Analysis of cumulative risk predictors for persistent stuttering: family perception and amount of speech disruptions. / Análise de preditores de risco cumulativo para a gagueira persistente: percepção familiar e quantidade de rupturas da fala.

PURPOSE: To investigate two independent variables considered as two possible predictors of cumulative risk for persistent stuttering: family perception of stuttering and amount of speech disruptions. METHODS: Participants were 452 children, aged 3 to 11:11 years, male and female, divided into 4 groups: group 1 (SCG), composed of 158 children who presented a percentage of stuttered speech disruptions ≥ 3% and family complaint of stuttering; group 2 (SWCG), 42 children who presented percentage of stuttered speech disruptions ≥ 3% and without family complaint of stuttering; group 3 (FCG), 94 children who presented percentage of stuttered speech disruptions ≤ 2. 9% with family complaints of stuttering and group 4 (FWCG), 158 children who presented a percentage of stuttered speech disruptions ≤ 2.9 without family complaints of stuttering. RESULTS: For the SCG group, there was a significant relationship between family complaints of stuttering and the number of speech disruptions typical of stuttering. In this group, there was a predominance of male children. For the SWCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FWCG group, there was a significant relation between the absence of a family complaint of stuttering and the reduced number of speech disruptions. CONCLUSION: The percentage of speech disruptions ≥ 3% is a risk indicator for persistent stuttering. The percentage of speech disruptions ≤ 2.9% associated with syllable and sound repetitions can be a risk indicator for persistent stuttering. Family complaints of syllable and sound repetitions may be a risk indicator for persistent stuttering. Family complaints of stuttering alone should not be considered an indicator of persistent stuttering.

OBJETIVO: Pesquisar duas variáveis independentes consideradas como possíveis preditores de risco cumulativo para a gagueira persistente (GP): percepção familiar da gagueira e quantidade de rupturas da fala. MÉTODO: Participaram 452 crianças, com idade entre 3 a 11:11 anos, de ambos os gêneros, divididos em 4 grupos: grupo 1 (GGQ), 158 crianças com percentual de rupturas gagas ≥3% e queixa familiar de gagueira; grupo 2 (GGS), 42 crianças com percentual de rupturas gagas ≥3% e sem queixa familiar de gagueira; grupo 3 (FQ), 94 crianças com percentual de rupturas gagas ≤2.9% com queixa familiar de gagueira e grupo 4 (FS), 158 crianças com percentual de rupturas gagas ≤2.9 sem queixa familiar de gagueira. RESULTADOS: Para o grupo GGQ há relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala típicas da gagueira e houve predominância de crianças do sexo masculino. Para o grupo GGS não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FQ não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FS houve relação significante entre a ausência de queixa familiar de gagueira e a reduzida quantidade de rupturas de fala. CONCLUSÃO: O percentual de rupturas ≥3% é um indicador de risco para a GP. A queixa familiar de rupturas do tipo repetições pode ser um indicador de risco para a GP. A queixa familiar de gagueira, isoladamente, não deve ser considerada como indicador de GP.

Characterization of feeding skills and clinical markers of preterm newborns with gastroschisis in a neonatal therapy unit.

OBJECTIVE: To describe the clinical and feeding findings of premature infants with gastroschisis (GTQ) in a neonatal intensive care unit and compare them to preterm infants (NBs) without congenital anomalies. METHODS: A retrospective case-control study was conducted with 50 premature NBs (25 with GTQ and 25 without comorbidities - control group). The NBs were compared regarding demographic and clinical data: risk of mortality and speech-language assessment (nonnutritive and nutritive sucking). Subsequently, a multiple logistic regression model was applied to determine the variables associated with the negative speech therapy outcome (speech therapy discharge after more than 7 days considering the first speech therapy evaluation). RESULTS: The results of the first analysis indicated that there was a difference between the GTQ and the CG for the following variables: total time in days of hospitalization; use of mechanical ventilation (invasive x noninvasive); days of life on the date of the first speech-language assessment; use of alternative feeding route; and the GTQ group had worse results. The results of the multiple logistic regression indicated that the diagnosis of GTQ, the use of invasive mechanical ventilation, and the absence of adequate intraoral pressure during the first speech-language evaluation were risk factors for a negative speech-language outcome. CONCLUSION: The feeding skills of preterm infants with QTG are related to the severity of the condition (gastrointestinal tract complications), requiring longer hospitalization, use of invasive mechanical ventilation, prolonged use of alternative feeding route and requiring more speech therapy to start oral feeding.

