The Relationship between Speech Sound Disorder and Cortical Auditory Evoked Potential.

INTRODUCTION: Speech sound disorder (SSD) is a speech and language disorder associated with difficulties in motor production, perception, and phonological representation of sounds and speech segments. Since auditory perception has a fundamental role in forming and organizing sound representation for its recognition, studies that evaluate the cortical processing of sounds are required. Thus, the present study aimed to verify the relation between SSD severity measured by the percentage of correct consonants (PCCs) with the cortical auditory evoked potentials (CAEPs) using speech stimulus. METHODS: Twenty-nine children with normal hearing participated in this research and were grouped into three groups by SSD level measured by the PCC index. In addition, the groups were subdivided according to the children's age group: between 60-71 months, 72-83 months, and 83-94 months. The CAEP with speech stimulus was carried out in all children. RESULTS: Older children had longer P1 and N1 latencies. In P2 latency, there was an interference of age only in the severe group. The N2 latency was affected by age, where older children had longer latency. CONCLUSION: The amplitude of CAEP has not suffered any interference with the age, or severity of SSD. For the latency, older children generally presented longer averages than younger ones.

Neuronal plasticity of the auditory pathway in children with speech sound disorder: a study of Long-Latency Auditory Evoked Potentials. / Plasticidade neuronal da via auditiva em crianças com transtorno dos sons da fala: estudo dos Potenciais Evocados Auditivos de Longa Latência.

PURPOSE: To analyze the results of Long-latency Auditory Evoked Potentials (LLAEP) in children with Speech Sounds Disorder (SSD) after speech therapy. METHODS: Longitudinal and prospective clinical study at 14 children with SSD, with ages ranging from five to seven years, of both genders. Were applied Picture Naming task and Imitation task, and from these tasks it was calculated the Percentage of Consonants Correct index. For an analysis of the LLAEP with speech stimulus and recorded the latency and amplitude values ​​of P1, N1, P2, N2 and P3 components. Each child was evaluated in two different moments: initial evaluation and after 12 sessions of speech therapy. RESULTS: It was observed that after twelve sessions of speech therapy the value of Percentage of Consonants Correct index increased, and a greater number of components were observed in the LLAEP records of children with SSD, as well as a statistically significant increase in the amplitude of the P3 component, demonstrating that anatomical and physiological changes occurred in the central auditory nervous system after intervention, resulting in improved of the LLAEP results. CONCLUSION: After speech therapy, improvement in the children's phonology was observed, and there was an increase in the number of components present in the LLAEP, as well as an increase in the amplitude of the P3 component, demonstrating that plasticity occurred in the auditory pathway during these three months of therapeutic intervention.

OBJETIVO: Avaliar os achados dos Potenciais Evocados Auditivos de Longa Latência (PEALL) em crianças com Transtorno dos Sons na Fala (TSF) após terapia fonoaudiológica. MÉTODO: Estudo clínico longitudinal e prospectivo em um grupo de 14 crianças com TSF, de cinco a sete anos de idade, de ambos os sexos. Foram aplicadas as provas de Nomeação de Figuras e Imitação de palavras, para as quais foi calculado o índice de gravidade Porcentagem de Consoantes Corretas. Foram registrados os PEALL com estímulo de fala e foram analisados os valores de latência e amplitude dos componentes P1, N1, P2, N2 e P3. Cada criança foi avaliada em dois diferentes momentos: avaliação inicial e após 12 sessões de terapia fonoaudiológica. RESULTADOS: Os resultados mostraram que após terapia fonoaudiológica, o valor do índice de gravidade Porcentagem de Consoantes Corretas aumentou e um maior número de componentes foi observado nos registros dos PEALL nas crianças com TSF. Também foi observado um aumento estatisticamente significativo na amplitude do componente P3, demostrando que modificações anatomofisiológicas ocorreram no sistema nervoso auditivo central após intervenção, proporcionando melhora nos resultados dos PEALL. CONCLUSÃO: Após terapia fonoaudiológica, foi observada melhora no desempenho fonológico das crianças, aumento no número de componentes presentes nos PEALL, bem como aumento na amplitude do componente P3, demonstrando que ocorreu plasticidade na via auditiva após um curto período de intervenção fonoaudiológica.

Sensitivity and specificity of the Percentage of Consonants Correct-Revised in the identification of speech sound disorder. / Sensibilidade e especificidade da Porcentagem de Consoantes Corretas Revisada na identificação do transtorno fonológico.

