[Oral language development in maltreated and foster children]. / Le développement du langage oral chez les enfants maltraités et placés.

Language disorders, which are still very poorly detected, are often present in abused children. While the consequences are well known and long-lasting, little is known about the development and specific characteristics of these children, depending on where they were placed, the type of abuse they suffered and the age at which they were placed. This finding led to a review of the literature aimed at better defining the state of knowledge on the subject, for the benefit of better detection and treatment.

Socio-familial environment influence on cognitive and language development in very preterm children.

BACKGROUND: Preterm children are at increased risk of cognitive and language delay compared with term-born children. While many perinatal factors associated with prematurity are well established, there is limited research concerning the influence of the socio-familial environment on the development of preterm children. This study aims to assess the relative impact of perinatal and socio-familial risk factors on cognitive and language development at 2 years corrected age (CA). METHOD: This retrospective cross-sectional study included preterm infants with a gestational age <32 weeks and/or a birth weight <1500 g, who underwent neurodevelopmental assessment at 2 years CA. Cognitive and language scores were assessed using the Bayley Scales of Infant-Toddler Development, third edition. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated using a multivariable model to examine the relationship between developmental delays and perinatal and socio-familial factors. RESULT: The prevalence of language delay was negatively associated with daycare attendance (aOR: 0.25, 95% CI: 0.07-0.85, p < 0.05) and high maternal educational levels (aOR: 0.24, 95% CI: 0.05-0.93, p < 0.05) and positively associated with bilingual environments (aOR: 5.62, 95% CI: 1.46-24.3, p < 0.05). Perinatal and postnatal risk factors did not show a significant impact on cognitive or language development. CONCLUSION: The development of language appears to be more influenced by the socio-familial environment than by early perinatal and postnatal factors associated with prematurity. These findings highlight the importance of considering socio-familial factors in the early identification and intervention of language delay among preterm children.

Delayed auditory experience results in past tense production difficulties and working memory deficits in children with cochlear implants: A comparison with children with developmental language disorder.

Extent evidence has shown that morphosyntax is one of the most challenging linguistic areas for children with atypical early language experiences. Over the last couple of years, comparisons between deaf children with CIs and children with DLD have gained interest - as cases of atypical early language experiences, including, but not restricted to, delayed onset of exposure to language input and language-processing difficulties. Evidence suggests that the morphosyntactic difficulties experienced by deaf children with CIs and children with DLD are very similar in nature. However, the few studies that have directly compared both groups are inconclusive, with deaf children with CIs either performing significantly better or on par with children with DLD. These differences in findings can be attributed, in part at least, to a failure to implement essential methodological controls - even more so given that deaf children with CIs comprise a very diverse population. The goal of the present study was to directly compare the performance of deaf children with CIs to that of children with DLD on a morphosyntactic ability known to be particularly difficult for both groups. Specifically, the present study conducted a detailed examination of the past tense marking abilities of deaf children with CIs and children with DLD while controlling for factors specific to deaf children with CIs, for children's basic cognitive abilities as well as for children's age, sex assigned at birth, and SES. Past tense verbs are particularly relevant as they are used as a marker of developmental language disorder (DLD) in children learning French. Moreover, extent evidence shows that deaf children with CIs and children with DLD have important WM difficulties, but also that there is an association between auditory perception, processing abilities, and working memory (WM) abilities as well as with the acquisition of morphological features, including tense marking. Unfortunately, no study has examined the relation between the accurate production of past tense verbs and WM abilities in children with CIs and children with DLD learning French. Fifteen deaf children with CIs between 5 and 7 years of age were compared to 15 children with DLD and to 15 typically-developing monolingual controls (MON), matched on important variables, using a past tense elicitation task as well as measures of phonological and nonverbal WM abilities. The results confirm that the deaf children with CIs and the children with DLD both performed significantly lower than the MON controls on the past tense elicitation task - suggesting that difficulties with past tense verbs in French might not only be a marker of DLD but, instead, a correlate of atypical language acquisition. Of importance, the present study is the first to show that deaf children with CIs perform significantly lower than children with DLD on a past tense elicitation task - highlighting the importance of using methodological controls. As well, significant correlations were found between the performance of the deaf children with CIs and of the children with DLD on the past tense elicitation task and their phonological and nonverbal WM abilities. Taken together with previous studies conducted in the same populations, this represents another evidence suggesting that early atypical language experiences result in language and WM deficits, including morphosyntactic difficulties.

Efecto de la otitis media en el desarrollo de la cognición y lenguaje infantil: una revisión narrativa de la literatura / Effect of otitis media on the development of childhood cognition and language: a narrative review of the literature

