Insights into Rett Syndrome girls' receptive vocabulary through eye movements and parental perception.

OBJECTIVE: This study evaluated the receptive vocabulary of girls diagnosed with Rett Syndrome (RS) by employing eye-tracking technology and examined how these objective measures compared with parents' perceptions of their daughters' language abilities. METHOD: Fourteen girls with RS and eleven typically developing peers participated. Instruments included the Kerr Scale, a parental questionnaire on communication skills, the Peabody Picture Vocabulary Test - PPVT-4, and eye-tracking equipment. The PPVT-4's initial 12 cards, each displaying four images, were presented on screen for 5 s for the child's initial inspection. Subsequently, the same card was shown for 5 s with instructions to identify the picture matching the word, repeated three times in a randomized order. RESULTS: Eye-tracking assessments revealed that girls with RS with less severe symptoms, performed below typically developing peers with aged 3-4 years. The number of eye fixations emerged as a reliable metric for assessing their performance. A positive correlation was found between parental reports of their daughters' vocabulary knowledge and their ability to identify the correct stimulus, suggesting comprehension and active engagement in the testing process. CONCLUSION: This study presents a pioneering approach by combining parental perceptions with eye-tracking measures to assess receptive vocabulary in girls diagnosed with Rett Syndrome. Despite showing lower performance levels compared to significantly younger peers, the findings suggest that these individuals use less effectively eye contact as a mode of communication.

Differences in scanpath pattern and verbal working memory predicts efficient reading in the Cloze gap-filling test.

Different tests measure text comprehension, including the cloze gap-filling test, often used for language learning. Different studies hypothesized cognitive strategies in this type of test and their relationship with working memory and performance. However, no study investigated the cloze test, working memory, and possible cognitive strategies, while performing the test. Therefore, this study aimed to identify cognitive visual strategies in the cloze test by applying an unsupervised algorithm and to analyze the relationship between these strategies with working memory and performance in the cloze test. Our sample consisted of 51 university students, the largest sample in studies of cognitive strategies with cloze tests. Participants answered an 11-item cloze test in a computer with eye-tracking, a verbal working memory test, and a visuospatial working memory test. Our analysis of participants' scanpath identified two main strategies: one with fewer toggles between text and word bank and fewer fixations than the other one, indicating the existence of a global strategy. Furthermore, a model predicting the efficiency of participants in the cloze test found that item complexity, using a global strategy, and higher scores of working memory were the most significant predictors. These results confirm the hypothesis of a global strategy being related to successfully achieving higher-order reading processes.

Eye Gaze Patterns during Reasoning Provide Insights Regarding Individual Differences in Underlying Cognitive Abilities.

Sequences of eye movements during performance of a reasoning task has provided insights into the strategies individuals use to solve that specific task; however, prior studies have not examined whether eye gaze metrics reflect cognitive abilities in a way that transcends a specific task. Thus, our study aimed to explore the relationship between eye movement sequences and other behavioral measures. Here, we present two studies that related different eye gaze metrics in a matrix reasoning task with performance on a different test of fluid reasoning and tests of planning, working memory, and cognitive flexibility. Additionally, we related gaze metrics to self-reported executive functioning in daily life, as measured by BRIEF-A. To perform this, we classified the participants' eye gaze in each item of the matrices test using an algorithm and then used LASSO regression models with the cognitive abilities as the dependent variable to select eye-tracking metrics to predict it. Overall, specific and distinct eye gaze metrics predicted 57% variance in the fluid reasoning scores; 17% variance in the planning scores; and 18% variance in the working memory scores. Taken together, these results support the hypothesis that the selected eye-tracking metrics reflect cognitive abilities that transcend specific tasks.

Cross-cultural adaptation, factor structure, and evidence of reliability of the Smartphone Addiction Scale in Brazil.

