Speech perception: Auditory and visual cue integration in children with and without phonological disorder in voiceless fricatives.

The literature reports contradictory results regarding the influence of visual cues on speech perception tasks in children with phonological disorder (PD). This study aimed to compare the performance of children with (n = 15) and without PD (n = 15) in audiovisual perception task in voiceless fricatives. Assuming that PD could be associated with an inability to integrate phonological information from two sensory sources, we presumed that children with PD would present difficulties in integrating auditory and visual cues compared to typical children. A syllable identification task was conducted. The stimuli were presented according to four conditions: auditory-only (AO); visual-only (VO); audiovisual congruent (AV+); and audiovisual incongruent (AV-). The percentages of correct answers and the respective reaction times in the AO, VO, and AV+ conditions were considered for the analysis. The correct percentage of auditory stimuli was considered for the AV- condition, as well as the percentage of perceptual preference: auditory, visual, and/or illusion (McGurk effect), with the respective reaction time. In comparing the four conditions, children with PD presented a lower number of correct answers and longer reaction time than children with typical development, mainly for the VO. Both groups showed a preference for auditory stimuli for the AV- condition. However, children with PD showed higher percentages for visual perceptual preference and the McGurk effect than typical children. The superiority of typical children over PD children in auditory-visual speech perception depends on type of stimuli and condition of presentation.

Fundamental frequency related parameters in Brazilians with COVID-19.

This study compares fundamental frequency (fo) and fundamental frequency standard deviation (foSD) of COVID-19 patients with the same parameters in the speech of subjects without COVID-19, and verifies whether there is an effect of age and sex in the patient group. Both groups, subjects with and without COVID-19, are formed by Brazilian Portuguese speakers. Speech samples were obtained from 100 patients with mild to severe symptoms of COVID-19, and 100 healthy subjects. A single 31-syllable Portuguese sentence was used as the elicitation material for all subjects. The recordings were divided into four age groups. The acoustic measures were semi-automatically extracted and analyzed by a series of analyses of variance. Patients with COVID-19 present vocal differences in fo-related parameters when compared to healthy subjects, that is, patient voices presented higher fo and foSD with respect to control voices. In addition, for patient voices, there was an age and sex effect on fo SD values. Vocal parameters of women and elderly subjects showed more marked differences in fo-related parameters, indicating that patient voices are higher-pitched and have a higher variation of fo SD. Consequently, fo-related parameters may be tested as vocal biomarkers in the screening of respiratory insufficiency by voice analysis, in patients with severe symptoms of COVID-19.

Speech production and speech perception in children with speech sound disorder.

The goal of the present study was to investigate the relationship between speech production (SP) and speech perception in children with Speech Sound Disorder (SSD) from both typical speech production (TSP) and child's own atypical speech production (ASP). Ten children with SSD were evaluated by a speech production task (naming test) and two speech perception tasks (phonological contrast identification) using the PERCEFAL instrument. In the identification task, the acoustic stimulus, from typical and child's own atypical speech productions, was presented to each child, and they needed to choose the corresponding stimulus between two pictures displayed on the computer screen. The percentages of errors on speech production (SP) task, on the identification task from TSP and ASP were calculated for each child. ANOVA showed a significant difference between speech production and speech perception. Post hoc analysis demonstrated a greater mean of errors in the ASP compared to the mean of errors in the TSP and SP performances. Only SP and ASP performances presented a significant correlation (r = 0.65). Errors involving manner and manner+place were most recurring in SP. TSP seems to precede SP; that is, children with SSD perceive more speech from typical production than they are able to produce. The significant correlation between ASP and SP suggests that the evaluation of these skills accesses the children's equivalent underlying phonological representation. A more accurate production, such as typical production, may have cues that help children with SSD to identify phonological contrasts, even if their underlying representations are overly broad or not established.

Hypernasal Speech Is Perceived as More Monotonous than Typical Speech.

BACKGROUND/PURPOSE: Anecdotal clinical reports have stated that hypernasal speech sounds monotonous. However, the relationship between the perception of intonation (i.e., the fundamental frequency variation across an utterance) and hypernasality (excessive nasal resonance during the production of non-nasal sounds) has not been investigated in research. We hypothesized that auditory-perceptual ratings of intonation would be significantly lower for more hypernasal stimuli. METHODS: One male and one female voice actor simulated 3 levels of intonation (monotone, normal, and exaggerated) at 4 different levels of hypernasality (normal, mild, moderate, and severe). Thirty participants listened to the simulations and rated the intonation on a visual analogue scale from 0 (monotone) to 100 (exaggerated). RESULTS: A mixed-effects ANOVA revealed main effects of intonation (F2 = 236.46, p < 0.001), and hypernasality (F3 = 159.89, p < 0.001), as well as an interaction between the two (F6 = 28.35, p < 0.001). Post hoc analyses found that speech was rated as more monotonous as hypernasality increased. Summary/Implications: The presence of hypernasality in speech can lead listeners to perceive speech as more monotonous. Instrumental measures should be used to corroborate auditory-perceptual evaluations of speech features like intonation.

Influence of voice focus on tongue movement in speech.

