Prevalence and Risk Factors for Dysphonia in Preschoolers at Five Years Old in a Capital City in the Northeast of Brazil.

GOALS: Identifying the prevalence and risk factors of childhood dysphonia in children turning 5 years old; and assess the link with the interactional, behavioral, sociodemographic, economic, and biological indicators METHOD: Analytical, transversal, nested within a birth cohort 5 years after its creation. Original cohort biologic data were recovered from the previous database. The current demographic and personal data were acquired from the official health institutions where the individuals were found. We managed to find 371 preschoolers, both sexes, enrolled in 141 public and private schools. Face-to-face interviews were performed with mothers regarding maternal and child health and biological, sociodemographic, economic, interactional-affective, and behavioral indicators. Speech therapists used the Consensus of Auditory-Perceptual Evaluation of Voice authorized for Portuguese for the perceptual-auditory judgment of children's voices. Bivariate and multivariate analyzes of the data were performed. A significance level of 5% (P < 0.05) was considered in all analyses. RESULTS: The prevalence of mild-moderate general dysphonia occurred in 26.4% of the preschoolers assessed with tense, rough, and breathy voice quality; low pitch; strong loudness and laryngeal resonance. There was a contrast between preschoolers with dysphonia, calm temperament, and family income of up to three minimum wages and those without these characteristics. We also have noted that a greater chance of dysphonia occurred in preschoolers with a calm temperament, family income of up to three minimum wages, nocturnal bruxism up to 3 years old and who did not use a pacifier. CONCLUSION: There was a high prevalence of dysphonia at 5 years old. Biological indicators have an impact on voice, while interactional, behavioral, sociodemographic, and economic indicators have a higher impact. There is a great need for investments in prevention, promotion, and vocal treatment to minimize negative socio-educational impacts and provide higher quality of life for children at greater risk for dysphonia.

Pediatric Dysphonia and the Access to Voice Therapy: A Study in Speech Therapy Services Available in a Capital City in the Northeast of Brazil.

OBJECTIVES: Defining the laryngeal and vocal alterations in the pediatric group studied in private speech therapy facilities; and estimating the time period between the problem being identified by the parents and the access to the proper provided services. METHODS: A cross-sectional analytical observational research with data collected from medical records by the speech therapist of each private facility. A written form was prepared and sent to the speech therapists of the 40 existing facilities. We received 124 of them from the pediatric group being assisted in 15 of the facilities. The form included questions about gender, age, vocal complaints; general degree of dysphonia; otorhinolaryngological diagnosis of vocal fold alterations; the age that the problem was identified by the parents and the beginning of speech therapy. The larynx was examined by videonasopharyngolaryngoscopy, and voice quality by auditory-perceptual assessment. RESULTS: The time period between the identification of the participant's dysphonia by the parents and the start of speech therapy was considered long (3.5years). The group showed variance in the proportion of nodule and cyst between genders. The highest prevalence of nodules occurred in boys; and the cyst in girls. Moderate general dysphonia occurred between 4 and 17years old, average age of 7years and 7months, with greater distribution between 5 and 10years of age. CONCLUSIONS: The average time delay until the start of speech therapy was 3.5years, more frequently in the 5-10years group and due to nodules in boys and cysts in girls.

Autoavaliação da comunicação em promotores de justiça em um estado do nordeste, Brasil / Communication self-assessment by public prosecutors in a north-eastern Brazilian state

RESUMO Objetivo Descrever a autoavaliação do promotor de justiça quanto à sua comunicação e reação do ouvinte e analisar a relação com o gênero, idade e anos de trabalho. Método Desenho descritivo, transversal. Foi elaborado um questionário e enviado aos 126 promotores, sendo devolvidos 33 questionários preenchidos. As variáveis independentes foram o gênero, idade e anos do exercício profissional. As variáveis dependentes foram a autoavaliação da comunicação ao longo dos anos de trabalho, os parâmetros de comunicação utilizados e a reação do ouvinte. Foi realizada análise descritiva e o Teste Exato de Fisher. Resultados A amostra foi constituída por ambos os gêneros, mediana de 43 anos de idade e 20 anos de trabalho. A maioria dos respondentes referiu que ao falar em público sente desmotivação, insegurança, tensão e dificuldade de persuadir o ouvinte. Houve maior proporção em mulheres de piora da comunicação ao longo dos anos de trabalho que em homens. Todas as mulheres relataram insegurança ao falar em público. Um terço dos promotores referiu alteração de voz. Os respondentes com mais de 43 anos de idade tiveram maior proporção de voz alterada que aqueles com idade menor. A maioria dos promotores com mais de 20 anos de trabalho revelou insegurança ao falar em público comparado com aqueles com idade menor. Conclusão Os promotores identificam seus parâmetros fortes e fracos da comunicação. O gênero, idade e tempo de profissão influenciam o desempenho comunicativo.

