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2.
Brain ; 143(3): 862-876, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-32155246

RESUMO

Humans are uniquely able to retrieve and combine words into syntactic structure to produce connected speech. Previous identification of focal brain regions necessary for production focused primarily on associations with the content produced by speakers with chronic stroke, where function may have shifted to other regions after reorganization occurred. Here, we relate patterns of brain damage with deficits to the content and structure of spontaneous connected speech in 52 speakers during the acute stage of a left hemisphere stroke. Multivariate lesion behaviour mapping demonstrated that damage to temporal-parietal regions impacted the ability to retrieve words and produce them within increasingly complex combinations. Damage primarily to inferior frontal cortex affected the production of syntactically accurate structure. In contrast to previous work, functional-anatomical dissociations did not depend on lesion size likely because acute lesions were smaller than typically found in chronic stroke. These results are consistent with predictions from theoretical models based primarily on evidence from language comprehension and highlight the importance of investigating individual differences in brain-language relationships in speakers with acute stroke.


Assuntos
Lobo Frontal/patologia , Lobo Parietal/patologia , Distúrbios da Fala/patologia , Acidente Vascular Cerebral/patologia , Lobo Temporal/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Lateralidade Funcional , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroimagem , Distúrbios da Fala/complicações , Acidente Vascular Cerebral/complicações , Adulto Jovem
3.
Ethiop J Health Sci ; 29(5): 551-558, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31666775

RESUMO

Background: Speech impairment, which reduces Quality of Life (QOL), frequently occurs in individuals with Parkinson's disease (PD). As speaking is required for social interaction, speech impairment can reduce one's life satisfaction. Although QOL has been well-studied in individuals with PD, the QOL of their caregivers has seldom been investigated. This study compared the QOL of individuals with PD and their caregivers. The relationships between QOL, self-rated speech scale, and life satisfaction level were examined. Method: A total of 20 individuals with PD and their caregivers completed the Parkinson's disease Questionnaire-39 (PDQ-39) scale and the Life Satisfaction Scale (LSS). In addition, PD participants were asked to complete the Self-Rated Speech Scale (SRSS) to rate their speech intelligibility. Result: PD participants reported significantly lower QOL scores than their caregivers. However, there was no difference between the two groups on the social support and stigma dimensions, indicating that both groups reported similar levels of social support and stigma in their daily lives. A moderate significant correlation was observed between the LSS and PDQ-39 scores in the PD group, suggesting that life satisfaction could affect their QOL. Moreover, moderate correlation was found between the LSS and SRSS, showing that participants self-reported speech intelligibility has an impact on their life satisfaction. Conclusion: In general, individuals with PD showed lower QOL than their caregivers. Given that the SRSS, LSS and QOL are moderately correlated, identifying patients' perception on their speech intelligibility and life satisfaction could help clinicians to better understand their patients' needs when delivering speech therapy services.


Assuntos
Cuidadores/psicologia , Doença de Parkinson/complicações , Doença de Parkinson/psicologia , Satisfação Pessoal , Qualidade de Vida/psicologia , Distúrbios da Fala/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Distúrbios da Fala/psicologia , Inquéritos e Questionários
4.
Artigo em Inglês | MEDLINE | ID: mdl-31717945

RESUMO

Background: Fetal alcohol spectrum disorder (FASD) is a developmental disorder with severe negative lifetime consequences. Although knowledge about the harmfulness of alcohol consumption during pregnancy has spread, the prevalence of fetal alcohol spectrum disorder is very high. Our study aims at identifying fetal alcohol syndrome (FAS)-associated dental anomalies or habits, which need early attention. Methods: Sixty children (30 FAS; 30 controls) were examined prospectively. Swallowing pattern, oral habits, breastfeeding, speech therapy, ergotherapy, physiotherapy, exfoliation of teeth, DMFT (decayed, missing, filled teeth) index, modified DDE (developmental defects of enamel) index and otitis media were recorded. Results: Swallowing pattern, exfoliation of teeth, and otitis media were not significantly different. Significant differences could be found concerning mouthbreathing (p = 0.007), oral habits (p = 0.047), age at termination of habits (p = 0.009), speech treatment (p = 0.002), ergotherapy, physiotherapy, and breastfeeding (p ≤ 0.001). DMFT (p ≤ 0.001) and modified DDE (p = 0.001) index showed significantly higher values for children with fetal alcohol syndrome. Conclusions: Children with fetal alcohol syndrome have a higher need for early developmental promotion such as speech treatment, ergotherapy, and physiotherapy. Mouthbreathing, habits, and lack of breastfeeding may result in orthodontic treatment needs. High DMFT and modified DDE indexes hint at a higher treatment and prevention need in dentistry.


