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1.
Codas ; 32(3): e20190058, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32609224

RESUMO

PURPOSE: Identify factors related to the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) representing more than one category and verify their association with sociodemographic and health care aspects in a speech-language pathology (SLP) outpatient clinic. METHOD: This is an observational, analytical, cross-sectional study based on a retrospective analysis of secondary data. One hundred eighty medical records of patients aged 5-16 years evaluated between 2010 and 2014 were included in the study. Sociodemographic and health care aspects were identified in these records, as well as presence of the ICF-CY Body Functions and Activities and Participation component categories. Analyses of the frequency distribution and measures of central tendency and dispersion of the variables, as well as Factor Analysis were carried out to create representative indicators of the ICF-CY categories identified. The Mann-Whitney and Kruskal-Wallis tests and the Spearman's correlation were used to analyze the associations, adopting a statistical significance level of 5%. RESULTS: Two factors that presented statistically relevant associations with the sociodemographic and health care variables were identified for the Body Functions component. As for the Activities and Participation component, three factors predominantly associated with the health care variables were identified. CONCLUSION: Items representative of the ICF-CY Body Functions and Activities and Participation categories and their respective factorial loads were identified. Statistically significant associations were verified between them and the sociodemographic and health care variables analyzed.


Assuntos
Atividades Cotidianas , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Transtornos da Linguagem , Distúrbios da Fala , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Avaliação da Deficiência , Humanos , Transtornos da Linguagem/diagnóstico , Estudos Retrospectivos , Fala , Distúrbios da Fala/diagnóstico
2.
J Biol Regul Homeost Agents ; 34(2): 683-686, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32475102

RESUMO

Parkinson's disease (PD), which is not only a motor disease, is one of the most frequent neurodegenerative diseases and affects 1.5-2% of people worldwide. The role of its non motor-symptoms is of first importance on quality of life. Speech impairment is considered a part of motor impairment and is widespread in PD where most frequent speech impairment is Hypokinetic dysarthria, a disorder characterized by reduced articulation movements and phonetic monotony. Many PD patients show difficulty in accessing the lexicon related to cognitive impairment. Clinical evaluation of speech disorders in PD includes the clinical history, verbal and non-verbal assessment of the voice, evaluation of the calibre of the language. It is also important to self-assess speech disturbances because PD patients often do not realize their own deficits. Self-assessment tests comprise subjective assessment of communicative disorder in different social situations, description of adopted strategies, perception of the reactions of interlocutors. The comparison between perceptive and subjective examination of speech disorders in PD patients are described in order to evaluate the presence of these deficits and their impact on quality of life in order to initiate early treatment with specific speech therapy.


Assuntos
Doença de Parkinson/complicações , Distúrbios da Fala/diagnóstico , Disfunção Cognitiva , Humanos , Qualidade de Vida , Distúrbios da Fala/etiologia , Voz
3.
Neurology ; 94(20): e2148-e2167, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32345733

RESUMO

OBJECTIVE: Determining the genetic basis of speech disorders provides insight into the neurobiology of human communication. Despite intensive investigation over the past 2 decades, the etiology of most speech disorders in children remains unexplained. To test the hypothesis that speech disorders have a genetic etiology, we performed genetic analysis of children with severe speech disorder, specifically childhood apraxia of speech (CAS). METHODS: Precise phenotyping together with research genome or exome analysis were performed on children referred with a primary diagnosis of CAS. Gene coexpression and gene set enrichment analyses were conducted on high-confidence gene candidates. RESULTS: Thirty-four probands ascertained for CAS were studied. In 11/34 (32%) probands, we identified highly plausible pathogenic single nucleotide (n = 10; CDK13, EBF3, GNAO1, GNB1, DDX3X, MEIS2, POGZ, SETBP1, UPF2, ZNF142) or copy number (n = 1; 5q14.3q21.1 locus) variants in novel genes or loci for CAS. Testing of parental DNA was available for 9 probands and confirmed that the variants had arisen de novo. Eight genes encode proteins critical for regulation of gene transcription, and analyses of transcriptomic data found CAS-implicated genes were highly coexpressed in the developing human brain. CONCLUSION: We identify the likely genetic etiology in 11 patients with CAS and implicate 9 genes for the first time. We find that CAS is often a sporadic monogenic disorder, and highly genetically heterogeneous. Highly penetrant variants implicate shared pathways in broad transcriptional regulation, highlighting the key role of transcriptional regulation in normal speech development. CAS is a distinctive, socially debilitating clinical disorder, and understanding its molecular basis is the first step towards identifying precision medicine approaches.


