ABSTRACT
Introdução: Os tumores do sistema nervoso central (SNC) constituem a segunda neoplasia mais frequente na criança. Os distúrbios tratados pela equipe de fonoaudiologia mais observados em pacientes com tumores são: disfagia, disfonia, alterações de linguagem, transtorno da articulação temporomandibular, disacusia, disartria e paralisia facial. A detecção precoce de alterações fonoaudiológicas em pacientes com tumores pediátricos, na fase do diagnóstico ou início do tratamento, é essencial para um manejo terapêutico mais adequado. Objetivo: descrever as alterações fonoaudiológicas de pacientes pediátricos com diagnóstico de tumor de sistema nervoso central em atendimento durante internação hospitalar. Método: Estudo retrospectivo, com coleta realizada através da pesquisa de dados extraídos de prontuário eletrônico, com dados dos pacientes internados de março de 2016 a agosto de 2018. Para avaliar a associação entre as variáveis categóricas, o teste Qui-quadrado de Pearson foi aplicado. O nível de significância adotado foi de 5% (p<0,05). Resultados: Verificou-se maior relevância nos dados relacionados aos distúrbios de deglutição e motricidade orofacial. Observou-se significância estatística na variável local da lesão - em fossa posterior -, com presença de alterações fonoaudiológicas. Conclusão: A amostra de pacientes oncológicos pediátricos demonstrou alterações fonoaudiológicas, principalmente nas áreas de disfagia e de motricidade orofacial.
Introduction: Central nervous system (CNS) tumors are the second most frequent neoplasm in children. The disorders treated by the speech therapy team most observed in patients with tumors are: dysphagia, dysphonia, language disorders, temporomandibular joint disorder, dysacusis, dysarthria and facial paralysis. Early detection of speech-language pathology changes in patients with pediatric tumors, at the stage of diagnosis or initiation of treatment, is essential for a more appropriate therapeutic management. Objective: to describe speech disorders in pediatric patients diagnosed with a tumor of the central nervous system in care during hospitalization. Method: Retrospective study, with collection performed through the research of data extracted from electronic medical records, with data of patients hospitalized from March 2016 to August 2018. To evaluate the association between categorical variables, Pearson's Chi-square test was applied. The level of significance adopted was 5% (p <0.05). Results: There was greater relevance in the data related to swallowing disorders and orofacial motricity. Statistical significance was observed in the local variable of the lesion - in the posterior fossa -, with the presence of speech-language disorders. Conclusion: The sample of pediatric cancer patients demonstrated speechlanguage disorders, especially in the areas of dysphagia and orofacial motricity.
Introducción: Los tumores del sistema nervioso central (SNC) son la segunda neoplasia maligna más frecuente em niños. Los trastornos tratados por el equipo de terapia del habla más observados en pacientes con tumores son: disfagia, disfonía, transtornos del lenguaje, trastorno de la articulación temporomandibular, disacusis, disartria y parálisis facial. La detección temprana de los câmbios em la patologia del habla y el linguaje en pacientes con tumores pediátricos, em la etapa de diagnóstico o inicio del tratamiento, es esencial para un manejo terapéutico más adecuado. Objetivo: describir los transtornos del habla y el lenguaje de los pacientes pediátricos diagnosticados con tumor del sistema nervioso central em la atención durante la hospitalización. Método: Estudio retrospectivo, com recopilación realizada a través de la investigación de datos extraídos de registros médicos electrónicos, com datos de pacientes hospitalizados de marzo de 2016 a agosto de 2018. Para evaluar la asociación entre variables categóricas, se aplico la prueba de Chi-cuadrado de Pearson. El nivel de significancia adoptado fue del 5% (p<0,05). Resultados: Hubo mayor relevância em los datos relacionados com los trastornos de la deglución y la motricidad orofacial. Se observo importancia estadística em la variable local de la lesión, em la fosa posterior, com la presencia de alteraciones de la patologia del habla y el lenguaje. Conclusión: La muestra de pacientes com cáncer pediátrico demostró la presencia de transtornos del habla y el lenguaje, especialmente em las áreas de disfagia y motricidad orofacial.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Articulation Disorders/etiology , Speech Disorders/etiology , Deglutition Disorders/etiology , Central Nervous System Neoplasms/complications , Hearing Disorders/etiology , Language Disorders/etiology , Retrospective Studies , Early Diagnosis , HospitalizationABSTRACT
RESUMO Objetivo Descrever a prevalência dos distúrbios da comunicação, deglutição e motricidade orofacial em um grupo de crianças e adolescentes, no momento da matrícula hospitalar em um instituto oncológico. Método Estudo transversal, com a inclusão de crianças com dois anos ou mais e adolescentes de ambos os gêneros, matriculados na Seção de Oncologia Pediátrica do Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA) no período de março de 2014 a abril de 2015 para investigação e/ou tratamento de tumores sólidos. Foi utilizado um protocolo para registro das informações sociodemográficas e clínicas e os achados da avaliação clínica fonoaudiológica, que contemplava aspectos do sistema sensório-motor oral, deglutição, fala, linguagem, voz e audição. Resultados Oitenta e oito crianças/adolescentes (41,3%) avaliados apresentavam algum tipo de distúrbio fonoaudiológico. As alterações fonoaudiológicas mais frequentes foram o distúrbio miofuncional orofacial, a disfonia e os transtornos de linguagem. Os menos frequentes foram a disacusia, a paralisia de língua e o trismo. A variável clínica que teve associação estatisticamente significante com a presença de alterações fonoaudiológicas foi o local da lesão. Conclusão O estudo demonstrou uma alta prevalência de alterações fonoaudiológicas em crianças e adolescentes no momento da matrícula hospitalar em um hospital oncológico. A ocorrência de transtornos fonoaudiológicos foi maior nos grupos de participantes com lesões localizadas no sistema nervoso central e na região da cabeça e pescoço.