Assuntos
Índice CPO , Transtornos do Espectro Alcoólico Fetal/fisiopatologia , Boca/fisiopatologia , Distúrbios da Fala/complicações , Anormalidades Dentárias/complicações , Consumo de Bebidas Alcoólicas/efeitos adversos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Gravidez
5.
Bull World Health Organ ; 97(10): 654-662, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31656330

RESUMO

Objective: To assess the outcomes of children diagnosed with hearing impairment 3 years earlier in terms of referral uptake, treatment received and satisfaction with this treatment, and social participation. Methods: We conducted a population-based longitudinal analysis of children with a hearing impairment in two rural districts of Malawi. Key informants within the community identified the cohort in 2013 (baseline). Informants clinically screened children at baseline, and by questionnaires at baseline and follow-up in 2016. We investigated associations between sociodemographic characteristics and outcomes by multivariate logistic regression. Results: We diagnosed 752 children in 2013 as having a hearing impairment and traced 307 (40.8%) children of these for follow-up in 2016. Referral uptake was low (102/184; 55.4%), more likely among older children (odds ratio, OR: 3.5; 95% confidence interval, CI: 1.2-10.2) and less likely for those with an illiterate caregiver (OR: 0.5; 95% CI: 0.2-0.9). Few of the children who attended hospital received any treatment (33/102; 32.4%) and 63.6% (21/33) of caregivers reported satisfaction with treatment. Difficulty making friends and communicating needs was reported for 10.0% (30/299) and 35.6% (107/301) of the children, respectively. Lack of school enrolment was observed for 29.5% (72/244) of children, and was more likely for older children (OR: 28.6; 95% CI: 10.3-79.6), girls (OR: 2.4; 95% CI: 1.2-4.8) and those with an illiterate caregiver (OR: 2.1; 95% CI: 1.0-4.1). Conclusion: More widespread and holistic services are required to improve the outcomes of children with a hearing impairment in Malawi.


Assuntos
Pessoas com Deficiência/psicologia , Pessoas com Deficiência/estatística & dados numéricos , Perda Auditiva/psicologia , Relações Interpessoais , Encaminhamento e Consulta/estatística & dados numéricos , Participação Social , Adolescente , Audiometria , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Perda Auditiva/terapia , Humanos , Lactente , Estudos Longitudinais , Malaui/epidemiologia , Masculino , Satisfação do Paciente , Distúrbios da Fala/complicações , Distúrbios da Fala/epidemiologia , Distúrbios da Fala/psicologia , Estudantes/psicologia , Inquéritos e Questionários , Resultado do Tratamento
6.
J Speech Lang Hear Res ; 62(9): 3220-3233, 2019 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-31479382

