Abstract in English:

ABSTRACT Purpose The present study aimed to investigate the behavior and the viscosity classification of liquids recommended for infants, up to six months, in Brazil, and their formulations used in Videofluoroscopy Swallowing Studies. Methods Breast milk from different gestational and breastfeeding time, two regular infant formulas, and one anti-reflux formula were evaluated in five different formulations: pure, mixed with liquid barium sulfate, in two proportions (20 and 33%), thickened with a specific thickener for neonates and thickened and mixed with 20% liquid barium sulfate, using the International Dysphagia Diet Standardisation Initiative model. The results were compared with data obtained from a previous rheological study. Results The breast milk samples and the infant formulas, in pure presentation, exhibited similar behavior except for the anti-reflux formula. The thickened samples with the addition of barium and the pure liquid barium sulfate exhibited the highest viscosity among the formulations. The increase in viscosity with the addition of barium occurred for all samples and for the thickened formulations, but not in linear behavior. The results showed minor differences of IDDSI classification compared to the findings obtained in the rheological study. Conclusion The present study revealed the variability of liquid viscosity across different formulations, supporting the idea of the importance of this knowledge in videofluoroscopic assessment. It has also highlighted the risk associated with using a subjective method in preparing the stimuli offered, allowing for greater reliability in diagnosing swallowing dynamics in neonates and infants. This approach may help prevent inaccurate diagnoses and harmful interventions.

Abstract in English:

ABSTRACT Purpose The aim of the study was to validate the Brazilian-Portuguese version of the Intelligibility in Context Scale (ICS-BP). Methods Sixty children (mean age in months = 55.05, SD = 4.2), 15 with parental or teacher concerns regarding their speech and 45 without concerns, underwent assessment using the phonology subtest of ABFW – Child Language Test. The percentage of consonants correct (PCC) was calculated and parents completed the ICS to evaluate their children's intelligibility with various communication partners. Descriptive statistics were obtained. Kruskal-Wallis and Spearman’ tests were used for independent group comparisons and correlation calculations, respectively. Linear regression models were established to predict PCC. Internal consistency was calculated using Cronbach's alpha. A Receiver Operating Characteristic (ROC) was used to analyse sensitivity and specificity. Significance was considered for p-values under 0.05. Results The majority of parents reported a mean score of 4.6 in a total of 5 (SD .10) at the ICS responses with different listeners, with better performance with other acquaintances and members of the family. The ICS demonstrated excellent internal consistency (α = 0.95). Positive correlations were found between ICS scores and PCC (r = .790) and a simple linear model was established between the ICS mean score and PCC. Sensitivity (0.98) and specificity (0.87) were considered high. Conclusion The ICS-BP indicated high psychometric values, suggesting that this instrument can be used to measure the intelligibility of Brazilian children.

Abstract in English:

ABSTRACT Purpose The Activity Ordering Task with a metacognitive facet (AOT-M) was developed, in our previous work, to address the disconnect between traditional working memory (WM) tasks and everyday WM demands, the lack of culturally sensitive, context-based WM tasks in India and enhance participant engagement. The present study aims to provide preliminary evidence of the AOT-M's psychometric properties among a non-clinical adult population, evaluate its sensitivity to cognitive and metacognitive changes with aging, establish construct validity, ecological validity, concurrent validity and test-retest reliability. Methods Ninety neurotypical adults, evenly distributed across three age groups, participated in the study. Descriptive statistics examined the distribution of performance spans and estimation discrepancies across age groups and the age-related statistical differences were evaluated using the Kruskal-Wallis Test. Construct validity was assessed using Rasch analysis, while ecological validity was evaluated with the Multidimensional Assessment of Research in Context (MARC) tool. Concurrent validity with sentence ordering and digit letter ordering tasks, was determined through Pearson’s correlation coefficient and test-retest reliability was assessed using the Intraclass Correlation Coefficient and Bland-Altman plots. Results The patterns observed in WM performance spans and estimation discrepancies highlighted the task's sensitivity to aging related cognitive and metacognitive changes. Evidence from the MARC tool substantiated ecological validity, and concurrent validity was demonstrated through significant correlations with established WM tasks. While Rasch analysis supported construct validity, moderate person reliability indicated some limitations in task sensitivity. The AOT-M demonstrated good test-retest reliability. Conclusion Overall, the study provides preliminary evidence of the AOT-M’s good psychometric properties within a neurotypical adult sample, suggesting it to be a promising addition to the cognitive communicative toolbox for Speech Language Pathologists.