Assuntos
Apraxias/genética , Distúrbios da Fala/genética , Fala/fisiologia , Fatores de Transcrição/genética , Adolescente , Apraxias/diagnóstico , Apraxias/fisiopatologia , Criança , Pré-Escolar , Feminino , Subunidades alfa Gi-Go de Proteínas de Ligação ao GTP/genética , Estudos de Associação Genética , Humanos , Masculino , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/fisiopatologia
4.
Codas ; 32(1): e20180156, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32049151

RESUMO

PURPOSE: To develop a Speech-language Pathology (SLP) program and verify its effects on the reading comprehension of dyslexic students. METHODS: Participants were eleven 4th and 5th-grade Elementary School students, eight boys and three girls, aged 9-11 years, diagnosed with developmental dyslexia. All individuals underwent the therapeutic program, which was composed of 16 sessions divided into four levels of complexity. A text adapted according to the Cloze technique and reading comprehension and orthography tasks were used in each session. The schoolchildren had their reading comprehension assessed pre- and post-program using a text available at the Test of Reading Comprehension of Expository Texts, adapted for application of the structural Cloze technique without support, according to the Evaluation of Reading Comprehension Levels. RESULTS: The participants showed better performance in reading comprehension at the post-program assessment not only in the filling of blanks in the text adapted according to the Cloze technique and in the Responses to Reading Comprehension Questions, but also in the level of reading comprehension achieved. CONCLUSION: The SLP program improved the reading comprehension performance and increased motivation to reading of dyslexic schoolchildren. Both the Cloze technique and the Reading Comprehension Questions were useful tools to develop and identify changes in the reading comprehension of the students assessed. This study is relevant because it prepared and verified the effects of a specific remediation program for schoolchildren with dyslexia by proposing the use of texts adapted according to the Cloze technique combined with other various tasks of reading comprehension and orthography.


Assuntos
Compreensão , Dislexia/reabilitação , Transtornos da Linguagem/reabilitação , Leitura , Distúrbios da Fala/reabilitação , Criança , Feminino , Humanos , Transtornos da Linguagem/diagnóstico , Testes de Linguagem , Masculino , Distúrbios da Fala/diagnóstico , Estudantes
5.
Codas ; 31(6): e20180296, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31800882

RESUMO

PURPOSE: To investigate the reliability in auditory-perceptual assessment of hypernasality of the Borg centiMax scale and the influence of the speech material on the reliability of two scales. METHODS: Four experienced speech-language pathologists rated hypernasality of 80 audio recordings of patients with repaired cleft palate (40 single-word string and 40 sentences) using the 5-point ordinal scale and the Borg centiMax scale. Intra and inter-rater reliability were calculated for both scales and for both types of speech samples. The comparison between the agreement coefficients of the two speech samples was calculated using the Z test and between the scales was calculated by Spearman correlation coefficient, considering as significant p<0.05. RESULTS: A very high and statistically significant correlation was found between the Borg centiMax scale and the ordinal scale for both speech samples. Intra- and inter-rater reliability was higher for Borg scale as compared to ordinal scale. Good to excellent intra-rater reliability was found for Borg scale for both speech samples. Poor to excellent intra-rater reliability was found for ordinal scale for both stimuli. Higher inter-rater reliability was demonstrated for Borg scale than ordinal scale for both speech samples. There was a significant difference between the single words string and sentences for intra- and inter-rater reliability using Borg scale, and for inter-rater reliability using ordinal scale. CONCLUSION: The Borg centiMax scale showed better intra and inter-rater reliability. Additionally, the speech material comprising of single words string showed better reliability in most of the comparisons for both scales.