PURPOSE: The purpose of the study was to determine the sensitivity and specificity, and to establish cutoff points for the severity index Percentage of Consonants Correct - Revised (PCC-R) in Brazilian Portuguese-speaking children with and without speech sound disorders. METHODS: 72 children between 5:00 and 7:11 years old - 36 children without speech and language complaints and 36 children with speech sound disorders. The PCC-R was applied to the figure naming and word imitation tasks that are part of the ABFW Child Language Test. Results were statistically analyzed. The ROC curve was performed and sensitivity and specificity values ​​of the index were verified. RESULTS: The group of children without speech sound disorders presented greater PCC-R values in both tasks, regardless of the gender of the participants. The cutoff value observed for the picture naming task was 93.4%, with a sensitivity value of 0.89 and specificity of 0.94 (age independent). For the word imitation task, results were age-dependent: for age group ≤6:5 years old, the cutoff value was 91.0% (sensitivity of 0.77 and specificity of 0.94) and for age group >6:5 years-old, the cutoff value was 93.9% (sensitivity of 0.93 and specificity of 0.94). CONCLUSION: Given the high sensitivity and specificity of PCC-R, we can conclude that the index was effective in discriminating and identifying children with and without speech sound disorders.

Sensibilidade e especificidade da Porcentagem de Consoantes Corretas Revisada na identificação do transtorno fonológico / Sensitivity and specificity of the Percentage of Consonants Correct-Revised in the identification of speech sound disorder

RESUMO Objetivo Verificar a sensibilidade, especificidade e estabelecer pontos de corte para o índice Porcentagem de Consoantes Corretas Revisado (PCC-R) em crianças com e sem transtorno fonológico falantes do Português Brasileiro. Método Participaram 72 crianças com idade entre 5:00 e 7:11 anos, sendo 36 sem queixas de alteração de fala e linguagem e 36 crianças com diagnóstico fonoaudiológico de transtorno fonológico. O índice de gravidade PCC-R foi aplicado nas provas de nomeação de figuras e de imitação de palavras do Teste de Linguagem Infantil ABFW. Os resultados foram analisados estatisticamente. Foi realizada a curva Roc e obtidos os valores de sensibilidade e especificidade do índice. Resultados O grupo de crianças sem transtorno fonológico apresentou valores do PCC-R maiores nas duas provas, independentemente do gênero dos participantes. O valor de corte na prova de nomeação de figuras foi de 93,4%, com sensibilidade de 0,89 e especificidade de 0,94, independentemente da idade. Já na prova de imitação de palavras, os valores obtidos variaram de acordo com a idade. Para a faixa etária ≤6:5 anos, o valor de corte foi de 91,0%, com sensibilidade de 0,77 e especificidade de 0,94. Para a faixa etária >6:5 anos, o valor de corte foi de 93,9%, com sensibilidade de 0,93 e especificidade de 0,94. Conclusão Dada a alta sensibilidade e especificidade do PCC-R, o índice foi efetivo na discriminação e identificação de crianças com e sem transtorno fonológico.

ABSTRACT Purpose The purpose of the study was to determine the sensitivity and specificity, and to establish cutoff points for the severity index Percentage of Consonants Correct - Revised (PCC-R) in Brazilian Portuguese-speaking children with and without speech sound disorders. Methods 72 children between 5:00 and 7:11 years old - 36 children without speech and language complaints and 36 children with speech sound disorders. The PCC-R was applied to the figure naming and word imitation tasks that are part of the ABFW Child Language Test. Results were statistically analyzed. The ROC curve was performed and sensitivity and specificity values ​​of the index were verified. Results The group of children without speech sound disorders presented greater PCC-R values in both tasks, regardless of the gender of the participants. The cutoff value observed for the picture naming task was 93.4%, with a sensitivity value of 0.89 and specificity of 0.94 (age independent). For the word imitation task, results were age-dependent: for age group ≤6:5 years old, the cutoff value was 91.0% (sensitivity of 0.77 and specificity of 0.94) and for age group >6:5 years-old, the cutoff value was 93.9% (sensitivity of 0.93 and specificity of 0.94). Conclusion Given the high sensitivity and specificity of PCC-R, we can conclude that the index was effective in discriminating and identifying children with and without speech sound disorders.

The influence of (central) auditory processing disorder on the severity of speech-sound disorders in children.