The present study evaluated global aspects of lingual movement during sentence production with backward and forward voice focus. Nine female participants read a sentence with a variety of consonants in a normal condition and with backward and forward voice focus. Midsagittal tongue movement was recorded with ultrasound. Tongue height over time at an anterior, a central, and a posterior measurement angle was measured. The outcome measures were speech rate, cumulative distance travelled, and average movement speed of the tongue. There were no differences in speech rate between the different conditions. The cumulative distance travelled by the tongue and the average speed indicated that the posterior tongue travelled a smaller cumulative distance and at a slower speed in the forward focus condition. The central tongue moved a larger cumulative distance and at a higher speed in the backward focus condition. The study offers first insights on how tongue movement is affected by different voice focus settings and illustrates the plasticity of tongue movement in speech.

Influence of Voice Focus on Oral-Nasal Balance in Speakers of Brazilian Portuguese.

OBJECTIVES: This study investigates whether a change in speaking voice focus affects the oral-nasal balance. The investigation was undertaken with different phonetic materials in speakers of Brazilian Portuguese, which features phonological and phonetic vowel nasalization. METHODS: Ten females read oral, balanced oral-nasal, and nasal loaded sentences in their normal voice, and with a backward focus and a forward focus. Nasalance scores were collected with a Nasometer 6400. RESULTS: A repeated measures ANOVA of the nasalance scores demonstrated a significant main effect of speaking condition (F(2, 18) = 12.87, p < 0.001). The mean nasalance scores across the stimuli in the backward focus and normal speaking conditions were 36.85% (SD 16.85) and 40.18% (SD 18.02), respectively, both significantly lower than the forward focus condition at 45.38% (SD 18.90). CONCLUSION: The results demonstrated that speaking focus influences oral-nasal balance in normal speakers. In future research, it should be investigated whether voice focus can also modify oral-nasal balance in hypernasal speakers with cleft palate and other disorders.

Correlation between laryngeal sensitivity and penetration/aspiration after stroke.

Stroke is the most common neurological disease in adults that is associated with deglutition disorders. The presence of laryngeal sensitivity is very important in developing safe swallowing without risk of pulmonary complications. The aim of this study was to correlate laryngeal sensitivity with laryngeal penetration and tracheal aspiration after swallows of three food consistencies (puree, thickened liquid, and liquid) in poststroke individuals in the late phase. A cross-sectional clinical study was performed with 91 post-ischemic stroke individuals, with oropharyngeal dysphagia, who were in rehabilitation center treatment from 2009 to 2011. They had a mean age of 68.1 years and average time since injury was 22.6 months; 39 had injury to the right hemisphere and 52 had injury to the left hemisphere. All underwent fiberoptic endoscopic evaluation of swallowing and evaluation of laryngeal sensitivity by touching the tip of the endoscope to the arytenoids and aryepiglottic folds. The linear correlation coefficient of Spearman was applied to evaluate the correlation between laryngeal penetration and tracheal aspiration and the presence/absence of laryngeal sensitivity. There was a negative correlation between the observation of penetration and tracheal aspiration and laryngeal sensitivity, with all bolus consistencies (p < 0.001 for aspiration and p ≤ 0.01 for penetration). The absence of laryngeal sensitivity determines the more frequent findings of penetration and tracheal aspiration. This sensory stimulus in the mucosa of the pharynx and larynx is an essential element for safe swallowing and its deficiency associated with altered motor activity can cause laryngeal penetration and aspiration in poststroke individuals regardless of food consistency.

Ultrasonographic analysis of the hyoid bone distance in individuals with neurogenic oropharyngeal dysphagia. / Análise ultrassonográfica da distância do osso hioide em indivíduos com disfagia orofaríngea neurogênica.

To compare the ultrasound measurement of distance from the approximation of the hyoid bone during of the maximum deglutition peak between healthy individuals and neurogenic dysphagic individuals and to verify the effect of food consistencies on the displacement of the hyoid bone. Prospective, controlled clinical study. Ultrasound recordings of the oropharyngeal deglutition were conducted in 10 adults diagnosed with oropharyngeal dysphagia and in 10 healthy adults, matched by sex and age group. A portable ultrasound model Micro ultrasound system with a microconvex transducer 5-10 MHz, coupled to a computer as well as the head stabilizer were used. The ultrasound images were recorded using the AAA software (Articulate Assistant Advanced) at a rate of 120 frames/second. Food consistencies level 0 (free volume and 5 mL) and level 4 (5 mL) were used, based on the International Dysphagia Diet Standardisation Initiative (IDSSI). The calculation of the mean and standard deviation was used for the descriptive analysis, while the repeated measures ANOVA test was used for the inferential analysis. Results showed dysphagic individuals had lower elevation of the hyoid bone marked by a longer distance from the approximation of the hyoid bone during of the maximum deglutition peak when compared to healthy individuals, regardless of the food consistency offered. It was concluded that the ultrasound measurement of distance from the approximation of the hyoid bone during of the maximum deglutition peak showed less laryngeal elevation in individuals with neurogenic oropharyngeal dysphagia when compared to healthy individuals for all food consistencies offered.