OBJECTIVE: To translate, adapt, and examine the factor structure and internal consistency of a Brazilian Portuguese version of the Smartphone Addiction Scale (SAS-BR) among university students. METHODS: The SAS was translated and adapted for use with Brazilian samples. The resulting instrument (SAS-BR) was then administered to 356 college students. Parallel analysis was used to explore the maximum number of dimensions that underlie the assessment, and data modeling was undertaken using exploratory multidimensional item response theory (E-MIRT). The reliability of the SAS-BR was tested by computing McDonald's omega (ω) and Cronbach's alpha (α) coefficients. RESULTS: Parallel analysis revealed a maximum of six factors. E-MIRT analysis revealed that a five-factor model was the best fit for the data. The five emergent factors were salience, positive anticipation, cyberspace-oriented relationship, preoccupation with smartphone, and physical symptoms; these factors together explained 50% of the variance. Confirmatory factor analysis, conducted using data from a second sample, replicated the five-factor structure. The internal consistency of the scale was found to be strong. CONCLUSION: The emergent factor structure of the SAS-BR was found to be similar to that of previous adaptations of this instrument for other Western countries.

Eye Movements and Cognitive Strategy in a Fluid Intelligence Test: Item Type Analysis.

Eye movements help to infer the cognitive strategy that a person uses in fluid intelligence tests. However, intelligence tests demand different relations/rules tokens to be solved, such as rule direction, which is the continuation, variation or overlay of geometric figures in the matrix of the intelligence test. The aim of this study was to understand whether eye movements could predict the outcome of an intelligence test and in the rule item groups. Furthermore, we sought to identify which measure is best for predicting intelligence test scores and to understand if the rule item groups use the same strategy. Accordingly, 34 adults completed a computerized intelligence test with an eye-tracking device. The toggling rate, that is, the number of toggles on each test item equalized by the item latency explained 45% of the variance of the test scores and a significant amount of the rule tokens item groups. The regression analyses also indicated toggling rate as the best measure for predicting the score and that all the rule tokens seem to respect the same strategy. No correlation or difference were found between baseline pupil size and fluid intelligence. Wiener Matrizen-Test 2 was demonstrated to be a good instrument for the purpose of this study. Finally, the implications of these findings for an understanding of cognition are discussed.

Contribution of Word Reading Speed to Reading Comprehension in Brazilian Children: Does Speed Matter to the Comprehension Model?

Studies have suggested that reading speed (RS) or fluency should be a component of reading comprehension (RC) models. There is also evidence of a relationship between RS and RC. However, some questions remain to be explored, as the changes in such a relationship may be a function of development. In addition, while there are studies published with English speakers and learners, less evidence exists in more transparent orthographies, such as Portuguese. This study investigated the relationship between RC and RS in typical readers. Objectives included elucidating the following: (1) the contribution of RS to RC controlling for intelligence, word recognition, and listening and (2) the differential relationships and contributions of RS to comprehension in different school grades. The sample of participants comprised 212 students (M = 8.76; SD = 1.06) from 2nd to 4th grade. We assessed intelligence, word recognition, word RS, listening, and RC. Performance in all tests increased as a function of grade. There were significant connections between RC and all other measures. Nonetheless, the regression analysis revealed that word RS has a unique contribution to RC after controlling for intelligence, word recognition, and listening, with a very modest but significant improvement in the explanatory power of the model. We found a significant relationship between RS and RC only for 4th grade and such relationship becomes marginal after controlling for word recognition. The findings suggest that RS could contribute to RC in Portuguese beyond the variance shared with listening and, mainly, word recognition, but such a contribution was very small. The data also reveal a differential relationship between RS and RC in different school grades; specifically, only for the 4th grade does RS begins to relate to RC. The findings add a developmental perspective to the study of reading models.

Hemiface Differences in Visual Exploration Patterns When Judging the Authenticity of Facial Expressions.