RESUMO

Purpose This study sought to determine if (a) children with childhood apraxia of speech (CAS), other speech sound disorders (SSDs), and typical development (TD) would perform differently on a standardized motor assessment and (b) whether comorbid language impairment would impact group differences. Method Speech, language, and motor abilities were assessed in children with CAS (n = 10), SSD (n = 16), and TD (n = 14) between the ages of 43 and 105 months. Motor skills were evaluated using the Movement Assessment Battery for Children-Second Edition (Henderson, Sugden, & Barnett, 2007), a behavioral assessment that is sensitive in identifying fine/gross motor impairments in children with a range of motor and learning abilities. Data were reanalyzed after reclassifying children by language ability. Results The CAS group performed below the normal limit on all components of the motor assessment and more poorly than the TD and SSD groups on Aiming and Catching and Balance. When children were reclassified by language ability, the comorbid CAS + language impairment group performed worse than the SSD-only and TD groups on Manual Dexterity and Balance and worse than the TD group on Aiming and Catching; all 7 children with CAS + language impairment evidenced performance in the disordered range compared to 1 of 3 children in the CAS-only group and 2 of 6 children in the SSD + language impairment group. Conclusions Children with CAS + language impairment appear to be at an increased risk for motor impairments, which may negatively impact social, academic, and vocational outcomes; referrals for motor screenings/assessments should be considered. Findings may suggest a higher order deficit that mediates cognitive-linguistic and motor impairments in this population.


Assuntos
Apraxias/fisiopatologia , Destreza Motora , Distúrbios da Fala/fisiopatologia , Transtorno Fonológico/fisiopatologia , Apraxias/complicações , Criança , Pré-Escolar , Feminino , Humanos , Idioma , Masculino , Distúrbios da Fala/complicações , Transtorno Fonológico/complicações
7.
Int J Pediatr Otorhinolaryngol ; 126: 109609, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31374387

RESUMO

PURPOSE: There has not been any valid method for the clinical diagnosis of Childhood Apraxia of Speech (CAS) up to now, and the golden standard for diagnosis is the expert's opinion. The current research was conducted to obtain criteria used by the Iranian Speech-Language Pathologists (SLPs) to establish speech characteristics and co-occurring problems of CAS based on their knowledge and clinical experience. METHODS: This research used a questionnaire-based survey design for data collection. The questionnaire was filled out by 260 anonymous participants, both physically and online. RESULTS: The nine top speech characteristics reported with 75.6% agreement as the core symptoms of CAS included: inconsistency (86.9%), consonant sequencing problems (75%), low intelligibility (75%), groping (72.7%), slow diadochokinetic (DDK) (72.3%), articulatory configuration problems (66.2%), difficulty with multisyllabic words (62.7%), suprasegmental disturbances (56.2%) and metathesis (53.5%). The consent of the Iranian practicing SLPs was consistent with the American Speech-Language-Hearing Association (ASHA) diagnostic criteria, Strand's 10-point checklist, and Ozanne's cluster model. More than half of the respondents have been identified with fine motor deficit and language impairment as the most common co-occurring problems of CAS. CONCLUSIONS: The results of this study are in accordance with the findings of previous practicing SLPs' surveys in different languages. Carrying out researches on the speech characteristics of Persian-speaking children suspected of CAS and compare with the results of clinicians' surveys will help us to find a reliable standard for differential diagnosis of Persian-speaking children in Iran.


Assuntos
Apraxias/diagnóstico , Patologia da Fala e Linguagem , Apraxias/complicações , Criança , Estudos Transversais , Humanos , Transtornos do Desenvolvimento da Linguagem/complicações , Transtornos das Habilidades Motoras/complicações , Distúrbios da Fala/complicações , Inquéritos e Questionários
9.
Am J Speech Lang Pathol ; 28(3): 984-999, 2019 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-31330115

RESUMO

Purpose Speech and language disorders are hallmark features of 22q11.2 deletion syndrome (22qDS). Learning disabilities, cognitive deficits, palate abnormalities, velopharyngeal dysfunction, behavioral differences, and various medical and psychiatric conditions are also major features of this syndrome. The goal of this document is to summarize the state of the art of current clinical and scientific knowledge regarding 22qDS for speech-language pathologists (SLPs) and provide recommendations for clinical management. Method Best practices for management of individuals with 22qDS were developed by consensus of an expert international group of SLPs and researchers with expertise in 22qDS. These care recommendations are based on the authors' research, clinical experience, and literature review. Results This document describes the features of 22qDS as well as evaluation procedures, treatment protocols, and associated management recommendations for SLPs for the often complex communication disorders present in this population. Conclusion Early diagnosis and appropriate management of speech-language disorders in 22qDS is essential to optimize outcomes and to minimize the long-term effects of communication impairments. Knowledge of this diagnosis also allows anticipatory care and guidance regarding associated features for families, health care, and educational professionals.