Characterization of feeding skills and clinical markers of preterm newborns with gastroschisis in a neonatal therapy unit / Caracterização das habilidades de alimentação e marcadores clínicos de recém-nascidos prematuros com gastrosquise em unidade de terapia neonatal

ABSTRACT Objective To describe the clinical and feeding findings of premature infants with gastroschisis (GTQ) in a neonatal intensive care unit and compare them to preterm infants (NBs) without congenital anomalies. Methods A retrospective case-control study was conducted with 50 premature NBs (25 with GTQ and 25 without comorbidities - control group). The NBs were compared regarding demographic and clinical data: risk of mortality and speech-language assessment (nonnutritive and nutritive sucking). Subsequently, a multiple logistic regression model was applied to determine the variables associated with the negative speech therapy outcome (speech therapy discharge after more than 7 days considering the first speech therapy evaluation). Results The results of the first analysis indicated that there was a difference between the GTQ and the CG for the following variables: total time in days of hospitalization; use of mechanical ventilation (invasive x noninvasive); days of life on the date of the first speech-language assessment; use of alternative feeding route; and the GTQ group had worse results. The results of the multiple logistic regression indicated that the diagnosis of GTQ, the use of invasive mechanical ventilation, and the absence of adequate intraoral pressure during the first speech-language evaluation were risk factors for a negative speech-language outcome. Conclusion The feeding skills of preterm infants with QTG are related to the severity of the condition (gastrointestinal tract complications), requiring longer hospitalization, use of invasive mechanical ventilation, prolonged use of alternative feeding route and requiring more speech therapy to start oral feeding.

RESUMO Objetivo Descrever os achados clínicos e de alimentação de prematuros com gastrosquise (GTQ) em uma unidade de terapia intensiva neonatal comparando-os a recém-nascidos (RNs) prematuros sem anomalias congênitas. Método Foi realizado estudo caso controle de caráter retrospectivo com 50 RNs prematuros (25 com GTQ e 25 sem comorbidades - grupo controle). Os RNs foram comparados quanto aos dados demográficos clínicos: risco de mortalidade e de avaliação fonoaudiológica (sucção não nutritiva e nutritiva). Posteriormente foi aplicado o modelo de regressão logística múltipla a fim de determinar as variáveis associadas ao desfecho fonoaudiológico negativo (alta fonoaudiológica após mais de 7 dias considerando a primeira avaliação fonoaudiológica). Resultados Os resultados da primeira análise indicaram que houve diferença entre o GTQ e o GC para as seguintes variáveis: tempo total em dias de internação; uso de ventilação mecânica (invasiva x não invasiva); dias de vida na data da primeira avaliação fonoaudiológica; uso de via alternativa de alimentação, sendo que o grupo GTQ apresentou piores resultados. Os resultados da regressão logística múltipla indicaram que o diagnóstico de GTQ, uso de ventilação mecânica invasiva e ausência de pressão intraoral adequada durante a primeira avaliação fonoaudiológica foram fatores de risco para o desfecho fonoaudiológico negativo. Conclusão As habilidades de alimentação dos prematuros com GTQ está relacionada à gravidade do quadro (complicações do trato gastro digestivo), exigindo maior tempo de internação, uso de ventilação mecânica invasiva, uso prolongado de via alternativa de alimentação e necessidade de mais atendimento fonoaudiológico para iniciar a alimentação por via oral.

Análise de preditores de risco cumulativo para a gagueira persistente: percepção familiar e quantidade de rupturas da fala / Analysis of cumulative risk predictors for persistent stuttering: family perception and amount of speech disruptions

RESUMO Objetivo Pesquisar duas variáveis independentes consideradas como possíveis preditores de risco cumulativo para a gagueira persistente (GP): percepção familiar da gagueira e quantidade de rupturas da fala. Método Participaram 452 crianças, com idade entre 3 a 11:11 anos, de ambos os gêneros, divididos em 4 grupos: grupo 1 (GGQ), 158 crianças com percentual de rupturas gagas ≥3% e queixa familiar de gagueira; grupo 2 (GGS), 42 crianças com percentual de rupturas gagas ≥3% e sem queixa familiar de gagueira; grupo 3 (FQ), 94 crianças com percentual de rupturas gagas ≤2.9% com queixa familiar de gagueira e grupo 4 (FS), 158 crianças com percentual de rupturas gagas ≤2.9 sem queixa familiar de gagueira. Resultados Para o grupo GGQ há relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala típicas da gagueira e houve predominância de crianças do sexo masculino. Para o grupo GGS não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FQ não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FS houve relação significante entre a ausência de queixa familiar de gagueira e a reduzida quantidade de rupturas de fala. Conclusão O percentual de rupturas ≥3% é um indicador de risco para a GP. A queixa familiar de rupturas do tipo repetições pode ser um indicador de risco para a GP. A queixa familiar de gagueira, isoladamente, não deve ser considerada como indicador de GP.