Assuntos
Distúrbios da Fala/diagnóstico , Medida da Produção da Fala/instrumentação , Qualidade da Voz , Fissura Palatina/fisiopatologia , Humanos , Reprodutibilidade dos Testes , Distúrbios da Fala/classificação , Distúrbios da Fala/etiologia , Insuficiência Velofaríngea/fisiopatologia , Distúrbios da Voz/fisiopatologia
6.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 39(4): 155-161, oct.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-191298

RESUMO

Introducción: Los locutores son profesionales de la voz que se caracterizan por presentar una alta exigencia vocal. El objetivo de esta investigación fue medir los cambios acústicos que podrían ser atribuidos a una rutina de calentamiento vocal sobre la calidad de la voz en locutores comerciales de radio y televisión en Chile. Material y método: Se seleccionaron 13 locutores comerciales, a quienes se le aplicó un programa de calentamiento vocal. Se midieron los parámetros de frecuencia fundamental, perturbación (jitter y shimmer), ruido, tiempo máximo de fonación y agilidad articulatoria. Todos los parámetros se midieron antes y después de la rutina de ejercicios. Por otra parte, 6 expertos fonoaudiólogos analizaron, mediante una escala visual análoga, los cambios en los espectrogramas de banda estrecha de las emisiones antes y después de la rutina de calentamiento vocal. Resultados: Se encontraron cambios significativos en la frecuencia fundamental y el tiempo máximo de fonación. En el análisis de los espectrogramas que realizaron los expertos, en 11 casos se observó mejoría entre el antes y el después de la rutina. Sumado a lo anterior, en 6 de estos casos los cambios fueron significativos. Conclusiones: El calentamiento vocal puede ser una eficaz herramienta para el cuidado de la voz en locutores comerciales


Introduction: The announcers are professionals of the voice that are characterized by presenting high vocal demand. The objective of this research was to measure the acoustic changes that could be attributed to a routine of vocal warm-up on the quality of the voice in commercial radio and television announcers in Chile. Material and method: Thirteen commercial announcers were selected and a vocal warm-up routine was applied. The parameters of fundamental frequency, jitter, shimmer, noise, maximum time of phonation and articulatory agility were measured. All parameters were measured before and after the exercise routine. On the other hand, 6 experts voice therapist analyzed through a visual analog scale changes in the narrow band spectrograms of the emissions before and after the vocal warm-up routine. Results: Significant changes were found in the fundamental frequency and maximum phonation time. In the analysis of the spectrograms performed by the experts, in 11 cases there was improvement between the before and after the routine. In addition to the above, in 6 of these cases the changes were significant. Conclusions: The vocal warm-up can be an effective tool for the care of the voice in commercial announcers


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Distúrbios da Fala/diagnóstico , Distúrbios da Voz/diagnóstico , Disfunção da Prega Vocal/diagnóstico , Temperatura Alta/efeitos adversos , Distúrbios da Fala/terapia , Distúrbios da Voz/terapia , Treinamento da Voz , Disfunção da Prega Vocal/complicações
7.
Codas ; 31(5): e20180121, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31691745

RESUMO

Apraxia of speech is defined as the inability to sequence the movements required for accurate articulatory production, traditionally involving a deficit in speech motor programming. Language clinicians often confront about speech inconsistency clinical cases, which raise questions concerning the differential diagnosis between apraxia and language disorders. Such problem often results in the difficulty to establish an adequate treatment decision. In this work, we discuss a clinical report in which both diagnosis and treatment raise questions about the apraxic speech condition in childhood. We start from the recognition that, in apraxia, it seems imperative to consider that the body to be considered is the one that surpasses its organic functions and structure. Clinical consequences are drawn from the premise that the human body is one whose ear can listen, and mouth can speak, i.e., the organic structure is a material realm open to the incidence of language and its "music", which creates the speaking body.