Comparar a medida ultrassonográfica de distância da aproximação do osso hioide no momento do pico máximo da deglutição entre indivíduos saudáveis e disfágicos neurogênicos e verificar o efeito das consistências do alimento no deslocamento do osso hioide. Estudo clínico prospectivo controlado. Foram realizadas avaliações ultrassonográficas da deglutição orofaríngea em 10 adultos com diagnóstico de disfagia orofaríngea e 10 adultos saudáveis, pareados por sexo e faixa etária. Para tanto, foi utilizado ultrassom portátil com transdutor microconvex 5-10 MHz, além de estabilizador de cabeça. As imagens ultrassonográficas foram gravadas pelo software Articulate Assistant Advanced a uma taxa de 120 quadros/segundo. Foram utilizadas as consistências de alimentos nível 0 (volume livre e 5 mL) e nível 4 (5 mL), conforme as recomendações do International Dysphagia Diet Standardisation Initiative. A distância foi mensurada no momento do pico máximo da deglutição entre a parte inferior do osso hioide e a inserção do músculo milo-hioideo. Cálculos de média e o desvio padrão foram utilizados na análise descritiva, enquanto o teste ANOVA de medidas repetidas foi aplicado na análise inferencial.Resultados evidenciaram que indivíduos disfágicos apresentaram menor elevação do osso hioide, marcada por maior distância da aproximação do osso hioide no momento do pico máximo da deglutição quando comparados aos indivíduos saudáveis, independentemente da consistência alimentar ofertada. Concluiu-se que a medida ultrassonográfica de distância da aproximação do osso hioide no momento do pico máximo da deglutição mostrou menor elevação laríngea em indivíduos com disfagia orofaríngea neurogênica quando comparados aos indivíduos saudáveis para todas as consistências alimentares ofertadas.

Efficacy in the use of gamification strategy in phonological therapy. / Eficácia no uso de estratégia de gamificação na terapia fonológica.

PURPOSE: to compare the efficacies of traditional phonological therapy and phonology associated with the gamification strategy in children with Phonological Disorder (PD). METHODS: ten individuals with PD participated who showed the process of replacing liquids. They were randomized into two groups: traditional phonological therapy (control group - CG) and phonological therapy associated with a gamification strategy mediated by computer (gamification group - GG). The phonological intervention comprised, for both groups, stages of speech perception and production. Interventions differed in the perception stage, in which the GG was submitted to the game with gamification strategies. At the end of each session, individuals speech production (% of correct answers) were registered for each therapeutic stage, based on target words and sounding words. For analysis the following were considered: The individuals mean of correct answers for each therapeutic stage; PCC-R value (percentage of correct consonants) pre and post therapy; beyond of the number of sessions used to reach 85% of correct production. RESULTS: there was no statistical difference between the types of intervention considering the average of correct answers of the productions and the number of sessions. There was a significant effect for pre- and post-therapy conditions in the comparison PCC-R values ​​for both models. The individuals in the GC had the PCC-R values higher than those of GG. CONCLUSION: both models of intervention present similar results, providing an improvement in the individuals phonological performance from the first session.

OBJETIVO: comparar as eficácias da terapia fonológica tradicional e terapia fonológica associada à estratégia de gamificação em sujeitos com Transtorno Fonológico (TF). MÉTODO: participaram dez sujeitos com TF que apresentavam o processo de substituição de líquidas. Os sujeitos foram randomizados em dois grupos: terapia fonológica tradicional (grupo controle - GC) e terapia fonológica associada a estratégia de gamificação mediada por computador (grupo gamificação - GG). A intervenção fonológica compreendeu, para ambos os grupos, etapas de percepção e produção de fala. As intervenções se diferenciaram na etapa de percepção, na qual o GG foi submetido ao jogo com estratégia de gamificação. Ao final de cada sessão, foram registrados a produção de fala dos sujeitos (% de acerto) para cada etapa terapêutica, a partir de palavras-alvo e palavras-sondagem. Para análise foram considerados: média de acerto dos sujeitos para cada etapa terapêutica; valores de PCC-R (Porcentagem de Consoantes Corretas Revisado) pré e pós terapia; além do número de sessões utilizadas para se atingir 85% de produção correta. RESULTADOS: não houve diferença estatisticamente significante entre os tipos de intervenção considerando a média de acertos das produções e o número de sessões. Houve efeito significante para as condições pré e pós terapia na comparação dos valores de PCC-R para ambos os modelos. Os sujeitos do GC tiveram os valores de PCC-R maiores do que as do GG. CONCLUSÃO: ambos os modelos de intervenção apresentam resultados semelhantes, propiciando melhora no desempenho fonológico do sujeito desde a primeira sessão.

Acoustic Characteristics of the Voice for Brazilian Portuguese Speakers Across the Life Span.