ABSTRACT Purpose To investigate two independent variables considered as two possible predictors of cumulative risk for persistent stuttering: family perception of stuttering and amount of speech disruptions. Methods Participants were 452 children, aged 3 to 11:11 years, male and female, divided into 4 groups: group 1 (SCG), composed of 158 children who presented a percentage of stuttered speech disruptions ≥ 3% and family complaint of stuttering; group 2 (SWCG), 42 children who presented percentage of stuttered speech disruptions ≥ 3% and without family complaint of stuttering; group 3 (FCG), 94 children who presented percentage of stuttered speech disruptions ≤ 2. 9% with family complaints of stuttering and group 4 (FWCG), 158 children who presented a percentage of stuttered speech disruptions ≤ 2.9 without family complaints of stuttering. Results For the SCG group, there was a significant relationship between family complaints of stuttering and the number of speech disruptions typical of stuttering. In this group, there was a predominance of male children. For the SWCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FWCG group, there was a significant relation between the absence of a family complaint of stuttering and the reduced number of speech disruptions. Conclusion The percentage of speech disruptions ≥ 3% is a risk indicator for persistent stuttering. The percentage of speech disruptions ≤ 2.9% associated with syllable and sound repetitions can be a risk indicator for persistent stuttering. Family complaints of syllable and sound repetitions may be a risk indicator for persistent stuttering. Family complaints of stuttering alone should not be considered an indicator of persistent stuttering.

Risk Factors for the Development of Persistent Stuttering: What Every Pediatrician Should Know.

Early identification and adequate treatment of children who stutter is important, since it has an impact on speech development. Considering the importance of aiding pediatricians to recognize children at risk for developing persistent stuttering, the aim of the present study was to correlate speech fluency characteristics of children, whose parents reported stuttering behaviors, to the risk factors of persistent stuttering. The participants were 419 children aged 2:0 to 11:11 years, who were divided into two groups: children with stuttering complaints (CSC), composed of children whose parents reported the presence of stuttering behaviors; and children with no stuttering complaint (CNSCs), composed of children with no stuttering behaviors. Risk variables were gathered based on a questionnaire answered by parents involving the following variables: sex, presence of family history of stuttering, whether stuttering behaviors were observed for more than 12 months, whether stuttering behaviors began before 5 years of age, increased effort to speak (i.e., syllable and sound repetitions and fixed articulatory positions), negative family attitude towards the child's speech, and negative attitude towards the child's own speech. The diagnosis of stuttering was determined by a formal speech assessment by a pathologist (SLP). The risk analysis indicated that increased effort to speak, negative family attitude towards the child's speech, and complaints of stuttering for more than 12 months were associated with a higher risk of stuttering in children. Therefore, when pediatricians are faced with complaints about the presence of stuttering behaviors and these factors are present, they should immediately refer the patient to an SLP for specific assessment.

Ensaio clínico de tratamento - em três modalidades - para crianças com distúrbios da fluência e gagueira / Treatment clinical trial - three types - for children with fluency disorders and stuttering

RESUMO Objetivo Delinear um ensaio clínico de tratamento - em três modalidades - que verificasse se os tramentos testados para a gagueira crônica do desenvolvimento (GCD) apresentam indicadores que permitam reunir informações para a continuidade da sua aplicação, estabelecendo uma relação benefício-risco eficaz e segura. Método Para a realização do estudo foram analisadas 252 crianças, com idades entre 2 e 12 anos, que realizaram avaliação e tratamento para a GCD. Dentre as crianças atendidas, 93 cumpriram todos os critérios de elegibilidade. Após a obtenção dos escores de risco para GCD (Protocolo de Risco para a Gagueira do Desenvolvimento) todas as crianças foram avaliadas segundo seu perfil da fluência e grau de gravidade da gagueira. Foram aplicados os tratamentos para GCD: Programa Verde; Programa Amarelo e Programa Vermelho. A determinação do tratamento mais indicado para cada criança foi baseada na análise do grau de risco para a GCD. Resultados Todos os programas terapeuticos apresentaram resultados de melhora pós-tratamento consistentes nos segmentos analisados com exceção de: repetição de palavras; prolongamentos no final das palavras e intrusão de sons/segmentos. Conclusão Os programas terapêuticos testados - verde, amarelo e vermelho - foram eficientes para a ampla maioria dos participantes. A intervenção direta, aplicada no Programa Vermelho, foi altamente eficiente para a promoção da fala fluente, indicando que para os casos com maior índice de cronicidade a aplicação de técnicas específicas é indicada.

ABSTRACT Purpose To present a treatment clinical trial, involving three types of treatment for chronic developmental stuttering (CDS), to verify whether they present indicators and sufficient information to establish an effective and safe benefit-risk relationship. Methods The study included 252 children between 2 and 12 years old, who underwent assessment and treatment for CDS. Among the selected children, 93 met the established inclusion criteria. After obtaining the scores for the risk of CDS (Protocol for the Risk of Developmental Stuttering), all children were assessed according to their fluency profile and the severity level of stuttering. The children underwent treatment for CDS Green, Yellow and Red Programs. The treatment chosen for each child was based on the analysis of the risk for CDS. Results All therapeutic programs presented positive results in the post-treatment assessment considering the analyzed parameters, with the exception of word repetition, sound prolongation at the end of words, and intrusion of sounds/word segments. Conclusion The tested therapeutic programs - green, yellow, and red - were efficient for most of the participants. The direct intervention used in the Red Program was highly efficient in promoting fluent speech. This result suggests that for most of the patients with a higher risk of developing the chronic form of stuttering, the use of specific fluency promotion techniques is indicated.