Abstract in Portuguese:

RESUMO Objetivo analisar a associação da postura habitual de lábios e de língua e características clínicas com queixas relacionadas ao sono em lactentes com Trissomia do 21 (T21). Método trata-se de um estudo observacional transversal, com amostra não probabilística, composta por 87 lactentes com T21, com média de idade de 8,8 meses. Os pais dos lactentes responderam ao Questionário sobre Sono na Criança (BISQ) e a perguntas sobre sinais e sintomas relacionados à apneia obstrutiva do sono. A postura habitual de lábios e língua foi obtida a partir da análise de vídeos da face dos lactentes. Informações referentes a dados pessoais e histórico de saúde foram extraídas dos prontuários e sobre alimentação e hábitos orais foram obtidas por entrevista aos pais. Foi realizada a análise descritiva dos dados referentes ao sono dos lactentes e análise de associação entre qualidade do sono, queixa de ronco, pausas respiratórias presenciadas, adoção de posições incomuns durante o sono e sono agitado e as demais variáveis, por meio do teste Qui-quadrado de Pearson, com nível de significância de 5%. Resultados A maioria dos lactentes (82,7%) apresentou boa qualidade do sono. Houve associação entre prematuridade e relato de pausas respiratórias presenciadas; adotar posições incomuns durante o sono apresentou associação com sexo feminino e com a postura habitual da língua contida na cavidade oral; e sono agitado apresentou associação com queixa de engasgo. Conclusão prematuridade, sexo, postura habitual de língua e queixas de engasgos foram fatores associados aos aspectos do sono investigados em lactentes com T21.

Abstract in English:

ABSTRACT Purpose To analyze the association of habitual lip and tongue posture and clinical characteristics with sleep-related problems in infants with Trisomy 21 (T21). Methods This cross-sectional observational study with a non-probabilistic sample included 87 infants with T21 with a mean age of 8.8 months. The infants' parents answered the Brief Infant Sleep Questionnaire (BISQ) and questions about signs and symptoms related to obstructive sleep apnea. The habitual lip and tongue posture was obtained by analyzing videos of the infants' faces. Information on personal data and health history was extracted from medical records, and information about feeding and oral habits was obtained by interviewing the parents. Descriptive analysis approached the infants' sleep data and the association between sleep quality, snoring, witnessed respiratory pauses, unusual sleeping positions, restless sleep, and the other variables, using Pearson's chi-square test with a 5% significance level. Results Most infants (82.7%) had good sleep quality. Prematurity was associated with witnessed respiratory pauses; unusual sleeping positions were associated with being a female and with the tongue habitually contained in the oral cavity; and restless sleep was associated with choking. Conclusion Prematurity, sex, habitual tongue posture, and choking were associated with the aspects of sleep investigated in infants with T21.

Abstract in Portuguese:

RESUMO Objetivo Avaliar a pressão de língua, a autopercepção da deglutição e se existe correlação entre a pressão de língua e a autopercepção da deglutição em indivíduos submetidos à laringectomia total. Método Estudo transversal, constituído por dois grupos: com laringectomia total e sem laringectomia total (pareado por idade e sexo aos indivíduos com laringectomia total). Os participantes foram submetidos à mensuração da pressão de ponta e de dorso de língua; e à autoavaliação da deglutição, por meio do questionário Swallow Outcomes After Laryngectomy (SOAL). Resultados A amostra totalizou 26 participantes, sendo 13 de cada grupo. As médias da pressão máxima de dorso de língua foram 41,2±18,7 e 27,9±9,3 kilopascal, respectivamente, nos grupos com e sem laringectomia total (p=0,03). As medianas da pressão máxima de ponta de língua foram 33,7 (23,8-49,3) e 29,1 (22,5-35,7) kilopascal, respectivamente, nos grupos com e sem laringectomia total (p=0,29). A mediana do SOAL foi 6 (2,5-8,5) pontos no grupo com laringectomia total. Não houve correlação estatisticamente significativa entre a pontuação do SOAL e a pressão de ponta (r=-0,17; p=0,58) e de dorso (r=-0,30; p=0,31) de língua. Conclusão Indivíduos com laringectomia total apresentam maior pressão de dorso de língua, apesar de não haver diferença na pressão de ponta de língua entre indivíduos com e sem laringectomia total. Não há correlação entre a pressão de língua e a autoavaliação da deglutição, embora haja correlação entre a pressão de ponta e de dorso de língua de indivíduos com laringectomia total.

