Pallidal deep brain stimulation in primary Meige syndrome: clinical outcomes and psychiatric features.

OBJECTIVES: To study the efficacy and safety of bilateral globus pallidus internus deep brain stimulation (GPi-DBS) in refractory Meige syndrome (MS) and evaluate the psychiatric disorders before and after surgery. METHODS: Twenty-two patients with MS treated with bilateral GPi-DBS were retrospectively analysed before surgery and after continuous neurostimulation. Before surgery, patients were assessed by the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS), Self-Rating Depression Scale, Medical Outcomes Study 36-Item Short-Form General Health Survey (SF-36) and Pittsburgh Sleep Quality Index (PQSI), which corresponded to motor symptoms, depressive state, quality of life and sleep quality, respectively. The implantable pulse generator of each patient was activated at 1 month after surgery. At 1 month, 3 months, 6 months and 12 months after continuous neurostimulation, all patients were evaluated by the same scales above. RESULTS: The BFMDRS movement scores decreased from 15.0±5.3 before surgery to 3.5±4.5 at 12 months after neurostimulation, with a mean improvement of 78% (p<0.001). The BFMDRS disability scores improved from 7.4±4.9 before surgery to 4.0±4.6 at 12 months after neurostimulation, with a mean improvement of 56% (p<0.001). The postoperative SF-36 scores had the remarkable improvement compared with baseline scores. Impaired sleep quality was found in 82% of patients and depression in 64% before surgery, which didn't neither obtained amelioration after continuous neurostimulation. CONCLUSIONS: Bilateral pallidal neurostimulation is a beneficial therapeutic option for refractory MS, which could improve the motor symptoms except for depression and sleep quality.

Speech sound disorder at 4 years: prevalence, comorbidities, and predictors in a community cohort of children.

AIM: The epidemiology of preschool speech sound disorder is poorly understood. Our aims were to determine: the prevalence of idiopathic speech sound disorder; the comorbidity of speech sound disorder with language and pre-literacy difficulties; and the factors contributing to speech outcome at 4 years. METHOD: One thousand four hundred and ninety-four participants from an Australian longitudinal cohort completed speech, language, and pre-literacy assessments at 4 years. Prevalence of speech sound disorder (SSD) was defined by standard score performance of ≤79 on a speech assessment. Logistic regression examined predictors of SSD within four domains: child and family; parent-reported speech; cognitive-linguistic; and parent-reported motor skills. RESULTS: At 4 years the prevalence of speech disorder in an Australian cohort was 3.4%. Comorbidity with SSD was 40.8% for language disorder and 20.8% for poor pre-literacy skills. Sex, maternal vocabulary, socio-economic status, and family history of speech and language difficulties predicted SSD, as did 2-year speech, language, and motor skills. Together these variables provided good discrimination of SSD (area under the curve=0.78). INTERPRETATION: This is the first epidemiological study to demonstrate prevalence of SSD at 4 years of age that was consistent with previous clinical studies. Early detection of SSD at 4 years should focus on family variables and speech, language, and motor skills measured at 2 years.

Prevalence of dyslalias in 8 to 16 year-old students with anterior open bite in the municipality of Envigado, Colombia.