Resumen La otitis media constituye una de las consultas médicas más comunes en la población infantil. Se caracteriza por la inflamación del oído medio en presencia de exudado en la cavidad timpánica, abarcando un amplio espectro de formas clínicas, dentro de las que destacan la otitis media aguda, con efusión y crónica. La hipoacusia de conducción es una de las complicaciones de la otitis media, por lo que es lógico pensar que algunas habilidades del lenguaje y cognición infantil podrían verse afectadas secundariamente. Sin embargo, la evidencia en torno al tema no es concluyente y se aprecian opiniones contrapuestas; asimismo, no existe actualmente una revisión de la literatura que agrupe las investigaciones existentes en torno al tema. Por ello, el presente estudio pretende identificar y analizar la evidencia científica disponible sobre el efecto de la otitis media en el desarrollo de la cognición y lenguaje infantil. Se realizó una revisión de la literatura guiada por protocolo PRISMA en bases de datos de acuerdo a términos claves. Fueron analizados 8 artículos que cumplieron con los criterios de inclusión. Los resultados recabados sugieren, por una parte, que la otitis media afecta el lenguaje en sus distintas dimensiones, el vocabulario comprensivo y la longitud media del enunciado; mientras que, por otra parte, no se encontró efecto directo de la otitis media o hipoacusia sobre la comprensión del lenguaje. Se concluye que las investigaciones analizadas presentan gran variabilidad de resultados y conclusiones. No existen reportes sobre su impacto en otros dominios de la cognición.

Abstract Otitis media is one of the most common medical consultations in children. It is characterized by inflammation of the middle ear in the presence of exudate in the tympanic cavity, covering a wide spectrum of clinical forms, among which acute otitis media, otitis media with effusion and chronic otitis media are the most outstanding. Conductive hearing loss is one of the complications of otitis media, so it is logical to think that some language and cognitive skills in children could be affected. However, the evidence on this matter is not conclusive and there are conflicting opinions; likewise, there is currently no review of the literature that compile the existing research on this topic. Therefore, the present study aims to identify and analyze the available scientific evidence on the effect of otitis media on the development of children's cognition and language. A review of the literature, guided by PRISMA protocol, was conducted in databases according to key terms. Eight articles that met the inclusion criteria were analyzed. The results suggest, on the one hand, that otitis media affects language in its different dimensions, comprehensive vocabulary and average sentence length; while on the other hand, no direct effect of otitis media or hearing loss on language comprehension was found. In is concluded that the research that were analyzed present great variability of results and conclusions. There are no reports on its impact on other domains of cognition.

Relação entre sofrimento psíquico e atraso na aquisição da linguagem nos dois primeiros anos de vida / Relationship between psych distress and delay in language acquisition in the first two years of life / Relación entre sufriemento psíquico y retraso en la adquisición del lenguaje en los dos primeros años de vida

Objetivo: Analisar relação entre sofrimento psíquico e atraso na aquisição da linguagem. Método: uma amostra de 101 bebês, acompanhados dos três aos 24 meses por meio de filmagens das interações com suas mães, foram avaliados por protocolos de avaliação do psiquismo (Sinais PREAUT, roteiro IRDI e MCHAT) e pelos sinais enunciativos de aquisição da linguagem (SEAL). Os dados foram analisados estatisticamente por meio do teste de correlação de Pearson. Resultados: Observou-se maior correlação entre o roteiro IRDI, os Sinais PREAUT no primeiro semestre de vida. No segundo, terceiro e quarto semestre de vida dos bebês, o risco psíquico e o atraso na aquisição da linguagem coincidem, mas também há casos de atraso na aquisição da linguagem sem risco psíquico. Conclusão: Houve relação significativa entre presença de sofrimento psíquico e atraso na aquisição da linguagem.

Objective: To analyze the relationship between psychic distress and language acquisition delay. Method: a sample of 101 babies, followed from three to 24 months of age through videotaping of interactions with their mothers, were evaluated by psychic protocols (PREAUT signs, IRDI and MCHAT script) and by the enunciative signs of language acquisition (SEAL). Data were analyzed using the STATISTICA 9.0 software. Results: There was a greater correlation between the IRDI script and the PREAUT signs in the first semester of life. In the second, third and fourth semester of life, the psychic risk and the delay in language acquisition coincide, but there are cases of delay in the acquisition of language without psychic risk. Conclusion: There was a significant relationship between the presence of psychic distress and language acquisition delay.

Objetivo: Analizar la relación entre sufrimiento psíquico y retraso en la adquisición del lenguaje. Método: una muestra de 101 bebés, seguidos desde los 3 a los 24 meses de edad mediante videograbación de interacciones con sus madres, fueron evaluados mediante protocolos de riesgo psíquico (signos PREAUT, guión IRDI y MCHAT) y mediante los signos enunciativos de adquisición del lenguaje (SEAL) . Los datos se analizaron con el software STATISTICA 9.0. Resultados: Hubo una mayor correlación entre el guión IRDI y los signos PREAUT en el primer semestre de vida. En el segundo, tercer y cuarto semestre de vida, el riesgo psíquico y el retraso en la adquisición del lenguaje coinciden, pero existen casos de retraso en la adquisición del lenguaje sin riesgo psíquico. Conclusión: hubo una relación significativa entre la presencia de sufriemento psíquico y el retraso en la adquisición del lenguaje.

