CoDAS最新文献

[This corrects the article doi: 10.1590/2317-1782/e20230358pt] [This corrects the article doi: 10.1590/2317-1782/e20230358en].

Purpose: To investigate the effectiveness of acoustically controlled auditory training (ACAT) and the maintenance of auditory skills acquired by children with impaired school performance.

Methods: Sample consisting of 20 schoolchildren: Control Group (CG - N=10) and Intervention Group (IG - N=10), aged from 8 to 13 years old, results below expectations in a school performance screening, adequate results in a cognitive screening and diagnosed with central auditory processing disorder (CAPD) after a battery of behavioral tests. The CG did not receive any type of intervention, only evaluation and reevaluation after three months. The IG was assessed immediately after eight ACAT sessions and three months post-intervention. Auditory processing assessment and reassessment data were subjected to statistical analysis (p<0.05).

Results: The sample was considered homogeneous regarding gender, age, education level and academic performance. Regarding CAP assessment data, both groups were homogeneous (excepting the Synthetic Sentence Identification - SSI test). Children from IG improved their performance on the Dichotic Digit, Consonant Vowel, SSI and Frequency Pattern (FPT) tests immediately after the intervention. After three months of ACAT, these values remained the same or increased, except for FPT. In the qualitative analysis, between normal and altered, the IG maintained adequate results after three months of ACAT. In the CG, six children maintained altered results and four reached normality in the reassessment after three months.

Conclusion: ACAT proved to be effective for rehabilitating the auditory skills of children with impaired school performance even three months after the end of the intervention.

Purpose: To identify whether there is interrater and intrarater agreement in the classification of the degree of central facial paralysis using two scales and verify which one is more appropriate to classify the severity of facial expressions according to experts' opinion.

Method: Observational, prospective, cross-sectional study of agreement analysis of the House & Brackmann (HB) scale and the Sunnybrook Facial Grading System (SFGS). Five speech-language-hearing pathologists with clinical experience analyzed post-stroke facial expression of 30 adults for interrater agreement. They were evaluated in two stages, with a 10-day interval; the second stage involved 20% ​​of the initial sample for intrarater agreement. The study used weighted kappa coefficient for the HB scale and the intraclass correlation coefficient for the SFGS classification.

Results: The HB scale indicated considerable interrater and excellent intrarater agreements. The SFGS had good interrater and intrarater agreements. All speech-language-hearing pathologists considered the SFGS the most appropriate scale for classifying central facial paralysis.

Conclusion: The SFGS performed better in interrater agreement analysis. The HB scale had considerable merits in the intrarater assessment. Both scales are adaptable and useful to assess and classify central facial paralysis. However, the speech-language-hearing pathologists indicated the SFGS as the most appropriate.

Purpose: to verify whether orofacial myofunctional symptoms are related to findings from orofacial myofunctional clinical assessment in adults sleeping breathing disorders (SBD).

Methods: observational study; 15 adults, with a mean age of 43 years and diagnosed with primary snoring or OSA by polysomnography; evaluated using the Orofacial Myofunctional Assessment Protocol MBGR, including the Clinical History Protocol to assess symptoms, and the Clinical Examination Protocol to identify signs, considering tests of mobility of lips, tongue, soft palate and jaw; tone of lips, tongue, cheeks and chin; respiratory mode; chewing; and swallowing solids and liquids. For the correlation between signs and symptoms, Spearman's Correlation Coefficient, considering p<0.05 statistically significant, was used.

Results: The main orofacial myofunctional complaints were related to chewing (use of only one side during chewing and the need to drink liquids during meals), and swallowing (choking and residue after swallowing). In the orofacial myofunctional assessment, there was a greater frequency of alterations in tongue tone; lip mobility; unilateral chewing pattern with increased speed and chewing inefficiency; swallowing with excessive contraction of the perioral muscles, associated head movement and presence of residue in the oral cavity. The correlation between the scores of orofacial myofunctional signs and symptoms showed significance only between the aspects related to the chewing function (p=0.034), being moderate and inversely proportional (r=-0.548).

Conclusion: a moderate negative correlation was found between masticatory signs and symptoms in adults with SBD, and no correlation was observed for breathing and swallowing functions.

Purpose: We aimed to describe tongue pressure in sarcopenic and dynapenic older adults.

Methods: An exploratory observational cross-sectional study was performed. Data were gathered from 29 institutionalized older adults (over 60 years old) and several methods were used in order to assess sarcopenia - handgrip strength (dynamometer), muscle mass (bioelectrical impedance analysis and calf circumference); physical performance (Short Physical Performance Balance); and tongue pressure (PLL Pró-Fono). For descriptive analysis, means and medians were described for quantitative variables and absolute and relative frequencies were described for qualitative variables. In the inferential analysis, Pearson's and Spearman's coefficients were used for correlation measurements and Chi-square and Fisher's were used for association, 5% significance level.

Results: Most patients were female (79.31%), with a median age of 81 years (IQR 12). Regarding diagnosis, 79.31% were sarcopenic, 17.24% were dynapenic and 3.45% did not present sarcopenia. Fifty-eight point six percent of patients presented low tongue pressure, being 88.2% aged 70-79 years old. Among sarcopenic older adults, 65.2% showed a decline in tongue pressure, while 40% showed similar results in the dynapenic group. There was a statistically significant positive correlation between handgrip and tongue pressure in the 70-79 years age group (p=0.03). With regards to women, there was an association between tongue pressure and sarcopenia (p=0.039) and a positive correlation between tongue pressure and handgrip (p=0.003).

Conclusion: A decline in tongue strength was observed in the two studied groups, with worse outcomes in sarcopenic older adults.

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.