INTRODUCTION: Vocal changes occur across the life span and can be reflected in acoustic measurements. OBJECTIVE: To investigate the characteristics of voice production of the Brazilian Portuguese speakers across the life span based on acoustic measures of Fundamental Frequency (fo) and noise-to-harmonic ratio (NHR) and to verify the differences in these measures between men and women. METHODS: A total of 526 recordings from Brazilian Portuguese speakers aged 5-93 years were included. Voices from these speakers were judged with normal vocal quality for their age using the G parameter of the GRBAS scale. The recordings were divided into 12 age groups (5-7 years; 8-9; 10-11; 12; 13-15; 16-18; 19-29; 30-39; 40-49; 50-59; 60-69 and, 70-93 years old). Acoustic analysis was conducted, extracting the parameters fo and NHR through Multi-Dimensional Voice Programsoftware. RESULTS: For women, there was a gradual decrease in fo from childhood to older age. Older women (60-93 years old) showed a lower fo than age groups up to 19-29 years (P< 0.00). For men, there was a decrease in fo up to the age group of 13-15 years (P< 0.00) and, then, it remained stable. Differences between sexes occurred from 12 years old, with higher fo values for women than men (P< 0.00). The NHR parameter remained stable across the life span for women while higher values for older subjects were found for men (P< 0.04). Regarding sex, men showed a higher NHR value than women (P< 0.002). CONCLUSION: Vocal changes occur across the life span and are reflected in the acoustic measure of fo for men and women. The beginning of vocal changes occurs from 12 years old with differences between sexes. The NHR measure was sensitive to indicate changes over a lifetime for men, with higher values for older subjects.

Perceptive-auditive and perceptive-visual judgment in the identification of gradient productions in fricatives. / Julgamento perceptivo-auditivo e perceptivo-visual na identificação de produções gradientes em fricativas.

PURPOSE: To analyze which method of judgment, auditory- perceptual (PAJ) of audios or perceptual-visual judgment (PVJ) (ultrasound images), is more sensitive to detect gradual productions between the class of deaf coronal fricatives and check if there is a correlation between these forms of judgment. METHOD: Audio and video files of language ultrasound (LUS) related to the production of the words "frog" and "key", of 11 children, between 6 and 12 years old, with atypical speech production, were selected from a bank data and edited for judgments. After instruction and prior training, 20 judges should choose, immediately upon presentation of the stimulus (auditory or visual), one of three options arranged on the computer screen. In PAJ the options were: correct, incorrect or gradient production, while in PVJ the options were images corresponding to the production of [s], [∫] or undifferentiated. The presentation time of the stimuli and the reaction time were automatically controlled by the PERCEVAL software. RESULTS: PVJ provided a higher percentage of identification of gradient stimuli and a shorter reaction time in performing the task compared to PAJ, both statistically significant. Spearman's correlation test did not show statistical significance between PAJ and PVJ responses, nor for reaction time. CONCLUSION: PVJ using US images proved to be the most sensitive method for detecting gradient production in the production of fricatives [s] and [∫], and can be used as a complementary method to PAJ in speech analysis.

OBJETIVO: Analisar qual método de julgamento, perceptivo-auditivo (JPA) de áudios ou julgamento perceptivo-visual (JPV) (imagens ultrassonográficas), é mais sensível para detectar produções gradientes entre a classe das fricativas coronais surdas e verificar se há correlação entre essas formas de julgamento. MÉTODO: Arquivos de áudio e vídeo de ultrassonografia de língua (USL) relativos às produções das palavras "sapo" e "chave", de 11 crianças, entre 6 a 12 anos de idade, com produção de fala atípica, foram selecionados de um banco de dados e editados para os julgamentos. Após instrução e treino prévio, 20 juízes deveriam escolher, imediatamente à apresentação do estímulo (auditivo ou visual), uma dentre três opções dispostas na tela do computador. No JPA as opções eram: produção correta, incorreta ou gradiente, enquanto no JPV as opções eram imagens correspondentes à produção de [s], de [∫] ou indiferenciada. O tempo de apresentação dos estímulos e o tempo de reação foram controlados automaticamente pelo software PERCEVAL. RESULTADOS: O JPV propiciou uma maior porcentagem de identificação dos estímulos gradientes e um menor tempo de reação na realização da tarefa comparativamente ao JPA, ambos estatisticamente significante. O teste de correlação de Spearman não mostrou significância estatística entre as respostas do JPA e JPV, nem para o tempo de reação. CONCLUSÃO: O JPV com o uso de imagens US mostrou-se o método mais sensível para a detecção da produção gradiente na produção de fricativas [s] e [∫], podendo ser utilizado como método complementar ao JPA na análise de fala.

Auditory-perceptual performance in children with and without phonological disorder in the stops class. / Desempenho perceptivo-auditivo em crianças com e sem transtorno fonológico na classe das oclusivas.

PURPOSE: To compare the auditory-perceptual performance of children with and without phonological disorder (PD) in the identification task of contrasts between stops phonemes. METHODS: Information was selected from a database regarding the auditory-perceptual performance of 46 children (23 with a diagnosis of PD with involvement in the stops (G1) and 23 with typical speech development (G2)), aged 4 and eight years old, in an identification task of the class of stops consonants in Brazilian Portuguese, using the speech perception assessment instrument (PERCEFAL). The reaction time, the number of errors and correctness, as well as the pattern of perceptual error were considered in the analysis. RESULTS: Regarding the auditory-perceptual accuracy, T-Test showed a statistically significant difference, in which typical children had a higher average of correctness than children with PD and shorter reaction time for correct answers. Regarding the error pattern, repeated measures ANOVA showed a significant effect for the group and error pattern, but not for the interaction between group and error pattern. Tukey's Post Hoc test showed for both groups that errors involving place of articulation were superior to voicing and voicing + place of articulation errors. CONCLUSION: children with phonological disorders have worse accuracy in relation to children without disorders and, also, longer response time for correctness. Errors involving the place of articulation between the stops were the most frequent for both groups.