ABSTRACT Purpose Describe the prevalence of communication, swallowing and orofacial myofunctional disorders in a group of children and adolescents at the time of registration at a cancer hospital. Methods A cross-sectional study conducted with children aged ≥2 and adolescents, of both genders, admitted to the Pediatric Oncology Section of the Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA) from March 2014 to April 2015 for investigation and/or treatment of solid tumors. A protocol was used to record the sociodemographic and clinical information and findings of the speech-language pathology clinical evaluation, which included aspects of the oral sensorimotor system, swallowing, speech, language, voice, and hearing. Results Eighty-eight children/adolescents (41.3%) presented some type of speech-language disorder. The most frequent speech-language disorders were orofacial myofunctional disorder, dysphonia, and language impairments, whereas the less frequent ones were dysacusis, tongue paralysis, and trismus. Site of the lesion was the clinical variable that presented statistically significant correlation with presence of speech-language disorders. Conclusion High prevalence of speech-language disorders was observed in children and adolescents at the time of admission at a cancer hospital. Occurrence of speech-language disorders was higher in participants with lesions in the central nervous system and in the head and neck region.
Subject(s)
Humans , Male , Female , Child , Adolescent , Articulation Disorders/epidemiology , Speech Disorders/epidemiology , Deglutition Disorders/epidemiology , Language Disorders/epidemiology , Neoplasms/complications , Articulation Disorders/etiology , Socioeconomic Factors , Speech Disorders/etiology , Brazil/epidemiology , Cancer Care Facilities , Deglutition Disorders/etiology , Prevalence , Cross-Sectional Studies , Language Disorders/etiology , Neoplasms/etiologyABSTRACT
Objetivo: Avaliar e comparar a influência das diferentes contenções ortodônticas superiores na fala e as percepções dos voluntários às diferentes condições provocadas pela sua utilização. Correlacionar as percepções entre si e com as dimensões do arco superior. Material e Métodos: Selecionou-se 21 (n) voluntários para utilizar 4 tipos de contenções removíveis superiores (Placa wrap-around convencional, em U e com orifício anterior e contenção termoplástica transparente-CTT) por 21 dias cada, com intervalos de 7 dias sem utilização entre elas. Durante a pesquisa, alguns voluntários desistiram ou não compareceram às avaliações, sendo excluídos. As percepções dos pacientes aos aparelhos foram avaliadas com a Escala Visual Analógica de 100 mm (n final=19), e correlacionou-se estas entre si. A avaliação da fala (n final=18) foi realizada em gravações de trechos vocais realizadas antes e imediatamente após a instalação das 4 contenções, assim como após 21 dias de uso destas. Para isto empregou-se a Análise Perceptiva Auditiva da fala e a Análise Acústica da frequência dos formantes F1 e F2 das vogais. Aplicou-se a ANOVA para dados repetidos e teste de Friedman com post hoc de Tukey, além das Correlações de Pearson e de Spearman para as avaliações. O nível de significância estatística estabelecido foi de 5%. Resultados: Os variados desenhos das contenções wrap-around não diferiram de forma significante em nenhuma das percepções e a CTT recebeu notas estatisticamente piores em todos os quesitos, com exceção da estética onde não diferiu estatisticamente das demais. Correlações positivas importantes foram encontradas entre alterações na fala e desconforto em todos os aparelhos. A interferência oclusal na CTT correlacionou-se muito positivamente a outras percepções, como alterações na fala e desconforto. Na avaliação perceptivo-auditiva, as alterações na fala aumentaram significantemente no momento imediato após a instalação do wrap-around com orifício e da CTT, e continuaram significantemente elevadas após 3 semanas. A frequência dos formantes das vogais foi prejudicada no momento inicial da instalação e as Alterações mantiveram-se presentes no wrap-around convencional, em U e na CTT após 3 semanas. Conclusões: A CTT prejudicou mais a fala que os wrap-around. Entre estes, os wrap-around convencional e em U interferiram menos na fala. O período de 3 semanas de uso dos aparelhos não foi totalmente suficiente para a readaptação da fala. A CTT foi pior classificada que as placas wrap-around em todas percepções avaliadas, exceto na estética, onde não diferiram significantemente. A cobertura oclusal da CTT pareceu ser a causadora da sua reprovação e das maiores alterações à fala nesta contenção. As dimensões do arco superior pouco influenciaram as percepções. Considerando as alterações na fala e as percepções dos pacientes, as contenções wrap-around apresentaram melhor desempenho e devem ser a primeira escolha quando a opção de contenção do arco superior for um aparelho removível.(AU)
Objective: To evaluate and compare the influence of different upper removable orthodontic retainers on speech and volunteers' perceptions to different conditions caused by their use. To correlate perceptions with each other and with upper arch dimensions. Material and Methods: 21 (n) volunteers were selected to use four types of upper removable retainers (conventional wrap-around, horseshoe-shaped wrap-around, wrap-around with an anterior "hole" and transparent thermoplastic retainer - TTR) for 21 days each, with intervals of 7 days without use between them. During the search, some volunteers dropped out or did not attend the evaluations and were excluded. Patients perceptions (final n=19) were evaluated with a visual analogue scale of 100 mm, and these were correlated with each other. Speech evaluation (final n=18) was performed in vocal excerpts recordings made before, immediately after and 21 days after the installation of each appliance, with Perceptual Auditory Analysis Auditory and Acoustic Analysis of formant frequencies F1 and F2 of the vowels. ANOVA for repeated measures and Friedman