ABSTRACT Purpose To describe how public prosecutors self-assess their communication approaches and how listeners react to them; to analyze how this relates to gender, age, and work experience. Methods Descriptive, transversal study. A questionnaire was developed and sent to 126 public prosecutors for completion. Thirty-three completed questionnaires were sent back. The independent variables were gender, age, and number of years of professional experience. The dependent variables were communication self-assessment throughout the years of work, communication parameters used, and listeners’ reactions. A descriptive analyzis and Fisher’s Exact Test was carried out. Results the sample contained both male and female participants with a median age of 43 years and an average of 20 years of professional experience. Most of the respondents claimed they had experienced demotivation, insecurity, tension, and difficulty when trying to convince listeners. More women than men reported they felt that their communication had worsened throughout their careers. All the women reported they experienced insecurity when speaking in public. One third of the public prosecutors stated they suffered from disorders on their voice. Those respondents aged over 43, experienced greater proportion on voice change than younger ones. In contrast to their younger colleagues, the majority of public prosecutors with more than 20 years of professional experience revealed that they felt insecure when speaking in public. Conclusion the public prosecutors identified their strong and weak communication parameters. Gender, age, and work experience affect communicative performance.

Communication self-assessment by public prosecutors in a north-eastern Brazilian state. / Autoavaliação da comunicação em promotores de justiça em um estado do nordeste, Brasil.

PURPOSE: To describe how public prosecutors self-assess their communication approaches and how listeners react to them; to analyze how this relates to gender, age, and work experience. METHODS: Descriptive, transversal study. A questionnaire was developed and sent to 126 public prosecutors for completion. Thirty-three completed questionnaires were sent back. The independent variables were gender, age, and number of years of professional experience. The dependent variables were communication self-assessment throughout the years of work, communication parameters used, and listeners' reactions. A descriptive analyzis and Fisher's Exact Test was carried out. RESULTS: the sample contained both male and female participants with a median age of 43 years and an average of 20 years of professional experience. Most of the respondents claimed they had experienced demotivation, insecurity, tension, and difficulty when trying to convince listeners. More women than men reported they felt that their communication had worsened throughout their careers. All the women reported they experienced insecurity when speaking in public. One third of the public prosecutors stated they suffered from disorders on their voice. Those respondents aged over 43, experienced greater proportion on voice change than younger ones. In contrast to their younger colleagues, the majority of public prosecutors with more than 20 years of professional experience revealed that they felt insecure when speaking in public. CONCLUSION: the public prosecutors identified their strong and weak communication parameters. Gender, age, and work experience affect communicative performance.

Conhecimento sobre educação vocal e autocuidado de políticos de Sergipe, Brasil / Knowledge of voice training and self-care among politicians in Sergipe, Brazil / Conocimiento sobre educación vocal y autocuidado de políticos de Sergipe, Brasil

