Pro-fono : revista de atualizacao cientifica最新文献

Background: Dizziness impact on the quality of life (QoL) of elderly patients with chronic vestibular dysfunction.

Aim: To evaluate the association between the impact of dizziness on the QoL of elderly patients with chronic vestibular dysfunction and demographic and clinical variables.

Method: A prospective study. A hundred and twenty elderly patients with chronic vestibular dysfunction underwent the Brazilian version of the Dizziness Handicap Inventory (DHI). In order to verify the association between the QoL and the demographic and clinical variables, the following testes were used: Mann-Whitney, Kruskal-Wallis and Spearman's correlation coefficient.

Results: There were significant associations between the presence of rotating and non-rotating dizziness with the total score of the DHI (p = 0.010) and physical (p = 0.049) and functional (p = 0.009) subscales; between recurrent falls with total DHI (p = 0.004) and physical (p = 0.045), functional (p = 0.010) and emotional (p = 0.011) subscales. Significant correlations were found between functional incapacity and total DHI (r = + 0.557; p < 0.001) and physical (r = + 0.326; p < 0.001), functional (r = + 0.570; p < 0.001) and emotional (r = + 0.521; p < 0.001) subscales.

Conclusions: The impact of dizziness on the QoL is higher in elderly patients with rotating and non-rotating dizziness, recurrent falls and functional incapacity.

Background: Promotion of a written narratives production program in the third grade of an Elementary School.

Aim: To analyze two written narrative practice proposals in order to verify which resources are more efficient in benefitting the textual productions of third grade Elementary School students.

Method: Sixty students were selected from two third grade groups of a public Elementary School in São Paulo (Brazil). For the analysis, students were divided into two groups (Group A and Group B). Fourteen children's storybooks were used. In Group A, the story was orally told by the researchers in a colloquial manner, keeping the narrator role and the original structure proposed by the author. In Group B, the story was fully read. The book was projected onto a screen and read aloud so the students could follow the reading and observe the corresponding illustrations. Voice changing resources in the characters' dialogues were used.

Results: In the overall comparison, statistically significant results were found for moment (initial and final assessments) and for interaction between groups. It was observed that both groups presented substantial development from initial to final assessment.

Conclusion: The Written Narratives Promotion Program based on the shared reading of children's storybooks constituted a more effective strategy than telling the stories using a single reader.

Background: Phonological disorder is one of the most frequent speech and language deficit observed in children and therefore studies using objective evaluation measurements should be developed and implemented during the diagnostic process.

Aim: To describe the acoustic characteristics of /l/ and /r/ liquid sounds.

Method: Speech production samples of 20 children with and without phonological disorder were gathered and acoustically analyzed. Six words were selected for repetition: /se'bola/, /'lama/, [see text]. The analyzed acoustic parameters were F1, F2 and F3, duration and steady-state portion from the target sound and slope analysis.

Results: For words containing /l/, the duration parameter was the great differentiator between the two groups; values of the control group were higher than those found for the group with phonological disorder. Considering words containing /r/ that were correctly produced by the control group and that were always substituted by /l/ in the disordered group, parameters involving duration presented higher values in the disordered group. Slope analysis demonstrated higher values for the control group.

Conclusion: Articulation accuracy of children in the control group was, overall, higher even when considering correctly produced words by the group with phonological disorder containing /l/. The analysis of other acoustic parameters, as well as the application of these parameters to other sounds of the Portuguese language, can help clinicians to make a precise evaluation and, consequently, to improve their therapeutic work.

Background: Temporal auditory processing and developmental dyslexia.

Aim: To characterize the temporal auditory processing in children with developmental dyslexia and to correlate findings with cortical malformations.

Method: Twenty school-aged children, ranging in age from 8 to 14 years were evaluated. These children were divided into two groups: the experimental group (EG) was composed by 11 children (eight were male) with developmental dyslexia and the control group (CG) was composed by nine normal children (six were male). After neurological assessment and verification of the intellectual level, language, reading and writing skills in order to determine the diagnosis, children underwent a peripheral audiological evaluation and Random Gap Detection Test and/or Random Gap Detection Test Expanded.