Abstract in English:

ABSTRACT Purpose To evaluate tongue pressure, self-perception of swallowing, and whether tongue pressure is correlated with self-perception of swallowing in individuals undergoing total laryngectomy. Methods Cross-sectional study with two groups – with and without total laryngectomy, matched by age and sex to individuals with total laryngectomy. Participants had their tongue tip and dorsum pressure measured and self-assessed their swallowing with the Swallow Outcomes After Laryngectomy questionnaire (SOAL). Results The sample totaled 26 participants, 13 from each group. The mean maximum tongue dorsum pressure was 41.2±18.7 and 27.9±9.3 kilopascals, respectively, in the groups with and without total laryngectomy (p = 0.03). The median maximum tongue tip pressure was 33.7 (23.8-49.3) and 29.1 (22.5-35.7) kilopascals, respectively, in the groups with and without total laryngectomy (p = 0.29). The median SOAL was 6 (2.5-8.5) points in the group with total laryngectomy. The SOAL score was not statistically significantly correlated with tongue tip pressure (r = -0.17; p = 0.58) or dorsum pressure (r = -0.30; p = 0.31). Conclusion Individuals with total laryngectomy had higher tongue dorsum pressure, although there was no difference in tongue tip pressure between individuals with and without total laryngectomy. Tongue pressure was not correlated with self-assessment of swallowing, although tongue tip pressure was correlated with dorsum pressure in individuals with total laryngectomy.

Abstract in Portuguese:

RESUMO Objetivo Elaborar e verificar a efetividade de um programa de estimulação das HA inserido na grade curricular comum e aplicado por professores em sala de aula. Método Um programa de estimulação das habilidades auditivas (HA) foi elaborado e aplicado no ano letivo de escolares da educação infantil. Trinta e quatro crianças foram estimuladas auditivamente (GEA) e comparadas a um grupo placebo (GP. N=31). Os alunos foram avaliados quanto às HA, habilidades pré-leitoras e de decodificação, pré e pós-intervenção. Duas reavaliações foram realizadas após a aplicação do programa, permitindo um acompanhamento do desempenho dos escolares em meio à pandemia Covid-19. Resultados O programa proposto conta com atividades que foram aplicadas pelos professores durante 25 semanas, entre 10-15 minutos/dia, em ambiente escolar. As HA estimuladas foram: detecção, discriminação, habilidades temporais, figura-fundo, fechamento, memória e atenção. Houve diferença significativa entre o desempenho do GEA e GP após a aplicação do programa. Conclusão O programa pôde ser incorporado na grade curricular, auxiliando no desenvolvimento das habilidades preconizados pelo Ministério da Educação. Após a estimulação auditiva, percebeu-se melhor desempenho em figura-fundo auditiva, resolução temporal, identificação e produção de rima e produção de palavra a partir de fonema dado no GEA.

Abstract in English:

ABSTRACT Purpose To develop and verify the effectiveness of a hearing abilities (HA) stimulation program included in the regular school curriculum and applied by teachers in the classroom. Methods An HA stimulation program was developed and applied to preschoolers during the school year; 34 children underwent auditory stimulation (ASG) and were compared to a placebo group (PG; n = 31). The students were assessed regarding their HA and pre-reading and decoding skills before and after the intervention. They were reassessed twice after applying the program to monitor the students' performance amid the COVID-19 pandemic. Results The program includes activities applied at school by teachers for 25 weeks, lasting 10-15 minutes/day, stimulating the following HA: detection, discrimination, temporal processing, figure-ground, closure, memory, and attention. The ASG and PG performances differed significantly after the program. Conclusion The program was incorporated into the curriculum, helping to develop the skills recommended by the Ministry of Education. After auditory stimulation, ASG performed better in auditory figure-ground, temporal resolution, rhyme identification and production, and word production from the phoneme given.

Abstract in Portuguese:

RESUMO Objetivo Verificar os resultados da prótese ativa de orelha média na audibilidade e na percepção auditiva da fala em indivíduos com malformação de orelha externa e/ou média. Método Estudo primário, observacional, retrospectivo, por meio da análise de prontuários de indivíduos com malformação de orelha externa e/ou média bilateral, usuários unilaterais de prótese ativa de orelha média. Os dados coletados referem-se aos limiares auditivos obtidos por meio da audiometria em campo livre e avaliação da percepção auditiva da fala - reconhecimento de sentenças no silêncio e no ruído, nas seguintes situações: sem a prótese, no momento da ativação, no primeiro e no terceiro mês de uso. Resultados Nove indivíduos foram incluídos no estudo. A idade média no momento da ativação foi de 24,6 anos (mínimo 12 e máximo 40 anos). Melhora estatisticamente significante dos limiares auditivos (p<0,05) e no teste de reconhecimento de sentenças no silêncio e no ruído (p<0,05) foi observada no momento da ativação da prótese. Não houve diferença significante entre as situações de avaliação após a ativação, indicando aclimatização pelo usuário. Conclusão Os resultados da prótese ativa de orelha média VSB (MED-EL) na audibilidade e na percepção auditiva da fala em indivíduos com malformação de orelha externa e/ou média foram melhores na condição da ativação, em comparação à condição pré-cirúrgica, mantendo-se estável ao longo do tempo; o que reforça sua indicação para essa população.