OBJETIVO: Comparar o desempenho perceptivo-auditivo de crianças com e sem transtorno fonológico (TF) na tarefa de identificação dos contrastes entre os fonemas oclusivos. MÉTODO: Foram selecionadas, de um banco de dados, informações referentes ao desempenho perceptivo-auditivo de 46 crianças (23 com diagnóstico de TF com acometimento nas oclusivas (G1) e 23 com desenvolvimento típico de fala (G2)), entre quatro e oito anos de idade, em uma tarefa de identificação na classe das consoantes oclusivas do Português Brasileiro, a partir do instrumento de avaliação de percepção de fala (PERCEFAL). O tempo de reação, os números de erros e acertos, bem como o padrão de erro perceptual foram considerados na análise. RESULTADOS: Com relação à acurácia perceptivo-auditiva o Test-T mostrou uma diferença estatisticamente significante, em que as crianças típicas tiveram uma média de acerto maior do que as crianças com TF e um tempo de reação menor para os acertos. No tocante ao padrão de erro a ANOVA de medidas repetidas mostrou um efeito significativo para o grupo e padrão de erro, mas não para a interação entre grupo e padrão de erro. O teste Post Hoc de Tukey mostrou para ambos os grupos que os erros envolvendo ponto articulatório foram superiores aos erros de vozeamento e vozeamento + ponto articulatório. CONCLUSÃO: crianças com transtorno fonológico apresentam pior acurácia em relação às crianças sem alteração e, ainda, um maior tempo de resposta para os acertos. Erros envolvendo o ponto de articulação entre as oclusivas foram os mais frequentes em ambos os grupos.

Tongue movements in the production of /l/ in children with and without speech sound disorders in different ages. / Movimentos de língua na produção do /l/ em crianças com e sem distúrbios dos sons da fala em diferentes faixas etárias.

PURPOSE: this study used the ultrasonography of the tongue movements and the dynamic models of speech production to characterize the articulatory gestures of in the production of /l/ at the Brazilian Portuguese in different age groups, comparing them between typical and atypical children. METHODS: the sample consisted of 30 typical and 30 atypical children between ages of four and eight-years-old, who underwent speech-language and ultrasonographic evaluations. The evaluation was realized by recording words reproduction with the sound /l/ and the following vocalic contexts: /a/, /i/ and /u/, repeating six times for each word. The software for recording and analysis was Articulate Assistant Advanced (AAA). The quantitative analysis considered the 42 points that intercepted the tongue curves in each image to describe the articulatory gestures; the estimation of the mean lines of each curve and the confidence intervals between typical and atypical children groups; and the differences between the mean tongue contours curves according to age group. RESULTS: the results presented a tongue tip elevation and dorsal and root retraction in /l/. Typical children, regardless of age, showed a greater refinement of articulatory tongue gestures than the atypical ones. In older children, there was more delimitation in the mean tongue contours from the tongue tip to the root. CONCLUSION: the ultrasonography of the tongue movements is a substantial implement to characterize the articulatory gestures of /l/, to the differentiation between typical and atypical productions in this sound, and observation of the development of the articulatory gestures.

OBJETIVO: este estudo utilizou a ultrassonografia dos movimentos de língua e modelos dinâmicos de produção de fala para caracterizar os gestos articulatórios na produção do /l/ no Português Brasileiro (PB) em diferentes faixas etárias, comparando-os entre crianças típicas e atípicas. MÉTODO: a amostra foi constituída por 30 crianças típicas e 30 atípicas, com idades entre 4 e 8 anos, submetidas a avaliações fonoaudiológica e ultrassonográfica. A avaliação foi realizada mediante gravação da produção de palavras com o som /l/ nos contextos vocálicos de /a/, /i/ e /u/, com seis repetições de cada palavra. O software utilizado foi o Articulate Assistant Advanced (AAA). Para as análises quantitativas foram considerados: os 42 pontos que interceptaram as curvas de língua em cada imagem para descrição dos gestos articulatórios; o cálculo das linhas médias de cada curva e os intervalos de confiança entre os grupos; e o cálculo das diferenças entre as curvas médias dos contornos de língua de acordo com a faixa etária. RESULTADOS: houve elevação de ponta de língua e retração de dorso e raiz na articulação do /l/. As crianças típicas, independentemente da idade, apresentaram maior refinamento dos gestos articulatórios de língua do que as atípicas. Nas crianças mais velhas, houve maior delimitação nos contornos médios de língua desde a ponta até a raiz. CONCLUSÃO: a ultrassonografia dos movimentos de língua é uma importante ferramenta para a caracterização dos gestos articulatórios do /l/, para diferenciação entre as produções típica e atípica deste som, e observação do desenvolvimento dos gestos articulatórios.

Indicators of speech fluency in stuttering and in phonological disorder. / Indicadores de fluência da fala na gagueira e no transtorno fonológico.