Past studies have found asymmetry biases in human emotion recognition. The left side bias refers to preferential looking at the left-hemiface when actively exploring face images. However, these studies have been mainly conducted with static and frontally oriented stimuli, whereas real-life emotion recognition takes place on dynamic faces viewed from different angles. The aim of this study was to assess the judgment of genuine vs. masked expressions in dynamic movie clips of faces rotated to the right or left side. Forty-eight participants judged the expressions on faces displaying genuine or masked happy, sad, and fearful emotions. The head of the actor was either rotated to the left by a 45° angle, thus showing the left side of the face (standard orientation), or inverted, with the same face shown from the right side perspective. The eye movements were registered by the eye tracker and the data were analyzed for the inverse efficiency score (IES), the number of fixations, gaze time on the whole face and in the regions of interest. Results showed shorter IESs and gaze times for happy compared to sad and fearful emotions, but no difference was found for these variables between sad and fearful emotions. The left side preference was evident from comparisons of the number of fixations. Standard stimuli received a higher number of fixations than inverted ones. However, gaze time was long on inverted compared to standard faces. Number of fixations on exposed hemiface interacted with the emotions decreasing from happy to sad and fearful. An opposite pattern was found for the occluded hemiface. These results suggest a change in fixation patterns in the rotated faces that may be beneficial for the judgments of expressions. Furthermore, this study replicated the effects of the judgment of genuine and masked emotions using dynamic faces.

Impaired Oculomotor Behavior of Children with Developmental Dyslexia in Antisaccades and Predictive Saccades Tasks.

Analysis of eye movement patterns during tracking tasks represents a potential way to identify differences in the cognitive processing and motor mechanisms underlying reading in dyslexic children before the occurrence of school failure. The current study aimed to evaluate the pattern of eye movements in antisaccades, predictive saccades and visually guided saccades in typical readers and readers with developmental dyslexia. The study included 30 children (age M = 11; SD = 1.67), 15 diagnosed with developmental dyslexia (DG) and 15 regular readers (CG), matched by age, gender and school grade. Cognitive assessment was performed prior to the eye-tracking task during which both eyes were registered using the Tobii® 1750 eye-tracking device. The results demonstrated a lower correct antisaccades rate in dyslexic children compared to the controls (p < 0.001, DG = 25%, CC = 37%). Dyslexic children also made fewer saccades in predictive latency (p < 0.001, DG = 34%, CG = 46%, predictive latency within -300-120 ms with target as 0 point). No between-group difference was found for visually guided saccades. In this task, both groups showed shorter latency for right-side targets. The results indicated altered oculomotor behavior in dyslexic children, which has been reported in previous studies. We extend these findings by demonstrating impaired implicit learning of target's time/position patterns in dyslexic children.

Early Stages of Sensory Processing, but Not Semantic Integration, Are Altered in Dyslexic Adults.

The aim of this study was to verify which stages of language processing are impaired in individuals with dyslexia. For this, a visual-auditory crossmodal task with semantic judgment was used. The P100 potentials were chosen, related to visual processing and initial integration, and N400 potentials related to semantic processing. Based on visual-auditory crossmodal studies, it is understood that dyslexic individuals present impairments in the integration of these two types of tasks and impairments in processing spoken and musical auditory information. The present study sought to investigate and compare the performance of 32 adult participants (14 individuals with dyslexia), in semantic processing tasks in two situations with auditory stimuli: sentences and music, with integrated visual stimuli (pictures). From the analysis of the accuracy, both the sentence and the music blocks showed significant effects on the congruency variable, with both groups having higher scores for the incongruent items than for the congruent ones. Furthermore, there was also a group effect when the priming was music, with the dyslexic group showing an inferior performance to the control group, demonstrating greater impairments in processing when the priming was music. Regarding the reaction time variable, a group effect in music and sentence priming was found, with the dyslexic group being slower than the control group. The N400 and P100 components were analyzed. In items with judgment and music priming, a group effect was observed for the amplitude of the P100, with higher means produced by individuals with dyslexia, corroborating the literature that individuals with dyslexia have difficulties in early information processing. A congruency effect was observed in the items with music priming, with greater P100 amplitudes found in incongruous situations. Analyses of the N400 component showed the congruency effect for amplitude in both types of priming, with the mean amplitude for incongruent items being greater than that of the congruent items. Electrophysiological findings were corroborated by the N400 literature and showed that the semantic processing of individuals with dyslexia was preserved. Furthermore, the findings indicate P100 visual sensory processing deficits in the dyslexic group and may suggest difficulty in the sensory stimuli process.

Reading component skills in dyslexia: word recognition, comprehension and processing speed.

