Observation of Communicative Behavior: an updated protocol from 0 to 72 months / Observação do Comportamento Comunicativo: protocolo atualizado de 0 a 72 meses

ABSTRACT Purpose: to describe the updating of the Observation of Communicative Behavior protocol in the age group from 0 to 72 months. Methods: the Observation of Communicative Behavior protocol was revised and updated, with the insertion of the child development milestones in its various areas, becoming a child development screening tool. Results: the protocol includes 188 items, distributed in 10 age groups from zero to 72 months. The items were organized as follows: from zero to 24 months, divided by quarter (four age groups); from 24 to 36 months per semester (two age groups); and from 36 to 72 months, divided by year (four age groups). The items covered the areas of child development and its main milestones. The score is registered in the protocol and a score of 0 - does not perform the action or behavior, 1 - performs the action in an atypical, restricted manner or it is being acquired, 2 - properly performs the action/behavior, is attributed to the response, after analysis. Few materials and a structured environment are needed to apply the protocol. Conclusion: the updating of the Observation of Communicative Behavior protocol has a direct impact on the initial assessment of children with or without suspected delay in child development and should be used by health professionals in monitoring typical child development (routine) or in cases where the child receives specific stimulation.

RESUMO Objetivo: descrever a atualização do protocolo Observação do Comportamento Comunicativo na faixa etária de 0 a 72 meses. Métodos: a Observação do Comportamento Comunicativo foi revisada e atualizada, com inserção de marcos do desenvolvimento infantil em suas diversas áreas, tornando-se um instrumento de triagem do desenvolvimento infantil. Resultados: o protocolo contempla 188 itens, distribuídos em 10 faixas etárias: de zero a 72 meses. Os itens foram organizados da seguinte forma: de zero a 12 meses, divididos por trimestre (quatro faixas etárias); de 12 a 24 meses, por semestre (duas faixas etárias); e, de 24 a 72 meses, divididos por ano (quatro faixas etárias). Os itens contemplam as áreas do desenvolvimento infantil e seus principais marcos. A pontuação é registrada no próprio protocolo, atribuindo a análise da resposta em 0 - não realiza a ação ou comportamento; 1 - realiza de maneira atípica, restrita ou está em aquisição; 2 - realiza adequadamente a ação/comportamento. São necessários poucos materiais para aplicação e ambiente estruturado. Conclusão: o protocolo Observação do Comportamento Comunicativo traz impacto direto na avaliação inicial de crianças com ou sem suspeita de atraso no desenvolvimento infantil e deve ser utilizado por profissionais da saúde, no acompanhamento do desenvolvimento infantil típico (rotina) ou em casos em que a criança recebe estimulação específica.

Memória operacional e vocabulário em crianças com Transtorno do Desenvolvimento da Linguagem / Memoria operativa y vocabulario en niños con Trastorno del Desarrollo del Lenguaje / Working memory and vocabulary in children with Developmental Language Disorder

O objetivo deste estudo foi verificar se existe diferença no desempenho de crianças com Transtorno do Desenvolvimento da Linguagem (TDL) e Desenvolvimento Típico de Linguagem (DTL) em testes de memória operacional fonológica (MOF) e de memória visual de curto prazo (MVCP), e se esse desem-penho está correlacionado com o vocabulário receptivo. Selecionamos 14 crianças com TDL e 28 com DTL. Todos os sujeitos foram submetidos a dois testes de memória de curto prazo e a um teste de vocabulário receptivo. A comparação entre os grupos foi realizada por meio do Teste t de Student e a correlação entre a memória de curto prazo e o vocabulário foi obtida pela correlação de Pearson. Crian-ças com TDL tiveram pior desempenho quando comparadas ao grupo controle, tanto em MOF quanto em MVCP. A correlação positiva entre os testes de memória e vocabulário sugere que tanto a alça fo-nológica quanto a memória visual são importantes para o processamento da linguagem, mesmo que a alça fonológica possa ter maior relevância

The aim of this study was to verify if there is a difference in performance between children with Developmental Language Disorder (DLD) and typical language development (TLD) in phonological working memory (PWM) test and visual short-term memory (VSTM), and if this performance is correlated with the result of a receptive vocabulary test. We selected 14 children with DLD and 28 with TLD. All subjects underwent two short-term memory tests and a receptive vocabulary test. The comparison between the groups was performed using the Student's t-test, and the correlation between the short-term memory and the vocabulary was obtained by Pearson's correlation. Children with DLD had a worse performance when compared with the control group, both in PWM and VSTM. The positive correlation between memory and vocabulary tests suggests that both the phonological loop and visual memory are important for the processing of language, even if the phonological loop may have greater relevance.

El objetivo de este estudio fue verificar si existe una diferencia en el desempeño de los niños con Trastorno del Desarrollo del Lenguaje (TDL) y el desarrollo del lenguaje típico (DLT) en las pruebas de memoria operativa fonológica (MOF) y memoria visual a corto plazo (MVCP), y si ese desempeño es correlacionado con el vocabulario receptivo. Seleccionamos 14 niños con TDL y 28 con DTL. Todos los sujetos se sometieron a dos pruebas de memoria a corto plazo y a una prueba de vocabulario receptivo. La comparación entre grupos se realizó mediante la prueba t de Student y la correlación entre la memoria a corto plazo y el vocabulario se obtuvo mediante la correlación de Pearson. Los niños con TDL tuvieron un peor desempeño en comparación con el grupo de control, tanto en la MOF como en la MVCP. La correlación positiva entre las pruebas de memoria y vocabulario sugiere que tanto el bucle fonológico como la memoria visual son importantes para el procesamiento del lenguaje, aunque el bucle fonológico puede tener mayor relevancia.