Treatment clinical trial - three types - for children with fluency disorders and stuttering. / Ensaio clínico de tratamento ­ em três modalidades ­ para crianças com distúrbios da fluência e gagueira.

PURPOSE: To present a treatment clinical trial, involving three types of treatment for chronic developmental stuttering (CDS), to verify whether they present indicators and sufficient information to establish an effective and safe benefit-risk relationship. METHODS: The study included 252 children between 2 and 12 years old, who underwent assessment and treatment for CDS. Among the selected children, 93 met the established inclusion criteria. After obtaining the scores for the risk of CDS (Protocol for the Risk of Developmental Stuttering), all children were assessed according to their fluency profile and the severity level of stuttering. The children underwent treatment for CDS Green, Yellow and Red Programs. The treatment chosen for each child was based on the analysis of the risk for CDS. RESULTS: All therapeutic programs presented positive results in the post-treatment assessment considering the analyzed parameters, with the exception of word repetition, sound prolongation at the end of words, and intrusion of sounds/word segments. CONCLUSION: The tested therapeutic programs - green, yellow, and red - were efficient for most of the participants. The direct intervention used in the Red Program was highly efficient in promoting fluent speech. This result suggests that for most of the patients with a higher risk of developing the chronic form of stuttering, the use of specific fluency promotion techniques is indicated.

OBJETIVO: Delinear um ensaio clínico de tratamento ­ em três modalidades ­ que verificasse se os tramentos testados para a gagueira crônica do desenvolvimento (GCD) apresentam indicadores que permitam reunir informações para a continuidade da sua aplicação, estabelecendo uma relação benefício-risco eficaz e segura. MÉTODO: Para a realização do estudo foram analisadas 252 crianças, com idades entre 2 e 12 anos, que realizaram avaliação e tratamento para a GCD. Dentre as crianças atendidas, 93 cumpriram todos os critérios de elegibilidade. Após a obtenção dos escores de risco para GCD (Protocolo de Risco para a Gagueira do Desenvolvimento) todas as crianças foram avaliadas segundo seu perfil da fluência e grau de gravidade da gagueira. Foram aplicados os tratamentos para GCD: Programa Verde; Programa Amarelo e Programa Vermelho. A determinação do tratamento mais indicado para cada criança foi baseada na análise do grau de risco para a GCD. RESULTADOS: Todos os programas terapeuticos apresentaram resultados de melhora pós-tratamento consistentes nos segmentos analisados com exceção de: repetição de palavras; prolongamentos no final das palavras e intrusão de sons/segmentos. CONCLUSÃO: Os programas terapêuticos testados ­ verde, amarelo e vermelho ­ foram eficientes para a ampla maioria dos participantes. A intervenção direta, aplicada no Programa Vermelho, foi altamente eficiente para a promoção da fala fluente, indicando que para os casos com maior índice de cronicidade a aplicação de técnicas específicas é indicada.

Effects of the presence of a dog on the psychic content expression of a stuttering person: case report. / Efeitos da presença do cão na expressão de conteúdos psíquicos de um sujeito que gagueja: estudo de caso.

Stuttering has negative impacts on an individual's quality of life and is associated with higher risk of development of social and psychological problems. From this perspective, despite the diversity of etiological hypotheses for and treatments of stuttering, the interface between psychology and speech therapy in the approach to the biopsychic aspects involved in this clinical scenario stands out. Recent research indicates that the presence, specifically of dogs, can assist patients in symbolic elaboration of psychic content. From this perspective, the aim of this study is evaluate the effects of a dog's presence on the expression of the psychic content of a stuttering person, with the hypothesis that framing may reduce symptoms. The subject is M., female, 45 years old, married, without children, hairdressing assistant, with elementary school completed. She underwent the process of speech therapy in presence of a dog. A semidirected interview was conducted after this process. A co-therapist dog of Golden Retriever breed participated in all sessions. The relevant subjective content observed in the setting during the speech therapy process, which seems to have been mobilized by the framework established by the interaction among the therapist, the patient, and the dog, seems to demonstrate an association with the manifestation of disfluencies. The dog made physical contact with, supported, motivated and welcomed the subject in situations in which psychic conflicts were demonstrated. This clinical case study indicates that the dog's presence and interaction framework favored the reduction of stuttering symptoms, promoting welcoming environment that enabled the subject's psyche-soma integration.