Introdução: políticos utilizam voz profissional, especialmente durante a campanha eleitoral. Objetivo: identificar a existência ou não de autocuidado vocal, na percepção dos parlamentares, no período eleitoral. Método: desenho exploratório, transversal, qualitativo com análise de conteúdo, composto por amostra de conveniência. Entre os 24 deputados estaduais, dez se dispuseram a participar voluntariamente, respondendo a um questionário autoaplicado, elaborado para este fim. As perguntas foram apresentadas em bloco que versavam sobre: a) perfil do respondente (gênero, idade, formação profissional e tempo de atuação como político); b) aquisição de informações sobre o uso da voz e acompanhamento fonoaudiológico; c) autopercepção da voz antes, durante e após a campanha eleitoral; d) queixa vocal atual. Resultados: dos dez respondentes, nove eram do gênero masculino; a média de idade foi de 45 (38-53) anos; a média de tempo de atividade política foi de 15 (11-22) anos e com outras profissões paralelas em que utilizam voz profissional. Destes, dois parlamentares relataram ter recebido orientação básica quanto à educação vocal em curso de radialismo, somente quatro políticos exercem algum tipo de autocuidado sobre o uso da voz. Foram identificadas quatro categorias que nomeamos de estereótipos em relação ao uso e cuidados com a voz: o "descuidado"; o "sem conhecimento, mas cuidadoso"; o "supostamente correto"; e o "teoricamente orientado, mas negligente". Considerações finais: somente quatro parlamentares pesquisados preocupam-se, ainda que de forma rudimentar, com o uso adequado da voz. Entre os respondentes observou-se que há um desconhecimento da contribuição do profissional de Fonoaudiologia quanto à educação vocal.

Introduction: politicians use professional vocals, particularly during the electoral campaigns. Objective: to indentify if there is or there is not a perception among members of the state assembly, of their vocal care during the electoral campaigns. Method: exploratory design, cross, qualitative with content analysis, in a convenience sample design. Within the 24 state deputies, 10 voluntarily agreed to participate, answering a self-applied questionnaire, elaborated for the study. The questions were presented in sections personal profile (age, gender, prior profession before entering politics and time as state deputy; knowledge of use of the vocals and if have had support from speech-language pathologist; perception of vocal behavior changes, prior, during and after electoral campaign; complains of any vocal issues during the collection of data. Results: out of the 10 interviewed, 9 were of the masculine gender, the average age was 45 (38-53) years; the average time of political activity was 15 (11-22) years and they had parallel professions were they utilized professional voice. Two state deputies had received basic vocal education in radio courses. Only 4 take some care of their voice. We identified four categories that we named stereotypes: the "non-caring"; the "without knowledge but caring"; the "supposing correct"; the "theoretically informed but negligent". Final considerations: only four respondents worried, even if in a rudimental form, with the use of adequate voice. It was observed that there is a lack of knowledge of the contribution of speech-language pathology to the vocal education.

Introducción: los políticos utilizan la voz profesionalmente, especialmente durante campañas electorales. Objetivo: Identificar la existencia o no de autocuidado vocal, en la percepción de los parlamentares, en periodos electorales. Método: estudio exploratorio, transversal, cualitativo, con análisis de contenido, compuesto por muestra de conveniencia. Entre 24 deputados estatales, diez se dispusieron a participar, contestando un cuestionario autoaplicado, elaborado para este fin. Las preguntas fueron presentadas en bloques que versaban sobre: a) perfil del encuestado (género, edad, profesión y tiempo de actuación como político); b) adquisición de informaciones sobre el uso de la voz y seguimiento fonoaudiológico; c) autopercepción de la voz antes, durante y después de campaña electoral; d) queja vocal presente. Resultados: de los diez encuestados, nueve eran hombres; la edad promedio fue de 45 (38-53) años; el tiempo promedio en actividad política fue de 15 (11-22) años y con otras profesiones paralelas en que también usaban la voz profesional. Dos parlamentares relataron haber recibido orientación básica relacionada con educación vocal en cursos de locución y solamente cuatro politicos ejercen algún tipo de autocuidado sobre el uso de la voz. Fueron identificadas cuatro categorías que llamamos de estereotipos relacionados con el uso de la voz y sus respectivos cuidados: el "descuidado"; el "sin conocimiento pero cuidadoso"; el "supuestamente correcto" y el "teóricamente orientado, pero negligente". Consideraciones finales: solamente cuatro parlamentares investigados se preocupan, aunque de forma rudimentaria, con el uso adecuado de la voz. Se observó que hay un desconocimiento de la contribución del profesional de fonoaudiología en relación con la educación vocal.