Síndrome de Silver-Russell: Características clínicas, de neurodesenvolvimento e comunicação: Estudo de casos clínicos / Silver-Russell syndrome: clinical, neurodevelopmental and communication characteristics: clinical case studies

RESUMO A Síndrome de Silver Russel (SSR) é uma condição geneticamente heterogênea com fenótipo clínico que inclui restrição do crescimento intrauterino e pós-natal, alterações craniofaciais, assimetrias corporais, baixo índice de massa corporal e dificuldades alimentares. Há expectativa de alterações do desenvolvimento motor, da coordenação global e de fala. O presente estudo tem como objetivo apresentar características da síndrome, do neurodesenvolvimento e comunicação de três crianças do sexo masculino, com diagnóstico da síndrome, na faixa etária de 16, 18 e 44 meses, respectivamente. Cumpriram-se os critérios éticos. Foi realizada análise de prontuário, com objetivo de coletar informações da anamnese realizada com os responsáveis, e da avaliação realizada com as crianças. A avaliação foi realizada por meio da aplicação dos seguintes instrumentos: Observação do Comportamento Comunicativo (OCC), Teste de Screening de Desenvolvimento Denver-II (TSDD-II) e o Early Language Milestone Scale (ELMS). O levantamento de características confirmou a hipótese da SSR; na OCC verificou-se atraso nos comportamentos comunicativos para todos os participantes; no TSDD-II verificou-se atraso nas habilidades motora grossa, motora fina-adaptativa, linguagem e pessoal social. Na ELM verificou-se escores aquém do esperado para as funções auditiva receptiva e auditiva expressiva com habilidades receptivas mais desenvolvidas do que as habilidades expressivas. A SSR merece ser reconhecida pela comunidade científica, uma vez que as características fenotípicas e os dados de vida pregressa, possibilitam que seja levantada a hipótese da síndrome, visando o diagnóstico correto precocemente e um planejamento terapêutico que minimize os efeitos deletérios desta condição.

ABSTRACT Silver Russell Syndrome (SRS) is a genetically heterogeneous condition with a clinical phenotype that includes intrauterine and postnatal growth restriction, craniofacial alterations, body asymmetries, low body mass index, and feeding difficulties. Alterations in motor development, global coordination, and speech are expected. The current study aims to present the syndrome, neurodevelopment, and communication characteristics of three male children diagnosed with the syndrome, aged 16, 18, and 44 months, respectively. Ethical principles were followed. An analysis of the medical records, aiming to collect information of the anamnesis, conducted with the guardians, and of the assessment carried out with the children was performed. The assessment was performed by applying the following instruments: Communicative Behavior Observation (CBO), Development Screening Test Denver-II (TSDD-II), and the Early Language Milestone Scale (ELMS). The survey of characteristics confirmed the SRS hypothesis; it was verified a delay in communicative behavior for all participants in CBO; in TSDD-II there was a delay in gross motor, fine motor-adaptive, language, and social personal skills. Scores below expectations were found for receptive auditory and expressive auditory functions, with receptive abilities more developed than expressive abilities, in ELM. The SRS deserves to be recognized by the scientific community, since the phenotypic characteristics and the data from the previous life allow the hypothesis of the syndrome to be raised, aiming at an early correct diagnosis and therapeutic planning that minimizes the harmful effects of this condition.

Silver-Russell syndrome: clinical, neurodevelopmental and communication characteristics: clinical case studies. / Síndrome de Silver-Russell: Características clínicas, de neurodesenvolvimento e comunicação: Estudo de casos clínicos.

Silver Russell Syndrome (SRS) is a genetically heterogeneous condition with a clinical phenotype that includes intrauterine and postnatal growth restriction, craniofacial alterations, body asymmetries, low body mass index, and feeding difficulties. Alterations in motor development, global coordination, and speech are expected. The current study aims to present the syndrome, neurodevelopment, and communication characteristics of three male children diagnosed with the syndrome, aged 16, 18, and 44 months, respectively. Ethical principles were followed. An analysis of the medical records, aiming to collect information of the anamnesis, conducted with the guardians, and of the assessment carried out with the children was performed. The assessment was performed by applying the following instruments: Communicative Behavior Observation (CBO), Development Screening Test Denver-II (TSDD-II), and the Early Language Milestone Scale (ELMS). The survey of characteristics confirmed the SRS hypothesis; it was verified a delay in communicative behavior for all participants in CBO; in TSDD-II there was a delay in gross motor, fine motor-adaptive, language, and social personal skills. Scores below expectations were found for receptive auditory and expressive auditory functions, with receptive abilities more developed than expressive abilities, in ELM. The SRS deserves to be recognized by the scientific community, since the phenotypic characteristics and the data from the previous life allow the hypothesis of the syndrome to be raised, aiming at an early correct diagnosis and therapeutic planning that minimizes the harmful effects of this condition.

A Síndrome de Silver Russel (SSR) é uma condição geneticamente heterogênea com fenótipo clínico que inclui restrição do crescimento intrauterino e pós-natal, alterações craniofaciais, assimetrias corporais, baixo índice de massa corporal e dificuldades alimentares. Há expectativa de alterações do desenvolvimento motor, da coordenação global e de fala. O presente estudo tem como objetivo apresentar características da síndrome, do neurodesenvolvimento e comunicação de três crianças do sexo masculino, com diagnóstico da síndrome, na faixa etária de 16, 18 e 44 meses, respectivamente. Cumpriram-se os critérios éticos. Foi realizada análise de prontuário, com objetivo de coletar informações da anamnese realizada com os responsáveis, e da avaliação realizada com as crianças. A avaliação foi realizada por meio da aplicação dos seguintes instrumentos: Observação do Comportamento Comunicativo (OCC), Teste de Screening de Desenvolvimento Denver-II (TSDD-II) e o Early Language Milestone Scale (ELMS). O levantamento de características confirmou a hipótese da SSR; na OCC verificou-se atraso nos comportamentos comunicativos para todos os participantes; no TSDD-II verificou-se atraso nas habilidades motora grossa, motora fina-adaptativa, linguagem e pessoal social. Na ELM verificou-se escores aquém do esperado para as funções auditiva receptiva e auditiva expressiva com habilidades receptivas mais desenvolvidas do que as habilidades expressivas. A SSR merece ser reconhecida pela comunidade científica, uma vez que as características fenotípicas e os dados de vida pregressa, possibilitam que seja levantada a hipótese da síndrome, visando o diagnóstico correto precocemente e um planejamento terapêutico que minimize os efeitos deletérios desta condição.