Lectura de oraciones en español: similitudes y diferencias entre niños con dislexia y niños con sordera / Reading sentences in spanish: some similarities and differences between children with dyslexia and those with deafness

Este estudio compara las estrategias para leer oraciones utilizadas por un grupo de escolares con dislexia (n = 107) y un grupo con sordera e implante coclear (n = 61) de lengua castellana. Los resultados indican que solo los participantes con sordera adoptan la estrategia de palabras clave (EPC), que consiste en identificar algunas de las palabras de la oración con contenido semántico propio, e ignorar las palabras funcionales. Se observa además que el uso de la EPC está asociado con un déficit sintáctico. Por otra parte, cuando los dos grupos se emparejan en el nivel lector con niños con desarrollo típico en lectura (Grupo Control, n = 785), las diferencias entre los Grupos Disléxico y Control desaparecieron. Sin embargo, los niños con sordera mantenían su tendencia a usar la EPC y seguían presentando dificultades para procesar las palabras funcionales. Estos resultados excluyen la hipótesis de que la EPC sea un procedimiento utilizado de forma general para compensar los déficits de lectura, pareciendo depender, más específicamente, de dificultades en la capacidad sintáctica

The present study compares the strategies to read sentences used by Spanish-speaking children with dyslexia (n = 107) and cochlear-implanted children with deafness (n = 61). The results show that children with deafness, but not with dyslexia, adopt the key-word-strategy (KWS), which consists of identifying some content words of the sentence while ignoring the function words. Furthermore, it appeared that the KWS was associated with poor syntactic ability. Moreover, when Dyslexic and Deaf Groups were carefully matched at reading level with normally developing children (Control Group, n = 785) all of the differences between dyslexics and normally developing children disappeared. Children with hearing loss however were still poor at dealing with function words and consequently maintained their tendency to use the KWS. These results exclude the hypothesis that the KWS is a broadly used procedure to compensate for reading deficits but seems, rather, to depend on poor syntactic ability

Hipoacusia unilateral: bases neurobiológicas de la ambliaudia / Unilateral hearing loss: neurobiological basis of amblyaudia

Resumen La hipoacusia unilateral es una alteración prevalente e importante en la población infantil que puede llevar a un deterioro del procesamiento auditivo. Cualquier patología que cause hipoacusia asimétrica (conductiva o sensorioneural) durante ventanas críticas del desarrollo cerebral, puede dar lugar a déficits del procesamiento auditivo que podrían persistir incluso después de la rehabilitación audiológica. Este proceso fisiopatológico se ha denominado "ambliaudia" y los niños que la presentan tienen un mayor riesgo de sufrir retraso en el desarrollo del lenguaje, así como de padecer dificultades académicas, sociales y cognitivas. Por esto, la ambliaudia se presenta como un desafío en audiología, siendo necesario comprender los mecanismos neurobiológicos que la subyacen. Entender de mejor manera cuáles son las consecuencias que tiene la pérdida auditiva asimétrica sobre el desarrollo del sistema nervioso podría ser clave para guiar de mejor forma las intervenciones terapéuticas. En este artículo se revisan trabajos en humanos y en modelos animales que describen las consecuencias neurobiológicas de la deprivación auditiva unilateral durante el desarrollo del sistema nervioso y su posible aplicación a la práctica clínica.

Abstract Unilateral hearing loss is a prevalent and important disorder in children that can lead to an impairment of auditory processing. Any pathology that causes asymmetric (conductive or sensorineural) hearing loss during critical brain development windows can lead to hearing deficits that may persist even after audiological rehabilitation. This pathophysiological process has been referred to as amblyaudia, and children are at greater risk of experiencing language developmental delays as well as academic, social and cognitive impairments. For this reason, amblyaudia presents itself as a challenge in audiology, and it has become necessary to understand its neurobiological mechanisms. A better understanding of the consequences of asymmetric hearing loss on the development of the nervous system may be key to better guiding therapeutic interventions. This article reviews studies performed in humans and animal models that describe the neurobiological consequences of unilateral hearing deprivation during the development of the nervous system and its possible applications to clinical practice.

Auditory training in autism spectrum disorder: a case report / Treinamento auditivo no transtorno do espectro autista: relato de caso

ABSTRACT This study aimed to measure the effects of a Computer-based Auditory Training Program (CBATP) on an adolescent diagnosed with Autism Spectrum Disorder (ASD) and Central Auditory Processing Disorder (CAPD). This is the case report of a male, 14-year-old adolescent diagnosed with ASD. The individual was submitted to basic audiological evaluation, central auditory processing assessment and hearing electrophysiology (EP), pre- and post-therapeutic intervention. Central auditory processing (CAP) was assessed by means of the following instruments: Time-compressed Speech Test (TCST), Random Gap Detection Test (RGDT), Staggered Spondaic Word Test (SSWT), Frequency (Pitch) Pattern Sequence Test (FPST), and Duration Pattern Test (DPT). The P300 component of the Event-related Potential (ERP) was used in the hearing EP. Pre-intervention assessment of CAP showed changes in the auditory skills of closure, figure-ground and temporal ordering, but normal temporal resolution ability. Post-intervention evaluation of CAP showed improvement in all previously mentioned auditory skills, except for the figure-ground ability, which remained unchanged. Regarding the findings of the hearing EP, a decrease in the latency of the P300 component was observed pre- and post-intervention. This study demonstrated that the use of a CBATP resulted in improvement in the hearing abilities assessed in an adolescent diagnosed with ASD.