Perfil e Saúde Mental dos Fonoaudiólogos de uma Capital do Nordeste, Brasil / Profile and Mental Health of Speech Language Pathologists and Audiologists in a Northeast Capital of Brazil / Perfil y Salud Mental de los Fonoaudiólogos de una Capital del Nordeste, Brasil

Os profissionais de saúde não se reconhecem passíveis de adoecimento físico e mental. Objetivo: Descrever o perfil e a saúde mental dos fonoaudiólogos de uma capital do Nordeste, Brasil. Método: Estudo descritivo, transversal, que fez uso do questionário Saúde Mental dos Profissionais de Saúde. Foram incluídas as categorias de análise: características socioeconômicas, investimento profissional, condições de trabalho, sexualidade, vida familiar e social, uso abusivo de álcool e drogas, estado geral de saúde, estresse e sofrimento psíquico. Participou a população de fonoaudiólogos de todos os serviços públicos e privados de uma capital do Nordeste. Os dados foram analisados de forma descritiva. Resultados: A população foi constituída por 36 fonoaudiólogos com predomínio de mulheres, entre 31 e 40 anos de idade, e a maioria com até dez anos de graduação. Os dados mostram que a maior parte da população trabalha com planos de saúde; um terço considera seus honorários insatisfatórios. Do total, a maioria trabalha de 8 a 14 horas diárias, de 5 a 6 dias por semana, e alguns não lembram quando foram ao médico. Alguns revelaram beber semanalmente e outros referiram embriaguez no último ano. Sobre relacionamentos, alguns afirmaram ser infiéis, uma parcela maior dos respondentes aponta para comportamento de risco nas relações extraconjugais. Detectou-se que a população tem fobias e síndrome de pânico; a maioria referiu que já se deprimiu, e alguns já pensaram em suicídio. Conclusões: A pesquisa revelou indícios de sofrimento mental, apontando para a necessidade de maiores cuidados e investimentos na própria saúde destes profissionais.

Health professionals do not recognize that they are liable to physical and mental illnesses. Objective: to describe the profile and mental health of speech language pathologists and audiologists from a northeastern capital of Brazil. Method: descriptive transversal study using the Saúde Mental dos Profissionais de Saúde (mental health of health professionals) questionnaire. The analysis included: socioeconomic characteristics, professional commitment, working conditions, sexuality, family/social life, use of alcohol and drugs, general health condition, mental stress and suffering. The population consisted of speech language pathologists and audiologists from all public and private services in a northeastern capital of Brazil. The data was analyzed in a descriptive manner. Results: The population consisted of 36 speech language pathologists and audiologists, mainly women, aged between 31 and 40, who had graduated up to 10 years before the study. The data showed that the majority of the population has health insurance patients. One third considers their earnings unsatisfactory. The majority works for 8 to 14 hours per day on 5 to 6 days per week, and some do not remember their last medical exam. Some reported to drink alcohol on a weekly basis, others to have been drunk at least once during the last year. Concerning their relationships, some reported to have been unfaithful, while a great part show risk behavior for extramarital affairs. It was found that the population suffers from phobias, panic syndrome, and, partly, depression. Some participants have even considered suicide. Conclusion: For the population in question, the study revealed evidence of mental suffering and the necessity of major health care and investments.

Los profesionales de la salud no se reconocen pasibles de enfermedades físicas y mentales. Objetivo: Describir el perfil y la salud mental de fonoaudiólogos de una capital del Nordeste, Brasil. Método: Estudio descriptivo, transversal, que utilizó el cuestionario Salud Mental de los Profesionales de la Salud. El análisis incluyó las siguientes categorías: características socio económicas, inversión profesional, condiciones laborales, sexualidad, vida familiar y social, abuso de alcohol y drogas, estado general de salud, estrés y sufrimiento psíquico. Participaron fonoaudiólogos de todos los servicios públicos y privados de una capital del nordeste. Los datos fueron analizados de forma descriptiva. Resultados: Población se constituió por 36 fonoaudiólogos con predominio de mujeres, de 31 a 40 años, la mayoría con hasta diez años de carrera profesional. Los datos demuestran que la mayoría de la población trabaja con planes de salud; un tercio está insatisfecha con sus honorarios. La mayoría trabaja de 8 a 14 horas diarias, de 5 a 6 días semanales y algunos no recuerdan cuando fueron al médico por última vez. Algunos revelaron beber semanalmente y otros referieron embriaguez en el último año. Sobre relacionamientos, algunos afirmaron ser infieles, una parte mayor apunta para comportamientos de riesgo en las relaciones extraconyugales. Se detectó que la población presenta fobias y síndrome de pánico; la mayoría se refirió a ya haberse deprimido y algunos han pensado en suicidio. Conclusiones: La investigación reveló indicios de sufrimiento mental y apuntando para la necesidad que tienen estes profesionales de mayores cuidados e inversiónes en la propria salud.