A gagueira gera impactos negativos na qualidade de vida dos sujeitos e está associada a maior risco de desenvolvimento de problemas sociais e psíquicos. Nessa perspectiva, apesar da diversidade das hipóteses etiológicas e dos tratamentos da gagueira, destaca-se a interface entre psicologia e fonoaudiologia na abordagem dos aspectos bio-psíquicos envolvidos nesse quadro clínico. Pesquisas recentes indicam que a presença, especificamente de cães, pode auxiliar o paciente na elaboração simbólica de conteúdos psíquicos. Nessa perspectiva, o objetivo desse estudo é avaliar os efeitos da presença do cão na expressão de conteúdos psíquicos de um sujeito que gagueja, com a hipótese de que o enquadre pode reduzir o sintoma. O sujeito é M., sexo feminino, 45 anos, casada, sem filhos, cursou ensino fundamental completo e de auxiliar de cabeleireira. Passou pelo processo de terapia fonoaudiológica na presença do cão. Foi realizada uma entrevista semi-dirigida após o processo. Um cão coterapeuta, da raça Golden Retriever, participou de todas as sessões. Alguns conteúdos subjetivos relevantes observados no setting no decorrer do processo terapêutico fonoaudiológico, os quais parecem ter sido mobilizados pelo enquadre estabelecido pela interação entre terapeuta-paciente-cão, parecem demonstrar associação com a manifestação das disfluências. O cão fez contato físico, deu suporte, motivou e acolheu o sujeito em situações de demonstração de conflitos psíquicos. Assim, este estudo de caso clínico indica que o enquadre da presença e interação do cão favoreceu a redução do sintoma da gagueira, promovendo ambiente acolhedor possibilitando a integração psique-soma do sujeito.

A influência da hereditariedade na ocorrência de variáveis preditoras na gagueira crônica do desenvolvimento / The influence of heredity on the predictor variables of chronic developmental stuttering

RESUMO Objetivo Testar a variável da hereditariedade familiar para a gagueira crônica do desenvolvimento (GCD) como preditora de efeito direto no desfecho da fluência da fala em crianças. Métodos Participaram do estudo 200 crianças, de 2 a 12 anos, de ambos os gêneros, sem distinção de raça e nível sócio-econômico-cultural, que apresentaram queixa de GCD, sem outras intercorrências de linguagem e/ou audição, no período de cinco anos. Os 200 participantes deste estudo foram divididos em três grupos (baixo risco para GCD, médio risco para GCD e alto risco para GCD) conforme os indicadores de risco aferidos pelo Protocolo de risco para a gagueira do desenvolvimento. Para determinação da variável de controle (hereditariedade positiva para a gagueira) foi considerado afetado o participante que apresentava familiar de primeiro grau (pai, mãe, irmãos) que se auto identificava como pessoa com gagueira. Todos os participantes foram avaliados segundo o Protocolo de risco para a gagueira do desenvolvimento e pela Avaliação do Perfil da Fluência de Fala. Resultados Os grupos de baixo, médio e alto risco para GCD com hereditariedade positiva não se diferenciaram estatisticamente dos grupos de baixo, médio e alto risco para GCD com hereditariedade negativa para nenhuma das variáveis demográficas e resultado da análise do Perfil de Fluência da Fala. Conclusão A variável hereditariedade não indicou o grau de risco na manifestação da fala nem identificou, decisivamente, as crianças em risco de persistência para a GCD.

ABSTRACT Purpose To test if the variable family heredity for chronic developmental stuttering (CDS) is a direct predictor of the speech fluency outcome in children. Methods Participants of the study were 200 children, between 2 and 12 years of age, of both genders, with no racial and socioeconomic distinction, diagnosed with a complaint of CDS, and with no language and/or hearing comorbidity, over a period of 5 years. Participants were divided in three study groups (low risk for CDS, moderate risk for CDS, and high risk for CDS) according to the risk indicators determined by the Risk Protocol for Developmental Stuttering. In order to determine the control variable (positive heredity for stuttering), we considered the participant as being affected if he/she presented a first-degree family member (father, mother, siblings) who self-declared themselves as a person who stuttered. All of the participants were assessed according to Risk Protocol for Developmental Stuttering and to The Speech Fluency Profile Assessment. Results No significant difference was observed for the demographic variables and for the results on The Fluency Profile Assessment among the groups with mild, moderate and high risk of stuttering when comparing the groups with positive and negative family heredity. Conclusion The variable family heredity did not indicate the risk level for the manifestation of stuttering and also did not identify those at risk of presenting CDS.

Clinical Trial for Stuttering Treatment: pilot study about dog participation in the therapy session. / Ensaio Clínico de Tratamento da Gagueira: estudo piloto com variável monitorada, participação do cão na sessão de terapia.

PURPOSE: To verify the effect of dog intervention on the regular session of speech therapy for developmental stuttering in adults. METHODS: The study involved young adults and adults with developmental stuttering. The study sample was composed of eight participants, six males and two females, ranging in age from 16 to 45 years. Participants were divided into two groups: G1 - those who underwent treatment for stuttering with the presence of a dog-therapist in the therapy room and G2 - those who underwent treatment for stuttering without the presence of the dog therapist. We included a control group, G3, composed of fluent participants, matched in age and sex to G1 and G2 to control the natural variability of speech fluency. RESULTS: Comparative results between the groups indicated that the group that performed the treatment without the presence of the dog achieved better performance, evolution and efficacy rates. CONCLUSION: for the population in this study, the dog intervention on speech therapy did not improve treatment.