test with post hoc Tukey, in addition to Pearson and Spearman correlation for the evaluations were applied for statistics evaluation. The level of statistical significance was set at 5%. Results: Different designs of wrap-around retainers did not differ significantly in any of the perceptions and TTR received significantly worse grades in all aspects, except for esthetics, which did not statistically differ from the others. Significant positive correlations were observed between changes in speech and discomfort on all appliances. Occlusal interference in TTR was very positively correlated to other perceptions, such as changes in speech and discomfort. Speech changes, evaluated by Perceptual Auditory Analysis, increased immediately after conventional wraparound and TTR installation, and reduced after 3 weeks of use, but not back to normal levels observed without device. However, this increase was statistically significant only for the conventional wrap-around and TTR, remaining significant high after 3 weeks. Formant frequencies of vowels were altered at initial time and the changes remained present in conventional, horseshoe-shaped and TTR appliances after 3 weeks. Conclusions: TTR was more harmful to speech than the wrap-around appliances. Among these, conventional and horseshoe-shaped has interfered less in speech. The 3-week period with retainers was not fully sufficient for speech adaptation. TTR was worse classified than the wrap-around retainers in all evaluated perceptions, except in esthetics, which did not differ significantly. Occlusal coverage of TTR seems to be the cause of its rejection and its major changes to speech. Upper arch dimensions little influence volunteers perceptions. Considering speech changes and volunteers perceptions, the wrap-around retainers had better performance and should be the first choice when retainer option is a removable device in the upper arch.(AU)
Subject(s)
Humans , Male , Female , Adult , Articulation Disorders/etiology , Orthodontic Appliance Design/adverse effects , Orthodontic Appliances/adverse effects , Analysis of Variance , Auditory Perception , Reference Values , Speech Acoustics , Speech Articulation Tests , Treatment Outcome , Visual Analog ScaleABSTRACT
OBJECTIVE: To perform a systematic review and meta-analysis of reported estimates of the association between gestational syphilis (GS) and stillbirth in the Americas region. METHODS: Cochrane Library, Embase, LILACS, MEDLINE/PubMed, PLOS, and ScienceDirect were searched for original research studies quantifying the relationship between GS and stillbirth in the region. A final sample of eight studies was selected. A cumulative meta-analysis plus four subgroup meta-analyses of study data on the association between maternal syphilis during pregnancy and stillbirth were conducted. The four meta-analyses were based on 1) definition of cases and the control; 2) syphilis treatment (presence or absence, effective or ineffective); 3) definition of stillbirth as "showing no signs of life at birth"; and 4) definition of stillbirth based on low birth weight and gestational age. Random-effects metaanalyses were used to calculate pooled estimates of stillbirth with exposure to GS, and each subgroup analysis was tested for heterogeneity. RESULTS: Women with GS had increased odds of stillbirth (pooled odds ratio (OR): 6.87; 95% confidence interval: 2.93, 16.08). There was considerable heterogeneity across the eight studies (percentage of variance (I²) = 95). The funnel plot was not statistically significant, pointing to a lack of publication bias. Increased odds of stillbirth among pregnant women with syphilis were also seen in all four subgroup meta-analyses. CONCLUSIONS: GS is a major contributing factor for stillbirths in the Americas. Interventions targeting GS are highly cost-effective and, along with high-quality point-of-care testing, should be implemented across the region to help reach the goal of eliminating congenital syphilis.
OBJETIVO: Llevar a cabo una revisión sistemática y metanálisis de los cálculos notificados de la asociación entre sífilis gestacional (SG) y mortinatalidad en la Región de las Américas. MÉTODOS: Se realizó una búsqueda en Cochrane Library, Embase, LILACS, MEDLINE/PubMed, PLOS y ScienceDirect de estudios de investigación originales que cuantificaran la relación entre la SG y la mortinatalidad en la Región de las Américas. Se seleccionó una muestra final de ocho estudios. Se efectuaron un meta-nálisis acumulativo y cuatro metanálisis de subgrupo de los datos de estudio sobre la asociación entre sífilis materna durante el embarazo y mortinatalidad. Los cuatro metanálisis se basaron en 1) la definición de casos y del control; 2) el tratamiento de la sífilis (presencia o ausencia, eficaz o ineficaz); 3) la definición de mortinatalidad como "ausencia de signos de vida al nacer"; y 4) la definición de mortinatalidad basada en el bajo peso al nacer y la edad gestacional. Se emplearon metanálisis de efectos aleatorios para calcular las estimaciones acumuladas de mortinatalidad con exposición a la SG, y se comprobó la heterogeneidad de cada uno de los análisis de subgrupo. RESULTADOS: Las mujeres con SG presentaron mayores probabilidades de mortinatalidad (razón de posibilidades [OR] acumulada: 6,87; IC de 95%: 2,93-16,08). Se observó una heterogeneidad considerable en los ocho estudios (porcentaje de variación [I2] = 95). El gráfico en embudo no fue estadísticamente significativo, lo que indica una ausencia de sesgo de publicación. En los cuatro metanálisis de subgrupo, también se observaron mayores probabilidades de mortinatalidad en las mujeres embarazadas con sífilis. CONCLUSIONES: La SG es un importante factor contribuyente a la mortinatalidad en la Región de las Américas. Las intervenciones dirigidas a la SG son altamente eficaces en función de los costos y deben ejecutarse en toda la región, junto con las pruebas diagnósticas de alta calidad en el lugar de asistencia, para ayudar a alcanzar la meta de eliminación de la sífilis congénita.