Ações de graduandos de Fonoaudiologia em Centro de Referência em Educação Especial do Nordeste / Speech Language Pathology under graduates Interventions in a SpecialEducation Reference Center from Brazilian Northeast / Acciones de graduandos em Fonoaudiología en el Centro de Referencia en Educación Especial del Nordeste

O objetivo desta comunicação é descrever ações de fonoaudiologia no Centro de Referência em Educação Especial, junto aos usuários e familiares, realizadas por graduandos de uma universidade do Nordeste do Brasil. Trata-se de estudo longitudinal aprovado pelo CEP(Conselho de Ensino e Pesquisa). Os dados foram coletados em prontuários e em relatos de pais e discentes e as ações ocorreram no único Centro de Referência em Educação Especial do Estado. Foram realizadas ações fonoaudiológicas individuais e grupais pelos discentes sob supervisão, encaminhando a esse Centro 47 escolares provenientes de serviços de Saúde e de Educação, de diferentes municípios, com queixas de dificuldades de linguagem/ aprendizagem. A amostra final constituiu-se de 27 usuários, 19 (70%) meninos e 23 (85%) inseridos em ensino regular. Os usuários foram organizados em oito grupos, participando de cinco oficinas de linguagem conduzidas por duplas de graduandos sob supervisão docente. Os pais participaram de dois encontros. Após as oficinas, observou-se favorecimento dos aspectos linguístico-cognitivos e de interação do grupo estudado, além de se ter propiciado espaço de escuta para os responsáveis. Os resultados evidenciam a eficácia das ações a partir da evolução das crianças e dos adolescentes e também a partir dos depoimentos dos familiares e dos graduandos. Os usuários foram encaminhados para atendimento fonoaudiológico na Clínica-Escola da Universidade, considerando-se o sistema de referência e contrarreferência entre os serviços. Os futuros profissionais tiveram a oportunidade de experienciar ações de fonoaudiologia norteadas pela Promoção da Saúde, no âmbito da educação inclusiva, contribuindo para o desenvolvimento do grupo estudado com repercussão em seu processo de inclusão sócio educacional.

The aim is to describe SLP activities carried out by undergraduates of a university in the Northeast of Brazil at a Reference Center for Special Education. It?s a longitudinal study approved by CEP. Data was collected from records and statements made by users? parents and the SLP students. The activities took place at the only Reference Center in the state and included supervised SLP individuals and groups activities carried out by the undergraduates. Among the students referred to the center were 47 with speech and language/learning problems, beneficiaries of other public services from different municipalities. The sample group was made up of 27 participants, 19 (70%) boys and 23 (85%) coming from mainstreameducation. The participants were allocated to eight groups and took part in five language workshops, run by two undergraduates and supervised by a tutor, while the participants? parents were invited to two meetings. Apart from giving the parents the opportunity to receive advice, the workshops proved to favour linguistic-cognitive abilities and to improve the interaction in the researched group. For further SLP treatment, the participants were referred to the school clinic of the university, considering the reference and counter-reference system between services. Both, the development the users underwent and the parents? and undergraduate students? testemonies show that activities were effective. The future professionals had the opportunity to experience SLP activities aiming to promote health in the areaof inclusive education, besides made a contribution to the further development and process of socioeducational inclusion of the researched group.