RESUMO O objetivo deste estudo foi mensurar o efeito do treinamento auditivo computadorizado em um adolescente diagnosticado com Transtorno do Espectro Autista e Transtorno do Processamento Auditivo. Participou do estudo um adolescente de 14 anos, do sexo masculino, diagnosticado com Transtorno do Espectro Autista. O sujeito foi submetido à avaliação audiológica básica, avaliação do processamento auditivo central e avaliação eletrofisiológica da audição pré e pós-intervenção. A avaliação do processamento auditivo foi composta do Teste de Fala Comprimida (FC), Randon Gap Detection Test (RGDT), Staggered Spondaic Words (SSW), Teste de Padrão de Frequência (TPF) e Teste de Padrão de Duração (TPD). Na avaliação eletrofisiológica, utilizou-se o Potencial Evocado Auditivo Cognitivo (P300). Na avaliação do processamento auditivo central pré-intervenção terapêutica, observou-se alteração nas habilidades de fechamento auditivo, figura-fundo e ordenação temporal. Na habilidade auditiva de resolução temporal, o sujeito da pesquisa demonstrou desempenho dentro dos padrões de normalidade. Na realização do processamento auditivo central, foi possível observar melhora nos resultados de todas as habilidades auditivas citadas anteriormente, exceto na habilidade de figura-fundo, que permaneceu alterada. Quantos aos achados da avaliação eletrofisiológica da audição, verificou-se diminuição da latência do componente P300 na comparação dos resultados pré e pós-treinamento auditivo. Este estudo demonstrou que a utilização de treinamento auditivo trouxe como efeito uma melhora das habilidades auditivas avaliadas de um adolescente diagnosticado com Transtorno do Espectro Autista.

Retraso del desarrollo del lenguaje en niños de 24 meses en un centro de salud en la Ciudad de Buenos Aires / Language development delay in 24-month-old children at a health care center of the City of Buenos Aires

Introducción. El retraso del desarrollo del lenguaje representa un desafío frecuente para pediatras y otros profesionales. El objetivo principal fue establecer su prevalencia en niñas y niños usuarios de un centro de salud. Población y métodos. Se evaluó el vocabulario expresivo de niñas y niños de 24 meses en un centro de salud utilizando el Inventario de Desarrollo de Habilidades Comunicativas MacArthur-Bates, versión breve (adaptación argentina). Se investigó la asociación entre el retraso del lenguaje y las características demográficas, socioeconómicas, conductuales/emocionales y de estrés parental. En aquellos con retraso expresivo, se evaluó el vocabulario receptivo y se investigaron posibles causas subyacentes (retraso cognitivo no verbal, trastornos del espectro autista, patología del oído medio e hipoacusia). Resultados. Se observó un retraso del desarrollo del lenguaje en 16 de 138 participantes (11,6%; intervalo de confianza -IC- 95%: 6,2-17%), asociado significativamente con antecedentes familiares de retraso del lenguaje, estrés parental y comportamiento problemático. El compromiso del vocabulario receptivo se identificó en 13 de 16 casos con retraso del desarrollo del lenguaje, y 7 presentaron sospecha de trastorno del espectro autista, de retraso global del desarrollo o ambas. Se observó la patología del oído medio en 5 de 9 estudiados. Los 9 participantes a los que se realizó una audiometría no presentaron resultados patológicos de acuerdo con los criterios adoptados en el presente trabajo. Conclusiones. El retraso del desarrollo del lenguaje representa un problema prevalente en nuestra población y se asoció principalmente con problemas de comportamiento y antecedentes familiares de retraso del lenguaje.

Introduction. Language development delay is a frequent challenge for pediatricians and other health care providers. The main objective of this study was to establish its prevalence among children attending a health care center. Population and methods. The expressive vocabulary of 24-month-old children attending a health care center was assessed using the Spanish-language MacArthur-Bates Communicative Development Inventories, short form (Argentine version). The association between language delay and demographic, socioeconomic, behavioral/emotional, and parental stress characteristics was analyzed. In children with expressive language delay, receptive vocabulary was assessed and possible underlying causes were studied (non-verbal cognitive delay, autistic spectrum disorders, middle ear pathology, and hearing impairment). Results. Language development delay was observed in 16 out of 138 participants (11.6%; 95% confidence interval: 6.2-17%), significantly associated with a family history of language delay, parental stress, and problem behavior. Receptive vocabulary compromise was identified in 13 out of 16 children with language development delay, and 7 were suspected of autistic spectrum disorder, overall developmental delay, or both. A middle ear pathology was observed in 5 out of 9 studied children. The 9 participants who had an audiometry did not have pathological results based on this study's criteria. Conclusions. Language development delay is a prevalent condition in our population and has been mainly associated with behavioral problems and a family history of language delay.

Desarrollo psicomotor en pacientes con cardiopatía congénita grave / Psychomotor development in patients with severe congenital heart disease

Objetivo. Analizar los hitos motores alcanzados en los dos primeros años de vida en pacientes con cardiopatía congénita grave. Pacientes y métodos. De 89 pacientes con cardiopatía congénita grave, 19 fueron excluidos por antecedentes de prematuridad o cromosomopatía, cuatro por antecedente de ictus isquémico y dos por ausencia de historia clínica. Se obtuvieron resultados del test de Denver (TD) a los 2, 6, 12, 15 y 18 meses, y resultados en los campos motor, del lenguaje y de interacción social. Resultados. El 59,4% fueron varones, y el 40,6%, mujeres. La edad media de los pacientes sometidos a oxigenación con membrana extracorpórea con TD patológico a los 18 meses fue de 3 meses, frente a 11,88 meses de los que presentaban un TD normal. El TD a los 2 meses resultó normal en el 98,4% de los pacientes, en el 87,5% a los 6 y 12 meses, en el 81,3% a los 15 meses, y en el 85% a los 18 meses. Dos de los pacientes con alteración en el neurodesarrollo normalizaron el TD antes de los 24 meses. El campo del neurodesarrollo más afectado fue el del lenguaje (15,6%), seguido del motor (10,9%) y de la interacción social (8%). Conclusiones. El retraso en el desarrollo psicomotor, especialmente en el área del lenguaje, es más frecuente en pacientes con cardiopatías congénitas graves, y la presencia de cianosis y la necesidad de circulación con membrana extracorpórea son las variables que más se asocian con este tipo de patología