Sleep quality, functional skills, and communication in preschool-aged children with autism spectrum disorder.

AIM: This study aimed to correlate sleep quality, the performance of functional skills (mobility, self-care, and social function), communication, independence, and severity of ASD in children with ASD. METHOD: 58 children between 3 and 5 years and 11 months old were investigated. The Childhood Autism Rating Scale was applied to determine the severity of autism; the Sleep Disturbance Scale for Children was used to investigate sleep quality, and the Pediatric Evaluation of Disability Inventory to investigate functional abilities and independence of the children. RESULTS: 68.9 % of the children showed indicative of sleep disorders. There was no correlation between the different sleep disorders and communication. Sleep disorders showed a negative correlation with functional performance and a positive correlation with ASD severity. INTERPRETATION: The current study offers an exploration between sleep and functional skills in children with ASD. These findings provide important clinical implications in the diagnosis and intervention process of children with ASD and also stimulate reflections on the importance in minimize the impact of sleep disorders and functional abilities on the quality of life of these individuals and their families.

Translation and cross-cultural adaptation of the Kaufman Speech Praxis Test for Children (KSPT) protocol. / Tradução e adaptação transcultural do protocolo Kaufman Speech Praxis Test for Children (KSPT).

PURPOSE: To present the Kaufman Speech Praxis Test for Children - KSPT instrument, as well as its Brazilian cross-cultural adaptation. METHODS: After obtaining permission to use the KSPT by the copyright holder, and compliance with ethical aspects, the instrument was translated and adapted into Brazilian Portuguese, preserving semantic, idiomatic, experimental and conceptual equivalences, when relevant. RESULTS: After translation and cross-cultural adaptation procedures, there were no changes in Part 1 (Oral movement); in Part 2 (Simple Phonemic and Syllabic Level), 12 test words were excluded and 16 were included; and in Part 3 (Complex Phonemic and Syllabic Level), 13 test words were excluded as they failed to correspond to the characteristics of phonoarticulatory production (phonetic/phonological) in Brazilian Portuguese. In part 4 (Spontaneous Length and Complexity - subjective measure) there were no changes to the English version of the KSPT. After the process, the final version of the material was approved by the author and applied to children for usability and equivalences check. The application to a significant population in Brazil for the construction of psychometric criteria will be carried out at a future stage. CONCLUSION: The KSPT translation is completed with changes in test words from the application protocol to respect the cross-cultural characteristics of the Brazilian-Portuguese language. Semantic, idiomatic, experimental and conceptual equivalences were respected throughout the application manual, clinical test guide and test statements. This instrument is expected to integrate advances in the diagnosis and monitoring of intervention procedures, effectively contributing to the area.

OBJETIVO: Apresentar o instrumento Kaufman Speech Praxis Test for Children ­ KSPT, bem como sua adaptação transcultural para o Brasil. MÉTODO: Após a permissão de utilização do KSPT pela detentora dos direitos autorais, e cumprimento dos aspectos éticos, o instrumento foi traduzido e adaptado para o português brasileiro, com manutenção de equivalências semântica, idiomática, experimental e conceitual, quando pertinente. RESULTADOS: Após procedimentos de tradução e adaptação transcultural, não houve mudanças na Parte 1 (Nível de movimento oral); na Parte 2 (Nível silábico e fonêmico simples), 12 palavras-teste foram excluídas e 16 incluídas; e na Parte 3 (Nível silábico e fonêmico complexo), 13 palavras-teste foram excluídas por não apresentarem correspondência em relação às características de produção fonoarticulatória (fonético/fonológico) no Português Brasileiro. Na parte 4 (Extensão e complexidade espontânea - medida subjetiva) não houve alterações da versão em inglês do KSPT. Após todo o processo o material final foi aprovado pela autora e aplicado em crianças para a verificação da usabilidade e verificação de equivalências. A aplicação em população significativa no Brasil para a construção de critérios psicométricos será realizada em etapa futura. CONCLUSÃO: A tradução do KSPT está finalizada com mudanças em palavras-teste do protocolo de aplicação, para respeitar as características transculturais da língua portuguesa falada no Brasil. Foram respeitadas as equivalências semântica, idiomática, experimental e conceitual, no manual de aplicação, guia de teste clínico e nos enunciados das provas. Espera-se que este instrumento integre avanços para o diagnóstico e acompanhamento de procedimentos de intervenção, trazendo uma contribuição efetiva para esta área.

Patterns of regulatory behavior in the still-face paradigm at 3 months: A comparison of Brazilian and Portuguese infants.

Three infant regulatory behavior patterns have been identified during the Face-to-Face Still-Face paradigm (FFSF) in prior research samples: a Social-Positive Oriented pattern (i.e., infants exhibit predominantly positive social engagement), a Distressed-Inconsolable pattern (i.e., infants display conspicuous negative affect that persists or increases across FFSF episodes), and a Self-Comfort Oriented pattern (e.g., infants primarily engage in self-comforting behaviors such as thumb-sucking). However, few studies have examined these patterns outside US and European countries or evaluated potential cross-country differences in these patterns. In this study, we compared the regulatory behavior patterns of 74 Brazilian and 124 Portuguese infants in the FFSF at 3 months of age, and evaluated their links to demographic and birth variables. The prevalence of the three regulatory patterns varied by country. The most frequent pattern in the Portuguese sample was the Social-Positive Oriented, followed by the Distressed-Inconsolable and the Self-Comfort Oriented. However, in the Brazilian sample, the Distressed-Inconsolable pattern was the most prevalent, followed by the Social-Positive Oriented and the Self-Comfort Oriented. Moreover, in the Brazilian sample, familial SES was higher among infants with a Social-Positive pattern whereas 1st-minute Apgar scores were lower among Portuguese infants with a Distressed-Inconsolable Oriented pattern of regulatory behavior. In each sample, Social Positive pattern of regulatory behavior was associated with maternal sensitivity, Self-Comfort Oriented pattern of regulatory behavior with maternal control, and Distressed-Inconsolable pattern with maternal unresponsivity.