OBJETIVO: Verificar o efeito da intervenção do cão na sessão regular de terapia fonoaudiológica para a gagueira do desenvolvimento em jovens adultos. MÉTODO: Foram selecionados jovens adultos e adultos com diagnóstico de gagueira do desenvolvimento. Concluíram o estudo oito participantes, seis do sexo masculino e dois do sexo feminino, com idades variando entre 16 e 45 anos. Os participantes foram divididos em dois grupos: G1 ­ que realizou o tratamento para gagueira com a presença de um cão terapeuta em sala de terapia e G2 ­ que realizou o tratamento para gagueira sem a presença do cão terapeuta. Foi incluído um grupo controle, G3 ­ composto por participantes fluentes, pareado em idade e sexo ao G1 e G2, para controle da variabilidade natural da fluência da fala. RESULTADOS: A análise comparativa entre os grupos indicou que o grupo que realizou o tratamento sem a presença do cão alcançou melhores índices de performance, evolução e eficácia. CONCLUSÃO: Para a população pesquisada neste estudo, não foi observado efeito da intervenção do cão na terapia fonoaudiológica.

Frequency of speech disruptions in Parkinson's Disease and developmental stuttering: A comparison among speech tasks.

OBJECTIVE: To analyze the frequency of speech disruptions across different speech tasks, comparing the performance of individuals with Parkinson's Disease (PD) and DS. METHOD: Participants were 20 people with PD, 20 people with DS and 40 fluent individuals. Speech samples were recorded during monologue speech, choral and solo oral reading. Transcriptions of 200 fluent syllables were performed to identify stuttering-like disfluencies (SLDs) and other disfluencies (ODs). RESULTS: People with PD presented significantly less speech disruptions when compared to people with DS, but significantly more speech disruptions than the control group. Stuttering-like disfluencies ocurred more frequently during monologue speech and solo oral reading for both PD and DS, whereas the control group did not present difference between these tasks. CONCLUSION: The stuttering pattern presented by people with PD is different from what is usually described as being neurogenic stuttering.

Dysphagia and associated clinical markers in neurologically intact children with respiratory disease.

OBJECTIVE: The identification of oropharyngeal aspiration is paramount since it can have negative consequences on a compromised respiratory status. Our hypothesis was that dysphagia in neurologically intact children with respiratory disease is associated to specific clinical markers. STUDY DESIGN: Using the medical files we conducted a retrospective, observational cohort study on children admitted to the pediatric hospital unit due to respiratory disease. We collected data on specific parameters of a clinical swallowing assessment and dysphagia was classified according to the Dysphagia Management Staging Scale. We also included the following clinical markers: age, days of hospitalization, need for orotracheal intubation (OTI), duration of orotracheal intubation (in hours), number of previous hospital admissions due to respiratory disease, number of previous hospital admissions due to other causes, and previous orotracheal intubations. RESULTS: The final study sample consisted of 102 patients (mean age of 5.88 months). For the purposes of statistical analysis, the patients were grouped according to the classification of dysphagia (ie, no dysphagia, mild dysphagia, and moderate-severe dysphagia). Data analysis indicated that the clinical markers of orotracheal intubation (P = 0.042), duration of orotracheal intubation (P = 0.025), and days of hospitalization (P = 0.037) were significant in children with moderate-severe dysphagia. CONCLUSIONS: Our data indicate that neurologically intact children with respiratory disease who were submitted to prolonged OTI (ie, over 48 h) should be prioritized for receiving a detailed swallowing assessment.

Speech fluency profile on different tasks for individuals with Parkinson's disease. / Perfil da fluência da fala em diferentes tarefas para indivíduos com Doença de Parkinson.

PURPOSE: To characterize the speech fluency profile of patients with Parkinson's disease. METHODS: Study participants were 40 individuals of both genders aged 40 to 80 years divided into 2 groups: Research Group - RG (20 individuals with diagnosis of Parkinson's disease) and Control Group - CG (20 individuals with no communication or neurological disorders). For all of the participants, three speech samples involving different tasks were collected: monologue, individual reading, and automatic speech. RESULTS: The RG presented a significant larger number of speech disruptions, both stuttering-like and typical dysfluencies, and higher percentage of speech discontinuity in the monologue and individual reading tasks compared with the CG. Both groups presented reduced number of speech disruptions (stuttering-like and typical dysfluencies) in the automatic speech task; the groups presented similar performance in this task. Regarding speech rate, individuals in the RG presented lower number of words and syllables per minute compared with those in the CG in all speech tasks. CONCLUSION: Participants of the RG presented altered parameters of speech fluency compared with those of the CG; however, this change in fluency cannot be considered a stuttering disorder.

Comparison between the speech performance of fluent speakers and individuals who stutter. / Comparação da performance de fala em indivíduos gagos e fluentes.

PURPOSE: The aim of this study was to compare the speech performance of fluent speakers and individuals who stutter during spontaneous speech, automatic speech, and singing. METHODS: The study sample was composed of 34 adults, 17 individuals who stutter and 17 fluent controls, matched for gender and age. The speech performance of participants was compared by means of three tasks: monologue, automatic speech, and singing. The following aspects were assessed: total number of common disruptions and total number of stuttering-like disruptions. RESULTS: Statistically significant difference was observed only for the monologue task in both intra- and inter-group comparisons. CONCLUSION: The outcomes of this study indicate that tasks of higher motor and melodic complexities, such as the monologue task, negatively affect the speech fluency of both fluent speakers and individuals who stutter.