Subject(s)
Humans , Male , Female , Child , Adolescent , Articulation Disorders/epidemiology , Cleft Lip/surgery , Cleft Palate/surgery , Articulation Disorders/diagnosis , Articulation Disorders/etiology , Audiometry , Cleft Lip/physiopathology , Cleft Palate/physiopathology , Cross-Sectional Studies , Prevalence , Saudi Arabia/epidemiology , Speech , Speech Articulation TestsABSTRACT
La articulación compensatoria es una alteración específica del paciente con fisura labiopalatina en la cual este modifica fonemas orales de alta presión produciéndolos cerca de las cuerdas vocales. Afecta la inteligibilidad y si no se resuelve conlleva múltiples problemas. Diversos factores se han relacionado con su instauración. Aún se discute su origen fonético-fonológico. La prevención y detección temprana resultan cruciales. Objetivo: determinar la frecuencia de articulación compensatoria en menores chilenos (nacidos entre junio de 2005 y junio de 2007) con diagnóstico de fisura con compromiso velar operados en la Fundación Gantz y relacionarla con factores intervinientes. Metodología: Revisión de fichas clínicas, aplicación de exclusiones y relación de datos y análisis estadístico de algunos de ellos. Resultados: 53 por ciento de los pacientes entre cinco y siete años presentaron articulación compensatoria (29 de 55). Este grupo fue intervenido del paladar en promedio a los doce meses e ingresó a fonoaudiología a los diez meses, presentando un 83 por ciento de asociación con dificultades de lenguaje. Solo un 32 por ciento de ellos presentó insuficiencia velofaríngea. Conclusiones: se encontró una alta frecuencia de articulación compensatoria que inicialmente se relacionaría con la fisura palatina e insuficiencia velofaríngea. Entre los aspectos críticos, se destaca la edad de cierre del velo, la edad del niño y los objetivos de la estimulación prelingüística y la asociación con retrasos/trastornos de lenguaje, principalmente del nivel fonológico.
Compensatory articulation is a specific alteration of cleft-palate patients in which the production of high pressure phonemes is changed: they are produced near the vocal cords. This change affects intelligibility and when not solved it causes several problems. Different factors have been linked to this phenomenon. Its phonetic-phonological cause is still discussed and both the prevention and early detection are vital. Objective: To determine the frequency of compensatory articulation in Chilean children born between June 2005 and June 2007 with diagnosis of cleft velum and operated in Gantz Foundation and relate it to the factors that intervene it. Method: The medical records of the children were reviewed and exclusion criteria were applied. Data gathered from the medical records were statistically analysed. Results: 53 percent of the children aged between 5 and 7 presented compensatory articulation. These children were operated on at the age of about 12 months and had had in speech therapy at the age of 10 months. They presented an 83 percent of association with language difficulties. Only 32 percent of the children showed velopharyngeal insufficiency. Conclusions: It was found a high compensatory articulation frequency, which would be initially related to the cleft palate and velopharyngeal insufficiency. Among the critical aspects, it can be highlighted the age of closure of the velum, age and the pre-linguistic stimulation objectives, and association with delays/language impairment, mainly, at the phonological level.
Subject(s)
Humans , Infant , Child, Preschool , Cleft Palate/physiopathology , Cleft Lip/physiopathology , Articulation Disorders/epidemiology , Chile , Velopharyngeal Insufficiency/epidemiology , Risk Factors , Speech Intelligibility , Articulation Disorders/etiologyABSTRACT
Ankyloglossia may prevent the tongue from contacting the anterior palate, which promotes an infantile swallow and hamper the progression to an adult-like swallow. This can result in an open bite deformity and in some cases it can be associated to mandibular prognathism and language problems like rhotacism, described as the inability or difficulty in pronouncing the sound / r /. The surgical cut of the frenum tissue that connects the tongue to the jawbone (frenulectomy) and the language rehabilitation treatment with functional oral devices, represent an alternative treatment for this problem. An 11-year-old boy reported with language performance problems, dental malposition and diagnostic of ankyloglossia condition, received frenulectomy surgery and language rehabilitation treatment with functional oral devices during six months. Language diagnosis was carried out in three periods of time: prior to the surgery, four weeks after the surgery and six months later. Combined surgical and functional therapies proved to be a better alternative than only surgical therapy. Combined therapies increased the speech abilities as well as swallowing functions, therefore, the patient's self-esteem.