BACKGROUND: Anterior open bite AOB is the most common malocclusion associated with speech disorders and the literature has shown that problems of occlusion involve all oral functions. AOB not only produce aesthetic and occlusal problems for the patient and modifies the union of the lips, tongue, teeth, palate, palatal rugae and oropharynx, and thus affecting the ability to communicate well with their surroundings. The prevalence of AOB in children and adolescent in our population is unknown. Furthermore, the most frequent type of dyslalias in children with this malocclusion is also unknown. Therefore, the aim of the study was to describe the frequency and types of dyslalia in students between 8-16 years with AOB, as well as the difference in the types of dyslalia according to the magnitude of AOB. METHODS: A cross-sectional study was conducted. Clinical assessment of AOB in students from the municipality of Envigado, Colombia, was performed. Students from 8 to 16 years of age were examined during the second semester of 2011 and first semester of 2012. Phonoaudiological assessment was carried out in students in the mixed or permanent dentition. Exclusion criteria included children with history of systemic disease, altered skeletal development, neurological and psychiatric disorders, and residents in other departments. In addition, students undergoing orthodontic treatment at the time of evaluation or with history of previous orthodontic treatment, as well as those who did not cooperate with the oral cavity evaluation, were excluded. RESULTS: Six thousand one hundred sixty five children were evaluated. One hundred sixty six presented AOB (prevalence: 2.7 %; 95 % CI: 2.28-3.10). Thirty four students were excluded. 26.5 % of the sample presented mild AOB, 66.7 % moderate, and 6.8 % severe. Some type of dyslalia was found in 77.4 % of the students, being distortion (75.8 %) the most common. The most frequently altered phonemes were: / d / t / s / ch / ñ /. No significant association between different types of dyslalia and AOB severity (p-value = 0.974) was found. CONCLUSION: Prevalence of AOB in Envigado is low (2.7 %). Phonation alterations are very common in children with AOB (77.8 %), and distortion is the most frequent type of dyslalia (75.8 %). In order to diagnose and treat occlusal and phonetic problems, and to avoid possible recurrence, interdisciplinary approach is recommended.

Phonological deficits in specific language impairment and developmental dyslexia: towards a multidimensional model.

An on-going debate surrounds the relationship between specific language impairment and developmental dyslexia, in particular with respect to their phonological abilities. Are these distinct disorders? To what extent do they overlap? Which cognitive and linguistic profiles correspond to specific language impairment, dyslexia and comorbid cases? At least three different models have been proposed: the severity model, the additional deficit model and the component model. We address this issue by comparing children with specific language impairment only, those with dyslexia-only, those with specific language impairment and dyslexia and those with no impairment, using a broad test battery of language skills. We find that specific language impairment and dyslexia do not always co-occur, and that some children with specific language impairment do not have a phonological deficit. Using factor analysis, we find that language abilities across the four groups of children have at least three independent sources of variance: one for non-phonological language skills and two for distinct sets of phonological abilities (which we term phonological skills versus phonological representations). Furthermore, children with specific language impairment and dyslexia show partly distinct profiles of phonological deficit along these two dimensions. We conclude that a multiple-component model of language abilities best explains the relationship between specific language impairment and dyslexia and the different profiles of impairment that are observed.

Development of reading and phonological skills of children at family risk for dyslexia: a longitudinal analysis from kindergarten to sixth grade.

The main focus of this article is to develop a better understanding of the developmental trajectories of literacy and phonological skills within Dutch-speaking children. Children at high and low risk for dyslexia were followed and compared at four different moments: kindergarten and first, third and sixth grades. Three groups were then compared: (1) dyslexic readers; (2) normal readers at high risk for dyslexia; and (3) normal readers at low risk for dyslexia. Children diagnosed with dyslexia scored lower than high-risk normal readers on phonological awareness (PA), rapid automatized naming (RAN), verbal short-term memory and literacy skills. Normal readers at high risk scored between both groups, confirming that dyslexia is to be considered as a continuum rather than an all-or-none condition. Growth analyses showed that the three groups evolved similarly on all measures except for phoneme deletion and literacy measures. Finally, solely PA and RAN explained a significant amount of variance in the evolution of reading skills.

How should children with speech sound disorders be classified? A review and critical evaluation of current classification systems.

BACKGROUND: Children with speech sound disorders (SSD) form a heterogeneous group who differ in terms of the severity of their condition, underlying cause, speech errors, involvement of other aspects of the linguistic system and treatment response. To date there is no universal and agreed-upon classification system. Instead, a number of theoretically differing classification systems have been proposed based on either an aetiological (medical) approach, a descriptive-linguistic approach or a processing approach. AIMS: To describe and review the supporting evidence, and to provide a critical evaluation of the current childhood SSD classification systems. METHODS & PROCEDURES: Descriptions of the major specific approaches to classification are reviewed and research papers supporting the reliability and validity of the systems are evaluated. MAIN CONTRIBUTION: Three specific paediatric SSD classification systems; the aetiologic-based Speech Disorders Classification System, the descriptive-linguistic Differential Diagnosis system, and the processing-based Psycholinguistic Framework are identified as potentially useful in classifying children with SSD into homogeneous subgroups. The Differential Diagnosis system has a growing body of empirical support from clinical population studies, across language error pattern studies and treatment efficacy studies. The Speech Disorders Classification System is currently a research tool with eight proposed subgroups. The Psycholinguistic Framework is a potential bridge to linking cause and surface level speech errors. CONCLUSIONS & IMPLICATIONS: There is a need for a universally agreed-upon classification system that is useful to clinicians and researchers. The resulting classification system needs to be robust, reliable and valid. A universal classification system would allow for improved tailoring of treatments to subgroups of SSD which may, in turn, lead to improved treatment efficacy.