Global and communicative development skills in preschool children with cleft lip and palate.

IMPORTANCE: Cleft lip and palate (CLP) is globally among the most common childhood malformations. This disorder impacts childhood development, including speech and language, and affects children worldwide. OBJECTIVE: To analyze child development skills (adaptive fine motor, gross motor, personal-social, and language) in preschool children with isolated CLP compared with children without this malformation. METHODS: The participants included an experimental group of 27 children with isolated CLP and a comparison group of 27 children without CLP aged between 48 and 59 months. The groups were evaluated using two instruments: the Denver Developmental Screening Test II (DDST-II) and the Avaliação do Desenvolvimento da Linguagem (ADL-Language Development Assessment). Data were analyzed by descriptive and inductive analyses, using the Student's t-test and the Mann-Whitney test, at a significance level of P ˂ 0.05. RESULTS: All children in the comparison group performed within normal standards for their age range in the DDST-II and the ADL. The worst performance in the experimental group was observed in language skills, followed, in declining order, by adaptive fine motor, personal-social, and gross motor as measured by the DDST-II. Children with isolated CLP also performed poorly in receptive, expressive, and global language in the ADL. No statistically significant differences were observed in the experimental group's scores for the ADL and the DDST-II. INTERPRETATION: Developmental skill levels were below expectations for children of this age with isolated CLP.

Instruments to assess children's language and speech translated and adapted into Brazilian Portuguese: an integrative literature review / Instrumentos avaliativos de linguagem e fala para crianças traduzidos e adaptados para a língua portuguesa do Brasil: uma revisão integrativa da literatura

ABSTRACT Purpose: to analyze the content and translation guidelines of instruments meant to assess language, speech sound production, and communicative skills of children, adapted to Brazilian Portuguese. Methods: a search was conducted in national and international databases to select articles on the assessment of language, speech, and communicative skills in children, considering the descriptors "translation", "adaptation", "cultural adaptation", "cross-cultural adaptation", "language", "speech", and "pragmatic". The search was conducted in the SciELO, Virtual Health Library, PubMed/MEDLINE, and Latin American and Caribbean Health Sciences Literature. Results: eight assessment instruments compatible with the inclusion criteria were found. Conclusion: of the instruments found, four approached specific investigations, such as syntax, narrative, pragmatic skills, and speech sound organization, while the other four had a more encompassing profile, verifying form, content, and/or use (pragmatics). Concerning the guidelines, the most recurrent stages between the translation proposals were translation, conciliation of the previous stage or synthesis version, back-translation, reviewing committee, pretest, and final version. The conceptual, item and operational equivalences were frequently cited for verification.

RESUMO Objetivo: analisar o conteúdo e as diretrizes de tradução de instrumentos de avaliação de linguagem, da produção dos sons da fala e das habilidades comunicativas para crianças, adaptados para a língua portuguesa do Brasil. Métodos: a partir da busca em base de dados nacionais e internacionais, foram selecionados artigos que tratassem da avaliação da linguagem, fala e habilidades comunicativas em crianças considerando os descritores "tradução", "adaptação", "adaptação cultural", "adaptação transcultural", "linguagem", "fala" e "pragmática". A pesquisa ocorreu nas bases de dados Scielo, Biblioteca Virtual em Saúde, Pubmed/Medline e Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde. Resultados: oito instrumentos de avaliação compatíveis com os critérios de inclusão foram encontrados. Conclusão: dentre os instrumentos encontrados, quatro são destinados a investigações pontuais, como sintaxe, narrativa, habilidades pragmáticas e organização dos sons da fala e os outros quatro têm perfil mais abrangente e averiguam forma, conteúdo e/ou uso (pragmática). A respeito das diretrizes, as etapas mais recorrentes entre as propostas tradutórias foram: tradução, conciliação da etapa anterior ou versão síntese, retrotradução, comitê de revisão, pré-teste e versão final. No que tange a verificação das equivalências, a conceitual, de item e operacional foram frequentemente citadas.

Pedagogical performance in the preschool teaching of students with Autism Spectrum Disorder / Atuação pedagógica no ensino pré-escolar de alunos com o Transtorno do Espectro Autista

ABSTRACT Purpose: to describe the panorama of the pedagogical context in the preschool teaching of students with Autism Spectrum Disorder (ASD), in a municipality in the state of São Paulo, Brazil. Methods: 32 teachers, including early childhood education (ECE), special education (SE), and specialized educational assistance (SEA), participated answering a questionnaire about their performance with autistic students. A descriptive qualitative analysis of the data was performed. Results: the average age of the teachers was 40.6 years old, with an undergraduate degree in Teaching, Pedagogy, Special Education, and/or Visual Arts, of which 84.4% were postgraduate. 87.4% knew ASD characteristics; 80%, SEA, 66.7%, SE, 57.1% of ECE teachers had receive the medical report. 78.1% reported difficulties in socialization, communication, behavior, learning; 15.6%, aggressive behavior / irritation; 12.5%, difficulties in attention / concentration; 6.2%, motor coordination difficulties in their autistic students. 62.5% considered that their autistic students had the potential to follow mainstream education; 68.8% received guidance from team professionals; 78.1% participated in courses/lectures on the theme; 28.1% considered they were able to teach autistic children; 78.1% stated that adjustments in the teaching structure were necessary. Conclusion: the scenario of the pedagogical context in the preschool teaching of students with ASD, in the studied municipality, needs reflections. Information on ASD characteristics, training courses, knowledge on individual follow-ups, so that teachers are prepared to promote effective teaching and learning, are needed.