Aim. Retrospective analysis of the neurodevelopment in the first two years of life in patients with severe congenital heart disease. Patients and methods. Out of 89 patients with severe congenital heart disease 19 were excluded due to a history of prematurity and/or chromosomopathy, four due to a history of ischemic stroke and two due to lack of medical history. Denver Test (DT) results at 2, 6, 12, 15 and 18 months, and results in motor, language and social interaction fields were achieved. Results. 59.4% were male and 40.6% female. The mean age of patients undergoing extracorporeal membrane oxygenation with pathological DT at 18 months was 3 months, compared to 11.88 months in those with normal DT. DT at 2 months was normal in 98.4% of patients, 87.5% at 6 and 12 months, 81.3% at 15 months and 85% at 18 months. Two patients with abnormal neurodevelopment normalized the DT before 24 months. The field of neurodevelopment most affected was language (15.6%), followed by motor (10.9%) and social interaction (8%). Conclusions. Psychomotor development delay, especially in the area of language, is more frequent in patients with severe congenital heart disease. The presence of cyanosis and the need for extracorporeal membrane oxygenation were the variables that are most associated with this type of pathology

Phonological acquisition in children with early-treated congenital hypothyroidism: association with clinical and laboratory parameters / Aquisição fonológica em crianças com hipotireoidismo congênito precocemente tratado: associação com dados clínicos e laboratoriais

ABSTRACT Purpose To evaluate the phonological characteristics of children with congenital hypothyroidism (CH). Methods Observational, analytical, cross-sectional, ambispective study including prepubertal children with CH (n=100; study group, SG) and controls without CH ( n=100; control group, CG). Assessments included a speech language pathology interview, the phonological evaluation of the ABFW Child Language Test, medical data, and neuropsychological tests in the first three years of life. Results On treatment onset of the SG, the median chronological age of the participants was 18.0 days and 48.4% had total T4 <2.5 µg/dL (31.75 nmol/L). At the age of 7 years, children in the SG had higher rates of consonant cluster simplification and lower rates of complete phonological system compared to those in the CG. On analysis of combined age groups (4+5 and 6+7 years), the CG had a higher frequency of complete acquisition versus the SG. On multivariate analysis, thyroid agenesis, abnormal scores on the Clinical Linguistic and Auditory Milestone Scale and developmental quotient tests were associated with the occurrence of phonological disorders. Conclusion Children with CH present delay in phonological acquisition, despite early diagnosis and adequate treatment, especially between the ages of 6-7 years. The etiology of CH and the results of neuropsychological tests in the first years of life seem to be related to this delay.

RESUMO Objetivo Avaliar as características fonológicas de crianças com hipotireoidismo congênito (HC). Método Estudo observacional, analítico, transversal e ambispectivo que incluiu crianças pré-púberes com HC (n = 100, Grupo de Estudo, GE) e um grupo controle de crianças pré-púberes sem HC (n = 100, Grupo Controle, GC). As avaliações incluíram uma entrevista fonoaudiológica, avaliação fonológica por meio do teste de linguagem infantil ABFW, e coleta de dados nos prontuários referentes às avaliações médicas e testes neuropsicológicos realizados nos três primeiros anos de vida. Resultados Quanto ao início do tratamento no GE, a idade cronológica mediana dos participantes foi de 18,0 dias e 48,4% apresentaram T4 total <2,5 μg / dL (31,75 nmol / L). Na comparação da avaliação fonológica por idade, aos 7 anos as crianças no GE tiveram maior ocorrência de simplificação de encontros consonantais e menor ocorrência de sistema fonológico completo quando comparadas às crianças do GC. Na análise de grupos etários combinados (4 + 5 e 6 + 7 anos), observou-se que o GC teve aquisição completa do sistema fonológico mais precocemente. Na análise multivariada, agenesia da tireoide, resultados alterados nos testes Clinical Linguistic and Auditory Milestone Scale (CLAMS) e Developmental Quotient Tests (CDC) foram associados à ocorrência de desvios fonológicos. Conclusão Crianças com HC apresentam atraso na aquisição fonológica, mesmo com diagnóstico precoce e tratamento adequado, especialmente entre as idades de 6-7 anos. A etiologia do HC, bem como os resultados obtidos nos testes neuropsicológicos nos primeiros anos de vida, parecem ter relação com este atraso.