Assuntos
Apraxias/diagnóstico , Apraxias/terapia , Transtornos do Desenvolvimento da Linguagem/diagnóstico , Transtornos do Desenvolvimento da Linguagem/terapia , Terapia da Linguagem/métodos , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/terapia , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Medida da Produção da Fala
8.
Georgian Med News ; (294): 62-68, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31687951

RESUMO

Recently, there has been a tendency for the growth of dentognathic deformities of various origins, accompanied by phonetic abnormalities. Aim - to increase the effectiveness of orthodontic treatment of dentognathic deformities, accompanied by phonetic disorders, by developing and justifying a set of diagnostic and therapeutic measures based on a multidisciplinary approach. The influence of the state of ENT organs on the formation of dentognathic deformities and phonetic disturbances is studied in 155 children. A clinical dental examination and orthodontic treatment is performed in 82 patients aged 6-12 years. Individual corrective speech therapy work has been carried out to overcome the defects of the phonological side of speech. A certain pathological "chain" of cause-effect relationships of dentognathic deformities with phonetic disorders and diseases of the ENT organs became the basis for a multidisciplinary approach to solving the problems identified. The qualitative and quantitative dependence of sound deterioration on the type of orthognathic deformities is established. A complex of diagnostic and therapeutic measures for patients with dental deformities accompanied by phonetic disorders, consisting of motivational, diagnostic and therapeutic blocks, has been developed and introduced into practice. The proposed complex of diagnostic and treatment measures made it possible to increase the efficiency of orthodontic treatment of children with dentognathic deformities with disturbances of sound pronunciation depending on the type of bite by means of a multidisciplinary approach involving an otolaryngologist, speech therapist, children's therapist and surgeon, which was confirmed in 86.6% of patients by the improvement of electromyography, anthropometric measurements of scanned models of jaws, cephalometry; the analysis of cone-beam computed tomography data showed a significant increase in the upper respiratory tract volume by 53.8±4.2%.


Assuntos
Anormalidades Maxilofaciais/diagnóstico , Anormalidades Maxilofaciais/cirurgia , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Fonética , Prognatismo/cirurgia , Distúrbios da Fala/cirurgia , Cefalometria , Criança , Humanos , Imageamento Tridimensional , Prognatismo/diagnóstico por imagem , Reprodutibilidade dos Testes , Distúrbios da Fala/diagnóstico , Resultado do Tratamento
9.
Otolaryngol Pol ; 73(5): 31-36, 2019 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-31701898

RESUMO

ntroduction: Laryngeal cancer and its treatment are associated with both short- and long-term side effects, affecting laryngeal functions and having an impact on the quality of life. Material and methods: Retrospective analysis of the medical records of patients receiving surgical or non-surgical, larynx- -preserving treatment for laryngeal cancer. R esults: After termination of the treatment, the highest proportion of patients with bad voice quality was in the glottic carcinoma group (both in early and late phase), with swallowing dysfunction in the transglottic carcinoma group. Compared to the situation before the treatment, the proportion of patients with impaired voice quality (bad voice quality and loss of voice) initially decreased among all groups (except for supraglottic carcinomas), and during the first post-treatment year either increased or did not change. The proportion of patients with no swallowing dysfunction increased in the supraglottic, subglottic and transglottic carcinoma groups. D iscussion: We consider necessary the implementation of a standard pre- and post-treatment monitoring of the voice and swallowing function in the management of patients with laryngeal cancer.