RESUMO Objetivo: descrever o panorama do contexto pedagógico no ensino pré-escolar de alunos com Transtorno do Espectro Autista (TEA), em um município do estado de São Paulo, Brasil. Métodos: participaram 32 professoras compreendendo o ensino infantil (EI), a educação especial (EE) e o atendimento educacional especializado (AEE), que responderam questionário sobre atuação com alunos autistas. Uma análise qualitativa descritiva dos dados foi realizada. Resultados: a média de idade das professoras foi 40,6 anos, com formação em Magistério, Pedagogia, Educação Especial e/ou Educação Artística, sendo 84,4% pós-graduadas. 87,4% conheciam características do TEA, tendo recebido laudo diagnóstico 80% das professoras do AEE; 66,7% da EE, 57,1% do EI. 78,1% referiram dificuldades de socialização, comunicação, comportamento, aprendizagem; 15,6% comportamento agressivo/irritação; 12,5% dificuldades de atenção/concentração; 6,2% dificuldades de coordenação motora, em seus alunos autistas. 62,5% consideram que seus alunos autistas apresentam potencial para acompanhar ensino regular; 68,8% recebiam orientações de profissionais da equipe; 78,1% participaram de cursos/palestras sobre a temática; 28,1% consideraram estarem aptas para ensinar crianças autistas; 78,1% afirmaram serem necessárias adequações na estrutura de ensino. Conclusão: o panorama do contexto pedagógico no ensino pré-escolar de alunos com TEA, no município pesquisado carece reflexões. É necessário informações sobre características do TEA, cursos de capacitação, informações sobre acompanhamentos individuais, para que os professores estejam preparados para promover o ensino-aprendizagem eficaz.

Family SES and maternal sensitivity predict infant patterns of regulatory behavior in Brazilian dyads.

Infant's patterns of regulatory behavior contribute to infant socioemotional development and attachment. These behavioral patterns affect and are affected by the quality of mother-infant interaction. In most studies with full-term infants, the Social-Positive Oriented pattern (i.e., the infant's ability to soothe his/her emotions in the context of reciprocal and positive interactions) is the most prevalent pattern, followed by the Distressed-Inconsolable and by the Self-Comfort Oriented patterns. However, these patterns are understudied in other populations beyond the US and European countries. The current research addresses this gap by studying the regulatory behavior patterns and their association with mother-infant interactions in Brazilian dyads and evaluating the association of these regulatory patterns with demographics. Analyses were based on data collected for 40 infants (20 boys, 20 girls) and their mothers. Infants' regulatory behavior patterns were evaluated in the Face-to-Face Still-Face paradigm and mother-infant interaction was evaluated during free play at 3 months age. Notably, our findings indicate that Distressed-Inconsolable was the most prevalent pattern in this sample; followed by the Social-Positive Oriented and the Self-Comfort Oriented patterns. Furthermore, we found that maternal sensitivity and family SES (social-economic status) predicted infant patterns of regulatory behavior.

Performance in motor, communicative and cognitive skills of girls with congenital hypothyroidism treated from the neonatal period. / Desempenho em habilidades motoras, comunicativas e cognitivas de crianças com hipotireoidismo congênito tratadas desde o período neonatal.

OBJECTIVE: To compare the performance in gross motor, fine motor-adaptive, language, cognitive and personal-social development skills of girls with a mean age of 36 to 71 months with Congenital Hypothyroidism treated from the neonatal period with that of their peers without thyroid alterations. METHODS: The participants included in the study were 30 children aged between 36 and 70 months divided into two groups paired for chronological age and socioeconomic status: 15 girls diagnosed with Congenital Hypothyroidism - Experimental Group (EG) and 15 girls without thyroid changes - Control Group (CG). The following assessment instruments were used: Interview with parents, Peabody Picture Vocabulary Test - Revised (PPVT-R), and Denver Developmental Screening Test - 2nd edition (DDST-II). Psychological testing of intellectual functioning was conducted with application of the Stanford-Binet Intelligence Scale (SBIS). The descriptive statistical analysis was performed using Student's t-test and the Mann-Whitney test at a significance level of 5% (p<0.05). RESULTS: Comparison of the PPVT-R and SBIS results showed a statistically significant difference between the EG and CG. Comparison of the DDST-II results showed a statistically significant difference between the groups for the fine motor-adaptive, language and gross motor areas. CONCLUSION: The present study confirms that Congenital Hypothyroidism affects child development, even when children are diagnosed and treated early, leading to alterations that can impair their motor, cognitive and language development.

OBJETIVO: Comparar o desempenho das habilidades motora grossa, motora fina-adaptativa, linguagem, cognitiva e pessoal-social de meninas entre 36 e 70 meses com hipotireoidismo congênito tratado no período pós-natal com seus pares sem alterações tireoidianas. MÉTODO: Participaram 15 meninas com diagnóstico de hipotireoidismo congênito, com idade cronológica variando de 36 a 70 meses no Grupo Experimental (GE); e 15 meninas sem alterações tireoidianas no Grupo Comparativo (GC), pareadas por idade cronológica e nível socioeconômico. Os instrumentos de avaliação utilizados foram: Entrevista com os pais; Teste de Vocabulário por Imagem Peabody (TVIP-R); e Teste de Triagem do Desenvolvimento de Denver II (TTDD-II). Foi realizada a avaliação psicológica, quanto ao nível intelectual, com a aplicação da Stanford-Binet Intelligence Scale (SBIS). A estatística foi realizada por meio de análise descritiva, teste "t" de Student e Teste de Mann-Whitney, nível de significância de p <5%. RESULTADOS: Na comparação do TVIP-R e SBIS, houve diferença estatisticamente significante entre o GE e o GC. Na comparação entre as áreas do TTDD-II, houve diferença estatisticamente significante entre os grupos para as áreas de Linguagem, Motora Grossa e Motora Fina-Adaptativa. CONCLUSÃO: O presente estudo confirmou a interferência do Hipotireoidismo Congênito no desenvolvimento infantil, mesmo quando diagnosticado e tratado precocemente, levando a mudanças no desenvolvimento que podem trazer prejuízos nas áreas motora, cognitiva e linguística.