El objetivo de esta comunicación es describir acciones de fonoaudiología en el Centro de Referencia en Educación Especial junto a usuarios y sus familiares, realizadas por graduandos de una universidad delnordeste de Brasil. Es un estudio longitudinal aprobado por el Consejo de Enseñanza e Investigación de una universidad. Los datos fueron recolectados por medio de informes y del relato de padres y discentes.Las acciones ocurrieron en el único Centro de Referencia en Educación Especial del estado. Los discentes realizaron acciones fonoaudiológicas individuales y en grupobajo supervisión y direccionaron a eseCentro 47 estudiantes de servicios de Salud y de Educación, de distintos municipios, con dificultades de lenguaje/aprendizaje. La muestra final constó de 27 usuarios, de los cuales 19(70%)eran niños y 23(85%) estaban inseridos en la enseñanza regular. Los usuarios fueron divididos en ocho grupos y participaron de cinco talleres de lenguaje, conducidos por parejas de graduandos bajo supervisión docente. Los padres participaron de dos encuentros. Tras los talleres, se observó una mejora en los aspectos lingüístico-cognitivos y de interacción del grupoestudiado, además de haberse propiciado espacio para escuchar a losresponsables por los niños. Los resultados demuestran la eficacia de las acciones a partir de la evolución de losniños y de los adolescentes y también por los testimonios de familiares y graduandos. Los usuarios fueron dirigidos a la Clínica-Escuela de la Universidad para recibir atención fonoaudiológica, gracias a un convenio entre los sistemas de educación y salud. Los futuros profesionales tuvieron la oportunidad de experimentar acciones fonoaudiológicas para la Promoción de la Salud en el ámbito de la educación inclusiva, lo que contribuyó con el desarrollo del grupo e influyó en su proceso de inclusión socio educacional.

Ações de graduandos de Fonoaudiologia em Centro de Referência em Educação Especial do Nordeste / Speech Language Pathology under graduates Interventions in a SpecialEducation Reference Center from Brazilian Northeast / Acciones de graduandos em Fonoaudiología en el Centro de Referencia en Educación Especial del Nordeste

O objetivo desta comunicação é descrever ações de fonoaudiologia no Centro de Referência em Educação Especial, junto aos usuários e familiares, realizadas por graduandos de uma universidade do Nordeste do Brasil. Trata-se de estudo longitudinal aprovado pelo CEP(Conselho de Ensino e Pesquisa). Os dados foram coletados em prontuários e em relatos de pais e discentes e as ações ocorreram no único Centrode Referência em Educação Especial do Estado. Foram realizadas ações fonoaudiológicas individuais e grupais pelos discentes sob supervisão, encaminhando a esse Centro 47 escolares provenientes de serviços de Saúde e de Educação, de diferentes municípios, com queixas de dificuldades de linguagem/ aprendizagem. A amostra final constituiu-se de 27 usuários, 19 (70%) meninos e 23 (85%) inseridos em ensino regular. Os usuários foram organizados em oito grupos, participando de cinco oficinas de linguagem conduzidas por duplas de graduandos sob supervisão docente. Os pais participaram de dois encontros. Após as oficinas, observou-se favorecimento dos aspectos linguístico-cognitivos e de interação do grupo estudado, além de se ter propiciado espaço de escuta para os responsáveis. Os resultados evidenciam a eficácia das ações a partir da evolução das crianças e dos adolescentes e também a partir dos depoimentos dos familiares e dos graduandos. Os usuários foram encaminhados para atendimento fonoaudiológico na Clínica-Escola da Universidade, considerando-se o sistema de referência e contrarreferência entre os serviços. Os futuros profissionais tiveram a oportunidade de experienciar ações de fonoaudiologia norteadas pela Promoção da Saúde, no âmbito da educação inclusiva, contribuindo para o desenvolvimentodo grupo estudado com repercussão em seu processo de inclusão sócio educacional.(AU)

The aim is to describe SLP activities carried out by undergraduates of a university in the Northeast of Brazil at a Reference Center for Special Education. It?s a longitudinal study approved by CEP. Data was collected from records and statements made by users? parents and the SLP students. The activities took place at the only Reference Center in the state and included supervised SLP individuals and groups activities carried out by the undergraduates. Among the students referred to the center were 47 with speech and language/learning problems, beneficiaries of other public services from different municipalities. The sample group was made up of 27 participants, 19 (70%) boys and 23 (85%) coming from mainstreameducation. The participants were allocated to eight groups and took part in five language workshops, run by two undergraduates and supervised by a tutor, while the participants? parents were invited to two meetings. Apart from giving the parents the opportunity to receive advice, the workshops proved to favour linguistic-cognitive abilities and to improve the interaction in the researched group. For further SLP treatment, the participants were referred to the school clinic of the university, considering the reference and counter-reference system between services. Both, the development the users underwent and the parents? and undergraduate students? testemonies show that activities were effective. The future professionals had the opportunity to experience SLP activities aiming to promote health in the areaof inclusive education, besides made a contribution to the further development and process of socioeducational inclusion of the researched group.(AU)

