Diagnostic properties of sensitivity changes in patients with maxillofacial fractures: a systematic review

Aim: Verify the accuracy of objective assessments compared to subjective tests in detecting changes in somatosensory perception in individuals affected by maxillofacial trauma. Methods: The review (PROSPERO n ° CRD42019125546) used the databases: MEDLINE, Cochrane, EMBASE, LILACS and other bibliographic resources. Prospective and retrospective studies that used objective and subjective methods of assessing facial sensitivity in maxillofacial fractures were included. There was no restriction on language or publication date. Risk of bias was assessed using the QUADAS-2. Data extraction and analysis were performed using a form developed for the study. Results: 21 studies were included. The clinical objective examination mainly includes assessments of: tactile sensitivity (95.24%) and nociceptive sensitivity (57.14%). The subjective assessment was based on the patient's report, spontaneously (61.90%), guided by structured questionnaires (33.33%) and/or using scales (9.52%) to measure the degree of impairment. In risk of bias assessment, were observed no adequate interpretation and classification of changes in subjective sensitivity, subject to inappropriate analysis of the data. In addition, the studies bring several instruments without standardization for assessing sensory modalities. Conclusion: The objective assessment is a complement to the subjective assessment, using the touch assessment as the main parameter in the profile of the facial peripheral integrity, associated or not with nociceptive assessment. Lack of consensus on the indication of specific instruments for testing is a limiting factor. Thus, based on the studies, is proposed a minimum battery of sensitivity assessment to obtain an overview of the patient's peripheral nervous situation

Comunicação Aumentativa e Alternativa e Habilidades de Linguagem de Crianças com Paralisia Cerebral: uma Revisão Sistemática / Augmentative and Alternative Communication and Language Skills of Children with Cerebral Palsy: a Systematic Review

RESUMO: O objetivo deste artigo foi identificar quais os sistemas de comunicação aumentativa e alternativa interferem nas habilidades de linguagem de crianças com paralisia cerebral. A questão norteadora foi: Quais os métodos de comunicação aumentativa e alternativa interferem nas habilidades de linguagem de crianças com paralisia cerebral? A população foi delimitada como crianças com diagnóstico médico de paralisia cerebral. Considerou-se comunicação aumentativa e/ou alternativa como intervenção. Habilidades comunicativas foram consideradas o desfecho. Foram selecionados artigos nas bases Medline, The Cochrane Central Register of Controlled Trials e EMBASE e em bases secundárias, por meio dos termos "Cerebral Palsy" e "Infant" e "Communication Aids for Disabled" e "Language Development". Os termos foram incluídos com seus entretermos e na língua indicada e requerida por cada base de dados. Não houve restrição de idioma, independentemente do ano de publicação até abril de 2019, que apresentassem, no título, resumo ou corpo do artigo, relação com o objetivo da pesquisa e os critérios de elegibilidade. Após a extração dos dados, as medidas foram transformadas em percentagem e descritas em uma síntese qualitativa. Foram encontrados 427 artigos nas bases de dados, sendo incluídos, após análises, seis artigos. As pranchas manuais foram as mais utilizadas pelos estudos encontrados, apesar de suas construções serem realizadas por meio de sistema simbólico computadorizado. Em todos os estudos encontrados, foram identificadas melhoras das habilidades comunicativas das crianças, independentemente do recurso e do modo de acesso utilizados. Todos os métodos de comunicação aumentativa e/ou alternativa utilizados nos estudos, apresentaram benefícios para as habilidades comunicativas de crianças com paralisia cerebral

ABSTRACT: The aim of this paper was to identify which augmentative and alternative communication systems interfere with the language skills of children with cerebral palsy. The guiding question was: What augmentative and alternative communication methods interfere with the language skills of children with cerebral palsy? The population was defined as children with a medical diagnosis of cerebral palsy. Augmentative and/or alternative communication was considered as an intervention. Communicative skills were considered the outcome. Papers were selected in Medline, The Cochrane Central Register of Controlled Trials and EMBASE and in secondary databases, using the terms "Cerebral Palsy" and "Infant" and "Communication Aids for Disabled" and "Language Development". The terms were included with their related terms and in the language indicated and required by each database. There was no language restriction, regardless of the year of publication until April 2019, which presented in the title, abstract or body of the article a relation with the research objective and the eligibility criteria. After data extraction, the measurements were transformed into percentages and described in a qualitative synthesis. Four hundred and twenty-seven articles were found in the databases, and after analysis 6 articles were included. The hand planks were the most used by the studies found, although their constructions were made through a computerized symbolic system. In all studies found, improvements in children's communication skills were identified, regardless of the resource and mode of access used. All augmentative and/or alternative communication methods used in the studies showed benefits for the communicative skills of children with cerebral palsy.

Vulnerabilidade comunicativa em pacientes de cuidado intensivo: considerações das estratégias de atuação do fonoaudiólogo na pandemia / Communicative vulnerability on intensive patients: speech therapy strategies during the pandemic / Vulnerabilidad comunicativa en pacientes de cuidados intensivos: consideraciones de las estrategias operativas del fonoaudiólogo en pandemia