La anquiloglosia puede evitar que la lengua entre en contacto con la región anterior del paladar, lo que promueve una deglución infantil y dificultan la adecuada deglusión en el adulto. Esto también puede dar lugar a una mordida abierta y en algunos casos, estar asociada con prognatismo mandibular y problemas de lenguaje como el rotacismo, que se describen como la incapacidad o dificultad para pronunciar el sonido / r /. La exsición quirúrgica del tejido que conecta frenillo de la lengua a la mandíbula (frenectomía) y el tratamiento rehabilitador del lenguaje con dispositivos orales funcionales, representan una alternativa de tratamiento para este problema. Un niño de 11 años de edad, con problemas de lenguaje, malposición dental y diagnóstico de anquiloglosia, fue sometido a frenectomía y tratamiento de rehabilitación dellenguaje mediante dispositivos orales funcionales durante seis meses. El diagnóstico del lenguaje se llevó a cabo en tres periodos de tiempo: antes de la cirugía, cuatro semanas después de la cirugía y seis meses más tarde. La combinación de tratamiento quirúrgico y funcionales demostraron ser una alternativa mejor que la terapia quirúrgica por sí sola. Las terapias combinadas aumentaron la capacidad del habla, así como funciones de deglución, por lo tanto, la autoestima del paciente.
Subject(s)
Humans , Male , Child , Mouth Abnormalities/therapy , Tongue Diseases/therapy , Lingual Frenum/abnormalities , Articulation Disorders/etiology , Mouth Abnormalities/complications , Tongue Diseases/complications , Physical Stimulation/methods , Oral Surgical Procedures/methods , Speech Intelligibility , Treatment Outcome , Articulation Disorders/therapy , VibrationABSTRACT
OBJETIVO: Comparar o desempenho em processamento temporal de crianças com transtorno fonológico submetidos a treino auditivo formal e informal. MÉTODOS: Quinze indivíduos com transtorno fonológico (limiares tonais ≤20 dBNA de 0,50 a 4 kHz e idades entre 7 anos e 10 anos e 11 meses) foram avaliados e divididos em três grupos: Grupo Controle - composto por cinco indivíduos (média de idade de 9,1 anos) sem transtorno do processamento auditivo, que passaram por duas avaliações do processamento auditivo (central) com intervalo de seis a oito semanas, sem receber qualquer intervenção; Grupo Treino Formal - composto por cinco indivíduos (média de idade de 8,3 anos), com transtorno do processamento auditivo, submetidos a oito sessões de treino formal; e Grupo Treino Informal - composto por cinco indivíduos (média de idade de 8,1 anos) com transtorno do processamento auditivo, submetidos a oito sessões de treino informal. RESULTADOS: Após oito sessões, o grupo treino formal apresentou melhora de 8 por cento e o grupo treino informal de 22,5 por cento no que se refere ao teste padrão temporal de frequência. Para o teste padrão temporal de duração, o grupo treino formal melhorou 12,9 por cento e o grupo treino informal 18,7 por cento. No desempenho nos testes padrão de frequência e padrão de duração, não houve diferença estatística entre as médias obtidas pelos dois grupos após a intervenção. CONCLUSÃO: Embora os resultados não tenham apresentado significância estatística, o estudo piloto apresentado sugere que ambos os treinos, formal e informal, proporcionam melhora das habilidades de processamento temporal em crianças com transtorno fonológico e do processamento auditivo.
PURPOSE: This study compared the temporal processing performance of children with phonological disorders submitted to formal and informal auditory training. METHODS: Fifteen subjects with phonological disorder (pure tone thresholds ≤20 dBHL from 0.50 to 4 kHz, and age between 7 years and 10 years and 11 months) were evaluated, divided into three groups: Control Group: five subjects (mean age 9.1 years) without auditory processing disorder, who passed through two evaluations of the auditory processing at intervals of six to eight weeks and without any intervention; Formal Training Group with five subjects (average 8.3 years) with auditory processing disorder submitted to eight sessions of formal training; and Informal Training Group, with five subjects (average 8.1 years) with auditory processing disorder submitted to eight sessions of informal training. RESULTS: After eight sessions the formal training group showed an improvement of 8 percent and the informal training group of 22.5 percent in comparison with the pitch pattern sequence test. For the duration pattern sequence test, the average of the formal training group improved by 12.9 percent and the informal training group by 18.7 percent. There was no statistical difference between the means obtained by both groups after intervention, neither in the pitch pattern nor in the duration pattern sequence test. CONCLUSION: Although the results did not present significant differences, this pilot study suggests that both formal and informal trainings provide improvement in the temporal processing abilities of children with phonological and auditory processing disorders.