Results: A statistically significant difference between children in the EG and CG were observed, with children in the EG presenting worst performances. Most of the children in the EG presented perisylvian polymicrogyria.

Conclusion: Children with developmental dyslexia may present temporal auditory processing disorders with deficits in phonological processing. Cortical malformations may be the anatomical substrate of these disorders.

Background: tense marking by deaf signers, in the Brazilian Sign Language and in written Portuguese.

Aim: to analyze verbal tense inflection in written Portuguese, to verify the relationship between the performance in using verbal tense inflexion and the educational status, and to verify tense marking in the production of sentences in the Brazilian sign language and in written Portuguese.

Method: participants were 18 deaf signers ranging in age from 15 to 23 years, and with an educational status varying from 3rd to 7th grade of elementary school. Participants were assessed for their knowledge of nine action verbs. Following that, they were asked to elaborate three sentences with each verb using written Portuguese and using Brazilian sign language, one in the past tense, one in the present tense and one in the future tense. Data were analyzed qualitative and quantitatively.

Results: Regarding the written productions, there was a predominance of the verb in the infinitive nominal form. Participants adequately used tense markers in most of the sentences produced when using the Brazilian sign language. Four subjects used sign language markers to indicate tense in their written sentences. There was a significant statistical relationship between the use of verbal inflexion in the present tense and higher educational status.

Conclusion: the deaf participants of the study presented and adequate use of tense markers in most of the sentences produced using Brazilian sign language, however difficulty was observed when using written Portuguese.

Background: overall voice and strain level analysis in rock singers.

Aim: to analyze the voice o rock singers according to two specific parameters: overall level of vocal deviation (OLVD) and strain level (SL); to compare these parameters in three different music samples.

Method: participants were 26 male rock singers, ranging in age from 17 to 46 years (mean = 29.8 years). All of the participants answered a questionnaire for sample characterization and were submitted to the recording of three voice samples: Brazilian National Anthem (BNA), Satisfaction and self-selected repertoire song (RS). Voice samples were analyzed by five speech-language pathologists according to OLVD and SL. Statistical analysis was done using the software SPSS, version 13.0.

Results: statistically significant differences were observed for the mean values of OLVD and SL during the performance of Satisfaction (OLVD = 32.8 and SL = 0.024 / p=0.024) and during the RS performance (OLVD = 38.4 and SL = 55.8 / p=0.010). The values of OLVD and SL are directly proportional to the samples of the BNA* and RS**, i.e. the higher the strain the higher the OLVD (p,0.001*; p=0.010**). When individually analyzing the three song samples, it is observed that the OLVD does not vary significantly among them. However, the mean values present a trend to increase from non-rock to rock performances (24.0 BNA / 32.8 Satisfaction / 38.4 RS). The level of strain found during the BNA performance presents statistically significant difference when compared to the rock performances (Satisfaction and RS, p=0.008 and p=0.001).

Conclusion: the obtained data suggest that rock style is related to the greater use of vocal strain and that this strain does not necessarily impose a negative impression to the voice, but corresponds to a common interpretative factor related to this style of music.

Background: genetic factors as a possible cause of stuttering.

Aim: to identify the speech fluency family profile (linguistic, electromyographic and acoustic aspects) in children with and without a close family history of stuttering.

Method: the study included a total of 127 individuals, 32 children (probands) and 95 members of the immediate family (father, mother, sisters and brothers). The individuals were divided in two groups: GI (SC) was composed of 17 probands with a diagnosis of stuttering, 17 fathers, 17 mothers, 10 brothers, and 13 sisters, and GII (NSC) was composed of 15 fluent probands, 15 fathers, 15 mothers, no brothers, and 8 sisters. All testing procedures were applied to all participants as follows: 1) identification of disruption typology; 2) electromyographic analyses; and 3) acoustic analyses.