Assuntos
Síndrome da Deleção 22q11/complicações , Transtornos da Linguagem/diagnóstico , Transtornos da Linguagem/terapia , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/terapia , Patologia da Fala e Linguagem/normas , Diagnóstico Precoce , Humanos , Transtornos da Linguagem/complicações , Transtornos da Linguagem/genética , Distúrbios da Fala/complicações , Distúrbios da Fala/genética
10.
Artigo em Russo | MEDLINE | ID: mdl-31317899

RESUMO

This lecture presents general information about children cerebral palsy concerning current views on its causes and pathogenesis as well as the data on different classifications of speech disorders (localization of lesions, clinical presentations) and their prevalence, which are important for general practitioners. Special attention is drawn to the principles and tasks of diagnostics of speech disorders, organization of treatment-correction measures considering all possible approaches to the care of patients.


Assuntos
Paralisia Cerebral , Distúrbios da Fala , Paralisia Cerebral/complicações , Criança , Humanos , Prevalência , Fala , Distúrbios da Fala/complicações
11.
Clin Linguist Phon ; 33(8): 790-814, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31221010

RESUMO

The goal of this research was to assess the support for motor speech disorders as explanatory constructs to guide research and treatment of reduced intelligibility in persons with Down syndrome (DS). Participants were the 45 adolescents with DS in the prior paper who were classified into five mutually-exclusive motor speech classifications using the Speech Disorders Classification System. An ordinal index classified participants' percentage of intelligible words in conversation as High (≥ 85%), Moderate (80% - 84.9%), or Low (< 80%). Statistical analyses tested for significant differences in intelligibility status associated with demographic, intelligence, and language variables, and intelligibility status associated with motor speech classifications and speech, prosody, and voice variables. For the 10 participants who met criteria for concurrent Childhood Dysarthria and Childhood Apraxia of Speech at assessment, 80% had reduced (Moderate or Low) intelligibility and 20% had High intelligibility (significant effect size: 0.644). Proportionally more of the 32 participants who met criteria for either dysarthria or apraxia had reduced intelligibility (significant effect size: 0.318). Low intelligibility was significantly associated with across-the-board reductions in phonemic and phonetic accuracy and with inappropriate prosody and voice. Findings are interpreted as support for motor speech disorders in adolescents with DS as explanatory constructs for their reduced intelligibility. Pending cross-validation of findings in diverse samples of persons with DS, studies are needed to assess the efficacy of motor speech classification status to guide selection of treatment methods and intelligibility targets. Abbreviations: CAS: Childhood Apraxia of Speech; CD: Childhood Dysarthria; DS: Down syndrome; II: Intelligibility Index; No MSD: No Motor Speech Disorder; OII: Ordinal Intelligibility Index; PSD: Persistent Speech Delay; SDCS: Speech Disorders Classification System; SMD: Speech Motor Delay.


Assuntos
Síndrome de Down/complicações , Transtornos do Desenvolvimento da Linguagem/complicações , Distúrbios da Fala/complicações , Inteligibilidade da Fala/fisiologia , Adolescente , Criança , Feminino , Humanos , Masculino , Fatores de Risco , Distúrbios da Fala/classificação
12.
Neuropsychologia ; 131: 53-61, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31121184

RESUMO

Impaired Semantic Verbal Fluency (SVF) in dementia due to Alzheimer's Disease (AD) and its precursor Mild Cognitive Impairment (MCI) is well known. Yet, it remains open whether this impairment mirrors the breakdown of semantic memory retrieval processes or executive control processes. Therefore, qualitative analysis of the SVF has been proposed but is limited in terms of methodology and feasibility in clinical practice. Consequently, research draws no conclusive picture which of these afore-mentioned processes drives the SVF impairment in AD and MCI. This study uses a qualitative computational approach-combining temporal and semantic information-to investigate exploitation and exploration patterns as indicators for semantic memory retrieval and executive control processes. Audio SVF recordings of 20 controls (C, 66-81 years), 55 MCI (57-94 years) and 20 AD subjects (66-82 years) were assessed while groups were matched according to age and education. All groups produced, on average, the same amount of semantically related items in rapid succession within word clusters. Conversely, towards AD, there was a clear decline in semantic as well as temporal exploration patterns between clusters. Results strongly point towards preserved exploitation-semantic memory retrieval processes-and hampered exploration-executive control processes-in AD and potentially in MCI.