Perfil da fluência da fala em diferentes tarefas para indivíduos com Doença de Parkinson / Speech fluency profile on different tasks for individuals with Parkinson's disease

RESUMO Objetivo Caracterizar o perfil da fluência da fala de indivíduos com Doença de Parkinson em diferentes tarefas de fala. Método Participaram do estudo 40 indivíduos, de 40 a 80 anos de idade, de ambos os gêneros, divididos em 2 grupos: GP (grupo pesquisa - 20 indivíduos com diagnóstico de Doença de Parkinson); GC (grupo controle - 20 indivíduos sem qualquer alteração de comunicação e/ou neurológica). Para todos os participantes, foram coletadas três amostras de fala envolvendo diferentes tarefas: monólogo, leitura individual e fala automática. Resultados O GP apresentou um número significativamente maior de rupturas, tanto comuns quanto gagas, e maiores porcentagens de descontinuidade de fala e disfluências gagas nas tarefas de monólogo e leitura quando comparado ao GC. Nas tarefas de fala automática, ambos os grupos apresentaram número reduzido de rupturas comuns e gagas, não apresentando diferença significante entre os grupos para esta tarefa. Em relação à velocidade de fala, tanto em palavras quanto em sílabas por minuto, os indivíduos com Doença de Parkinson apresentaram velocidade reduzida em relação ao grupo controle em todas as tarefas de fala. Conclusão O GP apresentou alteração em todos os parâmetros da fluência avaliados no presente estudo quando comparado ao grupo controle, porém esta alteração da fluência não se configura como um quadro de gagueira.

ABSTRACT Purpose To characterize the speech fluency profile of patients with Parkinson's disease. Methods Study participants were 40 individuals of both genders aged 40 to 80 years divided into 2 groups: Research Group - RG (20 individuals with diagnosis of Parkinson's disease) and Control Group - CG (20 individuals with no communication or neurological disorders). For all of the participants, three speech samples involving different tasks were collected: monologue, individual reading, and automatic speech. Results The RG presented a significant larger number of speech disruptions, both stuttering-like and typical dysfluencies, and higher percentage of speech discontinuity in the monologue and individual reading tasks compared with the CG. Both groups presented reduced number of speech disruptions (stuttering-like and typical dysfluencies) in the automatic speech task; the groups presented similar performance in this task. Regarding speech rate, individuals in the RG presented lower number of words and syllables per minute compared with those in the CG in all speech tasks. Conclusion Participants of the RG presented altered parameters of speech fluency compared with those of the CG; however, this change in fluency cannot be considered a stuttering disorder.

Comparação da performance de fala em indivíduos gagos e fluentes / Comparison between the speech performance of fluent speakers and individuals who stutter

RESUMO Objetivo O objetivo do estudo foi comparar a performance de fala do indivíduo com gagueira e do indivíduo fluente em tarefa de fala espontânea, tarefa de fala automática e a tarefa de canto. Método Participaram deste estudo 34 adultos, 17 com gagueira e 17 fluentes, pareados por gênero e idade. O estudo comparou o desempenho dos participantes em três tarefas de fala: monólogo, fala automática e canto. Foi analisado o número total de rupturas comuns e gagas. Resultados A tarefa de monólogo foi a única que apresentou diferenças estatisticamente significativas, tanto nas comparações intragrupos quanto nas comparações intergrupos. Conclusão O estudo mostrou que tarefas de maior complexidade motora e melódica, como a tarefa de monólogo, prejudica a fluência da fala, tanto em indivíduos com gagueira quanto em indivíduos fluentes.

ABSTRACT Purpose The aim of this study was to compare the speech performance of fluent speakers and individuals who stutter during spontaneous speech, automatic speech, and singing. Methods The study sample was composed of 34 adults, 17 individuals who stutter and 17 fluent controls, matched for gender and age. The speech performance of participants was compared by means of three tasks: monologue, automatic speech, and singing. The following aspects were assessed: total number of common disruptions and total number of stuttering-like disruptions. Results Statistically significant difference was observed only for the monologue task in both intra- and inter-group comparisons. Conclusion The outcomes of this study indicate that tasks of higher motor and melodic complexities, such as the monologue task, negatively affect the speech fluency of both fluent speakers and individuals who stutter.

Randomized clinical trial: the use of SpeechEasy® in stuttering treatment.