Assuntos
Carcinoma de Células Escamosas/complicações , Transtornos de Deglutição/diagnóstico , Neoplasias Laríngeas/complicações , Distúrbios da Voz/diagnóstico , Qualidade da Voz , Carcinoma de Células Escamosas/terapia , Estudos de Casos e Controles , Transtornos de Deglutição/etiologia , Feminino , Seguimentos , Humanos , Neoplasias Laríngeas/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Distúrbios da Fala/diagnóstico , Distúrbios da Voz/etiologia
10.
BMC Neurol ; 19(1): 241, 2019 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-31629403

RESUMO

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a fatal degenerative disease of a rapid course. In 25% of ALS sufferers, speech disorders occur as prodromal symptoms of the disease. Impaired communication affects physical health and has a negative impact on mental and emotional condition. In this study, we assessed which domains of speech are particularly affected in ALS. Subsequently, we estimated possible correlations between the ALS patients' subjective perception of their speech quality and an objective assessment of the speech organs carried out by an expert. METHODS: The study group consisted of 63 patients with sporadic ALS. The patients were examined for articulatory functions by means of Voice Handicap Index (VHI) and the Frenchay Dysarthria Assessment (FDA). RESULTS: On the basis of the VHI scores, the entire cohort was divided into 2 groups: group I (40 subjects) with mild speech impairment, and group II (23 subjects) displaying moderate and profound speech deficits. In an early phase of ALS, changes were typically reported in the tongue, lips and soft palate. The FDA and VHI-based measurements revealed a high, positive correlation between the objective and subjective evaluation of articulation quality. CONCLUSIONS: Deterioration of the articulatory organs resulted in the reduction of social, physical and emotional functioning. The highly positive correlation between the VHI and FDA scales seems to indicate that the VHI questionnaire may be a reliable, self-contained tool for monitoring the course and progression of speech disorders in ALS. TRIAL REGISTRATION: NCT02193893 .


Assuntos
Esclerose Amiotrófica Lateral/complicações , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/etiologia , Patologia da Fala e Linguagem/métodos , Adulto , Idoso , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fala/fisiologia
11.
Neurocase ; 25(5): 187-194, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31335278

RESUMO

Affective prosody and facial expression are essential components of human communication. Aprosodic syndromes are associated with focal right cerebral lesions that impair the affective-prosodic aspects of language, but are rarely identified because affective prosody is not routinely assessed by clinicians. Inability to produce emotional faces (affective prosoplegia) is a related and important aspect of affective communication has overlapping neuroanatomic substrates with affective prosody. We describe a patient with progressive aprosodia and prosoplegia who had right greater than left perisylvian and temporal atrophy with an anterior predominance. We discuss the importance of assessing affective prosody and facial expression to arrive at an accurate clinical diagnosis.


Assuntos
Lobo Frontal/patologia , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/patologia , Lobo Temporal/patologia , Apraxias/diagnóstico , Apraxias/patologia , Expressão Facial , Lobo Frontal/diagnóstico por imagem , Lateralidade Funcional , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Lobo Temporal/diagnóstico por imagem
12.
Int J Lang Commun Disord ; 54(6): 875-893, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31322824

RESUMO

BACKGROUND: There is a growing body of evidence that speech and language therapy (SLT) intervention is effective in improving communication ability for individuals with non-progressive acquired apraxia of speech (AOS). However, there is no universally agreed diagnostic standard for AOS, and diverging opinions on its diagnostic features. This has led to claims that diverse diagnostic criteria may be used to select participants for AOS research studies. These claims raise concerns for evidence-based practice in AOS but have yet to be systematically investigated. AIMS: To determine the presence, nature and extent of diversity in the diagnostic criteria for non-progressive AOS used in both published studies and clinical practice internationally. METHODS & PROCEDURES: The study used a scoping review methodology that followed the 2005 framework of Arksey and O'Malley and included a consultation exercise in the form of an online survey of international SLTs. The scoping review included 157 studies involving participants with acquired AOS, published between 1997 and 2017. There were 264 respondents to the online survey of SLTs, with a completion rate of 72%. Respondents came from 15 countries and had varying levels of clinical experience. MAIN CONTRIBUTION: This study found that no common set of diagnostic criteria for AOS was used universally across research and practice. Although the diagnostic criteria used to select participants with AOS were reported explicitly in most studies, they varied from study to study. Some studies used directly conflicting criteria. Use of specific diagnostic criteria in studies was influenced by year of publication but not by location. There was a trend towards increasing consistency in diagnostic criteria in recent years. Compared with the research, the survey revealed relatively greater consistency among SLTs on the speech features considered indicative of AOS, although the SLTs who responded to the survey showed variation in how diagnostic criteria were combined into sets. Use of specific diagnostic criteria was not associated with SLTs' location or experience. There were differences between the diagnostic criteria for AOS used most commonly in research studies and those selected most commonly by SLTs in the survey. These findings have implications for the generalizability of AOS research to clinical practice, as well as implications for effective research synthesis. CONCLUSIONS & IMPLICATIONS: The claim that research and practice in the field of AOS is characterized by the use of diverse diagnostic criteria is supported by this scoping review. The findings support the need to develop a universal consensus standard for AOS diagnosis to ensure consistency across research and clinical practice.