Subject(s)
Child , Female , Humans , Male , Articulation Disorders/rehabilitation , Auditory Perceptual Disorders/rehabilitation , Acoustic Stimulation/methods , Articulation Disorders/etiology , Auditory Perceptual Disorders/complications , Case-Control Studies , Pilot Projects , Speech Therapy/methodsABSTRACT
O objetivo deste estudo foi descrever o percurso e os resultados da terapia fonoaudiológica na síndrome de Prader-Willi, por meio do estudo longitudinal do caso de uma criança de 8 anos de idade, do gênero masculino, ao longo de quatro anos de terapia fonoaudiológica em uma clínica-escola. Foram realizadas filmagens de sessões de terapia e análise documental de informações dos prontuários referentes à anamnese, avaliação e relatórios terapêuticos fonoaudiológicos e avaliações multidisciplinares. A criança apresentou características típicas da síndrome de Prader-Willi como obesidade, hiperfagia, ansiedade, problemas de comportamento e auto-agressões. Em avaliação fonoaudiológica foram observados hipotonia orofacial, sialorréia, voz hipernasal, alterações cognitivas, dificuldades de compreensão oral, comunicação por meio de gestos e produção de palavras isoladas ininteligíveis. Inicialmente, a terapia fonoaudiológica teve o objetivo principal de promover o desenvolvimento da linguagem com ênfase na interação social por meio de atividades lúdicas. Com a evolução do caso o direcionamento principal passou a ser o desenvolvimento de habilidades conversacionais e narrativas. Foram observadas evoluções quanto à manutenção da atenção, brincadeira simbólica, contato social e comportamento. Além disso, houve aumento do vocabulário, evolução quanto à compreensão oral e desenvolvimento de habilidades narrativas. Dessa maneira, a intervenção fonoaudiológica em caso de síndrome de Prader-Willi foi eficaz em diferentes níveis, no que se refere às habilidades fonológicas, sintáticas, lexicais e pragmáticas da linguagem.
The aim of this study was to describe the trajectory and the outcomes of speech-language therapy in Prader-Willi syndrome through a longitudinal study of the case of an 8 year-old boy, along four years of speech-language therapy follow-up. The therapy sessions were filmed and documental analysis of information from the child's records regarding anamnesis, evaluation and speech-language therapy reports and multidisciplinary evaluations were carried out. The child presented typical characteristics of Prader-Willi syndrome, such as obesity, hyperfagia, anxiety, behavioral problems and self aggression episodes. Speech-language pathology evaluation showed orofacial hypotony, sialorrhea, hypernasal voice, cognitive deficits, oral comprehension difficulties, communication using gestures and unintelligible isolated words. Initially, speech-language therapy had the aim to promote the language development emphasizing social interaction through recreational activities. With the evolution of the case, the main focus became the development of conversation and narrative abilities. It were observed improvements in attention, symbolic play, social contact and behavior. Moreover, there was an increase in vocabulary, and evolution in oral comprehension and the development of narrative abilities. Hence, speech-language pathology intervention in the case described was effective in different linguistic levels, regarding phonological, syntactic, lexical and pragmatic abilities.
Subject(s)
Child , Humans , Male , Articulation Disorders/therapy , Language Therapy , Prader-Willi Syndrome/complications , Speech Therapy , Speech Disorders/therapy , Articulation Disorders/etiology , Speech Disorders/etiologyABSTRACT
Palatopharyngeal dysfunction may take place when palatopharyngeal valve is unable to perform its own closing due to a lack of tissue (palatopharyngeal insufficiency) or lack of proper movement (palatopharyngeal incompetence). Palatopharyngeal insufficiency induces nasal regurgitation of liquids, hypernasal speech, nasal escape, disarticulations and impaired speech intelligibility. Prosthetic management of palatopharyngeal insufficiency requires a close co-operation between an otolaryngologist and a speech pathologist. As a result, the patient can be socially and physically rehabilitated with the improved speech quality as well as prevention of leakage of liquids.
Subject(s)
Articulation Disorders/etiology , Cleft Palate/surgery , Humans , Male , Oroantral Fistula/rehabilitation , Palatal Obturators/psychology , Palate, Soft/pathology , Quality of Life , Respiratory Aspiration/etiology , Speech Disorders/etiology , Speech Intelligibility/physiology , Velopharyngeal Insufficiency/complications , Velopharyngeal Insufficiency/psychology , Voice Disorders/etiology , Young AdultABSTRACT
Si la meta terapéutica de la AR es lograr y mantener el menor grado de actividad o incluso de remisión, el manejo de la AR debe de incluir una evaluación cuantitativa clara de la inflamación de la artritis reumatoide en forma sistemática y regular. Debido a la alta variabilidad de la actividad de la AR, como también de la diversidad de sus otras manifestaciones, no es posible que una simple medición pueda realmente capturar la actividad global de la enfermedad.
Subject(s)
Humans , Arthritis , Arthritis, Rheumatoid , Inflammation/etiology , Articulation Disorders/etiologyABSTRACT
Through a transversal epidemiological study, conducted with 333 Brazilian children, males (157) and females (176), aged 3 to 6 years old, enrolled in a public preschool, this study aimed to evaluate the prevalence of the different types of vertical interincisal trespass (VIT) and the relationship between these occlusal aspects and anterior lisping and/or anterior tongue thrust in the articulation of the lingua-alveolar phonemes /t/, /d/, /n/ and /l/. All children involved were submitted to a VIT examination and to a speech evaluation. Statistical significance was analyzed through the Qui-square test, at a significance level of 0.05 (95 percent confidence limit). The quantitative analysis of the data demonstrated the following prevalences: 1 - the different types of VIT: 48.3 percent for normal overbite (NO), 22.5 percent for deep overbite (DO), 9.3 percent for edge to edge (ETE) and 19.8 percent for open bite (OB); 2 - interdental lisping in relation to the different types of VIT: 42 percent for NO, 12.5 percent for DO, 12.5 percent for ETE, 32.9 percent for OB; and 3 - children with anterior tongue thrust in the articulation of lingua-alveolar phonemes in relation to the different types of VIT: 42.1 percent for NO, 14 percent for DO, 10.5 percent for ETE, 33.3 percent for OB. The results demonstrated that there was a significant relationship between open bite and anterior lisping and/or anterior tongue thrust in the articulation of the lingua-alveolar phonemes /t/, /d/, /n/ and /l/; and that there was a significant relationship between deep overbite and the absence of anterior lisping and anterior tongue thrust in the articulation of the lingua-alveolar phonemes.