[Low level phonological processing and intelligence potential in preschool children]. / Basale phonologische Verarbeitung und Intelligenzpotenzial bei Vorschulkindern.

BACKGROUND: This study group recently developed a test material to assess phonological processing in children and presented various data regarding the reliability and validity. To assess concurrent validity the correlation between test results using this material and results of an intelligence test were examined. MATERIAL AND METHODS: A total of 203 preschool children aged from 5 years to -5 years 11 months participated in this study. Low level phonological processing was tested using minimal pairs for both words and non-words (logatoms) as described earlier. Intelligence was tested using the coloured progressive matrices test (CPM). RESULTS: No relevant correlation was found between all subscales of low level phonological processing and the intelligence test results. DISCUSSION: As shown previously a correlation exists between the level of maternal school education and low level phonological processing abilities of children. A direct link between low level phonological processing and children's intelligence is not supported by these data, as no such correlation could be found. It must be taken into account that general intelligence was assessed nonverbally.

Population-based screening of children for specific speech and language impairment in Germany: a systematic review.

OBJECTIVE: The study was aimed at evaluating the effectiveness of a systematic population-based screening programme for specific language impairment (SLI) in preschool children in Germany. METHODS: The study question was divided into a review of (1) evidence from studies evaluating screening programmes, (2) diagnostic instruments in the German language, and (3) studies evaluating speech and language interventions. A systematic database search was conducted between June and October 2007 and was updated in January and again in May 2008. Relevant studies were identified by 2 independent reviewers based on screened titles/abstracts and full texts. RESULTS: 4,806 studies were screened. The only existing controlled screening study did not provide data for SLI. No diagnostic study met the inclusion criteria. Sixteen randomized intervention studies were included, 3 studies contributed to the appraisal of earlier against later initiation of treatment. Most studies were of limited quality. We found indications of short-term positive effects from language therapies in children with SLI. Long-term outcomes were not investigated. No evidence supporting the advantage of earlier treatment initiation was identified. CONCLUSIONS: The benefit of population-based language screening of preschool children with SLI is not proven. Controlled screening studies are therefore necessary. For Germany, the accuracy of existing diagnostic instruments has not yet been sufficiently examined.

Speech disorders in neurofibromatosis type 1: a sample survey.

BACKGROUND: Neurofibromatosis type 1 (NF1) is an autosomal-dominant neurocutaneous disorder with an estimated prevalence of two to three cases per 10,000 population. While the physical characteristics have been well documented, speech disorders have not been fully characterized in NF1 patients. AIMS: This study serves as a pilot to identify key issues in the speech of NF1 patients. In particular, the aim is to explore further the occurrence and nature of problems associated with speech as perceived by the patients themselves. METHODS & PROCEDURES: A questionnaire was sent to 149 patients with NF1 registered at the Department of Genetics, Ghent University Hospital. The questionnaire inquired about articulation, hearing, breathing, voice, resonance and fluency. Sixty individuals ranging in age from 4.5 to 61.3 years returned completed questionnaires and these served as the database for the study. The results of this sample survey were compared with data of the normal population. OUTCOMES & RESULTS: About two-thirds of participants experienced at least one speech or speech-related problem of any type. Compared with the normal population, the NF1 group indicated more articulation difficulties, hearing impairment, abnormalities in loudness, and stuttering. CONCLUSION: The results indicate that speech difficulties are an area of interest in the NF1 population. Further research to elucidate these findings is needed.