Assuntos
Apraxias/diagnóstico , Distúrbios da Fala/diagnóstico , Apraxias/complicações , Diagnóstico Diferencial , Humanos , Testes de Linguagem , Distúrbios da Fala/etiologia , Terminologia como Assunto
13.
Stud Health Technol Inform ; 262: 252-255, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349315

RESUMO

This paper's objective is to present a proposed solution of Computer-based Speech Therapy System (CBST) for dyslalia screening. The problem of Speech Sound Disorders (SSD) is enunciated, and a brief presentation of several general CBST solutions is made. An Entropy-based method is proposed and the current state of advancement in the development and experimental validation of this solution is presented and discussed. Conclusions related to future improvements of the method are drawn based on the consequences identified in the final section.


Assuntos
Diagnóstico por Computador , Distúrbios da Fala , Transtorno Fonológico , Entropia , Humanos , Distúrbios da Fala/diagnóstico , Fonoterapia
14.
S Afr J Commun Disord ; 66(1): e1-e7, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31170786

RESUMO

BACKGROUND:  In speech-language pathology (SLP), there is a paucity of resources to provide just and equitable services to South Africa's culturally and linguistically diverse population. Although South Africa is a multilingual country, English remains the dominant language. However, there is limited research on resources for English additional language (EAL) speakers. OBJECTIVES:  This article addresses this gap by presenting the results of a critique of a commonly used language screening tool, the Renfrew Action Picture Test (RAPT), on EAL speakers. METHOD:  This tool is used as an example to broadly critique the use of culturally biased assessment instruments with EAL speakers from an indigenous linguistic and cultural background. It is administered to children who are EAL speakers and then critiqued by the children too. Their voice, often ignored in research, is central to the research. A mixed methods approach is used, including focus groups and test administration. This article is based on the results of the thematic analysis used to closely examine the patterns that emerge. RESULTS:  A key finding is that the cultural and linguistic background of the child assessed cannot be disregarded, as it plays a crucial role in understanding the response of the child. The interpretation of the response of the child to the presented material of the language assessment tool significantly influences the result of the assessment. CONCLUSION:  The speech language therapist has a responsibility to avoid skewed results based on uninformed interpretation of the response of the child. These findings provide useful insights for clinicians regarding culture-fair assessment.


Assuntos
Linguagem Infantil , Testes de Linguagem , Multilinguismo , Criança , Diversidade Cultural , Assistência à Saúde Culturalmente Competente , Feminino , Humanos , Transtornos da Linguagem/diagnóstico , Masculino , Pesquisa Qualitativa , Distúrbios da Fala/diagnóstico , Patologia da Fala e Linguagem/métodos
15.
Arq Neuropsiquiatr ; 77(5): 330-334, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31188996