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Malocclusion/complications , Malocclusion/epidemiology , Speech Disorders/etiology , Tongue Habits/adverse effects , Articulation Disorders/etiology , Brazil/epidemiology , Chi-Square Distribution , Cross-Sectional Studies , Open Bite/complications , Open Bite/epidemiology , Prevalence , Speech Articulation TestsABSTRACT
Objetivo: observar la capacidad de cinco individuos venezolanos que usan aparatos dentales ortodónticospara articular el habla y verificar la influencia de los aparatos en la percepción del habla por parte desus interlocutores. Métodos: se utilizó un corpus conformado por dos grabaciones de la lectura de unTest de Pares Mínimos realizadas por cinco hablantes antes y después de iniciar el tratamiento conlos aparatos. Dichas grabaciones fueron luego expuestas a veinte oyentes adultos con la finalidad deque identificaran lo oído; sirviéndose de un test ad hoc, basado en el de los Pares Mínimos arribaindicado. Cada uno de los oyentes marcó la opción que creyó haber percibido. Resultados: el análisisde los datos arrojados por los dos conjuntos de tests permitió determinar los sonidos, los rasgosdistintivos y los puntos articulatorios afectados por el uso de aparatos en los hablantes. Se demuestraque los sonidos mayormente afectados por los aparatos dentales son /t/, /m/, /p/, /f/, /b/, / /, /k/ y / /;los rasgos y oposiciones distintivas afectadas son [grave]: /b d/, /f s/, /m /, /m n/ y /p t/;[sonoro]: /g k/, /p b/ y /t d/ e [interrupto]: / - s/ ; por su parte, los lugares de articulación afectadosson bilabial, alveolar, palatal, dental e interdental. Conclusiones: la presencia de los aparatos dentalesortodónticos en la cavidad bucal causa serios problemas en la articulación de los sonidos lingüísticosafectando de esa manera la percepción del habla por parte de los interlocutores. Los problemas dearticulación con el paso del tiempo van decreciendo.
Purpose: to observe the capacity to articulate speech in five Venezuelan individuals who use orthodonticdental apparatus and to verify the influence of the apparatus on the perception of speech from theirinterlocutors. Methods: the corpus of study consists of two recordings of the lecture of a Minimal PairsTest done by five speakers before and after beginning the treatment with the apparatus. These recordingswere submitted to twenty listeners who were asked to answer what they have perceived. Each one ofthe listeners checked the option that they believed to have perceived. Results: data analysis showedthat sounds, distinctive features and places of articulation are affected by using apparatus by thespeakers. The sounds mostly affected by the dental apparatus are / t /, / m /, / p /, / f /, / b /, / /, / k / and / /; thedistinctive features affected are [grave]: / b - d /, / f - s /, / m - /, / m - n / and / p - t/; [sonorous]:/ g - k /, / p - b / and / t - d / and [interrupted]: / - s /; the places of articulation affected are bilabial,alveolar, palatal, dental and interdental. Conclusions: the existence of orthodontic dental apparatusesin the oral cavity causes serious problems in the articulation of the linguistic sounds affecting in thatway the perception of speech from the interlocutors. Articulation problems decrease with time.
Subject(s)
Humans , Adult , Orthodontic Appliances/adverse effects , Phonetics , Speech Perception/physiology , Articulation Disorders/etiology , Speech Articulation Tests , Articulation Disorders/diagnosisABSTRACT
Tema: ceceio interdental e alterações oclusais. Objetivo: verificar a ocorrência de ceceio anterior e alterações da oclusão no plano vertical anterior de crianças na faixa etária de 03 a 06 anos. Método: 132 crianças foram submetidas ao exame de oclusão dentária e da fala. Resultado: o ceceio anterior ocorreu em 51,5% das crianças avaliadas e apresentou-se associado a problemas oclusais no plano vertical anterior em 50% das crianças, enquanto que 50% das mesmas apresentavam ceceio sem alteração oclusal associada. Conclusão: o ceceio não demonstrou estar relacionado a alterações da oclusão dentária no plano vertical anterior. A presença da alteração oclusal pode representar risco para o desenvolvimento de ceceio na fala mas não é determinante para a sua ocorrência.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Articulation Disorders/etiology , Malocclusion/complications , Voice Disorders/etiology , Age Distribution , Malocclusion/diagnosis , Sex Distribution , Sex FactorsSubject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Language Development , Speech , Aphasia , Disabled Children , Speech Disorders/diagnosis , Speech Disorders/etiology , Speech Disorders/therapy , Voice Disorders/classification , Voice Disorders/etiology , Voice Disorders/therapy , Dyslexia , Fingersucking , Habits , Infant Care , Language Development Disorders , Language Disorders , Mastication , Mouth Breathing , Speech Acoustics , Stuttering , Tongue , Articulation Disorders/diagnosis , Articulation Disorders/etiology , Articulation Disorders/physiopathology , Articulation Disorders/prevention & control , Articulation Disorders/therapy , Hearing Disorders/classification , Hearing Disorders/etiology , Hearing Disorders/prevention & control , Hearing Disorders/therapy , Deglutition Disorders/etiologyABSTRACT