A comunicação garante autonomia do indivíduo em qualquer ambiente, e tratando-se do ambiente hospitalar, é um direito assegurado pelos principais órgãos de saúde. Porém, o que se percebe, muitas vezes, é um comportamento não assertivo por parte do profissional de saúde, resultando em comunicação não adequada e potencialmente devastadora para o paciente. A vulnerabilidade comunicativa é qualquer falha na comunicação entre o paciente e seu interlocutor, levando à desautorização ou privação do indivíduo em participar da sua recuperação. Assim, uma comunicação efetiva entre o profissional de saúde, o paciente e sua família deve levar em conta a compreensão do que lhe é dito e a oportunidade de se expressar. Atualmente, cerca de 23% dos infectados com o novo coronavírus (COVID-19) necessitam de cuidados intensivos e o manejo desses pacientes pode incluir intubação orotraqueal, ventilação mecânica e outros procedimentos cirúrgicos. O quadro clínico gerado pela infecção pode levar cerca de um quarto dos infectados à vulnerabilidade comunicacional, caracterizada pela impossibilidade de se expressar verbalmente, mesmo em estado consciente. Assim, a atuação do fonoaudiólogo no manejo dos distúrbios de comunicação do paciente crítico torna-se imprescindível, utilizando estratégias de intervenção que possam ampliar ou substituir a expressão verbal. Uma destas estratégias é a Comunicação Suplementar e Alternativa (CSA), que busca compensar prejuízos e incapacidades de sujeitos com impedimento ou dificuldade de fala, por meio de instrumentos que possibilitam a comunicação não-oralizada. Sua utilização no contexto hospitalar pode contribuir para o bem-estar do paciente, gerando uma melhor interação entre ele e a equipe cuidadora.

The effect of noise on attention and performance in reading and writing tasks.

PURPOSE: This study investigated the effects of two levels of noise on the performance of young students of three educational levels and tested their ability to maintain attentional focus in reading and writing tasks. METHODS: 162 school children in the third, fourth and fifth grades were placed in three groups according to their educational level: Control Group (CG), Experimental Group A (GEA) and Experimental Group B (GEB). All groups were submitted to a Sustained Attention Test, Reading Assessment and Isolated Words Test and Writing Dictation Sub-test (part of the International Dyslexia Test). The GEA and GEB performed the tests in a noisy environment: 20dB and 40dB, respectively. The CG was assessed in the usual school environmental noise at the same time of the day. The data was submitted to an ANOVA, the Kruskal-Wallis test and Spearman correlation test. RESULTS: The higher the score on the Sustained Attention Test, the shorter the time spent reading and fewer errors in the dictation task. There were no differences across the three grades within the GEA (lower levels of noise) with regard to the effect of noise on attention and in the reading and writing task performance. The higher levels of noise for the GEB, however, decreased the attention levels, therefore increasing mistakes on the dictation test. Comparing the performance across educational levels on the reading tasks, the fourth grade presented decreased reading time, while the third and fifth grades spent more time reading. CONCLUSION: Auditory interference can influence the ability to focus attention as well as worsen performance in reading and writing tasks at more intense noise levels.

Influence of Masticatory Behavior on Muscle Compensations During the Oral Phase of Swallowing of Smokers

Abstract Introduction Chewing and swallowing are physiologically interconnected functions, which share motor structures and supranuclear regions of the central nervous system (CNS), involving a sensorimotor synchrony. Objective To analyze the influence of masticatory behavior on muscular compensations in the oral phase of swallowing in smokers compared with nonsmokers. Methods A cross-sectional study comparing smokers and nonsmokers composed of 24 participants in each group. The aspects of food crunching, masticatory pattern, masticatory speed, atypical muscular contractions, and lip closure were analyzed during mastication. In swallowing, aspects of contraction of the orbicular and mental muscles, head movement and presence of deglutition, mastication, smoking, and of stomatognathic system of residues after swallowing were characterized. Results Statistically significant differences were identified between the study groups related to food grinding pattern, masticatory velocity, and mental contraction during swallowing. There was no significant association between masticatory function and compensations during swallowing. Conclusion Differences were observed in the pattern of chewing and swallowing in smokers compared with nonsmokers, but no influence of masticatory performance was observed in the presence of muscle compensations during the oral phase of swallowing.

Influence of Masticatory Behavior on Muscle Compensations During the Oral Phase of Swallowing of Smokers.

Introduction Chewing and swallowing are physiologically interconnected functions, which share motor structures and supranuclear regions of the central nervous system (CNS), involving a sensorimotor synchrony. Objective To analyze the influence of masticatory behavior on muscular compensations in the oral phase of swallowing in smokers compared with nonsmokers. Methods A cross-sectional study comparing smokers and nonsmokers composed of 24 participants in each group. The aspects of food crunching, masticatory pattern, masticatory speed, atypical muscular contractions, and lip closure were analyzed during mastication. In swallowing, aspects of contraction of the orbicular and mental muscles, head movement and presence of deglutition, mastication, smoking, and of stomatognathic system of residues after swallowing were characterized. Results Statistically significant differences were identified between the study groups related to food grinding pattern, masticatory velocity, and mental contraction during swallowing. There was no significant association between masticatory function and compensations during swallowing. Conclusion Differences were observed in the pattern of chewing and swallowing in smokers compared with nonsmokers, but no influence of masticatory performance was observed in the presence of muscle compensations during the oral phase of swallowing.

Orofacial myofunctional profile of patients with sleep disorders: relationship with result of polysomnography. / Perfil miofuncional orofacial de pacientes com distúrbios do sono: relação com resultado da polissonografia.

PURPOSE: This study aims to characterize the orofacial myofunctional profile of patients with sleep disorders and to relate them to the severity of the polysomnography result. METHODS: A cross-sectional, field study of patients referred to polysomnography with a random sample of adult patients of both genders complaining of snoring who were not receiving any form of treatment for sleep disorder. An anthroposcopic speech-language evaluation was performed and the results of the polysomnography examination were collected in order to respond to the objectives of the study. RESULTS: There was a significant association between the severity of the sleep disorder and environmental variables, such as smoking and alcoholism; also with individual characteristics, such as race, body mass index, waist circumference and systemic arterial hypertension. From the point of view of the myofunctional characteristics, there was a positive relationship between the severity of Obstructive Sleep Apnea and Hypopnea Syndrome with mental muscle contraction, Mallampati class, tongue dorsum elevation, tongue thickness, uvula characteristics, extension and mobility of the soft palate, and alteration in the respiratory pattern. CONCLUSION: This study made it possible to describe a trend of the existence of orofacial myofunctional alterations in individuals with Sleep Apnea and Obstructive Hypopnea Syndrome and also revealed that the greater the degree of impairment of orofacial structures, the greater the degree of disturbance is also revealed.