PURPOSE: To identify the indicators of speech fluency that differs subjects with stuttering, with phonological disorder, and with the two disorders in comorbidity. METHODS: Thirty subjects aged 4-11 years old were divided into 3 groups, each one with 10 subjects: groups with developmental stuttering (SG), phonological disorder (PDG), and with two diagnoses in comorbidity (SPDG) participated in this study. The procedures were speech fluency and phonology evaluation. The data were submitted to statistical analysis. RESULTS: Subjects from SG and SPDG showed a greater occurrence of stuttering-like disfluencies and total of disfluencies in relation to the subjects with PDG. Regarding to the other disfluencies, the three groups were similar. Subjects with PDG showed fewer monosyllabic word repetitions, part of word repetition and prolongations in relation to subjects from SG and SPDG. Blocks occurred more frequently in the two groups with stuttering (SG and SPDG) than in the group with PDG. Interjection occurred more frequently in subjects from SG than in PDG. CONCLUSION: The PDG was the most differentiated in quantitative and qualitative terms in the three groups analyzed. The similarities and differences between the groups will assist the differential diagnosis and, consequently, will enable improved therapy. The presence of blocks represents an important marker for the diagnosis of stuttering.

OBJETIVO: Identificar os indicadores de fluência da fala que diferenciam os sujeitos com gagueira, com transtorno fonológico e com os dois distúrbios em comorbidade. MÉTODO: Participaram deste estudo 30 sujeitos de 4 a 11 anos, separados em 3 grupos, cada um com 10 sujeitos: grupo com gagueira do desenvolvimento (GG), transtorno fonológico (GTF) e os dois diagnósticos em comorbidade (GGTF). Os procedimentos foram: avaliação da fluência da fala e da fonologia. Os dados foram submetidos à análise estatística. RESULTADOS: Os sujeitos do GG e GGTF apresentaram maior ocorrência das disfluências típicas da gagueira e do total das disfluências em relação aos do GTF. Em relação às outras disfluências, os três grupos foram semelhantes. O GTF manifestou menor quantidade de repetições de palavra monossilábica, de parte de palavra e prolongamentos em relação aos sujeitos dos GG e GGTF. Os bloqueios ocorreram mais frequentemente nos dois grupos com gagueira (GG e GGTF) em relação ao GTF. A interjeição ocorreu com maior frequência no GG quando comparado com o GTF. CONCLUSÃO: Dos três grupos analisados, o GTF foi o que mais se diferenciou em termos quantitativo e qualitativo. As semelhanças e diferenças entre os grupos auxiliarão o diagnóstico diferencial e, consequentemente, possibilitarão melhor terapia. A presença de bloqueio representa um importante marcador para o diagnóstico de gagueira.

Análise ultrassonográfica da distância do osso hioide em indivíduos com disfagia orofaríngea neurogênica / Ultrasonographic analysis of the hyoid bone distance in individuals with neurogenic oropharyngeal dysphagia

RESUMO Comparar a medida ultrassonográfica de distância da aproximação do osso hioide no momento do pico máximo da deglutição entre indivíduos saudáveis e disfágicos neurogênicos e verificar o efeito das consistências do alimento no deslocamento do osso hioide. Estudo clínico prospectivo controlado. Foram realizadas avaliações ultrassonográficas da deglutição orofaríngea em 10 adultos com diagnóstico de disfagia orofaríngea e 10 adultos saudáveis, pareados por sexo e faixa etária. Para tanto, foi utilizado ultrassom portátil com transdutor microconvex 5-10 MHz, além de estabilizador de cabeça. As imagens ultrassonográficas foram gravadas pelo software Articulate Assistant Advanced a uma taxa de 120 quadros/segundo. Foram utilizadas as consistências de alimentos nível 0 (volume livre e 5 mL) e nível 4 (5 mL), conforme as recomendações do International Dysphagia Diet Standardisation Initiative. A distância foi mensurada no momento do pico máximo da deglutição entre a parte inferior do osso hioide e a inserção do músculo milo-hioideo. Cálculos de média e o desvio padrão foram utilizados na análise descritiva, enquanto o teste ANOVA de medidas repetidas foi aplicado na análise inferencial.Resultados evidenciaram que indivíduos disfágicos apresentaram menor elevação do osso hioide, marcada por maior distância da aproximação do osso hioide no momento do pico máximo da deglutição quando comparados aos indivíduos saudáveis, independentemente da consistência alimentar ofertada. Concluiu-se que a medida ultrassonográfica de distância da aproximação do osso hioide no momento do pico máximo da deglutição mostrou menor elevação laríngea em indivíduos com disfagia orofaríngea neurogênica quando comparados aos indivíduos saudáveis para todas as consistências alimentares ofertadas.