Obstructive sleep apnea and oral language disorders / Apneia obstrutiva do sono e alterações da linguagem oral

Abstract Introduction Children and adolescents with obstructive sleep apnea (OSA) may have consequences, such as daytime sleepiness and learning, memory, and attention disorders, that may interfere in oral language. Objective To verify, based on the literature, whether OSA in children was correlated to oral language disorders. Methods A literature review was carried out in the Lilacs, PubMed, Scopus, and Web of Science databases using the descriptors “Child Language” AND “Obstructive Sleep Apnea”. Articles that did not discuss the topic and included children with other comorbidities rather than OSA were excluded. Results In total, no articles were found at Lilacs, 37 at PubMed, 47 at Scopus, and 38 at Web of Science databases. Based on the inclusion and exclusion criteria, six studies were selected, all published from 2004 to 2014. Four articles demonstrated an association between primary snoring/OSA and receptive language and four articles showed an association with expressive language. It is noteworthy that the articles used different tools and considered different levels of language. Conclusion The late diagnosis and treatment of obstructive sleep apnea is associated with a delay in verbal skill acquisition. The professionals who work with children should be alert, as most of the phonetic sounds are acquired during ages 3–7 years, which is also the peak age for hypertrophy of the tonsils and childhood OSA.

Resumo Introdução Crianças e adolescentes com Apneia Obstrutiva do Sono (AOS) podem apresentar sonolência diurna, alterações de aprendizado, memória e atenção, que podem interferir na linguagem oral. Objetivo Verificar, com base na literatura, se a AOS apresenta correlação com alterações da linguagem oral. Método Foi feita revisão bibliográfica nas bases de dados Lilacs, Pubmed, Scopus e Web of Science, a partir das palavras-chaves “Linguagem Infantil” AND “Apneia do Sono Tipo Obstrutiva”. Os artigos que não se relacionavam ao tema foram excluídos, bem como estudos com crianças que apresentassem outras comorbidades, além da AOS. Resultados Foram localizados 37 artigos na Pubmed, 47 na Scopus e 38 na Web of Science e nenhum na Lilacs. A partir dos critérios de inclusão e exclusão, foram selecionados seis estudos, publicados de 2004 a 2014. Dos artigos incluídos, observou-se em quatro artigos a relação do grupo com ronco primário/SAOS com a Linguagem Receptiva e em quatro artigos a relação dessa população com a Linguagem Expressiva. Ressalta-se que os artigos usaram instrumentos diferentes e consideraram níveis diversificados da Linguagem. Conclusão O diagnóstico e o tratamento tardio de AOS resultam em alterações significantes na qualidade da aquisição verbal. Torna-se imprescindível a atenção dos profissionais que atuam com a população infantil para esse aspecto, uma vez que grande parte dos sons da fala são adquiridos entre 3–7 anos, que corresponde ao período de pico de ocorrência de hipertrofia adenoamigdaliana e AOS na infância.

Variables ambientales y genéticas relacionadas con alteraciones en la adquisición del lenguaje en la infancia / Environmental and genetic variables related with alterations in language acquisition in early childhood

Introducción. Los problemas en la correcta adquisición del lenguaje se han estudiado mucho, pero con escasas conclusiones globales; a ello contribuye la variabilidad individual, la existencia de diferentes medidas para evaluar el lenguaje y a que en su desarrollo participa una compleja red de factores genéticos y ambientales. Objetivo. Revisar las variables ambientales y genéticas que se han investigado hasta la actualidad, para comprender mejor las causas de los trastornos específicos del lenguaje y crear nuevas evidencias que faciliten la elaboración de sistemas de detección precoz de estos trastornos. Desarrollo. Dentro de las variables ambientales relacionadas con peor desarrollo en el lenguaje infantil están el sexo masculino, un nivel educacional maternal bajo, una historia familiar de problemas en el lenguaje o problemas psiquiátricos, los problemas perinatales y los problemas de salud en la infancia. El bilingüismo parece ser un factor protector. El temperamento y el lenguaje tienen relación. Dentro de los factores genéticos existen ya varios genes específicos asociados con el lenguaje, dos de ellos con una influencia mayor en su adquisición fisiológica: FOXP2 y CNTNAP2. Los otros genes más relacionados con trastornos específicos del lenguaje son ATP2C2, CMIP, ROBO2, ZNF277 y NOP9. Conclusiones. La clave para entender el desarrollo de los trastornos específicos del lenguaje radica en llegar a comprender el verdadero papel que desempeñan los genes en la ontogenia, regulando los diferentes procesos de desarrollo y cómo este papel se ve modulado por el ambiente (AU)

Introduction. A great deal of research has addressed problems in the correct acquisition of language, but with few overall conclusions. The reasons for this lie in the individual variability, the existence of different measures for assessing language and the fact that a complex network of genetic and environmental factors are involved in its development. Aim. To review the environmental and genetic variables that have been studied to date, in order to gain a better understanding of the causes of specific language impairment and create new evidence that can help in the development of screening systems for the early detection of these disorders. Development. The environmental variables related with poorer early child language development include male gender, low level of education of the mother, familial history of problems with language or psychiatric problems, perinatal problems and health problems in early childhood. Bilingualism seems to be a protective factor. Temperament and language are related. Within the genetic factors there are several specific genes associated with language, two of which have a greater influence on its physiological acquisition: FOXP2 and CNTNAP2. The other genes that are most related with specific language disorders are ATP2C2, CMIP, ROBO2, ZNF277 and NOP9. Conclusions. The key to comprehending the development of specific language disorders lies in reaching an understanding of the true role played by genes in the ontogenesis, in the regulation of the different developmental processes, and how this role is modulated by the environment (AU)