OBJETIVO: Este trabalho se propõe a caracterizar o perfil miofuncional orofacial de pacientes com distúrbios do sono e relacionar esses com a gravidade do resultado da polissonografia. MÉTODO: Estudo transversal, de campo, realizado com pacientes encaminhados para polissonografia, com amostra aleatória, composta por pacientes adultos, de ambos os gêneros, com queixa de ronco e que não estivessem recebendo alguma forma de tratamento para o distúrbio do sono. Foi realizada avaliação fonoaudiológica antroposcópica e coletado o resultado do exame de polissonografia, a fim de responder aos objetivos do trabalho. RESULTADOS: Verificou-se associação significativa entre a gravidade do distúrbio de sono e variáveis ambientais, tais como tabagismo e etilismo; também com características individuais, tais como raça, índice de massa corporal, circunferência abdominal e hipertensão arterial sistêmica. Do ponto de vista das características miofuncionais, verificou-se relação positiva entre a gravidade da Síndrome da Apneia e Hipopneia Obstrutiva do Sono com a contração do músculo mentual, classe de Mallampati, elevação de dorso de língua, espessura de língua, características da úvula, extensão e mobilidade de palato mole, e alteração no padrão respiratório. CONCLUSÃO: A pesquisa possibilitou descrever uma tendência da existência de alterações miofuncionais orofaciais em indivíduos com Síndrome da Apneia e Hipopneia Obstrutiva do Sono e revelou, ainda, que quanto maior o grau de comprometimento das estruturas orofaciais, maior também se revela o grau do distúrbio.

Perfil miofuncional orofacial de pacientes com distúrbios do sono: relação com resultado da polissonografia / Orofacial myofunctional profile of patients with sleep disorders: relationship with result of polysomnography

RESUMO Objetivo Este trabalho se propõe a caracterizar o perfil miofuncional orofacial de pacientes com distúrbios do sono e relacionar esses com a gravidade do resultado da polissonografia. Método Estudo transversal, de campo, realizado com pacientes encaminhados para polissonografia, com amostra aleatória, composta por pacientes adultos, de ambos os gêneros, com queixa de ronco e que não estivessem recebendo alguma forma de tratamento para o distúrbio do sono. Foi realizada avaliação fonoaudiológica antroposcópica e coletado o resultado do exame de polissonografia, a fim de responder aos objetivos do trabalho. Resultados Verificou-se associação significativa entre a gravidade do distúrbio de sono e variáveis ambientais, tais como tabagismo e etilismo; também com características individuais, tais como raça, índice de massa corporal, circunferência abdominal e hipertensão arterial sistêmica. Do ponto de vista das características miofuncionais, verificou-se relação positiva entre a gravidade da Síndrome da Apneia e Hipopneia Obstrutiva do Sono com a contração do músculo mentual, classe de Mallampati, elevação de dorso de língua, espessura de língua, características da úvula, extensão e mobilidade de palato mole, e alteração no padrão respiratório. Conclusão A pesquisa possibilitou descrever uma tendência da existência de alterações miofuncionais orofaciais em indivíduos com Síndrome da Apneia e Hipopneia Obstrutiva do Sono e revelou, ainda, que quanto maior o grau de comprometimento das estruturas orofaciais, maior também se revela o grau do distúrbio.

ABSTRACT Purpose This study aims to characterize the orofacial myofunctional profile of patients with sleep disorders and to relate them to the severity of the polysomnography result. Methods A cross-sectional, field study of patients referred to polysomnography with a random sample of adult patients of both genders complaining of snoring who were not receiving any form of treatment for sleep disorder. An anthroposcopic speech-language evaluation was performed and the results of the polysomnography examination were collected in order to respond to the objectives of the study. Results There was a significant association between the severity of the sleep disorder and environmental variables, such as smoking and alcoholism; also with individual characteristics, such as race, body mass index, waist circumference and systemic arterial hypertension. From the point of view of the myofunctional characteristics, there was a positive relationship between the severity of Obstructive Sleep Apnea and Hypopnea Syndrome with mental muscle contraction, Mallampati class, tongue dorsum elevation, tongue thickness, uvula characteristics, extension and mobility of the soft palate, and alteration in the respiratory pattern. Conclusion This study made it possible to describe a trend of the existence of orofacial myofunctional alterations in individuals with Sleep Apnea and Obstructive Hypopnea Syndrome and also revealed that the greater the degree of impairment of orofacial structures, the greater the degree of disturbance is also revealed.