RESUMO

OBJECTIVE: Mini-Mental State Examination (MMSE) results are strongly influenced by educational level. The Brief Cognitive Screening Battery (BCSB) is an alternative assessment tool that provides more accurate results in individuals with less education. Our aim was to compare the MMSE and BCSB as screening tests. METHODS: The MMSE and BCSB were assessed in 112 participants by two evaluators blind to the other test's result. Participants were classified according to their level of education. The influence of education level was analyzed using the Kruskal-Wallis and multiple comparison tests. RESULTS: Scores of the MMSE (p < 0.0001) and the clock-drawing test (p < 0.0001) were influenced by education level but the delayed recall test score was not (p = 0.0804). The verbal fluency test (p = 0.00035) was influenced only by higher educational levels. It took three minutes less to apply the MMSE than to apply the BCSB (p < 0.0001). CONCLUSIONS: These findings suggest that the delayed recall test and the verbal fluency test of the BCSB are better than the MMSE and clock-drawing test as tools for evaluating cognition in people with limited education.


Assuntos
Transtornos Cognitivos/diagnóstico , Escolaridade , Testes de Estado Mental e Demência , Testes Neuropsicológicos , Idoso , Idoso de 80 Anos ou mais , Brasil , Transtornos Cognitivos/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Rememoração Mental , Pessoa de Meia-Idade , Valores de Referência , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/psicologia , Estatísticas não Paramétricas , Fatores de Tempo
17.
Am J Speech Lang Pathol ; 28(1): 121-135, 2019 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-31072155

RESUMO

Purpose Loosely defined diagnostic criteria for acquired apraxia of speech (AOS) limit clinicians' ability to diagnose the disorder validly and reliably. The purpose of this study was to contribute to the development of more precise diagnostic guidelines by characterizing the frequency and quality of sound distortion errors in speakers with clinically diagnosed AOS. Method Audio-recorded motor speech evaluations from 24 speakers with AOS and aphasia were analyzed by trained listeners using a narrow phonetic transcription protocol that included 12 distortion categories. We calculated percentage of segments transcribed with phonemic error, distortion error, and a combination of phonemic and distortion error. Results Distortion frequency varied substantially across participants, distributing on a continuum from 5% to 22% of segments. The frequency of phonemic errors was significantly greater than the frequency of distortion errors, which, in turn, was greater than the frequency of distorted substitution errors. The most common distortion qualities were voicing ambiguity and segment lengthening, but over 40% of distortion errors were distributed across an assortment of tongue modifications. Conclusions The results replicated observations from previous studies of speakers with quantitatively defined AOS in a new sample of participants with clinically diagnosed AOS. Similar distortion qualities were observed across studies, offering focus for diagnosticians and guidance for operationalizing future measures. The broad performance continua we observed help explain why binary classification of the presence/absence of AOS can be challenging and indicate a need to develop quantitative norms.


Assuntos
Afasia/diagnóstico , Apraxias/diagnóstico , Distúrbios da Fala/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Fonética , Psicometria , Índice de Gravidade de Doença , Acústica da Fala , Inteligibilidade da Fala , Medida da Produção da Fala/métodos
18.
Am J Speech Lang Pathol ; 28(1): 136-147, 2019 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-31072156

RESUMO

Purpose The purpose of this mixed methods study was to examine student perceptions of computer-based simulation and to identify components of the simulation experience that were valued by the students. The aim of this study was to inform the development of effective approaches to integrating simulation into the speech-language pathology graduate curriculum. Method Participants were 1st-year graduate students in a residential, speech-language pathology master's program ( N = 29). A convergent-parallel mixed methods study situated in the pragmatic paradigm was conducted. Students completed a quantitative survey regarding educational practices and participated in focus groups regarding their experiences in a semester-long, simulated diagnostic clinical placement. These quantitative data and qualitative inquiry were analyzed and interpreted to explore the perceptions and attitudes of participants. Results In response to the research questions, integration of the qualitative and quantitative data resulted in 4 primary themes related to the perceived strengths and weaknesses of computer-based simulation diagnostic evaluations. These themes were (a) Communication, (b) Skill Practice, (c) Technology, and (d) Independent Learning. Through analysis, these themes connected to represent a spectrum of strengths and weaknesses of computer-based simulation diagnostic evaluations. Conclusions The results of this study have allowed researchers to establish a framework for understanding the learning process associated with computer-based simulation from the perspective of the graduate student. This framework is useful in integrating simulations into the communication sciences and disorders curriculum in a manner that is systematic and in agreement with best practices in the nursing and medical literature.