Assuntos
Doença de Alzheimer/psicologia , Distúrbios da Fala/psicologia , Fala/fisiologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/complicações , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Distúrbios da Fala/complicações
13.
Cogn Neuropsychol ; 36(5-6): 282-299, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31131723

RESUMO

Gestures might serve communicative functions by supplementing spoken expressions or restorative functions by facilitating speech production. Also, speakers with speech deficits use gestures to compensate for their speech impairments. In this study, we examined gesture use in speakers with and without speech impairments and how spoken spatial expressions changed when gestures were restrained. Six patients with speech problems and with left frontal and/or temporal lesions and 20 neurotypical controls described motion events in 3 different conditions (spontaneous gesture, only speech, and only gesture). In addition to the group analyses, we ran case analyses. Results showed that patients used more gestures compared to controls. Gestures served both communicative and restorative functions for patients whereas controls only used gestures for communicative purposes. Case analyses revealed that there were differential patterns among patients. Overall, gesture production is multifunctional and gestures serve different functions for different populations as well as within a population.


Assuntos
Lesões Encefálicas/fisiopatologia , Gestos , Idioma , Comunicação Manual , Lesões Encefálicas/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fala , Distúrbios da Fala/complicações , Distúrbios da Fala/fisiopatologia
14.
J Speech Lang Hear Res ; 62(1): 153-168, 2019 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-30950754

RESUMO

Purpose We sought to estimate the prevalence of isolated epileptiform activity (IEA) in children with speech and language impairments and discuss the utility of an electroencephalogram (EEG) in assessing these children. Method We conducted a systematic review and searched for eligible studies in 8 databases. All languages were included, and meta-analyses were performed. Results We found 55 prevalence estimates (8 with control group). The odds of having IEA were 6 times greater for children with speech and language impairments than for typically developing children. The overall pooled prevalence of IEA was 27.3%. A wide variation between the prevalence estimates was, to a certain degree, explained by type of impairment (8.1% in speech impairments, 25.8% in language impairments, and 51.5% in language regression). Sleep EEGs detected a significantly higher prevalence than awake EEGs. Although the presence of epilepsy gave a significantly higher prevalence than if epilepsy was not present, 33.5% of children with language impairment but without epilepsy were found to have IEA in sleep EEGs. Conclusions This systematic review shows that IEA is 6 times more prevalent in children with speech and language impairment than in typically developing children. However, the prevalence rates vary to a great extent. Uncovering IEA will, in addition to information from other clinical assessments, provide a more comprehensive understanding of the child's impairments. We argue that, although EEG is of questionable value when assessing children with speech impairments, sleep EEG could be valuable when assessing children with language impairments and, in particular, children who experience language regression.


Assuntos
Eletroencefalografia , Epilepsia/fisiopatologia , Transtornos do Desenvolvimento da Linguagem/fisiopatologia , Distúrbios da Fala/fisiopatologia , Adolescente , Criança , Epilepsia/epidemiologia , Humanos , Transtornos do Desenvolvimento da Linguagem/complicações , Prevalência , Valores de Referência , Distúrbios da Fala/complicações
15.
Epilepsy Behav ; 94: 93-99, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30897536