The effect of noise on attention and performance in reading and writing tasks / Interferência do ruído no foco atencional e no desempenho em testes de leitura e escrita

ABSTRACT Purpose This study investigated the effects of two levels of noise on the performance of young students of three educational levels and tested their ability to maintain attentional focus in reading and writing tasks. Methods 162 school children in the third, fourth and fifth grades were placed in three groups according to their educational level: Control Group (CG), Experimental Group A (GEA) and Experimental Group B (GEB). All groups were submitted to a Sustained Attention Test, Reading Assessment and Isolated Words Test and Writing Dictation Sub-test (part of the International Dyslexia Test). The GEA and GEB performed the tests in a noisy environment: 20dB and 40dB, respectively. The CG was assessed in the usual school environmental noise at the same time of the day. The data was submitted to an ANOVA, the Kruskal-Wallis test and Spearman correlation test. Results The higher the score on the Sustained Attention Test, the shorter the time spent reading and fewer errors in the dictation task. There were no differences across the three grades within the GEA (lower levels of noise) with regard to the effect of noise on attention and in the reading and writing task performance. The higher levels of noise for the GEB, however, decreased the attention levels, therefore increasing mistakes on the dictation test. Comparing the performance across educational levels on the reading tasks, the fourth grade presented decreased reading time, while the third and fifth grades spent more time reading. Conclusion Auditory interference can influence the ability to focus attention as well as worsen performance in reading and writing tasks at more intense noise levels.

RESUMO Objetivo Investigar os efeitos de dois níveis de ruído sobre tarefas de atenção e de escrita e leitura em estudantes de três níveis de escolaridade. Método 162 sujeitos entre o 3º, 4º e 5º ano do Ensino Fundamental foram alocadas em três grupos conforme a escolaridade: controle (GC), experimental A (GEA) e experimental B (GEB). Todos os grupos foram submetidos aos testes de Atenção Concentrada de Cambraia; Avaliação de Leitura e Palavras Isoladas; Subteste Escrita sob Ditado do International Dyslexia Test. Os grupos GEA e GEB realizaram os testes em ambiente com ruídos de 20 dB e 40dB respectivamente. Os resultados foram analisados com teste de Kruskal-Wallis e correlação de Spearman com significância em 5%. Resultados Foi observado que quanto maior o escore no teste de atenção, menor o tempo gasto na leitura e menor o número de erros no ditado. Não houve diferenças nos três anos de escolaridade para o grupo GEA quanto à influência do ruído sobre a atenção e o desempenho de leitura e escrita. O grupo GEB apresentou decréscimo nos testes de atenção com aumento de erros no ditado. Comparando a escolaridade no teste de leitura, o 4º ano diminuiu o tempo de leitura enquanto os sujeitos dos 3º e 5º ano gastaram mais tempo de leitura. Conclusão A interferência auditiva é capaz de influenciar a capacidade de foco de atenção assim como o desempenho de leitura e de escrita em níveis de ruído mais intenso. Não foram observadas influências da escolaridade sobre os efeitos distratores.

Tobacco Influence on Taste and Smell: Systematic Review of the Literature

Abstract Introduction In Brazil, estimates show that 14.7% of the adult population smokes, and changes in smell and taste arising from tobacco consumption are largely present in this population, which is an aggravating factor to these dysfunctions. Objectives The objective of this study is to systematically review the findings in the literature about the influence of smoking on smell and taste. Data Synthesis Our research covered articles published from January 1980 to August 2014 in the following databases: MEDLINE (accessed through PubMed), LILACS, Cochrane Library, and SciELO.We conducted separate lines of research: one concerning smell and the other, taste. We analyzed all the articles that presented randomized controlled studies involving the relation between smoking and smell and taste. Articles that presented unclear methodologies and those whose main results did not target the smell or taste of the subjects were excluded. Titles and abstracts of the articles identified by the research strategy were evaluated by researchers. We included four studies, two of which were exclusively about smell: the first noted the relation between the perception of puff strength and nicotine content; the second did not find any differences in the thresholds and discriminative capacity between smokers and nonsmokers. One article considered only taste and supports the relation between smoking and flavor, another considered both sensory modalities and observes positive results toward the relation immediately after smoking cessation. Conclusion Three of the four studies presented positive results for the researched variables.

Intervenções e Metodologias Empregadas no Ensino da Escrita e Leitura de Indivíduos Surdos: Revisão de Literatura / Interventions and Methodologies Used in Teaching Reading and Writing to Deaf Individuals: a Literature Review

RESUMOO texto teve como objetivo verificar, na literatura disponível, intervenções/metodologias aplicadas no processo de aprendizagem da escrita por indivíduos surdos. Os dados foram coletados nas bases de dados Lilacs e SciELO, foram feitas buscas utilizando os seguintes termos de pesquisa: "leitura", "escrita", "aprendizagem", "distúrbios de aprendizagem" e "bilinguismo", sempre associados a "surdez". Os resumos dos textos encontrados foram lidos, tendo sido excluídos aqueles: cuja publicação excedesse há 10 anos; cujo objetivos/metodologia não privilegiassem abordagens metodológicas/ de intervenção para o ensino da língua escrita pelo surdo. Dos textos selecionados foram discutidas as intervenções realizadas e resultados apresentados. Os resultados indicaram que a maioria dos estudos acredita na língua de sinais sendo a língua materna do surdo, e que esta será utilizada como base para a escrita dos sujeitos surdos. Estratégias facilitadoras para aquisição da escrita foram apontadas, como: utilização de métodos visuais (textos escritos, imagens, dramatizações etc.); conversas, de forma a proporcionar o uso social da escrita; utilização de assuntos que interessem ao surdo; adequação espacial da sala de aula pelo professor, tornando-a mais favorável a situações de comunicação. Constata-se, assim, que os estudos têm pensado em melhorias para o ensino/intervenção na escrita de sujeitos surdos e que a Fonoaudiologia mostrou que está se inserindo nessa área tanto clinicamente como em pesquisas.