Abstract in English:

ABSTRACT Purpose To verify the results of active middle ear implant on audibility and auditory speech perception in individuals with external and/or middle ear malformations. Methods Primary, observational, retrospective study, through analysis of medical records of individuals with bilateral external and/or middle ear malformations, unilateral users of active middle ear implant. The data collected refer to auditory thresholds obtained through free-field audiometry and assessment of auditory speech perception - sentence recognition in silence and noise, in the following situations: without the implant, at the time of activation, in the first and in the third month of use. Results Nine individuals were included in the study. The average age at the time of activation was 24.6 years (minimum 12 and maximum 40 years). Statistically significant improvement in auditory thresholds (p<0.05) and in the sentence recognition test in silence and noise (p<0.05) was observed at the time of activation. There was no significant difference between the evaluation situations after activation, indicating acclimatization by the user. Conclusion The results of the active middle ear implant VSB (MED-EL) users on the audibility and auditory speech perception, in individual with external and/or middle ear malformation were better in the activation condition compared to the pre-surgical condition, maintaining stable over time; which reinforces its indication for this population.

Abstract in Portuguese:

RESUMO Objetivo Descrever a prevalência de dificuldades alimentares em crianças com idade entre seis meses e seis anos e onze meses, nascidas prematuras, e analisar as relações com as condições perinatais e neonatais. Método Estudo ambispectivo transversal, no qual a Escala Brasileira de Alimentação Infantil foi aplicada aos pais de 129 crianças acompanhadas em ambulatórios de prematuros, para avaliar a prevalência de Dificuldade Alimentar. As demais variáveis foram coletadas retrospectivamente nos prontuários. Resultados Quinze crianças (11,62%), das 129 que participaram, apresentaram Dificuldade Alimentar. As variáveis que influenciaram significativamente o resultado foram: nascer pequeno para a idade gestacional, ser filho de mãe com Diabetes Mellitus Gestacional e ser submetido à fototerapia. Ao observar os domínios avaliados pela Escala Brasileira de Alimentação infantil, foi possível observar que o tempo de suporte ventilatório teve correlação com o domínio Motor-Oral e o tempo de fototerapia com o domínio Sensório-Oral. Conclusão A Escala Brasileira de Alimentação Infantil mostrou que a prevalência de Dificuldade Alimentar a longo prazo em nascidos prematuros foi de 11,62%. Nascidos pequenos para a idade gestacional apresentaram maior prevalência. Crianças submetidas à fototerapia e filhos de mães com diabetes gestacional apresentaram menor prevalência. As outras variáveis estudadas não afetaram significativamente a prevalência de Dificuldades Alimentares, mas o tempo de suporte ventilatório afetou o domínio Motor-Oral e o tempo de fototerapia o Motor-Oral. Este estudo pioneiro marca a primeira aplicação da Escala Brasileira de Alimentação Infantil em crianças brasileiras nascidas prematuras.

Abstract in English:

ABSTRACT Purpose To describe the prevalence of feeding difficulties in preterm children aged six months to six years and eleven months, and to analyze the relationships with perinatal and neonatal conditions. Methods This cross-sectional ambispective study applied the Brazilian Infant Feeding Scale to the parents of 129 children followed in preterm outpatient clinics to assess the prevalence of feeding difficulties. Additional variables were collected retrospectively from medical records. Results Fifteen children (11.62%) out of 129 exhibited feeding difficulties. Significant influencing variables were being born small for gestational age, having a mother with gestational diabetes mellitus, and undergoing phototherapy. Ventilatory support duration correlated with the Motor-Oral domain, and phototherapy duration correlated with the Sensory-Oral domain of the Brazilian Infant Feeding Scale. Conclusion The Brazilian Infant Feeding Scale showed that the prevalence of long-term Feeding Difficulty in preterm infants was 11.62%. Small for Gestational Age newborns showed a higher prevalence. Children undergoing phototherapy and offspring of mothers with gestational diabetes showed a lower prevalence. The other variables studied did not significantly affect the prevalence of Feeding Difficulties, but the duration of ventilatory support affected the Oral-motor domain, and the duration of phototherapy also affected the Oral-Motor. This study marks the first application of the Brazilian Infant Feeding Scale in Brazilian preterm infants.

Abstract in Portuguese:

RESUMO Objetivo traduzir e adaptar transculturalmente para o português brasileiro o questionário “Down Syndrome Speech Intelligibility Survey”. Método foram realizadas as etapas da adaptação transcultural: tradução do instrumento do idioma de origem para o idioma-alvo, síntese das versões traduzidas, avaliação da síntese por juízes experts, avaliação do instrumento pelo público-alvo, retrotradução e estudo-piloto. Resultados após a tradução e síntese das traduções, na análise pelos juízes especialistas, a quase totalidade dos itens do instrumento (n=44, 97,77%) foi considerada muito relevante, muito viável e adequada pela maioria dos juízes. Na análise pela população-alvo, foram apontadas sugestões de mudança pelos pais, permitindo a realização de modificações para uma melhor compreensão do instrumento. A partir da retrotradução, foram identificadas algumas inconsistências da versão traduzida e adaptada em relação ao conteúdo proposto no instrumento original, sendo realizadas as devidas adequações. No estudo-piloto, foi identificada a necessidade de adaptar algumas perguntas; de excluir um dos itens, que apresentava conteúdo semelhante a outro; e de inserir orientações prévias para preenchimento, resultando na versão final do instrumento. Conclusão A tradução e adaptação transcultural permitiu verificar as evidências de validade baseadas no conteúdo da versão brasileira do Down Syndrome Speech Intelligibility Survey.