RESUMO

Few studies have examined treatment response in electrical status epilepticus in sleep (ESES), and fewer still have evaluated the effect of corticosteroid treatment employing a pulse-dose regimen. The aim of this study was to examine the effectiveness of pulse-dose prednisone in treating language and behavioral disturbances that often accompany ESES. The sample included 17 patients age 5 to 10 years at time of baseline electroencephalogram (EEG) and neuropsychological assessments. For all patients, focal, multifocal, or generalized spike and wave activity occupied greater than 50% of the nonrapid eye movement (REM) sleep record. Patients were seen for follow-up EEG recording and neuropsychological testing with an average of 10 months following initiation of pulse-dose prednisone. Improvement in language or behavior was examined in relation to resolution of ESES on EEG, age at seizure onset and treatment, duration of ESES, duration of treatment, lesional versus nonlesional epilepsy, history of language or behavioral regression, seizure control at follow-up, and intelligence quotient (IQ). With the exception of a greater likelihood of patients with low IQ to demonstrate improvement in language or behavior, improvement was seen in most patients, irrespective of ESES or other factors.


Assuntos
Glucocorticoides/uso terapêutico , Prednisona/uso terapêutico , Comportamento Problema , Transtornos do Sono-Vigília/tratamento farmacológico , Distúrbios da Fala/fisiopatologia , Estado Epiléptico/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Espectro Autista/epidemiologia , Criança , Eletroencefalografia , Feminino , Humanos , Deficiência Intelectual/epidemiologia , Idioma , Transtornos da Linguagem/complicações , Transtornos da Linguagem/fisiopatologia , Masculino , Testes Neuropsicológicos , Pulsoterapia , Convulsões , Distúrbios da Fala/complicações , Estado Epiléptico/complicações , Estado Epiléptico/fisiopatologia , Síndrome , Resultado do Tratamento
16.
Int J Pediatr Otorhinolaryngol ; 120: 112-117, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30776568

RESUMO

INTRODUCTION: In health-care, current efforts focus on providing patient-centered care. Specifically for patients with velopharyngeal insufficiency, and by extent patients with cleft palate, the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) questionnaire (Skirko et al., 2012; 2013) allows the clinician to map the impact of speech and swallowing difficulties on the patient's health-related quality of life (HRQoL). The current study evaluated the hypothesized association between this speech-related HRQoL measure and perceptually and instrumentally assessed speech variables, to provide evidence for the construct validity of the Dutch version of the VELO questionnaire. MATERIALS AND METHODS: Thirty participants, twenty-five patients with cleft palate and five controls, were enrolled. Perceptual speech assessment was conducted following the recently developed Belgian Dutch outcome tool for perceptual speech assessment in patients with cleft palate. In addition, nasalance values and the Nasality Severity Index (NSI) 2.0 were determined. The relationship between these speech outcomes and the scores on the VELO parent report was determined using Spearman rank-order correlation coefficients. RESULTS: Moderate to strong correlations were found between the total score on the VELO parent report and five speech variables: the VPC-SUM score (rs = -0.476), speech understandability (rs = -0.657), passive CSC's (rs = -0.654), speech acceptability (rs = -0.591) and the need for C(L)P-related speech therapy (rs = -0.711). Furthermore, these variables were associated with at least one subscale of the VELO questionnaire. DISCUSSION AND CONCLUSION: Correlations between speech outcomes and the Dutch version of the VELO questionnaire provide evidence for the construct validity of this version of the instrument. Furthermore, insights in these associations may lead the way to efficient therapy approaches, targeting speech features with the greatest impact on the patient's health-related quality of life.


Assuntos
Fissura Palatina/fisiopatologia , Qualidade de Vida , Distúrbios da Fala/diagnóstico , Fala/fisiologia , Bélgica , Criança , Pré-Escolar , Fissura Palatina/complicações , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Distúrbios da Fala/complicações , Distúrbios da Fala/terapia , Fonoterapia/métodos , Inquéritos e Questionários/estatística & dados numéricos , Insuficiência Velofaríngea/diagnóstico
18.
Pediatr Res ; 85(3): 275-282, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30568186