The cognitive model of reading comprehension (RC) posits that RC is a result of the interaction between decoding and linguistic comprehension. Recently, the notion of decoding skill was expanded to include word recognition. In addition, some studies suggest that other skills could be integrated into this model, like processing speed, and have consistently indicated that this skill influences and is an important predictor of the main components of the model, such as vocabulary for comprehension and phonological awareness of word recognition. The following study evaluated the components of the RC model and predictive skills in children and adolescents with dyslexia. 40 children and adolescents (8-13 years) were divided in a Dyslexic Group (DG; 18 children, MA = 10.78, SD = 1.66) and control group (CG 22 children, MA = 10.59, SD = 1.86). All were students from the 2nd to 8th grade of elementary school and groups were equivalent in school grade, age, gender, and IQ. Oral and RC, word recognition, processing speed, picture naming, receptive vocabulary, and phonological awareness were assessed. There were no group differences regarding the accuracy in oral and RC, phonological awareness, naming, and vocabulary scores. DG performed worse than the CG in word recognition (general score and orthographic confusion items) and were slower in naming. Results corroborated the literature regarding word recognition and processing speed deficits in dyslexia. However, dyslexics can achieve normal scores on RC test. Data supports the importance of delimitation of different reading strategies embedded in the word recognition component. The role of processing speed in reading problems remain unclear.

Pharmacotherapy for sleep bruxism.

BACKGROUND: Sleep bruxism is an oral activity characterized by involuntary teeth grinding or clenching during sleep. Several forms of treatment have been proposed for this disorder, including behavioural, dental and pharmacological strategies. OBJECTIVES: To evaluate the effectiveness and safety of pharmacological therapy for the treatment of sleep bruxism compared with other drugs, no treatment or placebo. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 8, 2014), MEDLINE (1966 to August 2014), EMBASE (1980 to August 2013) and LILACS (1982 to August 2014). We identified additional reports from the reference lists of retrieved reports and from reviews on treatment of sleep bruxism. We applied no language restrictions. SELECTION CRITERIA: We selected randomized controlled trials (RCTs) or quasi-RCTs that compared drugs with other drugs, no treatment or placebo in people with sleep bruxism. DATA COLLECTION AND ANALYSIS: Review authors carried out data extraction and quality assessment of the included trials independently and in duplicate. We discussed discrepancies until we reached consensus. We consulted a third review author in cases of persistent disagreement. We contacted authors of primary studies when necessary. MAIN RESULTS: We identified 18 potentially relevant RCTs, but only seven met the inclusion criteria. All studies had a small number of participants, ranging from seven to 16 people per study and had a cross-over design. Three studies were of low risk of bias, while four were of uncertain risk. Amitriptyline (three studies), bromocriptine (one study), clonidine (one study), propranolol (one study), levodopa (Prolopa®) (one study) and tryptophan (one study) were compared with placebo. Studies evaluating bromocriptine, clonidine, propranolol and levodopa reported our primary outcome of indices of bruxism motor activity.Results were imprecise and consistent with benefit, no difference or harm. These were the specific findings for each of the drugs according to specific outcomes: 1. Amitriptyline versus placebo for masseteric electromyography (EMG) activity per minute: standardized mean difference (SMD) -0.28 (95% confidence interval (CI) -0.91 to 0.34; P value = 0.37), 2. bromocriptine versus placebo for bruxism episodes per hour: mean difference (MD) 0.60 (95% CI -2.93 to 4.13), bruxism bursts per hour: MD -2.00 (95% CI -53.47 to 49.47), bruxism bursts per episode: MD 0.50 (95% CI -1.85 to 2.85) or number of episodes with grinding noise: MD 2.40 (95% CI -24.00 to 28.80), 3. clonidine versus placebo for number of bruxism episodes per hour: MD -2.41 (95% CI -4.84 to 0.02), 4. propranolol versus placebo for the number of bruxism episodes per hour: MD 1.16 (95% CI -1.89 to 4.21), 5. L-tryptophan versus placebo for masseteric EMG activity per second: SMD 0.08 (95% CI -0.90 to 1.06) and 6. levodopa versus placebo for bruxism episodes per hour of sleep: MD -1.47 (95% CI -3.64 to 0.70), for bruxism bursts per episode: MD 0.06 (95% CI -2.47 to 2.59).We combined several secondary outcomes (sleep duration, masseteric EMG activity per minute and pain intensity) in a meta-analysis for comparison of amitriptyline with placebo. The results for most comparisons were uncertain because of statistical imprecision. One study reported that clonidine reduced rapid eye movement (REM) sleep stage and increased the second stage of sleep. However, results for other sleep-related outcomes with clonidine were uncertain. Adverse effects were frequent in people who took amitriptyline (5/10 had drowsiness, difficulty awakening in the morning, insomnia or xerostomia compared with 0/10 in the placebo group), as well as in people who received propranolol (7/16 had moderate-to-severe xerostomia compare with 2/16 in the placebo group). Clonidine was associated with prolonged morning hypotension in three of 16 participants. The use of preventive medication avoided any adverse effects in people treated with levodopa and bromocriptine. AUTHORS' CONCLUSIONS: There was insufficient evidence on the effectiveness of pharmacotherapy for the treatment of sleep bruxism. This systematic review points to the need for more, well-designed, RCTs with larger sample sizes and adequate methods of allocation, outcome assessment and duration of follow-up. Ideally, parallel RCTs should be used in future studies to avoid the bias associated with cross-over studies. There is a need to standardize the outcomes of RCTs on treatments for sleep bruxism.