In this study, the adaptation of patients to removable partial dentures was evaluated related to articulation of Turkish phonemes. Articulation of /t,d,n,l,r/, /g,k/, /b,p,m/ and /s,z,Ö,v,f,y,j,h,c/ phonemes were evaluated by three speech pathologists, on records taken from 15 patients before the insertion of a removable partial denture, just after insertion, and one week later. The test consisted of evaluation of phoneme articulation of independent syllables in terms of distortion, omission, substitution, mass effect, hypernasality and hyponasality. Data were evaluated with Cochrane Q, McNemar and Kruskal-Wallis tests. The results showed that for some phonemes, problems in articulation occurred after the insertion of a removable partial denture while for others a significant amelioration was observed after the insertion of a removable partial denture. In general, problems in articulation of evaluated phonemes were resolved after one week of use
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Articulation Disorders/etiology , Denture, Partial, Removable/adverse effects , Chi-Square Distribution , Phonation , Proprioception , Speech Articulation Tests , Turkey , Voice QualityABSTRACT
As fissuras labiopalatinas säo alteraçöes faciais de origem embriológicas, resultantes da falta de fusäo dos processos nasais mediais entre si, e destes com os processos maxilares (lateralmente). O indivíduo portador dessas fissuras apresenta, devido a alteraçöes anatômicas e funcionais, diversos distúrbios relacionados, principalmente, às áreas médica, odontológica e fonoaudiológica. Sabe-se, hoje, que o sucesso do tratamento dos pacientes portadores de fissuras labiopalatinas está relacionado ao trabalho de uma equipe multidisciplinar especializada e integrada. Dentro desta equipe, o ortodontista deverá atuar na correçäo dos desvios do crescimento facial e dos distúrbios oclusais. O fonoaudiólogo, por sua vez, deverá procurar restabelecer as funçöes estomatognáticas (fala sucçäo, mastigaçäo, deglutiçäo e respiraçäo) e atuar nas áreas da linguagem, voz e audiçäo, quando alteradas. A atuaçäo ortodontista/fonoaudiólogo está intimamente relacionada, uma vez que a intervençäo de um deles interfere e depende diretamente do trabalho do outro. Estes profissionais devem buscar um atendimento globalizado, eficiente e adequado, com o intuito de proporcionar uma melhor qualidade de vida ao paciente. Em funçäo disso, o conhecimento das áreas de ortodontia e fonoaudiologia se faz necessário por parte de ambos, ortodontistas e fonoaudiólogos, que tratam de indivíduos portadores de fissuras labiopalatinas
Subject(s)
Tooth Abnormalities/therapy , Cleft Lip , Cleft Palate , Maxillofacial Development , Articulation Disorders/etiology , Language Development Disorders , Mastication , Hearing Disorders/etiologyABSTRACT
Nasality is related to factors like velopharyngeal closure and acoustic factors pertaining to cavities. The present investigation is a retrospective study aimed at evaluating the effects of variation in the timing of palatal repair on nasality during speech development in complete cleft lip and palate cases. It has been observed that the delay in palatal repair is associated with increase in nasality. Also, from the operated complete cleft lip and palate cases, it has been observed that the early and medium repair groups had almost similar effects on nasality of speech. (if they were operated before 36 months of age).
Subject(s)
Age Factors , Articulation Disorders/etiology , Child , Child, Preschool , Cleft Lip/complications , Cleft Palate/complications , Humans , Infant , Retrospective Studies , Speech Intelligibility , Voice Disorders/etiologyABSTRACT
A Paediatric dentist may be the first person consulted for professional advice concerning children with speech problems. A positive significant relationship has been hypothesized by some authors between tongue-thrust swallowing and articulation disorders in children. This study was undertaken to find out whether any articulation disorders are associated with the habit of tongue-thrust swallowing, or is it the type of anterior bite that plays an important role in the normal or abnormal speech production in tongue-thrust swallowers. Forty subjects with tongue-thrust swallowing in the age group of 7-16 years were examined. Of these 20 had normal anterior bite while rest had anterior open bite. A word articulation test was used and word level articulation testing was done for initial, medial and final positions. The sounds tested were: Linguoalveolars, Labiodentals, Linguodentals, Linguopalatals, Bilabials and Linguovelars. The results of the study have indicated that the presence of articulation disorders is strongly associated with the anterior open bite present in tongue-thrust swallowers but a simple, direct relationship between the presence of defective consonant sounds and tongue-thrust swallowing has not been found.
Subject(s)
Adolescent , Articulation Disorders/etiology , Chi-Square Distribution , Child , Deglutition Disorders/complications , Female , Humans , Male , Malocclusion/complications , Speech Articulation Tests , Tongue Habits/adverse effectsABSTRACT
The effects of variation in the timing of palatal repair on articulation skills in complete cleft lip and palate was evaluated from fifty subjects. The present study confirmed that development of articulation was similar in the groups operated upon before 24 months and between 24 to 36 months. The insignificant difference suggests that articulation was good irrespective of the early or medium timing of palatal repair.