ABSTRACTThe purpose of this paper is to determine, in the available literature, interventions/methodologies in the learning process of writing by deaf individuals. The collection was carried out in the LILACS and SCIELO databases; the following search terms were used: "reading", "writing", "learning", "learning disorders" and "bilingualism", always associated with "deafness ". The abstracts of the texts were read, and the following criteria were used for exclusion purposes: those published more than 10 years ago, objectives/methodology that did not favor methodological approaches/intervention for teaching written language to deaf students. Of the selected studies, interventions were discussed and results presented. The results indicated that most authors believe in sign language as the mother tongue of the deaf, and sign language will be the basis for writing for deaf subjects. Strategies to facilitate the acquisition of writing have been identified as: use of visual methods (written texts, pictures, dramatization); conversations in order to provide the social function of writing, use of matters of interest to the deaf; the teacher making the classroom space more conducive to communication situations. It appears, therefore, that studies have been thinking about improvements to teaching/intervention focusing on teaching writing to the deaf, and, furthermore speech language therapy seems to be coming into this area, both clinically and in research.

Phonemic discrimination and the relationship with other linguistic levels in children with typical phonological development and phonological disorder.

PURPOSE: To compare children with typical language development (TLD) and evolutional phonological disorder (EPD) regarding the phonemic discrimination and the linguistic performance of language levels (morphological, syntactic, semantic, and perceptual and productive vocabulary). METHODS: The sample comprised 36 children, aged between 5 years and 7 years and 11 months, with TLD and EPD. Children with EPD were awaiting care in the speech units of two higher education institutions and children with TLD were screened in public schools. For inclusion in the study, the criteria were the following: being authorized by the informed consent and being within the required age group. After the inclusion of children, all subjects underwent the phonemic discrimination test with figures, to the average phrase value test, which assesses the morphosyntactic and semantic/lexical aspects, and the expressive vocabulary test. For statistical evaluation of the influence of variables, Spearman's nonparametric correlation coefficient was used, and for comparison between the groups regarding evaluation performance, Mann-Whitney test was used. RESULTS: Only children with EPD showed influence of phonemic discrimination in other linguistic levels. In addition, a significant difference was observed between the performances of both groups in relation to the phonemic discrimination, vocabulary, and all levels assessed in the questions and description modality. CONCLUSION: The comparison between both groups showed a statistically significant difference in phonemic discrimination and morphosyntactic and lexical/semantic development, with better performance in the TLD group.

Utilização de Softwares por Fonoaudiólogos no Rio Grande do Sul / Use of Softwares for Speech Language Pathologists in Rio Grande do Sul / El uso de softwares por Fonoaudiologos en Rio Grande do Sul

Averiguar a utilização de softwares na prática dos fonoaudiólogos no Rio Grande do Sul. Métodos: Realizou-se um estudo transversal, com os fonoaudiólogos registrados no conselho regional de fonoaudiologia da 7a região, com aplicação de um questionário on line, onde se obteve dados sobre: formação; cidades e áreas de atuação; objetivos e reação dos pacientes quanto ao uso dos softwares na prática clínica. Resultados: Dos dados coletados, verificou-se que 62,5% profissionais utilizam softwares, sendo a maioria localizada na região metropolitana e Porto Alegre. As especialidades mais citadas na utilização de softwares foram linguagem, motricidade orofacial, disfagia e audiologia, com principal finalidade terapêutica, havendo uma boa aceitação pelos pacientes. Conclusão: Foi possível demostrar que a utilização de softwares pelos fonoaudiólogos no Rio Grande do Sul contribui no processo terapêutico, baseando-se em uma metodologia diferenciada da prática convencional, uma vez que apresenta uma boa receptividade pelos pacientes...

To investigate the use of software in the practice of for Speech Language Pathologists in Rio Grande do Sul. Methods: A cross-sectional study was conducted, with the for Speech Language Pathologists registered in the regional council of the 7th region, with application of an online survey, which was analyzed: instruction; cities and areas of working; objectives and reaction of patients to use the software in clinical practice. Results: From the data collected, it was found that 62.5% professionals use software in their practice, with the majority located in the metropolitan region and Porto Alegre city. The specialties most often cited is the use of software was language orofacial myology, dysphagia and audiology, with main therapeutic purpose, with good patient acceptance. Conclusion: It was possible to demonstrate that the use of software by Speech Language Pathologists in Rio Grande do Sul contributes to the therapeutic process, based on a different methodology from conventional practice, since it provides a good reception by patients...

Investigar el uso de software en la práctica del Fonoaudiólogo en Rio Grande do Sul. Métodos: Se realizo un estudio transversal, con los Fonoaudiólogos registrados en el consejo regional de la séptima región, con la aplicación de un cuestionario on line, que revelo: la formación; ciudades y áreas de actuación; objetivos y reacción de los pacientes a utilizar el software en la práctica clínica. Resultados: A partir de los datos, se encontró que 62,5% de los profesionales usan software, con su mayoría ubicados en la región metropolitana y Porto Alegre. Las especialidades más frecuentemente citado en el uso de software fueron lenguaje, motricidad orofacial, disfagia y audiología, con finalidad terapéutica principal, con buena aceptación del paciente. Conclusión: Se ha podido demostrar que el uso de software por fonoaudiólogos en Rio Grande do Sul contribuye al proceso terapéutico, basado en una metodología diferente de la práctica convencional, ya que ofrece una buena recepción por parte de los pacientes...

