted of food offered in three consistencies, analyzing 13 items and functional classification.

Results: The sample included 149 older adults - 47 neurotypical (CDR 0), 37 with mild dementia (CDR 1), 40 with moderate dementia (CDR 2), and 25 with severe dementia (CDR 3). The groups differed significantly, indicating greater changes in swallowing according to the severity of dementia. For instance, CDR 3 had greater changes in oral spillage of liquids than CDR 0 (p=0.012*). Cough with solids and drop in oxygen saturation with liquids were greater in CDR 3 than in CDR 1 (p=0.039* and p=0.047*, respectively). CDR 3 also had a higher frequency of reduced laryngeal excursion with nectar than CDR 2 (p=0.044*). Only positive cervical auscultation with nectar showed greater change in CDR 2 than in CDR 1 (p=0.019*). Oral residue of solids had a greater change in CDR 1 than in CDR 0 (p=0.030*).

Conclusion: The severity of dementia was associated with swallowing impairments, highlighting the need for specific interventions in this population.

Purpose: To analyze the association of habitual lip and tongue posture and clinical characteristics with sleep-related problems in infants with Trisomy 21 (T21).

Methods: This cross-sectional observational study with a non-probabilistic sample included 87 infants with T21 with a mean age of 8.8 months. The infants' parents answered the Brief Infant Sleep Questionnaire (BISQ) and questions about signs and symptoms related to obstructive sleep apnea. The habitual lip and tongue posture was obtained by analyzing videos of the infants' faces. Information on personal data and health history was extracted from medical records, and information about feeding and oral habits was obtained by interviewing the parents. Descriptive analysis approached the infants' sleep data and the association between sleep quality, snoring, witnessed respiratory pauses, unusual sleeping positions, restless sleep, and the other variables, using Pearson's chi-square test with a 5% significance level.

Results: Most infants (82.7%) had good sleep quality. Prematurity was associated with witnessed respiratory pauses; unusual sleeping positions were associated with being a female and with the tongue habitually contained in the oral cavity; and restless sleep was associated with choking.

Conclusion: Prematurity, sex, habitual tongue posture, and choking were associated with the aspects of sleep investigated in infants with T21.

Purpose: To develop and verify the effectiveness of a hearing abilities (HA) stimulation program included in the regular school curriculum and applied by teachers in the classroom.

Methods: An HA stimulation program was developed and applied to preschoolers during the school year; 34 children underwent auditory stimulation (ASG) and were compared to a placebo group (PG; n = 31). The students were assessed regarding their HA and pre-reading and decoding skills before and after the intervention. They were reassessed twice after applying the program to monitor the students' performance amid the COVID-19 pandemic.

Results: The program includes activities applied at school by teachers for 25 weeks, lasting 10-15 minutes/day, stimulating the following HA: detection, discrimination, temporal processing, figure-ground, closure, memory, and attention. The ASG and PG performances differed significantly after the program.

Conclusion: The program was incorporated into the curriculum, helping to develop the skills recommended by the Ministry of Education. After auditory stimulation, ASG performed better in auditory figure-ground, temporal resolution, rhyme identification and production, and word production from the phoneme given.

Purpose: To verify the results of active middle ear implant on audibility and auditory speech perception in individuals with external and/or middle ear malformations.

Methods: Primary, observational, retrospective study, through analysis of medical records of individuals with bilateral external and/or middle ear malformations, unilateral users of active middle ear implant. The data collected refer to auditory thresholds obtained through free-field audiometry and assessment of auditory speech perception - sentence recognition in silence and noise, in the following situations: without the implant, at the time of activation, in the first and in the third month of use.

Results: Nine individuals were included in the study. The average age at the time of activation was 24.6 years (minimum 12 and maximum 40 years). Statistically significant improvement in auditory thresholds (p<0.05) and in the sentence recognition test in silence and noise (p<0.05) was observed at the time of activation. There was no significant difference between the evaluation situations after activation, indicating acclimatization by the user.