Efeitos da prematuridade na aquisição da linguagem e na maturação auditiva: revisão sistemática / Effects of prematurity on language acquisition and auditory maturation: a systematic review

RESUMO Objetivo Verificar quais os prejuízos a prematuridade causa à linguagem e à audição. Estratégia de pesquisa Utilizou-se os descritores language/linguagem, hearing/audição, prematurity/prematuridade nas bases de dados LILACS, MEDLINE, Biblioteca Cochrane e Scielo. Critérios de seleção Ensaios randomizados controlados, estudos de intervenção não randomizados e estudos descritivos (transversais, de coorte, projetos de caso-controle). Análise dos dados Os artigos foram avaliados independentemente por dois autores, conforme os critérios de seleção. Foram selecionados 26 estudos, sete publicados no Brasil e 19 na literatura internacional. Resultados Dezenove estudos fizeram comparação entre nascidos a termo e prematuros. Dois dos estudos fizeram comparações entre prematuros pequenos para idade gestacional e adequados para idade gestacional. Em quatro estudos a amostra era composta de crianças com prematuridade extrema, os demais trabalhos foram realizados em crianças com prematuridade acentuada e moderada. Nestes estudos, foram utilizados, para análise da audição, as Emissões Otoacústicas, o Potencial Evocado de Tronco Encefálico, a timpanometria, o Potencial Evocado Auditivo de Estado Estável e audiometria de reforço visual. Para avaliação de linguagem, a maioria dos artigos utilizou a Escala Bayley de Desenvolvimento Infantil. Observou-se na maioria dos estudos revisados a prematuridade relacionando-se direta ou indiretamente à aquisição de habilidades auditivas e de linguagem nos primeiros anos de vida. Conclusão Dessa forma, pôde-se constatar que a prematuridade bem como os aspectos relacionados a ela (idade gestacional, baixo peso e intercorrências ao nascer) influenciam a maturação da via auditiva central podendo causar efeitos negativos na aquisição da linguagem.

ABSTRACT Purpose To verify which damages prematurity causes to hearing and language. Research strategies We used the decriptors language/linguagem, hearing/audição, prematurity/prematuridade in databases LILACS, MEDLINE, Cochrane Library and Scielo. Selection criteria randomized controlled trials, non-randomized intervention studies and descriptive studies (cross-sectional, cohort, case-control projects). Data analysis The articles were assessed independently by two authors according to the selection criteria. Twenty-six studies were selected, of which seven were published in Brazil and 19 in international literature. Results Nineteen studies comparing full-term and preterm infants. Two of the studies made comparisons between premature infants small for gestational age and appropriate for gestational age. In four studies, the sample consisted of children with extreme prematurity, while other studies have been conducted in children with severe and moderate prematurity. To assess hearing, these studies used otoacoustic emissions, brainstem evoked potentials, tympanometry, auditory steady-state response and visual reinforcement audiometry. For language assessment, most of the articles used the Bayley Scale of Infant and Toddler Development. Most studies reviewed observed that prematurity is directly or indirectly related to the acquisition of auditory and language abilities early in life. Conclusion Thus, it could be seen that prematurity, as well as aspects related to it (gestational age, low weight at birth and complications at birth), affect maturation of the central auditory pathway and may cause negative effects on language acquisition.

Aspectos sociodemográficos, clínicos e familiares de pacientes com o transtorno do espectro autista no sul de Santa Catarina / Sociodemographic, clinical and familial aspects of patients with autism spectrum disorder in southern Santa Catarina

O transtorno do espectro autista (TEA) é considerado um distúrbio global do desenvolvimento que atinge a linguagem, a cognição e a interação social. OBJETIVO: Descrever o perfil diagnóstico de pacientes com o transtorno do espectro autista atendidos no Ambulatório de Neurogenética da Universidade do Sul de Santa Catarina. MÉTODOS: Foram analisados 122 prontuários de pacientes diagnosticados com Transtorno do Espectro Autista em acompanhamento regular no ambulatório de neurogenética da UNISUL entre os anos de 2010 e 2013. RESULTADOS: Foi encontrada a razão de 3 meninos para cada menina com TEA. O sexo feminino foi fator de risco para outros problemas de saúde. Problemas do sono e pais com problemas psiquiátricos estiveram associados a outras patologias clínicas e psiquiátricas. CONCLUSÃO: Entre os pacientes com TEA, o sexo feminino, história de pais com problemas psiquiátricos, e distúrbios do sono apresentaram associação estatística com comorbidades neurológicas, respiratórias e genéticas.

The Autism Spectrum Disorder (ASD) is considered a global disorder of the human development and it involves language, cognition and social interaction. AIM: To describe the diagnosis profile of patients living with ASD and attending the Neurogenetics Ambulatory of the Santa Catarina Southern University (UNISUL). METHODS: There have been analyzed 122 medical records of patients diagnosed with ASD in regular follow-up in the UNISUL's Neurogenetics Ambulatory between 2010 and 2013. RESULTS: The gender ratio of three boys to each girl in the sample have been found. Female gender was a risk factor for the occurrence of other medical conditions. Sleeping issues and parents with mental disorders were associated to other diseases. CONCLUSION: Among the patients with ASD, female gender, having parents with mental disorders and presenting sleeping problems were associated with neurological, respiratory and genetic comorbidities.