Abstract in English:

ABSTRACT Purpose Translate and cross-culturally adapt the “Down Syndrome Speech Intelligibility Survey” questionnaire into Brazilian Portuguese. Methods The following steps were taken for cross-cultural adaptation: translation of the instrument from the source language to the target language, synthesis of the translated versions, evaluation of the synthesis by expert judges, evaluation of the instrument by the target audience, back translation, and pilot study. Results After the translation and synthesis of the translations, most expert judges analyzed almost all instrument items (n = 44, 97.77%) as very relevant, very feasible, and appropriate. In the analysis by the target population, parents suggested changes, improving the understanding of the instrument. The back translation revealed some inconsistencies in the translated and adapted version in relation to the original instrument’s content, and the appropriate adjustments were made. The pilot study identified the need to adapt some questions, exclude one item (which had similar content to another), and include prior instructions for completion, resulting in the final instrument version. Conclusion The translation and cross-cultural adaptation verified the validity evidence based on the content of the Brazilian version of the Down Syndrome Speech Intelligibility Survey.

Abstract in English:

ABSTRACT Purpose To assess the safety and immediate effect of photobiomodulation of low-level laser in vocally healthy women. Methods Experimental research in 36 vocally healthy women aged 18 to 45 years, with skin phototype I to III and body mass index below 25. Participants were randomized to form four groups: Group 1: placebo laser photobiomodulation followed by voiced tongue trill technique (VTTT); Group 2: 3 J infrared laser per point (total 21 J) followed by VTTT; Group: 3: 6 J infrared laser per point (total 42 J) followed by VTTT; and Group 4: 9 J infrared laser per point (total 63 J) followed by VTTT. The following outcomes were assessed: auditory-perceptual evaluation, acoustic analysis (jitter, shimmer, amplitude perturbation quotient [APQ], noise-to-harmonic ratio, period perturbation quotient, cepstral peak prominence, and cepstral peak prominence smoothed), and self-perceived phonatory effort. All participants’ records were taken before and immediately after the experiments. Results There was no significant difference in voice quality, acoustic parameters, or self-perceived phonatory discomfort between intervention moments in the placebo, VTTT + 3 J, and VTTT + 6 J groups in the intragroup comparison. G4 (VTTT + 9 J) decreased shimmer and APQ aperiodicity measures (respective p-values: 0.033; 0.044). Conclusion Results indicate aperiodicity measures improved with VTTT preceded by 9 J low-level laser application per point, commending this irradiation dosimetry as a possible energy for voice therapy in light-skinned and normal-BMI women. There was no evidence of worsened measures or in-creased discomfort with this resource, indicating it is safe for clinical practice.

Abstract in Portuguese:

RESUMO Objetivo Analisar a função de deglutição em idosos com demência através de avaliação clínica em um Centro de Referência em Assistência à Saúde do Idoso. Método Estudo observacional transversal retrospectivo com idosos, estratificados através do Clinical Dementia Rating (CDR). A caracterização ocorreu a partir de dados extraídos dos prontuários e que incluíram avaliação funcional, cognitiva e de humor. A avaliação clínica da deglutição consistiu na oferta de alimentos em três consistências, analisando treze itens e classificação funcional. Resultados Participaram 149 idosos: 47 neurotípicos (CDR 0), 37 com demência leve (CDR 1), 40 com demência moderada (CDR 2) e 25 com demência grave (CDR 3). Houve diferenças significativas entre os grupos, indicando maior alteração na deglutição conforme a gravidade da demência. Por exemplo, o CDR 3 apresentou maior alteração para escape oral para líquidos em comparação ao CDR 0 (p=0,012*). Tosse para sólidos e queda na saturação de oxigênio para líquidos foram maiores no CDR 3 do que CDR 1 (p=0,039* e p=0,047*, respectivamente). O CDR 3 também mostrou maior frequência de excursão laríngea reduzida para néctar em comparação ao CDR 2 (p=0,044*). Apenas a ausculta cervical positiva para néctar mostrou maior alteração no CDR 2 do que CDR 1 (p=0,019*). O resíduo oral para sólidos mostrou maior alteração no CDR 1 comparado ao CDR 0 (p=0,030*). Conclusão Houve associação entre a gravidade da demência e comprometimentos na deglutição, evidenciando a necessidade de intervenções específicas nessa população.