Conclusion: The results of the active middle ear implant VSB (MED-EL) users on the audibility and auditory speech perception, in individual with external and/or middle ear malformation were better in the activation condition compared to the pre-surgical condition, maintaining stable over time; which reinforces its indication for this population.

Purpose: Translate and cross-culturally adapt the "Down Syndrome Speech Intelligibility Survey" questionnaire into Brazilian Portuguese.

Methods: The following steps were taken for cross-cultural adaptation: translation of the instrument from the source language to the target language, synthesis of the translated versions, evaluation of the synthesis by expert judges, evaluation of the instrument by the target audience, back translation, and pilot study.

Results: After the translation and synthesis of the translations, most expert judges analyzed almost all instrument items (n = 44, 97.77%) as very relevant, very feasible, and appropriate. In the analysis by the target population, parents suggested changes, improving the understanding of the instrument. The back translation revealed some inconsistencies in the translated and adapted version in relation to the original instrument's content, and the appropriate adjustments were made. The pilot study identified the need to adapt some questions, exclude one item (which had similar content to another), and include prior instructions for completion, resulting in the final instrument version.

Conclusion: The translation and cross-cultural adaptation verified the validity evidence based on the content of the Brazilian version of the Down Syndrome Speech Intelligibility Survey.

Purpose: To investigate evidence of horse riding in the development of language, cognition, social, emotional, and behavioral aspects in neurotypical children and adolescents.

Research strategies: Search in the databases of LILACS, MEDLINE, Web of Science, EMBASE, Scopus, and grey literature, without date or language restrictions. Registration in the Open Science Framework (OSF), under number DOI 10.17605/OSF.IO/32ETZ. For search strategies: "Equine-Assisted Therapy", "Child or Adolescent Development", Cognition, Socialization, and "Child Behavior".

Selection criteria: Randomized clinical trials and non-randomized experimental before-and-after studies, case series, and prospective observational studies of neurotypically developing people up to 18 years old. Studies with people with disabilities and neurodevelopmental disorders were excluded. Interventions researched: horse riding and animal-assisted therapy.

Data analysis: Two judges identified primary studies independently by reading the titles and abstracts, considering the inclusion criteria; a third judge was consulted to resolve divergences. The risk of bias was assessed using the ROBINS-I and ROBINS 2 tools.

Results: Altogether, 131 studies were obtained, and duplicates (27) were removed. Subsequently, 104 studies were analyzed and 77 were excluded. Of the 27 studies evaluated in full text, 21 were excluded. Six studies were eligible for this review - four non-randomized clinical studies and two randomized clinical trials.

Conclusion: The non-randomized studies showed significant improvements in cognitive functions and behavioral and emotional aspects. The randomized studies, on the other hand, found significant gains in social competence.

Purpose: To evaluate tongue pressure, self-perception of swallowing, and whether tongue pressure is correlated with self-perception of swallowing in individuals undergoing total laryngectomy.

Methods: Cross-sectional study with two groups - with and without total laryngectomy, matched by age and sex to individuals with total laryngectomy. Participants had their tongue tip and dorsum pressure measured and self-assessed their swallowing with the Swallow Outcomes After Laryngectomy questionnaire (SOAL).

Results: The sample totaled 26 participants, 13 from each group. The mean maximum tongue dorsum pressure was 41.2±18.7 and 27.9±9.3 kilopascals, respectively, in the groups with and without total laryngectomy (p = 0.03). The median maximum tongue tip pressure was 33.7 (23.8-49.3) and 29.1 (22.5-35.7) kilopascals, respectively, in the groups with and without total laryngectomy (p = 0.29). The median SOAL was 6 (2.5-8.5) points in the group with total laryngectomy. The SOAL score was not statistically significantly correlated with tongue tip pressure (r = -0.17; p = 0.58) or dorsum pressure (r = -0.30; p = 0.31).

Conclusion: Individuals with total laryngectomy had higher tongue dorsum pressure, although there was no difference in tongue tip pressure between individuals with and without total laryngectomy. Tongue pressure was not correlated with self-assessment of swallowing, although tongue tip pressure was correlated with dorsum pressure in individuals with total laryngectomy.