Contrasting group analysis of Brazilian students with dyslexia and good readers using the computerized reading and writing assessment battery "BALE".

The analysis of cognitive processes underpinning reading and writing skills may help to distinguish different reading ability profiles. The present study used a Brazilian reading and writing battery to compare performance of students with dyslexia with two individually matched control groups: one contrasting on reading competence but not age and the other group contrasting on age but not reading competence. Participants were 28 individuals with dyslexia (19 boys) with a mean age of 9.82 (SD ± 1.44) drawn from public and private schools. These were matched to: (1) an age control group (AC) of 26 good readers with a mean age of 9.77 (SD ± 1.44) matched by age, sex, years of schooling, and type of school; (2) reading control group (RC) of 28 younger controls with a mean age of 7.82 (SD ± 1.06) matched by sex, type of school, and reading level. All groups were tested on four tasks from the Brazilian Reading and Writing Assessment battery ("BALE"): Written Sentence Comprehension Test (WSCT); Spoken Sentence Comprehension Test (OSCT); Picture-Print Writing Test (PPWT 1.1-Writing); and the Reading Competence Test (RCT). These tasks evaluate reading and listening comprehension for sentences, spelling, and reading isolated words and pseudowords (non-words). The dyslexia group scored lower and took longer to complete tasks than the AC group. Compared with the RC group, there were no differences in total scores on reading or oral comprehension tasks. However, dyslexics presented slower reading speeds, longer completion times, and lower scores on spelling tasks, even compared with younger controls. Analysis of types of errors on word and pseudoword reading items showed students with dyslexia scoring lower for pseudoword reading than the other two groups. These findings suggest that the dyslexics overall scores were similar to those of younger readers. However, specific phonological and visual decoding deficits showed that the two groups differ in terms of underpinning reading strategies.

Transcranial direct current stimulation of the prefrontal cortex modulates the desire for specific foods.

We aimed to assess whether modulation of the dorsolateral prefrontal cortex (DLFPC) with noninvasive brain stimulation, namely transcranial direct current stimulation (tDCS), modifies food craving in healthy subjects. We performed a randomized sham-controlled cross-over study in which 23 subjects received sham and active tDCS (anode left/cathode right and anode right/cathode left) of the DLPFC. Subjects were exposed to food and also watched a movie of food associated with strong craving. Desire for food consumption was evaluated by visual analogue scales (VAS) and food consumption before and after treatment. In addition we measured visual attention to food using an eye tracking system. Craving for viewed foods as indexed by VAS was reduced by anode right/cathode left tDCS. After sham stimulation, exposure to real food or food-related movie increased craving; whereas after anode left/cathode right tDCS, the food-related stimuli did not increase craving levels, as revealed by the VAS scale. Moreover, compared with sham stimulation, subjects fixated food-related pictures less frequently after anode right/cathode left tDCS and consumed less food after both active stimulation conditions. These changes were not related to mood changes after any type of tDCS treatment. The effects of tDCS on food craving might be related to a modulation of neural circuits associated with reward and decision-making.