Abstract in English:

ABSTRACT Purpose To analyze swallowing in older adults with dementia through clinical evaluation at a referral center for elderly healthcare. Methods Retrospective, cross-sectional, observational study with older people, stratified by the Clinical Dementia Rating (CDR). Characterization was based on data extracted from medical records, including functional, cognitive, and mood assessments. The clinical evaluation of swallowing consisted of food offered in three consistencies, analyzing 13 items and functional classification. Results The sample included 149 older adults – 47 neurotypical (CDR 0), 37 with mild dementia (CDR 1), 40 with moderate dementia (CDR 2), and 25 with severe dementia (CDR 3). The groups differed significantly, indicating greater changes in swallowing according to the severity of dementia. For instance, CDR 3 had greater changes in oral spillage of liquids than CDR 0 (p=0.012*). Cough with solids and drop in oxygen saturation with liquids were greater in CDR 3 than in CDR 1 (p=0.039* and p=0.047*, respectively). CDR 3 also had a higher frequency of reduced laryngeal excursion with nectar than CDR 2 (p=0.044*). Only positive cervical auscultation with nectar showed greater change in CDR 2 than in CDR 1 (p=0.019*). Oral residue of solids had a greater change in CDR 1 than in CDR 0 (p=0.030*). Conclusion The severity of dementia was associated with swallowing impairments, highlighting the need for specific interventions in this population.

Abstract in Portuguese:

RESUMO Objetivo O objetivo deste estudo foi avaliar as contribuições do método DHACA no desenvolvimento da Comunicação Expressiva em crianças com Transtorno do Espectro do Autismo (TEA). Método Trata-se de uma pesquisa longitudinal, do tipo série de casos. A amostra foi constituída por 12 crianças com TEA, com comunicação não verbal ou minimamente verbal, nível de suporte um ou dois. Os dados do estudo foram obtidos por meio da aplicação do Protocolo ACOTEA-R a partir da análise de vídeos gravados das sessões de intervenção antes e após a utilização do Método DHACA. Foram realizadas 20 (vinte) sessões individuais de atendimento fonoaudiológico utilizando o Método DHACA. Resultados Após intervenção com o protocolo ACOTEA-R, houve um avanço geral nas habilidades de comunicação expressiva de 10 dos 12 participantes. Quanto ao perfil comunicativo, inicialmente 10 crianças eram não verbais e 02 minimamente verbais. Após a intervenção, 07 evoluíram para o padrão verbal, enquanto 05 crianças permaneceram não verbais. Destaca-se o progresso das seguintes habilidades comunicativas: utilização de frases com quatro ou mais palavras, nomeação de objetos, expressões sociais, cumprimento de pessoas e produção de comentários. Evidenciou-se, ademais, que 08 dos 12 participantes conseguiram avançar até a terceira habilidade do Método DHACA, caracterizada pelo Pedido com Ampliação Lexical e Morfossintática. Conclusão Evidenciou-se evolução no desenvolvimento da comunicação expressiva das crianças, tanto por meio do uso do livro de comunicação quanto pela fala, após intervenção com o método DHACA.

Abstract in English:

ABSTRACT Purpose This study aimed to assess the contributions of the DHACA method to expressive communication development in children with autism spectrum disorder (ASD). Methods This longitudinal case series study had a sample of 12 children with ASD, nonverbal or minimally verbal communication, and support level one or two. Data were collected by applying the ACOTEA-R Protocol by analyzing videos recorded during intervention sessions before and after using the DHACA. Participants underwent 20 individual speech-language-hearing sessions with the DHACA. Results After the intervention with the ACOTEA-R, 10 of the 12 children improved their overall expressive communication skills. Concerning the communicative profile, initially, 10 children were nonverbal and 2 were minimally verbal. After the intervention, 7 evolved to a verbal pattern, whereas 5 remained nonverbal. The progress of the following communication skills stands out: use of sentences with four or more words, naming objects, social expressions, greeting people, and making comments. Moreover, 8 of the 12 participants advanced to the third skill in the DHACA, characterized by request with lexical and morphosyntactic expansion. Conclusion The children’s speech and use of the communication book indicated progress in their expressive communication development after intervention with the DHACA.