Aspectos da fluência em tarefa de narrativa oral na síndrome del22q11. 2 / Fluency aspects of oral narrative task in del22q11. 2 syndrome

RESUMO Objetivo Investigar os aspectos da fluência em tarefa de narrativa oral na síndrome del22q11.2 e comparar com indivíduos com desenvolvimento típico de linguagem. Método Participaram deste estudo 15 indivíduos com diagnóstico da síndrome del22q11.2, de ambos os gêneros, com idade cronológica de sete a 17 anos, que foram comparados a 15 indivíduos com desenvolvimento típico de linguagem, semelhantes quanto ao gênero e à idade cronológica. A narrativa oral foi eliciada com o livro Frog Where Are You?, e os aspectos da fluência foram analisados quanto ao tipo e frequência de disfluência (comum e gaga) e velocidade de fala. Foram analisados também o número e a duração das pausas. Os achados foram analisados estatisticamente. Resultados O grupo com a síndrome del22q11.2 apresentou média superior em relação ao grupo sem a síndrome, para a porcentagem de disfluências comuns, principalmente hesitação e revisão. O grupo com a síndrome também apresentou média superior para disfluências gagas, sendo a pausa a disfluência mais frequente. Quanto à velocidade de fala, o grupo com a síndrome apresentou média inferior para o número de palavras e sílabas por minuto. Assim sendo, conclui-se que os indivíduos com a síndrome del22q11.2 apresentaram mais dificuldades para narrar do que os seus pares. Conclusão Os aspectos da fluência investigados foram semelhantes entre os grupo com a síndrome del22q11.2 e com desenvolvimento típico de linguagem quanto à presença de hesitação, revisão e pausa na narrativa oral, porém distinto quanto à frequência dessas disfluências, que foi superior para os indivíduos com a síndrome.

ABSTRACT Purpose To investigate the fluency aspects of the oral narrative task in individuals with del22q11.2 syndrome and compare them with those of individuals with typical language development. Methods Fifteen individuals diagnosed with del22q11.2 syndrome, both genders, aged 7-17 years participated in this study. They were compared with 15 individuals with typical language development, with similar gender and chronological age profiles. The oral narrative was elicited using the book “Frog, Where Are You?”, and the fluency aspects were analyzed according to speech rate and type and frequency of disfluency (typical and stuttering). The number and duration of pauses were also investigated. The data were statistically analyzed. Results The group with del22q11.2 syndrome showed a higher average when compared with the group without the syndrome for the percentage of typical disfluencies, mainly hesitation and revision. The group presenting the syndrome also showed a higher average for stuttering disfluencies, with pause as the most frequent disfluency. With respect to speech rate, the group with the syndrome presented a lower average for the number of words and syllables per minute. Individuals with del22q11.2 syndrome showed greater difficulties of narration than their peers. Conclusion The fluency aspects of the oral narrative task in subjects with del22q11.2 syndrome were similar to those of individuals with typical language development regarding the presence of hesitation, revision, and pause, but they were different with respect to frequency of disfluency, which was higher in individuals with the syndrome.

Trabajando las habilidades de comunicación con las familias / Working on communication skills with families

No disponible

Desempenho linguístico de prematuros de 2 anos, considerando idade cronológica e idade corrigida / Linguistic performance in 2 years old preterm, considering chronological age and corrected age

RESUMO Introdução O nascimento prematuro acarreta problemas que não se restringem à mortalidade perinatal. Alguns prematuros, mesmo na ausência de lesões cerebrais, apresentam consequências negativas em diversos aspectos do desenvolvimento, como dificuldades em adquirir linguagem. Objetivo O objetivo deste estudo foi verificar o desempenho linguístico de prematuros, na faixa etária de 2 anos, considerando a idade cronológica e a idade corrigida. Métodos Participaram do estudo 23 sujeitos prematuros e para verificar as habilidades linguísticas foi aplicado o Test of Early Language Development – TELD-3. Resultados Os sujeitos prematuros apresentaram desempenho total alterado no TELD-3 em 39,13% dos casos. Os prematuros também foram analisados considerando o atraso para a idade cronológica e a corrigida e não houve diferença no desempenho para os subtestes receptivo (p = 0,250) e expressivo (p = 1,000). Conclusão O grupo de prematuros aos 2 anos de idade constitui população de risco para alterações de linguagem que não podem ser compensadas com a correção da idade.

ABSTRACT Introduction Preterm birth causes problems that are not restricted to perinatal mortality. Some premature, even in the absence of brain damage, have negative effects on various aspects of development, such as language difficulties. Objective This study aimed to verify the linguistic performance of preterm children at 2 years old, considering the chronological age and corrected age. Methods The study included 23 preterm children and applied the Test of Early Language Development- TELD-3 to assess the language skills. Results The premature children showed the linguistic performance alterations in Teld-3 in 39.13% of cases. They were also analyzed considering the delay to the chronological and corrected ages and there was no difference in performance for both receptive subtests (p = 0.250) and significant (p = 1.000). Conclusion The group of premature children at 2 years is a population at risk for language disorders that cannot be compensated with age correction.