Saccadic movements using eye-tracking technology in individuals with autism spectrum disorders: pilot study.

OBJECTIVE: To verify differences in the visual scanning strategies between pervasive developmental disorders (PDD) and controls when they are observing social and non-social pictures. METHOD: PDD group (PDDG) comprised by 10 non-retarded subjects (age from 4 to 41) and age-matched control group (CG). Nine social pictures with human beings (including two pictures of cat mask), and 3 nonsocial pictures of objects were presented for 5 seconds. Saccadic movements and fixation were recorded with equipment EyeGaze (LC Technologies Inc.). RESULTS: PDDG (mean=292.73, SE=67.62) presented longer duration of saccadic movements for social pictures compared to CG (mean=136.06, SE=14.01) (p=0.04). The CG showed a higher number of fixations in the picture 7 (a women using a cat mask, with the eyes erased) (CG: mean=3.40; PDDG: mean=1.80; p=0.007). CONCLUSION: The results suggest differences in strategies that PDD explore human picture. Moreover, these strategies seem not to be affected by the lack of expected part of the face (the eyes).

Saccadic movements using eye-tracking technology in individuals with autism spectrum disorders: pilot study / Movimentos sacádicos de indivíduos do espectro autista por varredura visual: estudo piloto

OBJECTIVE: To verify differences in the visual scanning strategies between pervasive developmental disorders (PDD) and controls when they are observing social and non-social pictures. METHOD: PDD group (PDDG) comprised by 10 non-retarded subjects (age from 4 to 41) and age-matched control group (CG). Nine social pictures with human beings (including two pictures of cat mask), and 3 nonsocial pictures of objects were presented for 5 seconds. Saccadic movements and fixation were recorded with equipment EyeGaze® (LC Technologies Inc.). RESULTS: PDDG (mean=292.73, SE=67.62) presented longer duration of saccadic movements for social pictures compared to CG (mean=136.06, SE=14.01) (p=0.04). The CG showed a higher number of fixations in the picture 7 (a women using a cat mask, with the eyes erased) (CG: mean=3.40; PDDG: mean=1.80; p=0.007). CONCLUSION: The results suggest differences in strategies that PDD explore human picture. Moreover, these strategies seem not to be affected by the lack of expected part of the face (the eyes.

OBJETIVO: Verificar diferenças nas estratégias de varredura visual de indivíduos com transtorno invasivo do desenvolvimento (TID) comparados a controles normais na observação de figuras sociais e não sociais. MÉTODO: Estudo caso-controle. Grupo TID: dez sujeitos com TID, inteligência normal e idade entre 4 e 41 anos; Grupo Controle: dez sujeitos pareados por idade. Os sujeitos observaram por 5 segundos 9 figuras de seres humanos e 3 figuras de objetos. Os movimentos sacádicos e o número de fixações foram gravados em equipamento EyeGaze® (LC Technologies Inc.). RESULTADOS: O grupo TID apresentou maior duração dos movimentos sacádicos na observação de figuras humanas [TID=292,73 (EP=67,62); controle= 136,06 (EP=14,01); p=0,04]. O grupo controle apresentou maior número de fixações na figura 7 (mulher com máscara de gato sem os olhos) (TID=1,8; controle=3,4; p=0,007). CONCLUSÃO: Indivíduos com TID parecem utilizar estratégias diferentes para explorar figura humana. Além disso, o padrão de investigação deles não se modifica quando observam uma figura que rompe com o esperado (a falta dos olhos.