Abstract in Portuguese:

RESUMO Objetivo Validar a estrutura interna do Teste de Concordância de Scripts em Fonoaudiologia (FonoTCS) que será desenvolvido em formato virtual com acesso livre, para ser utilizado na avaliação do raciocínio clínico de jovens profissionais e estudantes de fonoaudiologia com formação generalista, falantes do português brasileiro. Método Trata-se de estudo de validação de estrutura interna de instrumento. Participaram 25 fonoaudiólogos especialistas, com mais de 10 anos de experiência clínica generalista e 35 estudantes convocados para o Enade. Ambos os grupos avaliaram os 30 casos clínicos com 120 itens do FonoTCS. Para a seleção final dos especialistas que compuseram a amostra, foram retirados os juízes cujas avaliações apresentavam resultados de Z2 >2 e Z<-2 distantes da resposta modal. Para a seleção dos itens presentes no formato final do teste, permaneceram aqueles que, na correlação de Pearson entre as notas transformadas dos estudantes para um determinado Item, com a soma das notas transformadas para todos os Itens, obtiveram valor superior a 0,05. O teste Alfa de Cronbach foi aplicado para medir a consistência interna do FonoTCS e a pontuação de cada item foi definida a partir do método de escore agregado. Resultados As respostas de 13 fonoaudiólogos foram consideradas para definição da pontuação final do teste. O instrumento final apresentou 88 itens distribuídos em 28 casos clínicos. A consistência interna foi igual a 0,903 com intervalo de confiança de 95% expresso por 0,86|---|0,95. Estes valores indicam uma alta consistência interna entre os itens do FonoTCS. Conclusão O FonoTCS é válido e confiável para ser utilizado na avaliação do raciocínio clínico de jovens profissionais e estudantes de fonoaudiologia com formação generalista, falantes do português brasileiro.

Abstract in English:

ABSTRACT Purpose To validate the internal structure of the Speech-Language Pathology Script Concordance Test (FonoTCS), which will be developed in a virtual, open-access format, to be used in the assessment of clinical reasoning among young professionals and students of speech-language pathology with a generalist background, speakers of Brazilian Portuguese. Methods This is a study to validate the internal structure of the instrument. Twenty-five specialist speech-language pathologists, with more than 10 years of generalist clinical experience, and 35 students summoned for Enade participated. Both groups evaluated the 30 clinical cases with 120 items from FonoTCS. For the final selection of specialists who made up the sample, judges whose evaluations showed Z2 results >2 and Z<-2 distant from the modal response were removed. For the selection of items present in the final format of the test, those that remained had a Pearson correlation between the transformed scores of students for a given item and the sum of the transformed scores for all items, with a value greater than 0.05. The Cronbach's Alpha test was applied to measure the internal consistency of FonoTCS, and the score of each item was defined based on the aggregated score method. Results The responses of 13 specialists were considered for the definition of the final test score. The final instrument had 88 items distributed across 28 clinical cases. The internal consistency was 0.903 with a 95% confidence interval expressed by 0.86|---|0.95. These values indicate a high internal consistency among the items of FonoTCS. Conclusion FonoTCS is valid and reliable for use in evaluating the clinical reasoning of young professionals and speech-language pathology students with generalist training, who are Brazilian Portuguese speakers.

Abstract in Portuguese:

RESUMO Objetivo Traduzir e adaptar culturalmente o instrumento Deafness and Additional Disabilities Questionnaire (DAD-Q) para o Português Brasileiro. Método Realizou-se a tradução, retrotradução, revisão por comitê de especialistas e adaptação cultural. Para a adaptação cultural, participaram 11 mães de crianças surdas com deficiências adicionais, usuárias de implante coclear. A confiabilidade do instrumento traduzido foi estimada utilizando-se a análise de consistência interna (Alfa de Cronbach). Adotou-se como equivalência a ausência de dificuldade de compreensão das questões por, no mínimo, 80% das participantes. As participantes também classificaram a dificuldade em responder à versão no português brasileiro do instrumento e o tempo de aplicação. Resultados As divergências na tradução foram resolvidas pelo comitê de especialistas e 100% das participantes afirmaram compreender todas as questões do instrumento, sem dificuldades. O coeficiente alfa de Cronbach demonstrou consistência interna quase perfeita do instrumento e substancial nos demais domínios. A maioria das participantes classificou o instrumento como “muito fácil” e “rápido” de responder. Conclusão O instrumento DAD-Q foi traduzido e adaptado para o Português Brasileiro, resultando no “Questionário de Surdez e Deficiências Adicionais (DADQ-PT)”.

Abstract in English:

ABSTRACT Purpose Translate and culturally adapt the Deafness and Additional Disabilities Questionnaire (DAD-Q) into Brazilian Portuguese. Methods Translation, back-translation, review by an expert committee, and cultural adaptation were conducted. For the cultural adaptation, 11 mothers of deaf children with additional disabilities, who use cochlear implants, participated. The reliability of the translated instrument was estimated using internal consistency analysis (Cronbach's Alpha). Equivalence was defined as the absence of difficulty in understanding the questions by at least 80% of the participants. The participants also rated the difficulty in responding to the Brazilian Portuguese version of the instrument and the time required for its application. Results The discrepancies in the translation were resolved by the expert committee, and 100% of the participants reported understanding all the questions in the instrument without difficulty. The Cronbach's alpha coefficient demonstrated nearly perfect internal consistency for the instrument and substantial consistency in the other domains. Most participants rated the instrument as "very easy" and "quick" to respond to. Conclusion The DAD-Q instrument was translated and adapted into Brazilian Portuguese, resulting in the Questionário de Surdez e Deficiências Adicionais (DADQ-PT).