ABSTRACT To compare the ultrasound measurement of distance from the approximation of the hyoid bone during of the maximum deglutition peak between healthy individuals and neurogenic dysphagic individuals and to verify the effect of food consistencies on the displacement of the hyoid bone. Prospective, controlled clinical study. Ultrasound recordings of the oropharyngeal deglutition were conducted in 10 adults diagnosed with oropharyngeal dysphagia and in 10 healthy adults, matched by sex and age group. A portable ultrasound model Micro ultrasound system with a microconvex transducer 5-10 MHz, coupled to a computer as well as the head stabilizer were used. The ultrasound images were recorded using the AAA software (Articulate Assistant Advanced) at a rate of 120 frames/second. Food consistencies level 0 (free volume and 5 mL) and level 4 (5 mL) were used, based on the International Dysphagia Diet Standardisation Initiative (IDSSI). The calculation of the mean and standard deviation was used for the descriptive analysis, while the repeated measures ANOVA test was used for the inferential analysis. Results showed dysphagic individuals had lower elevation of the hyoid bone marked by a longer distance from the approximation of the hyoid bone during of the maximum deglutition peak when compared to healthy individuals, regardless of the food consistency offered. It was concluded that the ultrasound measurement of distance from the approximation of the hyoid bone during of the maximum deglutition peak showed less laryngeal elevation in individuals with neurogenic oropharyngeal dysphagia when compared to healthy individuals for all food consistencies offered.

Syllabic patterns in typical and atypical phonological development: ultrasonographic analysis. / Padrões silábicos no desenvolvimento fonológico típico e atípico: análise ultrassonográfica.

Objective The present study aims to compare the production of syllabic patterns of the CVC and CV types performed by Brazilian children with typical and atypical phonological development through ultrasonography of tongue. Methods Ten children (five with typical and with five atypical phonological development) recorded nine pairs of words from the syllables: CCV and CV. The images and audios were captured simultaneously by the Articulate Assistant Advanced software. The data were submitted to perceptive analysis and ultrasonographic articulatory analysis (the area between the tip and the blade of the tongue). The area measurements were submitted to one-way repeated measures ANOVA. Results ANOVA demonstrated a significant effect for the clinical condition (typical and atypical), (F (1.8) = 172.48, p> 0.000) forthe area measurements. In both syllabic patterns (CCV and CV) the atypical children showed greater values ​​of the area between the tip and the blade of the tongue. Regarding the syllabic patterns analyzed, the statistical test showed no significant effect (F (1.8)=0.19, p>0.658). Conclusion The use of a greater area of ​​the tongue by children with atypical phonological development suggests the non-differentiation of the tip and the anterior body gestures of the tongue in the production of CV and CCV.

Acoustic characteristics of healthy voices of adults: from young to middle age. / Características acústicas de vozes saudáveis de adultos: da idade jovem à meia-idade.

PURPOSE: Characterize voices of adult individuals without vocal complaints and verify the effect of gender and age with the use of acoustic measures. METHODS: One-hundred and seventy-six voice recordings belonging to adults between 19 and 59 years old, divided into four age groups, for decade, recorded in a database were analyzed. All voices analyzed were classified with no deviation in vocal quality. Acoustic analysis of the parameters was performed: Fundamental Frequency (sustained vowel and connected speech), Jitter, Shimmer and Noise-to-Harmonic Ratio through Multi Dimension Voice Program (KayPentax) software. The effect of gender, age and possible interactions were verified through the Factorial Anova test. When necessary, post hoc was performed with the Least Significant Difference test. RESULTS: There were changes in the voice as a function of age, with a decrease in the Fundamental Frequency in the vowel and connected speech modalities in women and in the Fundamental Frequency of the speech in men. In men, an increase in shimmer measure was observed with the advancing age. Differences between genders were found in the measures of Fundamental Frequency, Jitter and Noise to Harmonic Ratio. CONCLUSION: Vocal changes due to advancing age can be identified acoustically at the end of adulthood, and in women, these changes can be marked previously to the menopausal period.

Eficácia no uso de estratégia de gamificação na terapia fonológica / Efficacy in the use of gamification strategy in phonological therapy

RESUMO Objetivo comparar as eficácias da terapia fonológica tradicional e terapia fonológica associada à estratégia de gamificação em sujeitos com Transtorno Fonológico (TF). Método participaram dez sujeitos com TF que apresentavam o processo de substituição de líquidas. Os sujeitos foram randomizados em dois grupos: terapia fonológica tradicional (grupo controle - GC) e terapia fonológica associada a estratégia de gamificação mediada por computador (grupo gamificação - GG). A intervenção fonológica compreendeu, para ambos os grupos, etapas de percepção e produção de fala. As intervenções se diferenciaram na etapa de percepção, na qual o GG foi submetido ao jogo com estratégia de gamificação. Ao final de cada sessão, foram registrados a produção de fala dos sujeitos (% de acerto) para cada etapa terapêutica, a partir de palavras-alvo e palavras-sondagem. Para análise foram considerados: média de acerto dos sujeitos para cada etapa terapêutica; valores de PCC-R (Porcentagem de Consoantes Corretas Revisado) pré e pós terapia; além do número de sessões utilizadas para se atingir 85% de produção correta. Resultados não houve diferença estatisticamente significante entre os tipos de intervenção considerando a média de acertos das produções e o número de sessões. Houve efeito significante para as condições pré e pós terapia na comparação dos valores de PCC-R para ambos os modelos. Os sujeitos do GC tiveram os valores de PCC-R maiores do que as do GG. Conclusão ambos os modelos de intervenção apresentam resultados semelhantes, propiciando melhora no desempenho fonológico do sujeito desde a primeira sessão.