OBJECTIVE: To identify a cutoff value based on the Percentage of Consonants Correct-Revised index that could indicate the likelihood of a child with a speech-sound disorder also having a (central) auditory processing disorder . METHODS: Language, audiological and (central) auditory processing evaluations were administered. The participants were 27 subjects with speech-sound disorders aged 7 to 10 years and 11 months who were divided into two different groups according to their (central) auditory processing evaluation results. RESULTS: When a (central) auditory processing disorder was present in association with a speech disorder, the children tended to have lower scores on phonological assessments. A greater severity of speech disorder was related to a greater probability of the child having a (central) auditory processing disorder. The use of a cutoff value for the Percentage of Consonants Correct-Revised index successfully distinguished between children with and without a (central) auditory processing disorder. CONCLUSIONS: The severity of speech-sound disorder in children was influenced by the presence of (central) auditory processing disorder. The attempt to identify a cutoff value based on a severity index was successful.

The influence of (central) auditory processing disorder on the severity of speech-sound disorders in children

OBJECTIVE: To identify a cutoff value based on the Percentage of Consonants Correct-Revised index that could indicate the likelihood of a child with a speech-sound disorder also having a (central) auditory processing disorder . METHODS: Language, audiological and (central) auditory processing evaluations were administered. The participants were 27 subjects with speech-sound disorders aged 7 to 10 years and 11 months who were divided into two different groups according to their (central) auditory processing evaluation results. RESULTS: When a (central) auditory processing disorder was present in association with a speech disorder, the children tended to have lower scores on phonological assessments. A greater severity of speech disorder was related to a greater probability of the child having a (central) auditory processing disorder. The use of a cutoff value for the Percentage of Consonants Correct-Revised index successfully distinguished between children with and without a (central) auditory processing disorder. CONCLUSIONS: The severity of speech-sound disorder in children was influenced by the presence of (central) auditory processing disorder. The attempt to identify a cutoff value based on a severity index was successful.

The influence of (central) auditory processing disorder in speech sound disorders / Influência do transtorno do processamento auditivo (central) no transtorno fonológico

ABSTRACT INTRODUCTION: Considering the importance of auditory information for the acquisition and organization of phonological rules, the assessment of (central) auditory processing contributes to both the diagnosis and targeting of speech therapy in children with speech sound disorders. OBJECTIVE: To study phonological measures and (central) auditory processing of children with speech sound disorder. METHODS: Clinical and experimental study, with 21 subjects with speech sound disorder aged between 7.0 and 9.11 years, divided into two groups according to their (central) auditory processing disorder. The assessment comprised tests of phonology, speech inconsistency, and metalinguistic abilities. RESULTS: The group with (central) auditory processing disorder demonstrated greater severity of speech sound disorder. The cutoff value obtained for the process density index was the one that best characterized the occurrence of phonological processes for children above 7 years of age. CONCLUSION: The comparison among the tests evaluated between the two groups showed differences in some phonological and metalinguistic abilities. Children with an index value above 0.54 demonstrated strong tendencies towards presenting a (central) auditory processing disorder, and this measure was effective to indicate the need for evaluation in children with speech sound disorder.

RESUMO INTRODUÇÃO: Considerando a importância das informações recebidas auditivamente para a aquisição e organização das regras fonológicas, a avaliação do processamento auditivo (central) traz contribuições significativas para o diagnóstico e direcionamento da intervenção fonoaudiologia das crianças com transtorno fonológico. OBJETIVO: Estudar as medidas fonológicas e o processamento auditivo (central) de crianças com transtorno fonológico. MÉTODO: Estudo clínico e experimental com 21 sujeitos com transtorno fonológico, entre 7,0 e 9,11 anos, separados em dois grupos: com e sem transtorno do processamento auditivo (central). Foram avaliadas as provas de fonologia, inconsistência de fala e habilidades metalinguísticas. RESULTADOS: O grupo com transtorno do processamento auditivo (central) apresentou maior gravidade do transtorno fonológico. O valor de corte obtido para o process density index foi o que melhor caracterizou a ocorrência dos processos fonológicos para crianças acima de sete anos. CONCLUSÃO: A comparação do desempenho das provas avaliadas nos dois grupos mostrou diferenças quanto a alguns aspectos fonológicos e metalinguísticas. As crianças com valor do índice acima de 0,54 demonstraram uma forte tendência a apresentar alteração no processamento auditivo (central), sendo que esta medida foi efetiva para indicar a necessidade de avaliação de crianças com transtorno fonológico.

The influence of (central) auditory processing disorder in speech sound disorders.