Prevalence of Phonological Articulation Disorders in Preschool Children in the City of Skopje.

INTRODUCTION: Speech communication is a complex process based on the function of the central nervous system, and also on the speech mechanisms conditioned and controlled by auditory perception, verbal memory, intellectual activity and peripheral speech apparatus.The aim of this study was to determine the prevalence of the most common phonological articulation disorders in preschool children, from 4-6 years old. MATERIALS AND METHODS: A cross-sectional study was conducted during 2018, on a representative sample of 550 preschool children aged 4 - 6 years, who attend preschool institutions-kindergartens in the city of Skopje. The study used standardized articulation tests: The Global Articulation Test (GAT) and the Triple Test (vocals, plasia, affricative, fricative, nasal, and lateral), and a questionnaire filled out by a social worker at the kindergarten about the socioeconomic status and the child's health condition. RESULTS: Using GAT, we found that 260 (47.3%) children didn't manifest any phonological articulation disorders, but 290 (52.7%) had disorders. The analysis of gender-based data showed a higher percentage of speech disorders in 57% of boys and 46.9% of girls. The highest percentage of speech disorder is sigmatism with 24.5% in boys and 20.4% in girls, rhotacismus was found in 17.8% in boys and 16.5% in girls. Lambdacism with 8.3% was found in boys and 4.2% in girls. A mixed form (sigmatism, rotacism, and lambdacism) was also found in 2.4% of boys and 3.5% of girls. CONCLUSIONS: The calculated prevalence of phonological articulation disorders in preschool children aged 4-6 years is 52.7%, (57.9% in boys and 46.9% in girls), or every second child in kindergarten has some form of speech disorder. These findings indicate that the treatment of speech disorders should begin in the appropriate services as soon as possible, because the early detection and treatment of speech disorders enable child's normal intellectual development. The treatment should be started in the preschool period, to allow the start of the educational process without any speech problems.

What influences literacy outcome in children with speech sound disorder?

PURPOSE: In this study, the authors evaluated literacy outcome in children with histories of speech sound disorder (SSD) who were characterized along 2 dimensions: broader language function and persistence of SSD. In previous studies, authors have demonstrated that each dimension relates to literacy but have not disentangled their effects. Methods Two groups of children (86 SSD and 37 controls) were recruited at ages 5-6 and were followed longitudinally. The authors report the literacy of children with SSD at ages 7-9, compared with controls and national norms, and relative to language skill and SSD persistence (both measured at age 5-6). RESULTS: The SSD group demonstrated elevated rates of reading disability. Language skill but not SSD persistence predicted later literacy. However, SSD persistence was associated with phonological awareness impairments. Phonological awareness alone predicted literacy outcome less well than a model that also included syntax and nonverbal IQ. CONCLUSIONS: Results support previous literature findings that SSD history predicts literacy difficulties and that the association is strongest for SSD + language impairment (LI). Magnitude of phonological impairment alone did not determine literacy outcome, as predicted by the core phonological deficit hypothesis. Instead, consistent with a multiple deficit approach, phonological deficits appeared to interact with other cognitive factors in literacy development.

Phonological representations in deaf children: rethinking the "functional equivalence" hypothesis.

The sources of knowledge that individuals use to make similarity judgments between words are thought to tap underlying phonological representations. We examined the effects of perceptual similarity between stimuli on deaf children's ability to make judgments about the phonological similarity between words at 3 levels of linguistic structure (syllable, rhyme, and phoneme). Manipulation of stimulus contrasts (acoustic, visual/orthographic, tactile/motoric) allowed a finer-grained estimate of the sources of knowledge that deaf individuals use to make similarity judgments between words. The results showed that the ability to make syllable-, rhyme-, and phoneme-level judgments was not tied to "phonological" facilitation when these conditions are contrasted. These findings are inconsistent with long-held assumptions of "functional" equivalence between "heard" and "seen" speech in the development of phonological representations in deaf learners. We argue that previous studies reporting evidence for phonological effects in similarity judgments have failed to sufficiently control for alternative sources of sensory information, namely, visual and tactile/motoric.