BACKGROUND: Numerous studies have demonstrated the benefit of devices delivering altered auditory feedback (AAF) as a therapeutic alternative for those who stutter. AIMS: The effectiveness of a device delivering AAF (SpeechEasy®) was compared with behavioural techniques in the treatment of stuttering in a randomized clinical trial. METHODS & PROCEDURES: Two groups of adults who stutter participated: group 1 consisted of 10 men and one woman aged 21-42 years (mean = 30.0). Group 2 consisted of six men and one woman aged 20-50 years (mean = 35.6). Participants in group 1 were fit with a SpeechEasy® device and were not given any additional training (i.e., supplementary fluency enhancing techniques). Participants used the device daily for 6 months. Participants in group 2 received treatment in the form of a 12-week fluency promotion protocol with techniques based on both fluency shaping and stuttering modification. OUTCOMES & RESULTS: There were no statistically significant differences (p > .05) between groups in participants' stuttered syllables following treatment. That is, both therapeutic protocols achieved approximately 40% reduction in number of stuttered syllables from baseline measures, with no significant relapse after 3 or 6 months post-treatment. CONCLUSIONS & IMPLICATIONS: The results suggest that the SpeechEasy® device can be a viable option for the treatment of stuttering.

Comparison of different speech tasks among adults who stutter and adults who do not stutter.

OBJECTIVES: In this study, we compared the performance of both fluent speakers and people who stutter in three different speaking situations: monologue speech, oral reading and choral reading. This study follows the assumption that the neuromotor control of speech can be influenced by external auditory stimuli in both speakers who stutter and speakers who do not stutter. METHOD: Seventeen adults who stutter and seventeen adults who do not stutter were assessed in three speaking tasks: monologue, oral reading (solo reading aloud) and choral reading (reading in unison with the evaluator). Speech fluency and rate were measured for each task. RESULTS: The participants who stuttered had a lower frequency of stuttering during choral reading than during monologue and oral reading. CONCLUSIONS: According to the dual premotor system model, choral speech enhanced fluency by providing external cues for the timing of each syllable compensating for deficient internal cues.

Comparison of different speech tasks among adults who stutter and adults who do not stutter

OBJECTIVES: In this study, we compared the performance of both fluent speakers and people who stutter in three different speaking situations: monologue speech, oral reading and choral reading. This study follows the assumption that the neuromotor control of speech can be influenced by external auditory stimuli in both speakers who stutter and speakers who do not stutter. METHOD: Seventeen adults who stutter and seventeen adults who do not stutter were assessed in three speaking tasks: monologue, oral reading (solo reading aloud) and choral reading (reading in unison with the evaluator). Speech fluency and rate were measured for each task. RESULTS: The participants who stuttered had a lower frequency of stuttering during choral reading than during monologue and oral reading. CONCLUSIONS: According to the dual premotor system model, choral speech enhanced fluency by providing external cues for the timing of each syllable compensating for deficient internal cues.

Diadococinesia sequencial em crianças fluentes e com gagueira desenvolvimental persistente: análise da velocidade e tipo do erro da consoante alvo / Sequential diadochokinesis in fluent and stuttering children: rate of production and type of errors

RESUMO Objetivo Comparar a performance motora oral complexa em crianças com gagueira persistente do desenvolvimento e em crianças fluentes, a partir do cálculo da velocidade de produção da diadococinesia sequencial (DDK/SMR) e análise da tipologia de desvio da consoante alvo. Métodos Participaram do estudo 46 crianças com idades entre 4 anos e 11 anos e 11 meses, divididas em dois grupos: Grupo Pesquisa (GI), composto por 23 crianças com diagnóstico de gagueira; Grupo Controle (GII), composto por 23 crianças fluentes, pareadas por gênero e idade aos participantes do GI. Para cada participante, foram coletadas e gravadas três amostras de DDK/SMR em janelas de 15 segundos cada, sendo analisadas, posteriormente, a velocidade de produção articulatória, o número e os tipos de erros apresentados nas amostras. Resultados Os grupos não se diferenciaram em nenhuma das variáveis testadas, ou seja, apresentaram desempenhos semelhantes quanto à velocidade de produção articulatória, quanto ao número de erros e quanto aos tipos de erros (o desvio da consoante alvo mais frequente foi a inversão, para ambos os grupos). Conclusão As crianças com gagueira do desenvolvimento e as crianças fluentes apresentaram desempenho semelhante nas variáveis testadas, sugerindo que a prova de diadococinesia sequencial não foi eficiente para auxiliar na identificação precoce da gagueira em crianças.

ABSTRACT Purpose To compare the oral motor performance of stuttering and fluent children based on the production rate of sequential diadochokinesis (DDK) and on the type of errors. Methods Participants were 46 children, aged between 4 years and 11 years and 11 months, divided into two groups: Research Group (GI), composed of 23 children with persistent developmental stuttering; Control Group (GII), composed of 23 fluent children, paired by age and gender to participants of GI. For each participant, three samples of sequential DDK were recorded in 15-second windows. These samples were later analyzed considering articulatory rate, and number and type of consonant errors per sample. Results The groups did not present significant differences when considering the analyzed variables. Both fluent and stuttering children presented similar performances for articulatory rate and consonant errors (i.e., the most frequent type of error was consonant exchange). Conclusion Children with developmental stuttering and their fluent peers presented similar performances in all of the tested variables, suggesting that sequential DDK was not enough to identify the stuttering group.