Esclerose lateral amiotrófica: declínio funcional com o tempo desde o diagnóstico / Amyotrophic lateral sclerosis: functional decay with time since diagnosis

Esclerose lateral amiotrófica (ELA) e uma doença degenerativa ainda incurável que acomete os neurônios motores do cérebro e da medula espinhal. À medida que esses neurônios morrem, a musculatura sofre atrofia progressiva, com a conseqüente redução do controle motor até o ponto da paralisia. Ela tende a acometer pessoas de meia idade entre 55 e 65 anos. Sua incidência é de 1:100 mil por ano, mas tem aumentado. Há escassez de instrumentos para avaliar o grau de severidade e perda de funções. A Escala Funcional de ELA (Cederbaum, 1996) permite avaliar o paciente em dez áreas: fala, salivação, deglutição, escrita, alimentação, higiene e vestir-se, autocuidado noturno, andar, subir escadas, e respirar. Há dez questões, uma por área, e cinco alternativas por questão, uma por nível, com escores de zero (perda total de função) a 4 (função normal). O escore médio global tende a cair de 4,0 a 0,0 à medida que o paciente piora. Para preencher a escala, o cuidador do paciente deve marcar a alternativa que melhor descreve o funcionamento do paciente em cada área. Este estudo apresenta a tradução da escala, bem como dados preliminares de sua validação com 119 pacientes brasileiros, confirmando um declínio como função do decurso do tempo desde o diagnostico. A escala possibilita comparar efeitos e aperfeiçoar procedimentos terapêuticos.

Amyotrophic lateral sclerosis (ALS) is a still incurable degenerative disease that affects motor neurons in the brain and spinal cord. As the motor neurons gradually die the muscles they innervate suffer progressive atrophy, so that control of voluntary movements becomes increasingly difficult to the point of paralysis. ALS tends to occur in 55-65 year old middle-age adults. Its prevalence is 1: 100 thousand per year, but has increased in recent years. There is a scarcity of instruments for assessing patient's progressive loss of functions. Cederbaum's (1996) ALS Functional Rating Scale (ALSFRS) permits assessing patients' functioning in ten areas: speech, salivation, swallowing, writing, feeding, hygiene and dressing, nocturnal self-care, walking, climbing stairs, and breathing. There are ten questions, one per area, and five alternatives for each question, one per level, with scores varying from zero (total function loss) to 4 (normal functioning). Global average score tends to drop from 4,0 to 0,0 as the patient becomes worse. When filling in ALSFRS, the caretaker is to mark the alternative that best describes the patient's functioning level at each area. The study presents ALSFRS Portuguese translation and preliminary validity data of 119 Brazilian patients, which reveal a decline in overall functioning level as a function of time since diagnosis ALSFRS permits comparing effects of therapeutic procedures.

Esclerose lateral amiotrófica: declínio funcional com o tempo desde o diagnóstico / Amyotrophic lateral sclerosis: functional decay with time since diagnosis

Esclerose lateral amiotrófica (ELA) e uma doença degenerativa ainda incurável que acomete os neurônios motores do cérebro e da medula espinhal. À medida que esses neurônios morrem, a musculatura sofre atrofia progressiva, com a conseqüente redução do controle motor até o ponto da paralisia. Ela tende a acometer pessoas de meia idade entre 55 e 65 anos. Sua incidência é de 1:100 mil por ano, mas tem aumentado. Há escassez de instrumentos para avaliar o grau de severidade e perda de funções. A Escala Funcional de ELA (Cederbaum, 1996) permite avaliar o paciente em dez áreas: fala, salivação, deglutição, escrita, alimentação, higiene e vestir-se, autocuidado noturno, andar, subir escadas, e respirar. Há dez questões, uma por área, e cinco alternativas por questão, uma por nível, com escores de zero (perda total de função) a 4 (função normal). O escore médio global tende a cair de 4,0 a 0,0 à medida que o paciente piora. Para preencher a escala, o cuidador do paciente deve marcar a alternativa que melhor descreve o funcionamento do paciente em cada área. Este estudo apresenta a tradução da escala, bem como dados preliminares de sua validação com 119 pacientes brasileiros, confirmando um declínio como função do decurso do tempo desde o diagnostico. A escala possibilita comparar efeitos e aperfeiçoar procedimentos terapêuticos.(AU)