Contrasting deficits on executive functions between ADHD and reading disabled children.

BACKGROUND: The object of this study was to analyze the executive functioning of children with attention deficit hyperactivity disorder (ADHD) or reading disability (RD) independent of their non-executive deficits. METHODS: Three carefully diagnosed groups of children, aged between 7 and 12 years (35 ADHD, 22 RD and 30 typically developing children), were tested on a wide range of tasks related to five major domains of executive functioning (EF): inhibition, visual working memory, planning, cognitive flexibility, and verbal fluency. Additional tasks were selected for each domain to control for non-executive processing. RESULTS: ADHD children were impaired on interference control, but not on prepotent and ongoing response suppression. ADHD showed deficits on visual working memory, planning, cognitive flexibility and phonetic fluency. RD children were impaired on phonetic fluency. The only EF measure that differentiated ADHD from RD was planning. CONCLUSIONS: The present sample of ADHD children showed several EF deficits, whereas RD children were almost spared executive dysfunction, but exhibited deficits in phonetic fluency.

Short-term adaptation to sound statistics is unimpaired in developmental dyslexia.

Developmental dyslexia is presumed to arise from phonological impairments. Accordingly, people with dyslexia show speech perception deficits taken as indication of impoverished phonological representations. However, the nature of speech perception deficits in those with dyslexia remains elusive. Specifically, there is no agreement as to whether speech perception deficits arise from speech-specific processing impairments, or from general auditory impairments that might be either specific to temporal processing or more general. Recent studies show that general auditory referents such as Long Term Average Spectrum (LTAS, the distribution of acoustic energy across the duration of a sound sequence) affect speech perception. Here we examine the impact of preceding target sounds' LTAS on phoneme categorization to assess the nature of putative general auditory impairments associated with dyslexia. Dyslexic and typical listeners categorized speech targets varying perceptually from /ga/-/da/ preceded by speech and nonspeech tone contexts varying. Results revealed a spectrally contrastive influence of the preceding context LTAS on speech categorization, with a larger magnitude effect for nonspeech compared to speech precursors. Importantly, there was no difference in the presence or magnitude of the effects across dyslexia and control groups. These results demonstrate an aspect of general auditory processing that is spared in dyslexia, available to support phonemic processing when speech is presented in context.

Three-dimensional ultrasound evaluation of tongue posture and its impact on articulation disorders in preschool children with anterior open bite.

Background Tongue posture plays an important role in the etiology of anterior open bite (AOB) and articulation disorders, and is crucial for AOB treatment planning and posttreatment stability. Clinical assessment of tongue posture in children is unreliable due to anatomical limitations. The aim of the study was to present functional diagnostics using three-dimensional ultrasound (3DUS) assessment of resting tongue posture in comparison to clinical assessment, and the associations between the improper tongue posture, otorhinolaryngological characteristics, and articulation disorders in preschool children with AOB. Patients and methods A cross-sectional study included 446 children, aged 3-7 years, 236 boys and 210 girls, examined by an orthodontist to detect the prevalence of AOB. The AOB was present in 32 children. The control group consisted of 43 children randomly selected from the participants with normocclusion. An orthodontist, an ear, nose and throat (ENT) specialist and a speech therapist assessed orofacial and ENT conditions, oral habits, and articulation disorders in the AOB group and control group. Tongue posture was also assessed by an experienced radiologist, using 3DUS. The 3DUS assessment of tongue posture was compared to the clinical assessment of orthodontist and ENT specialist. Results The prevalence of AOB was 7.2%. The AOB group and the control group significantly differed regarding improper tongue posture (p < 0.001), and articulation disorders (p < 0.001). In children without articulation disorders from both groups, the improper tongue posture occured less frequently than in children with articulation disorders (p < 0.001). After age adjustment, a statistical regression model showed that the children with the improper tongue posture had higher odds ratios for the presence of AOB (OR 14.63; p < 0.001) than the others. When articulation disorders were included in the model, these odds ratios for the AOB became insignificant (p = 0.177). There was a strong association between the improper tongue posture and articulation disorders (p = 0.002). The 3DUS detected the highest number of children with improper resting tongue posture, though there was no significant difference between the 3DUS and clinical assessments done by orthodontist and ENT specialist. Conclusions The 3DUS has proved to be an objective, non-invasive, radiation free method for the assessment of tongue posture and could become an important tool in functional diagnostics and early rehabilitation in preschool children with speech irregularities and irregular tongue posture and malocclusion in order to enable optimal conditions for articulation development.