Phonemic discrimination and the relationship with other linguistic levels in children with typical phonological development and phonological disorder / Discriminação fonêmica e a relação com os demais níveis linguísticos em crianças com desenvolvimento fonológico típico e com desvio fonológico evolutivo

PURPOSE: To compare children with typical language development (TLD) and evolutional phonological disorder (EPD) regarding the phonemic discrimination and the linguistic performance of language levels (morphological, syntactic, semantic, and perceptual and productive vocabulary). METHODS: The sample comprised 36 children, aged between 5 years and 7 years and 11 months, with TLD and EPD. Children with EPD were awaiting care in the speech units of two higher education institutions and children with TLD were screened in public schools. For inclusion in the study, the criteria were the following: being authorized by the informed consent and being within the required age group. After the inclusion of children, all subjects underwent the phonemic discrimination test with figures, to the average phrase value test, which assesses the morphosyntactic and semantic/lexical aspects, and the expressive vocabulary test. For statistical evaluation of the influence of variables, Spearman's nonparametric correlation coefficient was used, and for comparison between the groups regarding evaluation performance, Mann-Whitney test was used. RESULTS: Only children with EPD showed influence of phonemic discrimination in other linguistic levels. In addition, a significant difference was observed between the performances of both groups in relation to the phonemic discrimination, vocabulary, and all levels assessed in the questions and description modality. CONCLUSION: The comparison between both groups showed a statistically significant difference in phonemic discrimination and morphosyntactic and lexical/semantic development, with better performance in the TLD group. .

OBJETIVO: Comparar crianças com desenvolvimento típico de linguagem (DTL) e com desvio fonológico evolutivo (DFE) quanto à discriminação fonêmica e ao desempenho linguístico dos níveis da linguagem (morfológico, sintático, semântico e vocabulários perceptivo e produtivo). MÉTODOS: A amostra foi constituída por 36 crianças, com idades de 5 a 7 anos e 11 meses e com DTL e com DFE. As crianças com DFE aguardavam atendimento nos setores de fala de duas Instituições de Ensino Superior (IES) e as crianças com DTL foram triadas em escolas públicas. Para a inclusão na pesquisa, os critérios foram: autorização pelo Termo de Consentimento Livre e Esclarecido (TCLE), ter a idade estipulada e ter DTL. Após a inclusão das crianças, todos os sujeitos foram submetidos ao teste de figuras para discriminação fonêmica (TFDF), ao teste média de valores de frases (MVF), que avalia os aspectos morfossintáticos e semânticos/lexicais, e ao teste de vocabulário expressivo (TVExp). Para avaliação estatística da influência das variáveis, foi realizado o coeficiente de correlação não paramétrico de Spearman, e para a comparação dos grupos em relação aos desempenhos das avaliações, o teste U de Mann-Whitney. RESULTADOS: Somente as crianças com DFE apresentaram influência da discriminação fonêmica nos demais níveis linguísticos. Além disso, há uma diferença significativa entre os desempenhos dos grupos DTL e DFE em relação a discriminação fonêmica, vocabulário e todos os níveis avaliados na modalidade perguntas e descrição. CONCLUSÃO: A comparação entre os dois grupos mostrou que há diferença estatisticamente significativa em relação à discriminação fonêmica e ao desenvolvimento morfossintático e semântico/lexical, com melhor desempenho no grupo com DTL. .

Medidas faciais em indivíduos adultos sem queixas orofaciais: compatibilidade entre medidas antropométricas e percepção facial / Facial measurements in adults with no orofacial complaints: compatibility between anthropometric measurements and facial perception

OBJETIVO: verificar a compatibilidade entre os achados de medidas faciais mensuradas pelo paquímetro e a percepção das características faciais realizada subjetivamente por um avaliador experiente. MÉTODOS: foram avaliados 24 sujeitos do sexo feminino e 24 do sexo masculino, pareados por sexo e idade, sem queixas morfológicas e funcionais do sistema estomatognático. Foram avaliados os aspectos de simetria entre os terços médio e inferior, altura e largura da face, e canto externo dos olhos direito e esquerdo às comissuras do lábio direita e esquerda, respectivamente. Cada medida foi realizada três vezes por paquímetro digital para consideração da média entre estes valores, considerando-se assimétricas comparações com diferenças superiores à 4 milímetros. A largura da face foi obtida por meio do paquímetro digital adaptado com prolongamento de 10 centímetros. Já a avaliação da percepção das características faciais foi realizada por um avaliador cegado quanto às medidas obtidas, devendo assinalar simetrias e assimetrias nestes mesmos aspectos avaliativos. RESULTADOS: por meio do teste de concordância de Kappa e Qui-quadrado, pode-se verificar uma boa compatibilidade entre as avaliações realizadas, demonstrando-se a fidedignidade entre os métodos utilizados. Além disso, verificou-se que existe uma relação entre a simetria dos terços da face e a atribuição da tipologia facial na avaliação perceptiva, observando-se simetria em faces médias e curtas e ausência de um padrão determinante para faces longas. CONCLUSÃO: a caracterização da simetria facial por paquímetro apresenta uma boa compatibilidade com a percepção subjetiva de um avaliador experiente. .

PURPOSE: to verify the compatibility between findings of facial measurements by caliper and perception of facial features made ​​subjectively by an experienced evaluator. METHODS: 24 female and 24 male subjects, paired for sex and age, without morphological and functional complaints of the stomatognathic system were evaluated. Aspects of symmetry between the middle and lower thirds, height and width of the face, and outer corner of the right and left eyes to the corners of the right and left respectively lip were evaluated. Each measurement was performed three times by a digital caliper to consider the average of these values, considering asymmetric comparisons with differences more than 4 millimeters. The width of the face was obtained through digital caliper fitted with extension 10 centimeters. The evaluation of the perception of facial features was performed by a blinded evaluator as to the digital caliper measurements that should point symmetries and asymmetries in these same evaluative aspects. RESULTS: through the agreement Kappa and Chi- square test, it was possible to verify proper compatibility between the assessments, demonstrating the reliability of the methods used. Furthermore, it was found that there is a relationship between symmetry thirds of the face and assignment of facial typology on the perceptual evaluation, observing symmetry in medium and short faces and absence of a decisive standard for long faces. CONCLUSION: the characterization of facial symmetry by a digital caliper has a good compatibility with the subjective perception of an experienced evaluator. .