Language evaluation in children with pre-lingual hearing loss and cochlear implant / Avaliação de linguagem em crianças com deficiência auditiva pré-lingual e implante coclear

Abstract Introduction The cochlear implant is an effective device for children with severe and/or profound prelingual hearing loss, since it provides considerable improvement in oral language acquisition through the auditory pathway. The use of a cochlear implant contributes to the development of auditory perception, favoring the acquisition of the linguistic processes related to communication skills, which might have a positive effect on other areas of development. Objective The aim of this study was to verify the performance of children using cochlear implants for expressive and receptive oral language. Methods This was a prospective cross-sectional study that used the following tests: Child language test in the phonology, vocabulary, fluency and pragmatics areas, and the Peabody picture vocabulary test. Thirty children participated in this study, of both genders, aged between 36 and 72 months, with severe and/or profound bilateral sensorineural hearing loss, without other impairments and users of unilateral cochlear implant with full electrode insertion for a minimum of 12 months. Results The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language. Even though when compared to the normative language acquisition process, the results showed that these children had patterns of linguistic skills that are below their chronological age; the results indicate that these children are developing expressive and receptive oral language skills, and this is the outcome that should be taken into account in this study. Conclusion The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language skills, but not in all the studied semantic categories.

Resumo Introdução O implante coclear é um tratamento eficaz para crianças com deficiência auditiva pré-lingual de grau severo e/ou profundo, uma vez que proporciona melhoria considerável na aquisição da linguagem oral por meio da via auditiva. O uso do implante coclear contribui para o desenvolvimento da percepção auditiva e favorece a aquisição dos processos linguísticos voltados à aquisição de habilidades comunicativas que poderá repercutir positivamente em outras áreas do desenvolvimento. Objetivo Verificar o desempenho de crianças usuárias de implante coclear quanto à linguagem oral expressiva e receptiva. Método Estudo prospectivo transversal onde os seguintes testes foram usados: teste de linguagem infantil nas áreas de fonologia, vocabulário, fluência e pragmática e teste de vocabulário de imagens Peabody. Participaram deste estudo 30 crianças de ambos os sexos de 36 a 72 meses, com deficiência auditiva sensorioneural de grau severo e/ou profundo bilateral, sem outros comprometimentos e usuárias de implante coclear unilateral com inserção total dos eletrodos havia, no mínimo, 12 meses. Resultados O maior tempo de uso do implante coclear, a menor idade na cirurgia e o melhor desempenho na percepção auditiva da fala influenciaram o desempenho na linguagem oral expressiva e receptiva. Embora comparativamente ao processo de aquisição normativo da linguagem os resultados encontrados tenham revelado que essas crianças demonstraram habilidades linguísticas em padrões abaixo de sua idade cronológica, os resultados apontaram que essas crianças estão em evolução da linguagem oral expressiva e receptiva, esse é o resultado que deve ser valorizado neste estudo. Conclusão O maior tempo de uso do implante coclear, a menor idade na cirurgia e o melhor desempenho na percepção auditiva da fala influenciaram o desempenho na linguagem oral expressiva e receptiva, porém não em todas as categorias semânticas estudadas.

Language evaluation in children with pre-lingual hearing loss and cochlear implant.

INTRODUCTION: The cochlear implant is an effective device for children with severe and/or profound prelingual hearing loss, since it provides considerable improvement in oral language acquisition through the auditory pathway. The use of a cochlear implant contributes to the development of auditory perception, favoring the acquisition of the linguistic processes related to communication skills, which might have a positive effect on other areas of development. OBJECTIVE: The aim of this study was to verify the performance of children using cochlear implants for expressive and receptive oral language. METHODS: This was a prospective cross-sectional study that used the following tests: Child language test in the phonology, vocabulary, fluency and pragmatics areas, and the Peabody picture vocabulary test. Thirty children participated in this study, of both genders, aged between 36 and 72 months, with severe and/or profound bilateral sensorineural hearing loss, without other impairments and users of unilateral cochlear implant with full electrode insertion for a minimum of 12 months. RESULTS: The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language. Even though when compared to the normative language acquisition process, the results showed that these children had patterns of linguistic skills that are below their chronological age; the results indicate that these children are developing expressive and receptive oral language skills, and this is the outcome that should be taken into account in this study. CONCLUSION: The longer duration of the cochlear implant use, the younger age at surgery and the better performance in the auditory perception of speech influenced the performance in expressive and receptive oral language skills, but not in all the studied semantic categories.

Desempenho em habilidades motoras, comunicativas e cognitivas de crianças com hipotireoidismo congênito tratadas desde o período neonatal / Performance in motor, communicative and cognitive skills of girls with congenital hypothyroidism treated from the neonatal period

RESUMO Objetivo Comparar o desempenho das habilidades motora grossa, motora fina-adaptativa, linguagem, cognitiva e pessoal-social de meninas entre 36 e 70 meses com hipotireoidismo congênito tratado no período pós-natal com seus pares sem alterações tireoidianas. Método Participaram 15 meninas com diagnóstico de hipotireoidismo congênito, com idade cronológica variando de 36 a 70 meses no Grupo Experimental (GE); e 15 meninas sem alterações tireoidianas no Grupo Comparativo (GC), pareadas por idade cronológica e nível socioeconômico. Os instrumentos de avaliação utilizados foram: Entrevista com os pais; Teste de Vocabulário por Imagem Peabody (TVIP-R); e Teste de Triagem do Desenvolvimento de Denver II (TTDD-II). Foi realizada a avaliação psicológica, quanto ao nível intelectual, com a aplicação da Stanford-Binet Intelligence Scale (SBIS). A estatística foi realizada por meio de análise descritiva, teste "t" de Student e Teste de Mann-Whitney, nível de significância de p <5%. Resultados Na comparação do TVIP-R e SBIS, houve diferença estatisticamente significante entre o GE e o GC. Na comparação entre as áreas do TTDD-II, houve diferença estatisticamente significante entre os grupos para as áreas de Linguagem, Motora Grossa e Motora Fina-Adaptativa. Conclusão O presente estudo confirmou a interferência do Hipotireoidismo Congênito no desenvolvimento infantil, mesmo quando diagnosticado e tratado precocemente, levando a mudanças no desenvolvimento que podem trazer prejuízos nas áreas motora, cognitiva e linguística.