ABSTRACT Purpose to compare the efficacies of traditional phonological therapy and phonology associated with the gamification strategy in children with Phonological Disorder (PD). Methods ten individuals with PD participated who showed the process of replacing liquids. They were randomized into two groups: traditional phonological therapy (control group - CG) and phonological therapy associated with a gamification strategy mediated by computer (gamification group - GG). The phonological intervention comprised, for both groups, stages of speech perception and production. Interventions differed in the perception stage, in which the GG was submitted to the game with gamification strategies. At the end of each session, individuals speech production (% of correct answers) were registered for each therapeutic stage, based on target words and sounding words. For analysis the following were considered: The individuals mean of correct answers for each therapeutic stage; PCC-R value (percentage of correct consonants) pre and post therapy; beyond of the number of sessions used to reach 85% of correct production. Results there was no statistical difference between the types of intervention considering the average of correct answers of the productions and the number of sessions. There was a significant effect for pre- and post-therapy conditions in the comparison PCC-R values ​​for both models. The individuals in the GC had the PCC-R values higher than those of GG. Conclusion both models of intervention present similar results, providing an improvement in the individuals phonological performance from the first session.

Ultrasound assessment of swallowing: a scoping review protocol / Avaliação ultrassonográfica da deglutição: um protocolo de revisão de escopo

ABSTRACT Purpose: to conduct a scoping review to identify procedures to obtain and analyze ultrasound images related to swallowing in adults and older adults. Methods: the strategy (participants, concept, and context) was employed to determine inclusion criteria - population (adults and older adults), concept (ultrasound assessment), and context (assessment of swallowing). The review will analyze observational, experimental and/or quasi-experimental, descriptive, analytical, and qualitative studies, and opinion texts and articles. It will exclude studies unavailable in full text, in animals, or in vitro, letters to the editor, errata, study protocols, and studies using ultrasound with purposes other than swallowing. There will be no restriction on the language. Two independent professionals will select the studies in the databases (MEDLINE, EMBASE, LILACS, Web of Science, and Scopus). The review will analyze the year of publication, study design, sample, age, and procedures to assess swallowing with ultrasound. Data will be presented in diagrams, tables, and narrative. Final Considerations: the literature has described ultrasound as an assessment instrument to analyze biomechanical swallowing movements. This scoping review will describe methods to acquire ultrasound images to assess swallowing.

RESUMO Objetivo: realizar uma revisão de escopo para identificar os procedimentos de obtenção e análise de imagens ultrassonográficas relacionadas à deglutição de adultos e idosos. Métodos: a estratégia (participantes, conceito e contexto) foi empregada para determinar os critérios de inclusão - população (adultos e idosos), conceito (avaliação ultrassonográfica) e contexto (avaliação da deglutição). Serão analisados os estudos observacionais, experimentais e/ou quase experimentais, descritivos, analíticos, qualitativos, textos e artigos de opinião; e eliminados os que não estiverem disponíveis na íntegra, estudos em animais, in vitro, cartas ao editor, errata, protocolos de estudo e os que usaram a ultrassonografia para fins que não contemplam a deglutição. Não haverá restrições a idiomas. Os estudos serão escolhidos por dois profissionais, independentemente, a partir das bases de dados (MEDLINE, EMBASE, LILACS, Web of Science e Scopus). Serão analisados o ano do estudo, delineamento, amostra, idade e os procedimentos para avaliação ultrassonográfica da deglutição. Os dados serão expostos por meio de diagramas, narrativas e tabelas. Considerações Finais: a ultrassonografia vem sendo descrita na literatura como um instrumento de avaliação que permite a análise dos movimentos biomecânicos da deglutição. Esta revisão de escopo irá permitir a descrição dos métodos de aquisição da ultrassonografia na avaliação da deglutição.

The contrast between alveolar and velar stops with typical speech data: acoustic and articulatory analyses. / O contraste entre oclusivas alveolares e velares em dados típicos de fala: análises acústica e ultrassonográfica.

PURPOSE: This study used acoustic and articulatory analyses to characterize the contrast between alveolar and velar stops with typical speech data, comparing the parameters (acoustic and articulatory) of adults and children with typical speech development. METHODS: The sample consisted of 20 adults and 15 children with typical speech development. The analyzed corpus was organized through five repetitions of each target-word (/'kap ə/, /'tapə/, /'galo/ e /'daɾə/). These words were inserted into a carrier phrase and the participant was asked to name them spontaneously. Simultaneous audio and video data were recorded (tongue ultrasound images). The data was submitted to acoustic analyses (voice onset time; spectral peak and burst spectral moments; vowel/consonant transition and relative duration measures) and articulatory analyses (proportion of significant axes of the anterior and posterior tongue regions and description of tongue curves). RESULTS: Acoustic and articulatory parameters were effective to indicate the contrast between alveolar and velar stops, mainly in the adult group. Both speech analyses showed statistically significant differences between the two groups. CONCLUSION: The acoustic and articulatory parameters provided signals to characterize the phonic contrast of speech. One of the main findings in the comparison between adult and child speech was evidence of articulatory refinement/maturation even after the period of segment acquisition.