Risk factors for proper oral language development in children: a systematic literature review.

PURPOSE: To conduct a systematic review of literature production related to risk factors for proper oral language development in children. METHODS: We used the terms "child language," "risk factors," and "randomized controlled trial" in MEDLINE (accessed via PubMed), Lilacs, SciELO, and The Cochrane Library from January 1980 to February 2014. Randomized controlled trials involving the study of some risk factors related to child language were included. Works with individuals who were not from the age group 0-12 years and presented no reliable definition of risk factors were excluded. The research findings were classified according to their theme and categorized methodological aspects. RESULTS: We observed the lack of a standardized list of risk factors for language available for health professionals. The main risk factor mentioned was family dynamics, followed by interaction with parents, immediate social environment, and encouragement given to the child in the first years of life. It was also observed that organic hazards such as brain injury, persistent otitis media, and cardiac surgery, besides the type of food and parental counseling, may be related to language disorders. CONCLUSION: More randomized controlled trials involving the evaluation of risk factors for child language and the creation of further studies involving children above 6 years of age and males are needed.

Risk factors for proper oral language development in children: a systematic literature review / Fatores de risco para o desenvolvimento adequado da linguagem oral em crianças: uma revisão sistemática da literatura

Purpose: To conduct a systematic review of literature production related to risk factors for proper oral language development in children. Methods: We used the terms "child language," "risk factors," and "randomized controlled trial" in MEDLINE (accessed via PubMed), Lilacs, SciELO, and The Cochrane Library from January 1980 to February 2014. Randomized controlled trials involving the study of some risk factors related to child language were included. Works with individuals who were not from the age group 0–12 years and presented no reliable definition of risk factors were excluded. The research findings were classified according to their theme and categorized methodological aspects. Results: We observed the lack of a standardized list of risk factors for language available for health professionals. The main risk factor mentioned was family dynamics, followed by interaction with parents, immediate social environment, and encouragement given to the child in the first years of life. It was also observed that organic hazards such as brain injury, persistent otitis media, and cardiac surgery, besides the type of food and parental counseling, may be related to language disorders. Conclusion: More randomized controlled trials involving the evaluation of risk factors for child language and the creation of further studies involving children above 6 years of age and males are needed. .

Objetivo: Este artigo tem como objetivo realizar uma revisão sistemática da produção bibliográfica relacionada aos fatores de risco para o desenvolvimento adequado da linguagem oral em crianças. Estratégia de pesquisa: Utilizaram-se os termos "child language", "risk factors" e "randomized controlled trial" nas bases de dados MEDLINE (acessado via PubMed), LILACS, Biblioteca Cochrane e SciELO, durante o período de janeiro de 1980 a fevereiro de 2014. Critérios de seleção: Foram incluídos ensaios controlados randomizados que envolvessem o estudo de algum fator de risco relacionado à linguagem de crianças. Foram excluídos trabalhos com indivíduos que não tivessem entre 0 e 12 anos e apresentassem definição não confiável de fator de risco. Análise dos dados: Os achados da pesquisa foram classificados de acordo com o tema investigado e os aspectos metodológicos categorizados. Resultados: Observou-se a inexistência de algum tipo de lista padronizada de fatores de risco para a linguagem disponível aos profssionais da saúde. O principal fator de risco apontado foi a dinâmica familiar, seguido da interação com os pais, o ambiente social imediato e o estímulo dado à criança nos primeiros anos de vida. Observou-se também que os riscos orgânicos, como lesão cerebral, otite média persistente e cirurgia cardíaca, além do tipo de alimentação e aconselhamento parental, podem estar relacionados aos transtornos de linguagem. Conclusão: São necessários mais ensaios clínicos controlados randomizados envolvendo a verificação dos fatores de risco para a linguagem em crianças e a criação de mais estudos envolvendo crianças acima dos 6 anos de idade e do sexo masculino.

Avaliação simplificada e comportamental do processamento auditivo em escolares: estabelecendo relações / Auditory processing screening and behavioral evaluation in students: establishing relations

Objetivo caracterizar o processamento auditivo de escolares que falharam na avaliação simplificada do processamento auditivo e comparar esses achados com os resultados na avaliação comportamental do processamento auditivo. Métodos realizou-se a avaliação audiológica básica (audiometria tonal e vocal e medidas de imitância acústica), bateria comportamental do processamento auditivo composta pelos testes PSI (Pediatric Speech Intelligibility) versão em português, PPS (Pitch Pattern Sequence), MLD (Masking Level Difference), SSW (Stagged Spondaic Words) versão em português e GIN (Gap in Noise) e reteste da avaliação simplificada do processamento auditivo com escolares de 9 a 14 anos, matriculados entre o 4º ano e a 8ª série do ensino fundamental de uma escola de ensino público de Porto Alegre. Resultados dos 11 escolares avaliados que falharam na avaliação simplificada, 10 (90,9%) apresentaram alterações na bateria comportamental do processamento auditivo. Os subperfis com maior número de alterações foram os de decodificação e integração, as habilidades auditivas mais prejudicadas foram de interação binaural e separação e integração binaural concomitantemente. Não houve associação significante entre as tarefas da avaliação simplificada e os testes da bateria comportamental ao comparar o mesmo correlato neurofisiológico ou tarefa semelhante. Conclusão foi possível caracterizar o processamento auditivo dos escolares avaliados. A partir da comparação entre a avaliação simplificada e a bateria comportamental verificou-se que a avaliação simplificada pode ser um preditor sensível às alterações de processamento auditivo, apesar de não se identificar as...