Prevalence of communication, swallowing and orofacial myofunctional disorders in children and adolescents at the time of admission at a cancer hospital. / Prevalência de distúrbios da comunicação, deglutição e motricidade orofacial em crianças e adolescentes no momento da matrícula em um hospital oncológico.

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.

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.

Language disorders in children: classification and clinical syndromes.

This article reviews the normal pattern of language development in infants and young children. Classifications of childhood language disorders are presented and common clinical syndromes are described. Etiologic and comorbid factors associated with the development of language disorder are discussed in relation to current understanding of genetic and neuroanatomic aspects of brain development. Finally, the long-term outcome of individuals with childhood-onset language disorders is discussed.

Locus and nature of perceptual phonological deficit in Spanish children with reading disabilities.

The aims of this study were (a) to determine whether Spanish children with reading disabilities (RD) show a speech perception deficit and (b) to explore the locus and nature of this perceptive deficit. A group of 29 children with RD, 41 chronological age-matched controls, and 27 reading ability-matched younger controls were tested on tasks of speech perception. The effect of linguistic unit (word vs. syllable) and type of phonetic contrast (voicing, place and manner of articulation) were analyzed in terms of the number of errors and the response time. The results revealed a speech perception deficit in Spanish children with RD that was independent of the type of phonetic contrast and of linguistic unit.

The prevalence of lisping in young adults.

UNLABELLED: This paper reports the results of a pilot study that investigated the prevalence of lisping in a cohort of young adults. The motivation for the study was the observation that a substantial number of incoming students in speech language pathology at the Ghent University (Belgium), still presented with frontal lisping of the /s/, /z/ and sometimes other alveolar sounds too. Seven hundred and forty eight students (374 females, 374 males), native speakers of Dutch, were video-recorded while reading aloud the Dutch version of the text "The north wind and the sun..." from the International Phonetic Association (1974). Analysis of the samples yielded an overall prevalence of lisping of 23.3%. Significantly less participants presented with lisping among students of humanities than among students of natural sciences or social sciences. No significant difference was found between males and females. It remains to be determined if this high prevalence of lisping in adults represents a recent trend or if the persistence of the pattern of lisping into adulthood in some individuals is perhaps quite normal. LEARNING OUTCOMES: As a result of this activity, the participant will be able to (1) discuss the nature and prevalence of residual phonological errors in general and (2) to discuss the prevalence of lisping in young adult native speakers of Dutch in particular.

[Prevalence of malocclusion and its association with functional alterations of the stomatognathic system in schoolchildren]. / Prevalência de maloclusão e sua associação com alterações funcionais do sistema estomatognático entre escolares.

The aim of this research was to estimate the prevalence of malocclusion among 12-year-old schoolchildren in Camaragibe, Pernambuco State, Brazil. Malocclusions were stratified by the degree of severity, and their association with alterations of the following functions was also analyzed: speech articulation, respiration, and deglutition. Occlusion was assessed by means of the Treatment Priority Index (TPI) and the functions referred to by means of the criteria used in routine clinical speech therapy by a single calibrated examiner (kappa values ranging from 0.64 to 1.00). Schoolchildren were selected randomly from 11 public schools. Of the 173 selected children, 82.1% presented malocclusion (95%CI: 76.4-87.8), with 38.2% classified as minor manifestations of malocclusion; 20.8% definite malocclusions; 13.3% severe malocclusions; and 9.8% very severe malocclusions. The conclusion was that there is a high repressed demand for orthodontic treatment, and that the greater the severity of the malocclusion, the stronger the possibility of association with functional alterations, which must be taken into consideration when planning appropriate public services for these conditions.