Assuntos
Currículo , Educação de Pós-Graduação/métodos , Transtornos da Linguagem/diagnóstico , Distúrbios da Fala/diagnóstico , Patologia da Fala e Linguagem/educação , Competência Clínica , Comunicação , Simulação por Computador , Feminino , Grupos Focais , Humanos , Simulação de Paciente , Estudantes de Ciências da Saúde/psicologia , Estados Unidos
19.
J Plast Surg Hand Surg ; 53(5): 309-315, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31107134

RESUMO

Studies on the impact of cleft palate surgery on speech with stringent methodology are called for, since we still do not know the best timing or the best method for surgery. The purpose was to report on speech outcome for all Swedish-speaking 5-year-olds born with a non-syndromic unilateral cleft lip and palate (UCLP), in 2008-2010, treated at Sweden's six cleft palate centres, and to compare speech outcomes between centres. Speech was assessed in 57 children with percent consonants correct adjusted for age (PCC-A), based on phonetic transcriptions from audio recordings by five independent judges. Also, hypernasality and perceived velopharyngeal function were assessed. The median PCC-A for all children was 93.9, and medians in the different groups varied from 89.9 to 96.8. In the total group, 9 children (16%) had more than mild hypernasality. Twenty-two children (38.5%) were perceived as having competent/sufficient velopharyngeal function, 25 (44%) as having marginally incompetent/insufficient velopharyngeal function, and 10 children (17.5%) as having incompetent/insufficient velopharyngeal function. Ten children were treated with secondary speech improving surgery and/or fistula surgery. No significant differences among the six groups, with eight to ten children in each group, were found. The results were similar to those in other studies on speech of children with UCLP, but poorer than results in normative data of Swedish-speaking 5-year-olds without UCLP. Indications of differences in frequency of surgical treatment and speech treatment between centres were observed.


Assuntos
Fenda Labial/complicações , Fissura Palatina/complicações , Distúrbios da Fala/etiologia , Pré-Escolar , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Feminino , Humanos , Masculino , Estudos Prospectivos , Distúrbios da Fala/diagnóstico , Medida da Produção da Fala , Suécia
20.
Eur Arch Otorhinolaryngol ; 276(6): 1767-1774, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30919058

RESUMO

PURPOSE: Oral or oropharyngeal tumors degrade patients' speech quality because of their location. The treatment of these cancers also affects the functional outcomes, depending on type (surgery, radiotherapy, chemotherapy), volume resection (according the size of the tumor) or on the anatomical area treated, and the post-treatment delay. The aim of this work is to determine the factors influencing the chronic speech disorders (in terms of intelligibility and severity) of patients treated for an oral or oropharyngeal cancer. METHODS: Speech-perceptive assessment was led by a panel of six expert speech therapists, on a task of a description of a picture, presented to 87 patients. Clinical and treatment data were gathered by examining medical files. RESULTS: Intelligibility and severity scores in our population were 6.06 (interquartile range 4.2-8) and 7.61 (interquartile range 6.8-9.5) on a maximum of 10. After adjusting for age and anatomical region involved, multivariate analysis showed a principal impact of surgery on both intelligibility and severity, while the size of the tumor significantly affected the intelligibility score [- 143; 95% CI (- 2.21, - 0.65)]. These results are consistent with the definitions of intelligibility and severity of speech disorders. CONCLUSIONS: The lack of information on the impact of tumor location, however, requires more work to contribute to reducing impact on the quality of life of patients.


Assuntos
Neoplasias Orofaríngeas/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/etiologia , Inteligibilidade da Fala , Idoso , Doença Crônica , Cognição , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais , Qualidade de Vida
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