Purpose to characterize the auditory processing of students who failed in the simplified evaluation of the auditory processing and compare these found results with the results in the behavioral auditory processing evaluation. Methods it was performed the basic audiological evaluation (vocal and tonal audiometry and acoustic immitance measurements), the behavioral battery of the auditory processing, composed by the PSI (Pediatric Speech Intelligibility) portuguese version, PPS (Pitch Pattern Sequence), MLD (Masking Level Difference), SSW (Stagged Spondaic Words) portuguese version and GIN (Gap in Noise), and the retest of the simplified evaluation of the auditory processing with students from nine to fourteen years old registered between 4th to 8th grade of a public school in Porto Alegre. Results ten (90,9%) out of the eleven evaluated students that failed in the simplified evaluation showed alterations in the behavioral battery of auditory processing tests. The subprofiles which had the major number of alterations were the ones of decoding and integration, the most impaired auditory abilities were binaural interaction and separation and binaural integration concomitantly. There was no relevant association between the tasks of the simplified evaluation and the tests of the behavioral battery when comparing the same neuralphisiological report or similar task. Conclusion it was possible to characterize the auditory processing of the analyzed students. From the comparison between the simplified evaluation and the behavioral battery it was noted that the simplified evaluation can be a sensible predictor to the alterations of the auditory processing, in spite of not identifying the specific association between the compared abilities. .

Influence of gustatory and olfactory perception in the oral phase of swallowing in smokers.

PURPOSE: To analyze the difference between nonsmokers and smokers on the changes in the perceptions of smell and taste and to verify the influence of these aspects in the emergence of compensatory movements during swallowing. METHODS: To evaluate these aspects, capabilities of olfactory and gustatory recognition were observed, as well as the compensation swallowing. Twenty-four patients were evaluated in each study group aged from 18 years, grouped in a stratified way. The olfactory evaluation consisted in presenting seven essences and one of three options should be chosen. For the taste test, 16 flavors were offered in a non-sequential and decreasing way in amount of solute. Swallowing solid and liquid was evaluated, in which aspects of compensation perioral muscles were observed. RESULTS: Worst performance in olfactory and gustatory tests among smokers (p≤0.01) was found. Through the results of χ2 and Fisher's exact tests, it was found that the contraction of the mentalis muscle is less observed in non-smokers, and smokers have an average degree of statistically significant change compared to nonsmokers. Furthermore, through the Spearman correlation coefficient, it was found that the worsening in the sensory tests implies increased compensation during swallowing in smokers. CONCLUSION: These data allowed us to verify that the sensory changes have influence on swallowing pattern, indicating that these changes are aspects that should be considered in the differential diagnosis of changes in swallowing.

Influence of gustatory and olfactory perception in the oral phase of swallowing in smokers / Influência da percepção olfativa e gustativa na fase oral da deglutição de indivíduos tabagistas

Purpose: To analyze the difference between nonsmokers and smokers on the changes in the perceptions of smell and taste and to verify the influence of these aspects in the emergence of compensatory movements during swallowing. Methods: To evaluate these aspects, capabilities of olfactory and gustatory recognition were observed, as well as the compensation swallowing. Twenty-four patients were evaluated in each study group aged from 18 years, grouped in a stratified way. The olfactory evaluation consisted in presenting seven essences and one of three options should be chosen. For the taste test, 16 flavors were offered in a non-sequential and decreasing way in amount of solute. Swallowing solid and liquid was evaluated, in which aspects of compensation perioral muscles were observed. Results: Worst performance in olfactory and gustatory tests among smokers (p≤0.01) was found. Through the results of χ2 and Fisher's exact tests, it was found that the contraction of the mentalis muscle is less observed in non-smokers, and smokers have an average degree of statistically significant change compared to nonsmokers. Furthermore, through the Spearman correlation coefficient, it was found that the worsening in the sensory tests implies increased compensation during swallowing in smokers. Conclusion: These data allowed us to verify that the sensory changes have influence on swallowing pattern, indicating that these changes are aspects that should be considered in the differential diagnosis of changes in swallowing. .

Objetivo: Analisar a diferença entre indivíduos não fumantes e fumantes quanto às modificações nas percepções de olfato e paladar e verificar a influência desses aspectos no aparecimento de movimentos compensatórios durante a deglutição. Métodos: Para avaliação desses aspectos, foram verificadas as capacidades de reconhecimento olfativo e gustativo, bem como as compensações de deglutição. Foram avaliados 24 indivíduos em cada grupo de estudo com idade a partir de 18 anos, agrupados de forma estratificada. A avaliação olfativa consistiu na apresentação de sete essências, devendo ser escolhida uma entre três opções. Para o teste de paladar, foram oferecidos 16 sabores de forma não sequencial e decrescente em quantidade de soluto. Foi avaliada a deglutição de sólido e líquido na qual se observaram aspectos de compensação da musculatura perioral. Resultados: Foi verificado pior desempenho nos testes olfativo e gustativo entre indivíduos tabagistas (p≤0,01). Por meio dos resultados dos testes do χ2 e exato de Fisher, foi verificado que a contração da musculatura mentual é menos observada em não fumantes, sendo que fumantes apresentam grau médio de alteração estatisticamente significativo em relação a não fumantes. Além disso, por meio do coeficiente de correlação de Spearman, verificou-se que a piora no desempenho dos testes sensoriais implica aumento de compensações durante a deglutição em indivíduos fumantes. Conclusão: Estes dados permitiram verificar que as modificações sensoriais apresentam influência no padrão de deglutição, evidenciando que essas alterações são aspectos que devem ser considerados ...