El objetivo de esta comunicación es describir acciones de fonoaudiología en el Centro de Referencia en Educación Especial junto a usuarios y sus familiares, realizadas por graduandos de una universidad delnordeste de Brasil. Es un estudio longitudinal aprobado por el Consejo de Enseñanza e Investigación de una universidad. Los datos fueron recolectados por medio de informes y del relato de padres y discentes.Las acciones ocurrieron en el único Centro de Referencia en Educación Especial del estado. Los discentes realizaron acciones fonoaudiológicas individuales y en grupobajo supervisión y direccionaron a eseCentro 47 estudiantes de servicios de Salud y de Educación, de distintos municipios, con dificultades de lenguaje/aprendizaje. La muestra final constó de 27 usuarios, de los cuales 19(70%)eran niños y 23(85%) estaban inseridos en la enseñanza regular. Los usuarios fueron divididos en ocho grupos y participaron de cinco talleres de lenguaje, conducidos por parejas de graduandos bajo supervisión docente. Los padres participaron de dos encuentros. Tras los talleres, se observó una mejora en los aspectos lingüístico-cognitivos y de interacción del grupoestudiado, además de haberse propiciado espacio para escuchar a losresponsables por los niños. Los resultados demuestran la eficacia de las acciones a partir de la evolución de losniños y de los adolescentes y también por los testimonios de familiares y graduandos. Los usuarios fueron dirigidos a la Clínica-Escuela de la Universidad para recibir atención fonoaudiológica, gracias a un convenio entre los sistemas de educación y salud. Los futuros profesionales tuvieron la oportunidad de experimentar acciones fonoaudiológicas para la Promoción de la Salud en el ámbito de la educación inclusiva, lo que contribuyó con el desarrollo del grupo e influyó en su proceso de inclusión socio educacional.(AU)

Stomatognathic evaluation at five years of age in children born premature and at term.

BACKGROUND: The high frequency of alterations of the stomatognathic system associated with premature birth may suggest that prematurity is an important risk factor in the development of this system. Prematurity has an incidence between 6-11% of births and is associated with factors such as genetic, maternal conditions (obstetric problems, nutritional status, infections) and antenatal care. In addition, undesirable situations, such as changes in enamel and the development of the skeletal structure, also appears to be associated with prematurity. This study aimed to look for changes in the stomatognathic system at five years of age associated with premature birth. METHODS: We estimated the prevalence of developmental disorders of the stomatognathic system in the primary dentition of preschool children at five years of age. Changes in preterm infants (n = 32) compared with term born (n = 381) were evaluated . Clinical examinations and questionnaire with sociodemographic and health of mothers and children information. Gestational age, birth weight, head circumference, Apgar score and mechanical ventilation, were collected from the medical records to birth records. The explanatory variable was preterm (<37 weeks gestational age). RESULTS: Prevalence of 7.7% of preterm infants was found. Of these, 40.6% had atresic palate, 56.2% malocclusion and 21.8% enamel hypoplasia. Forty (9.6%) children were not breastfed at the breast, and 26 (65.0%) had some type of malocclusion, showing association between not breastfeeding with an abnormal development of the stomatognathic system. The group of preterm infants showed five times more changes in head circumference and three times more mechanical ventilation use at birth. Change in head circumference at birth and mechanical ventilation has a significant association between groups of preterm and term infants. CONCLUSIONS: Mechanical ventilation at birth directly contributed to an increased risk of developmental disorders of the stomatognathic system in preterm infants, especially dental hypoplasia. Non-breastfed children had a higher risk of developing malocclusion. Alterations in head circumference were related effective on dental malocclusion. The results suggest that changes in the stomatognathic system are influenced by premature birth and points to the imperative need of using methods of preventive.

Vocal function and vocal discomfort in sheltered and non-sheltered 7- to 10-year-old school children in Aracaju, Brazil.