ABSTRACT Objective To compare the performance in gross motor, fine motor-adaptive, language, cognitive and personal-social development skills of girls with a mean age of 36 to 71 months with Congenital Hypothyroidism treated from the neonatal period with that of their peers without thyroid alterations. Methods The participants included in the study were 30 children aged between 36 and 70 months divided into two groups paired for chronological age and socioeconomic status: 15 girls diagnosed with Congenital Hypothyroidism - Experimental Group (EG) and 15 girls without thyroid changes - Control Group (CG). The following assessment instruments were used: Interview with parents, Peabody Picture Vocabulary Test - Revised (PPVT-R), and Denver Developmental Screening Test - 2nd edition (DDST-II). Psychological testing of intellectual functioning was conducted with application of the Stanford-Binet Intelligence Scale (SBIS). The descriptive statistical analysis was performed using Student's t-test and the Mann-Whitney test at a significance level of 5% (p<0.05). Results Comparison of the PPVT-R and SBIS results showed a statistically significant difference between the EG and CG. Comparison of the DDST-II results showed a statistically significant difference between the groups for the fine motor-adaptive, language and gross motor areas. Conclusion The present study confirms that Congenital Hypothyroidism affects child development, even when children are diagnosed and treated early, leading to alterations that can impair their motor, cognitive and language development.

Language, neurodevelopment, and behavior in Angelman syndrome: a case report. / Linguagem, neurodesenvolvimento e comportamento na Síndrome de Angelman: relato de caso.

PURPOSE: This study aimed to present findings on language, behavior, and neurodevelopment in a girl diagnosed with Angelman Syndrome, evaluated when she was three and eight years old. METHODS: The following evaluation instruments were used: Observation of Communication Behavior, Early Language Milestone (ELM) Scale, and Denver Developmental Screening Test, 2nd edition (DDST-II). RESULTS: In this case report, presence of AS phenotype signals such as wide mouth and wide-spaced teeth, tongue thrusting, strabismus, up slanting palpebral fissures, and sialorrhea are verified. Expressive and receptive deficits were verified in the language assessment, with the absence of orality and loss of comprehension with very similar performances in both evaluations. The ELM and DDST-II tests indicated severe impairment of all abilities evaluated at both three and eight years of age. Performance was quite similar in both evaluations in all areas of child development. Little progress was observed over time despite the great therapeutic and educational investment. CONCLUSION: The presence of a complex scenario such as AS demands high complexity clinical needs, a situation that is worsened due to scarcity of therapeutic resources that could minimize the harmful impacts of AS and culminate in increased quality of life for the AS population and their families.

OBJETIVO: O objetivo deste estudo é apresentar achados de linguagem, comportamento e neurodesenvolvimento de uma menina com diagnóstico da Síndrome de Angelman, avaliada aos três e aos oito anos. MÉTODO: Os instrumentos de avaliação foram Observação do Comportamento Comunicativo, Early Language Milestone Scale (ELM) e Teste de Screening de Desenvolvimento DENVER-II (TSDD-II). RESULTADOS: No caso apresentado, verifica-se a presença dos sinais fenotípicos da SA, tais como boca larga, dentes espaçados, língua protuberante, estrabismo, fissuras palpebrais ascendentes e sialorreia. Na avaliação de linguagem, foram verificados déficits expressivos e receptivos, com ausência de oralidade e prejuízos na compreensão. O TSDD-II e a ELMS indicaram grave comprometimento de todas as habilidades avaliadas aos três e aos oito anos. O desempenho encontrado, nas duas avaliações, foi muito semelhante em todas as áreas do desenvolvimento infantil. Ao longo dos anos, verificou-se pouca evolução, apesar do grande investimento terapêutico e educacional. CONCLUSÃO: A presença de um quadro complexo como a SA demanda necessidades clínicas de alta complexidade, situação agravada frente à escassez de recursos terapêuticos que possam minimizar os impactos deletérios da síndrome, culminando em comprometimento da qualidade de vida da população com a SA, bem como de suas famílias.

Transcultural adaptation process of the Griffiths-III Mental Development Scale.

BACKGROUND: The Griffiths-III Mental Development Scale (GMDS-III) is used in the diagnosis of child development in several countries, presenting cross-cultural adaptation of the original British version. In Brazil, there is a shortage of standardized and normalized diagnostic tools for the child population. The study describes the cross-cultural adaptation of the GMDS-III for the Brazilian reality. METHOD: Ethical aspects were fulfilled (CAAE: 34802014.0.0000.5417). Six steps of the cross-cultural adaptation process suggested by the American Association of Orthopedic Surgeons Outcomes Committee were followed: two independent translations; synthesis translations and version T1-2 preparation; T1-2 version retrotranslation, blinded, by two natives of the origin language and fluent in the target language; expert committee review maintaining conceptual, idiomatic, semantic, and cultural equivalence, elaborating the pre-final version; application of the pre-final version, in Portuguese, for 96 Brazilian children; documentation submission to the original scale authors. RESULTS: Five hundred seventy-one words/expressions translated and adapted from English to Brazilian Portuguese. No gross inconsistencies or conceptual error were found in the translation. The pre-final version was applied to 72 children, distributed along the scale age range, with no absence of response for any item, making a satisfactory distribution of the skills assessed in the instrument. Original scale authors issued a certificate agreeing with the process. CONCLUSIONS: The GMDS-III was adapted transculturally to the Brazilian reality following a rigorous methodology. This work is an anchor for scale normalization with application in a representative sample of Brazilian children, as well as verification of psychometric properties in the Brazilian version. This was the first step towards the beginning of the transformation of the Brazilian children's scenario regarding the use of a standardized and normalized assessment instrument, providing an early and assertive diagnosis.

Child development skills and language in toddlers with cleft lip and palate.

INTRODUCTION: Children born with cleft lip and palate (CLP) are exposed to several risk factors for developmental delay. METHODS: This cross-sectional and descriptive study compared the performance of gross motor, adaptive fine motor, social-personal and language skills in children with non-syndromic cleft lip and palate (age = 36-47 months, n = 30) matched as to chronological age and gender. The evaluation instruments were Denver Developmental Screening Test II and MacArthur Communicative Development Inventory - part D, employed for the receptive and expressive vocabulary checklist. Intergroup comparisons were performed using t tests and Chi-square tests. The Pearson correlation coefficient was used to verify the inter-category correlation (p ≤ 0.05). RESULTS: There was statistically significant difference in gross motor, adaptive fine motor, and language skills, both in receptive and expressive aspects, in the comparison between groups. In the personal-social area, children with CLP presented performance below the expected, without statistically significant difference between groups. CONCLUSIONS: Children with CLP are at risk for developmental disorders and should be monitored from early childhood to minimize the deleterious effects of this risk condition.