INTRODUCTION: Considering the importance of auditory information for the acquisition and organization of phonological rules, the assessment of (central) auditory processing contributes to both the diagnosis and targeting of speech therapy in children with speech sound disorders. OBJECTIVE: To study phonological measures and (central) auditory processing of children with speech sound disorder. METHODS: Clinical and experimental study, with 21 subjects with speech sound disorder aged between 7.0 and 9.11 years, divided into two groups according to their (central) auditory processing disorder. The assessment comprised tests of phonology, speech inconsistency, and metalinguistic abilities. RESULTS: The group with (central) auditory processing disorder demonstrated greater severity of speech sound disorder. The cutoff value obtained for the process density index was the one that best characterized the occurrence of phonological processes for children above 7 years of age. CONCLUSION: The comparison among the tests evaluated between the two groups showed differences in some phonological and metalinguistic abilities. Children with an index value above 0.54 demonstrated strong tendencies towards presenting a (central) auditory processing disorder, and this measure was effective to indicate the need for evaluation in children with speech sound disorder.

Implications of diadochokinesia in children with speech sound disorder.

PURPOSE: To verify the performance of children with and without speech sound disorder in oral motor skills measured by oral diadochokinesia according to age and gender and to compare the results by two different methods of analysis. METHODS: Participants were 72 subjects aged from 5 years to 7 years and 11 months divided into four subgroups according to the presence of speech sound disorder (Study Group and Control Group) and age (<6 years and 5 months and >6 years and 5 months). Diadochokinesia skills were assessed by the repetition of the sequences 'pa', 'ta', 'ka' and 'pataka' measured both manually and by the software Motor Speech Profile®. RESULTS: Gender was statistically different for both groups but it did not influence on the number of sequences per second produced. Correlation between the number of sequences per second and age was observed for all sequences (except for 'ka') only for the control group children. Comparison between groups did not indicate differences between the number of sequences per second and age. Results presented strong agreement between the values of oral diadochokinesia measured manually and by MSP. CONCLUSION: This research demonstrated the importance of using different methods of analysis on the functional evaluation of oro-motor processing aspects of children with speech sound disorder and evidenced the oro-motor difficulties on children aged under than eight years old.

Implicações da diadococinesia oral no transtorno fonológico / Implications of diadochokinesia in children with speech sound disorder

OBJETIVO: Verificar o desempenho de crianças com e sem transtorno fonológico nas habilidades motoras orais medidas pela diadococinesia oral, de acordo com as variáveis idade e gênero, além de comparar os métodos de análise manual e por meio de software específico. MÉTODOS: Participaram do estudo 72 sujeitos, com idade entre 5 anos e 7 anos e 11 meses, que foram divididos em quatro subgrupos em função da presença do diagnóstico de transtorno fonológico (grupo controle e grupo estudo) e da idade (<6 anos e 5 meses e >6 anos e 5 meses). A diadococinesia oral foi avaliada na repetição das sequências 'pa', 'ta', 'ka' e 'pataka' utilizando o método de análise manual e pelo softwareMotor Speech Profile®. RESULTADOS: Houve diferença somente relacionada à variável gênero nos grupos, mas que não influenciou na produção do número de sequências por segundo. Houve correlação entre o número de sequências por segundo e a idade em todas as sequências, exceto para 'ka', somente no grupo controle. Os resultados da comparação entre grupos indicaram que não houve diferença entre as distribuições do número de sequências por segundo nas sequências estudadas nas duas faixas etárias analisadas. Observou-se concordância forte entre as medidas realizadas a partir dos dois métodos. CONCLUSÃO: O presente estudo mostrou a importância de se avaliar funcionalmente, por meio da aplicação de diferentes métodos de análise, aspectos do processamento motor da fala em crianças com transtorno fonológico, evidenciando as dificuldades motoras em crianças na faixa etária inferior a 8 anos de idade.

PURPOSE: To verify the performance of children with and without speech sound disorder in oral motor skills measured by oral diadochokinesia according to age and gender and to compare the results by two different methods of analysis. METHODS: Participants were 72 subjects aged from 5 years to 7 years and 11 months divided into four subgroups according to the presence of speech sound disorder (Study Group and Control Group) and age (<6 years and 5 months and >6 years and 5 months). Diadochokinesia skills were assessed by the repetition of the sequences 'pa', 'ta', 'ka' and 'pataka' measured both manually and by the software Motor Speech Profile®. RESULTS: Gender was statistically different for both groups but it did not influence on the number of sequences per second produced. Correlation between the number of sequences per second and age was observed for all sequences (except for 'ka') only for the control group children. Comparison between groups did not indicate differences between the number of sequences per second and age. Results presented strong agreement between the values of oral diadochokinesia measured manually and by MSP. CONCLUSION: This research demonstrated the importance of using different methods of analysis on the functional evaluation of oro-motor processing aspects of children with speech sound disorder and evidenced the oro-motor difficulties on children aged under than eight years old.