OBJECTIVE: To compare vocal function, school performance, and vocal discomfort between sheltered and nonsheltered school children in Aracaju, Brazil. METHODS: A controlled cross-sectional study was carried out on 7- to 10-year-old children who attended school regularly. Two groups of children were studied: the study group (SG), with children who lived in a shelter, and the control group (CG) containing children who lived with their families. We interviewed 44 children for the SG and 15 (34%) revealed vocal discomfort (SG = 15). Concomitantly, we interviewed 400 regular school children from the same geographical area and 45 (11.25%) were selected for the control group (CG). They were paired by sex and age with the sheltered children using a 3:1 ratio. Both groups were interviewed about school performance and vocal discomfort and were evaluated using perceptual and acoustic measurements for the voice and larynx. RESULTS: Children from both groups had started public school late. There were more individuals with vocal discomfort in the SG and individuals in this group also had a slower speech rate and inadequate pneumophonic coordination compared with the CG. The Dysphonia Severity Index (DSI) revealed mild-moderate deviation for both groups. Upper harmonics and palatal tonsil hypertrophy were higher in the CG, whereas laryngeal constriction was more common in the SG. CONCLUSION: All the SG children revealed mild-moderate deviance on the DSI, a higher level of vocal discomfort, a slow speech rate, inadequate pneumophonic coordination, and laryngeal constriction. The results here presented suggest that social conditions are important for voice behavior in children.

Voice performance evaluation of street children from Aracaju, Brazil using perceptual-auditory and acoustic analyses.

OBJECTIVE: To compare the voice performance of children involved in street labor with regular children using perceptual-auditory and acoustic analyses. METHODS: A controlled cross-sectional study was carried out on 7- to 10-year-old children of both genders. Children from both groups lived with their families and attended school regularly; however, child labor was evident in one group and not the other. A total of 200 potentially eligible street children, assisted by the Child Labor Elimination Programme (PETI), and 400 regular children were interviewed. Those with any vocal discomfort (106, 53% and 90, 22.5%) had their voices assessed for resonance, pitch, loudness, speech rate, maximum phonation time, and other acoustic measurements. RESULTS: A total of 106 street children (study group [SG]) and 90 regular children (control group [CG]) were evaluated. The SG group demonstrated higher oral and nasal resonance, reduced loudness, a lower pitch, and a slower speech rate than the CG. The maximum phonation time, fundamental frequency, and upper harmonics were higher in the SG than the CG. Jitter and shimmer were higher in the CG than the SG. CONCLUSION: Using perceptual-auditory and acoustic analyses, we determined that there were differences in voice performance between the two groups, with street children having better quality perceptual and acoustic vocal parameters than regular children. We believe that this is due to the procedures and activities performed by the Child Labor Elimination Program (PETI), which helps children to cope with their living conditions.

Characteristics and professional use of voice in street children in Aracaju, Brazil.

The objective of the study was to evaluate voice characteristics of children engaged in street selling, which involves an essentially professional use of voice in this population. A controlled cross-sectional study was carried out. A randomly chosen sample of 200 school children with a history of street selling assisted by public social services and 400 school children without this experience was selected. Seven- to 10-year-old children of both sexes were studied. Both groups were interviewed and given vocal assessment (auditory-perceptual assessment and spectrographic acoustic measures) and otorhinolaryngological evaluation (physical and videonasolaryngoscopic examination). Children with abnormal results in both groups were compared using chi(2) (Chi-squared test). The significance level was established at 5% (P<0.05). Voice problems were detected more frequently in working children (106-53%) than in regular school children (90-22.5%). The control group achieved better school performance as more children in this group attend school regularly than street children, although age-for-grade deficit was similar. The control group had more access to medical visits (80-40%) and treatment with a doctor (34-17%). Language assessment has shown that the control group had more dysphonia (73-37%) and myofunctional orofacial disorders (20-10%). Street children had more normal voice but had more nasal disorders and greater glottal closure than the school control group. Voice disorders were present in both groups, but less frequently in street children. Although subject to inadequate living conditions, street children had better voice quality than the control group. An explanation could be that by adapting their voice professionally for selling goods in the streets, they developed adequate resilience to their difficult living conditions.