RESUMO

BACKGROUND: Study about deliberate self-harm (DSH) in children with different types of disabilities was scarce. This study compared the incidence and patterns of DSH between children with and without disabilities aged 6-17 years using a matched case-control study in Beijing. METHODS: A total of 650 pairs of children with and without disabilities were surveyed. Characteristics of latest episode of self-harm within the 12 months were compared. Associations between disability status, sociodemographic factors, smoking, drinking, sleep problems, and self-harm were examined. RESULTS: Children with disabilities showed significant higher incidence of DSH than children without disabilities. Two groups differed significantly in terms of self-harm methods, body parts injured, premeditation, wishing to be known by others and help-seeking behavior. The adjusted OR for self-harm was 4.76 (2.99-7.55) for children with disabilities compared with children without disabilities. Children who slept fewer than 6 h per night, had difficulty falling asleep at night sometimes/often, and went to sleep after midnight 1 to 3 nights per month or at least once a week were at elevated risk of self-harm. CONCLUSION: This study highlights a strong relationship between disability, sleep problems, and DSH. Interventions to reduce self-harm should target disability and sleep problems as important risk factors.


Assuntos
Crianças com Deficiência , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/epidemiologia , Adolescente , Consumo de Bebidas Alcoólicas/efeitos adversos , Pequim/epidemiologia , Estudos de Casos e Controles , Criança , Feminino , Transtornos da Audição/complicações , Transtornos da Audição/psicologia , Humanos , Incidência , Deficiência Intelectual/complicações , Deficiência Intelectual/psicologia , Masculino , Transtornos Mentais/complicações , Transtornos Mentais/psicologia , Análise de Regressão , Fatores de Risco , Comportamento Autodestrutivo/complicações , Transtornos do Sono-Vigília , Fumar/efeitos adversos , Classe Social , Distúrbios da Fala/complicações , Distúrbios da Fala/psicologia , Inquéritos e Questionários
19.
Int J Lang Commun Disord ; 54(2): 234-248, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30039902

RESUMO

BACKGROUND: Electropalatography (EPG) records details of the location and timing of tongue contacts with the hard palate during speech. It has been effective in treating articulation disorders that have failed to respond to conventional therapy approaches but, until now, its use with children and adolescents with intellectual/learning disabilities and speech disorders has been limited. AIMS: To evaluate the usefulness of EPG in the treatment of speech production difficulties in children and adolescents with Down syndrome (DS) aged 8-18 years. METHODS & PROCEDURES: A total of 27 children with DS were assessed on a range of cognitive and speech and language measures and underwent additional EPG assessment. Participants were randomly allocated to one of three age-matched groups receiving either EPG therapy, EPG-informed conventional therapy or 'treatment as usual' over a 12-week period. The speech of all children was assessed before therapy using the Diagnostic Evaluation of Articulation and Phonology (DEAP) and reassessed immediately post- and 3 and 6 months post-intervention to measure percentage consonants correct (PCC). EPG recordings were made of the DEAP assessment items at all time points. Per cent intelligibility was also calculated using the Children's Speech Intelligibility Measure (CSIM). OUTCOMES & RESULTS: Gains in accuracy of production immediately post-therapy, as measured by PCC, were seen for all groups. Reassessment at 3 and 6 months post-therapy revealed that those who had received therapy based directly on EPG visual feedback were more likely to maintain and improve on these gains compared with the other groups. Statistical testing showed significant differences between groups in DEAP scores across time points, although the majority did not survive post-hoc evaluation. Intelligibility across time points, as measured by CSIM, was also highly variable within and between the three groups, but despite significant correlations between DEAP and CSIM at all time points, no statistically significant group differences emerged. CONCLUSIONS & IMPLICATIONS: EPG was an effective intervention tool for improving speech production in many participants. This may be because it capitalizes on the relative strength of visual over auditory processing in this client group. The findings would seem to warrant an increased focus on addressing speech production difficulties in current therapy.


Assuntos
Transtornos da Articulação/terapia , Biorretroalimentação Psicológica/métodos , Síndrome de Down/complicações , Distúrbios da Fala/terapia , Fonoterapia/métodos , Adolescente , Transtornos da Articulação/complicações , Criança , Feminino , Humanos , Masculino , Método Simples-Cego , Distúrbios da Fala/complicações , Resultado do Tratamento
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