Abstract in English:

ABSTRACT Purpose This study aims to improve the existing knowledge about the application of Transcranial Direct Current Stimulation in rehabilitating Developmental Dyslexia, both alone and in conjunction with other therapeutic approaches. Research strategies The research was carried on the PubMed, Elsevier, LILACS and ERIC – Institute of Education Science. Selection criteria Peer-reviewed journal articles were included if published in English, Portuguese, and Spanish and be broken down from the research question devised by the PICO acronym. Data analysis Specific data collected according to delineation, summarized by descriptive analysis. Results Eleven articles were analyzed. Five of them associated tDCS with cognitive-linguistic or reading stimulation therapy. Assembly and application frequency parameters varied. The results indicated a positive effect on reading skills after the intervention in all of them. Conclusion The selected studies showed an improvement in reading speed and accuracy after active transcranial direct current stimulation, whether or not it combined with other cognitive-linguistic and reading stimulation. In some cases, the positive effects persisted up to six months after the intervention, making this a tool that can be used in the treatment of individuals with dyslexia.

Abstract in Portuguese:

RESUMO Objetivo investigar evidências da equitação no desenvolvimento de linguagem, cognição, aspectos sociais, emocionais e comportamentais em crianças e adolescentes neurotípicos. Estratégia de pesquisa Consulta nas bases de dados da Lilacs, MEDLINE, Web of Science, EMBASE, Scopus e literatura cinzenta, sem restrições de data ou idioma. Registro na plataforma Open Science Framework (OSF), sob número: DOI 10.17605/OSF.IO/32ETZ. Para estratégias de busca: “Equine-Assisted Therapy”, “Child or Adolescent Development", Cognition, Socialization e "Child Behavior”. Critérios de seleção Ensaios clínicos randomizados e estudos experimentais não randomizados de antes e depois, série de casos e observacionais prospectivos de pessoas com desenvolvimento neurotípico com até 18 anos de idade. Excluídos os estudos com pessoas com deficiência e transtornos do neurodesenvolvimento. Análise dos dados Equitação e terapia assistida por animais. Análise dos dados: A identificação de estudos primários foi realizada por dois juízes de forma independente, por meio de leitura dos títulos e resumos baseada nos critérios de inclusão e um terceiro juiz era consultado para caso de desempate. O risco de viés foi avaliado pelas ferramentas ROBINS-I e a ROBINS-2. Resultados Foram obtidos 131 estudos, sendo removidos os duplicados (27). Em seguida, 104 estudos foram analisados e 77 excluídos. Dos 27 estudos avaliados integralmente, 21 foram excluídos. Seis estudos foram elegíveis para esta revisão, sendo quatro estudos clínicos não randomizados e dois ensaios clínicos randomizados. Conclusão Os estudos não randomizados apontaram melhoras significativas quanto às funções cognitivas, aspectos comportamentais e emocionais. Já os estudos randomizados, encontraram ganhos significativos quanto à competência social.

Abstract in English:

ABSTRACT Purpose To investigate evidence of horse riding in the development of language, cognition, social, emotional, and behavioral aspects in neurotypical children and adolescents. Research strategies Search in the databases of LILACS, MEDLINE, Web of Science, EMBASE, Scopus, and grey literature, without date or language restrictions. Registration in the Open Science Framework (OSF), under number DOI 10.17605/OSF.IO/32ETZ. For search strategies: “Equine-Assisted Therapy”, “Child or Adolescent Development”, Cognition, Socialization, and “Child Behavior”. Selection criteria Randomized clinical trials and non-randomized experimental before-and-after studies, case series, and prospective observational studies of neurotypically developing people up to 18 years old. Studies with people with disabilities and neurodevelopmental disorders were excluded. Interventions researched: horse riding and animal-assisted therapy. Data analysis Two judges identified primary studies independently by reading the titles and abstracts, considering the inclusion criteria; a third judge was consulted to resolve divergences. The risk of bias was assessed using the ROBINS-I and ROBINS 2 tools. Results Altogether, 131 studies were obtained, and duplicates (27) were removed. Subsequently, 104 studies were analyzed and 77 were excluded. Of the 27 studies evaluated in full text, 21 were excluded. Six studies were eligible for this review – four non-randomized clinical studies and two randomized clinical trials. Conclusion The non-randomized studies showed significant improvements in cognitive functions and behavioral and emotional aspects. The randomized studies, on the other hand, found significant gains in social competence.