Amyotrophic lateral sclerosis (ALS) is a still incurable degenerative disease that affects motor neurons in the brain and spinal cord. As the motor neurons gradually die the muscles they innervate suffer progressive atrophy, so that control of voluntary movements becomes increasingly difficult to the point of paralysis. ALS tends to occur in 55-65 year old middle-age adults. Its prevalence is 1: 100 thousand per year, but has increased in recent years. There is a scarcity of instruments for assessing patient's progressive loss of functions. Cederbaum's (1996) ALS Functional Rating Scale (ALSFRS) permits assessing patients' functioning in ten areas: speech, salivation, swallowing, writing, feeding, hygiene and dressing, nocturnal self-care, walking, climbing stairs, and breathing. There are ten questions, one per area, and five alternatives for each question, one per level, with scores varying from zero (total function loss) to 4 (normal functioning). Global average score tends to drop from 4,0 to 0,0 as the patient becomes worse. When filling in ALSFRS, the caretaker is to mark the alternative that best describes the patient's functioning level at each area. The study presents ALSFRS Portuguese translation and preliminary validity data of 119 Brazilian patients, which reveal a decline in overall functioning level as a function of time since diagnosis ALSFRS permits comparing effects of therapeutic procedures.(AU)

Comunicaçäo alternativa na USP na década 1991-2001: tecnologia e pesquisa em reabilitaçäo, educaçäo e inclusäo / Alternative communication at University of Säo Paulo in 1991-2001: technology and research for rehabilitation, education and inclusion

Este artigo faz revisäo histórica de pesquisa e desenvolvimento em sistemas computadorizados de comunicaçäo alternativa, diagnóstico e (re) habilitaçäo desenvolvidos na última década para portadores de distúrbios neuromotores (paralisia cerebral, esclerose lateral amiotrófica, anartria), neurossensoriais (surdez profunda pré- linguística) e neurolinguísticos (afasia, dislexia), e suas combinaçöes (surdez congênita e amputaçäo de mäos, paralisia cerebral e deficiência visual, afasia com surdez verbal pura e tetraplegia por lesäo medular). Aborda sistemas computadorizados para avaliaçäo, comunicaçäo e (re) habilitaçäo cognitiva baseados em pictoideogramas PIC e PCS, semantografia Bliss, Língua de Sinais Brasileira, e escrita alfabética segmentada em níveis silábico e fonêmico, que podem ser operados por input direto (teclado, mouse, tela sensível ao toque) e indireto (varredura automática com diferentes estratégias e parâmetros temporais...

Competência de leitura: modelos teóricos e sistemas computadorizados para avaliação de leitura silenciosa e em voz alta / Reading competence: theoretical models and computer systems for the assessment of silent reading and reading aloud

O artigo apresenta dois testes de multimídia desenhados para a avaliação neuropsicológica da competência de leitura, um para a leitura em voz alta e o outro para a leitura silenciosa. O Teste de Leitura em Voz Alta apresenta listas de itens psicolingüísticos variando em termos de lexicalidade, regularidade, extensão e freqüência. Sucesso na leitura de pseudopalavras e de palavras irregulares de alta freqüência indica que as rotas fonológica e lexical, respectivamente, estão bem desenvolvidas e preservadas. O teste avalia parâmetros temporais da pronúncia (tempo de reação, duração e freqüência de segmentação) como função das variáveis psicolingüísticas e da proficiência de leitura. O Teste de Leitura Silenciosa apresenta pares figura-palavra. A tarefa é julgar se a palavra é correta. Em metade dos casos a ortografia é correta, na outra é incorreta. Quando a ortografia é correta, em metade dos casos a semântica é correta, na outra é incorreta. Falha em identificar o desencontro semântico indica falta de processamento semântico. Quando a ortografia é incorreta, em metade dos casos a troca é visual, e falha em notá-la sugere leitura logo gráfica. Na outra metade é fonológica, e falha em notá-la sugere leitura baseada exclusivamente em processamento fonológico sem acesso lexical. Assim, o teste examina processamentos logográfico, fonológico e lexical. Os testes devem ser usados em combinação para diagnóstico diferencial (AU)