Results: the percentage of affected mothers was 41.1%, and the percentage of affected fathers was 35.3%. In addition, the percentage of affected sisters was 6.7%, and 40% of the brothers were affected. Similarity was observed in the typology of speech disruptions in all of the affected individuals of the same family; however, a trend towards a greater severity of the disorder in probands was observed. Similarity was found in muscle activation for diadochokinesia rates in all the affected individuals in the same family. This suggests the existence of a speech motor pattern within the same family that can be measured by capturing peripheral muscle activation. Similarity was found in the acoustic variation for diadochokinetic rates in all affected individuals of the same family.

Conclusion: this study represents one of the first endophenotypic research proposals on stuttering characterized by two aspects: objective inclusion criteria and the type of stuttering symptomatology manifested.

Background: phonological awareness, rapid naming, reading and writing in students with learning difficulties of a municipal public school.

Aim: to characterize and compare the performance of students from public schools with and without learning difficulties in phonological awareness, rapid naming, reading and writing.

Method: participants were 60 students from the 2nd to the 4th grades of municipal public schools divided into 6 groups. Each group was composed by 10 students, being 3 groups of students without learning difficulties and 3 groups with students with learning difficulties. As testing procedure phonological awareness, rapid automatized naming, oral reading and writing under dictation assessments were used.

Results: the results highlighted the better performance of students with no learning difficulties. Students with learning difficulties presented a higher ratios considering time/speed in rapid naming tasks and, consequently, lower production in activities of phonological awareness and reading and writing, when compared to students without learning difficulties.

Conclusion: students with learning difficulties presented deficits when considering the relationship between naming and automatization skills, and among lexical access, visual discrimination, stimulus frequency use and competition in using less time for code naming, i.e. necessary for the phoneme-grapheme conversion process required in the reading and writing alphabetic system like the Portuguese language.

Background: analysis of the pragmatic aspects of language in children with Down syndrome.

Aim: to verify the influence of environmental and contextual variables in the pragmatic aspects of language of Down syndrome (DS) children when interacting with their caregivers and therapist, and to compare their performance in both situations.

Method: participants were 15 children with DS with ages ranging from 4 to 6.11 years. Data were obtained through anamnesis, the protocol of functional communicative profile, and a socioeconomic questionnaire. Data obtained from both interaction situations (with the caregiver and with the therapist) were compared, and submitted to statistical analysis.

Results: Caregiver's socioeconomic and educational levels were the variables that most had an influence on the pragmatic aspects of the child in both interaction situations. Children presented proportional rates of functional communication when compared to the data obtained for their caregivers and the communicative functions more frequently used by them were recognition of others, comment and performative. Comparisons between the interaction situations indicated no statistically significant differences concerning the children's communicative performance.

Conclusion: caregivers' socioeconomic and educational levels might be considered risk factors for the development of the pragmatic aspects of language in children with DS and special attention should be given to these families during the speech-language therapeutic process. Independently of the interlocutor, these children were able to initiate and maintain communication, using communicative means and functions in a similar fashion.

Background: the Gaps-in-Noise (GIN) test assesses the auditory temporal resolution skill. Studies have described the GIN test an instrument of easy application and with good sensitivity and specificity.

Aim: to compare the results of the GIN test in normal listeners with and without tinnitus and to correlate the obtained results with pure tone thresholds and age.

Method: hearing tests were performed in 44 subjects (hearing threshold up to 25 dB HL in the frequencies of 0.25 to 8 kHz). Two groups were considered for comparison: the Control Group with 23 subjects, 8 men and 15 women, aged between 22-40 (mean 29.7), and the Research Group with 18 tinnitus patients, 3 men and 15 women, aged between 21-45 (mean 31.3). All subjects underwent pure tone audiometry, speech tests, acoustic immittance measurements and the GIN test. For the statistical analysis, the significance level of 0.05 was adopted.

Results: considering pure tone audiometry, the overall mean for hearing thresholds was significantly higher for the Research Group when compared to the Control Group (p = 0.001). The comparison between the groups for the performance in the GIN test indicated that the Control Group detected gaps with a shorter time interval than the Research Group (p < 0.001). There was no correlation between the age of the subjects and the level of the GIN test.

Conclusion: the GIN test identified deficit in the hearing skill of temporal resolution in patients with tinnitus. In the studied age group (21 to 45 years) there was no correlation between age and the results obtained in the GIN test.