Linguagem, neurodesenvolvimento e comportamento na Síndrome de Angelman: relato de caso / Language, neurodevelopment, and behavior in Angelman syndrome: a case report

RESUMO Objetivo O objetivo deste estudo é apresentar achados de linguagem, comportamento e neurodesenvolvimento de uma menina com diagnóstico da Síndrome de Angelman, avaliada aos três e aos oito anos. Método Os instrumentos de avaliação foram Observação do Comportamento Comunicativo, Early Language Milestone Scale (ELM) e Teste de Screening de Desenvolvimento DENVER-II (TSDD-II). Resultados No caso apresentado, verifica-se a presença dos sinais fenotípicos da SA, tais como boca larga, dentes espaçados, língua protuberante, estrabismo, fissuras palpebrais ascendentes e sialorreia. Na avaliação de linguagem, foram verificados déficits expressivos e receptivos, com ausência de oralidade e prejuízos na compreensão. O TSDD-II e a ELMS indicaram grave comprometimento de todas as habilidades avaliadas aos três e aos oito anos. O desempenho encontrado, nas duas avaliações, foi muito semelhante em todas as áreas do desenvolvimento infantil. Ao longo dos anos, verificou-se pouca evolução, apesar do grande investimento terapêutico e educacional. Conclusão A presença de um quadro complexo como a SA demanda necessidades clínicas de alta complexidade, situação agravada frente à escassez de recursos terapêuticos que possam minimizar os impactos deletérios da síndrome, culminando em comprometimento da qualidade de vida da população com a SA, bem como de suas famílias.

ABSTRACT Purpose This study aimed to present findings on language, behavior, and neurodevelopment in a girl diagnosed with Angelman Syndrome, evaluated when she was three and eight years old. Methods The following evaluation instruments were used: Observation of Communication Behavior, Early Language Milestone (ELM) Scale, and Denver Developmental Screening Test, 2nd edition (DDST-II). Results In this case report, presence of AS phenotype signals such as wide mouth and wide-spaced teeth, tongue thrusting, strabismus, up slanting palpebral fissures, and sialorrhea are verified. Expressive and receptive deficits were verified in the language assessment, with the absence of orality and loss of comprehension with very similar performances in both evaluations. The ELM and DDST-II tests indicated severe impairment of all abilities evaluated at both three and eight years of age. Performance was quite similar in both evaluations in all areas of child development. Little progress was observed over time despite the great therapeutic and educational investment. Conclusion The presence of a complex scenario such as AS demands high complexity clinical needs, a situation that is worsened due to scarcity of therapeutic resources that could minimize the harmful impacts of AS and culminate in increased quality of life for the AS population and their families.

Curricular intervention protocol for teaching learners with Autism Spectrum Disorder: an integrative review / Instrumentos de intervenção curricular para o ensino de aprendizes com o Transtorno do Espectro Autista: revisão integrativa

ABSTRACT Objective: to conduct an integrative review of scientific papers indexed in national and international databases on curricular intervention protocols, which favor the linguistic aspects, translated and cross-culturally adapted to Brazilian Portuguese for the teaching of individuals with Autism Spectrum Disorder. Methods: a survey of scientific studies indexed in Pubmed, Portal Regional da Biblioteca Virtual em Saúde, Web of Science, Scopus and ERIC databases was carried out from February to March 2018. Papers in English and Portuguese language of the last 20 years on the proposed theme were selected. The inclusion criteria used were: to be a school curricular intervention protocol that favors the linguistic aspects; to be directed to learners with Autism Spectrum Disorder; to be translated and cross-culturally adapted to Brazilian Portuguese. Results: 214 papers were analyzed revealing the lack of studies on the topic. These data indicate a gap in national basic education, which may corroborate the low qualitative aspects of inclusive education in the country. The Collaborative Model for Promoting Competence and Success for Students with Autism Spectrum Disorder enables a more effective teaching of learners with autism, since this protocol empowers teachers in curricular adaptation to also develop the language skills and overcome the educational challenges of the students with this condition. Conclusion: the Brazilian scenario is that of absent instruments, which may interfere with the quality of inclusive education in Brazil.

RESUMO Objetivo: realizar uma revisão integrativa de artigos científicos indexados em bases de dados nacionais e internacionais sobre instrumentos de intervenção curricular escolar, que favoreça os aspectos linguísticos, traduzidos e adaptados para o Português Brasileiro para o ensino de indivíduos com o Transtorno do Espectro Autista. Métodos: foi realizado um levantamento de estudos científicos indexados nas bases de dados Pubmed, Portal Regional da Biblioteca Virtual em Saúde, Web of Science, Scopus e ERIC no período de Fevereiro a Março de 2018. Foram considerados para a pesquisa textos em língua inglesa e portuguesa dos últimos 20 anos sobre o tema proposto. Os critérios de inclusão utilizados foram: ser um instrumento de intervenção curricular escolar que favoreça os aspectos linguísticos; estar direcionado a aprendizes com Transtorno do Espectro Autista e; estar traduzido e adaptado para o Português Brasileiro. Resultados: 214 artigos foram analisados, revelando a inexistência de estudos sobre o tema em tela. Este achado aponta uma lacuna na educação básica nacional, o que pode corroborar os baixos aspectos qualitativos da educação inclusiva no país. O Collaborative Model for Promoting Competence and Success for Students with Autism Spectrum Disorder pode viabilizar um ensino mais eficaz a aprendizes com autismo, uma vez que este instrumento habilita professores na intervenção curricular escolar com vistas a desenvolver também as habilidades linguísticas e a superar os desafios educacionais dos alunos com esta condição. Conclusão: o cenário brasileiro é de ausência de instrumentos, o que pode interferir na qualidade da educação inclusiva no Brasil.