Made available in DSpace on 2016-04-27T18:11:55Z (GMT). No. of bitstreams: 1 Silvia Daniella Guedes Ferraz.pdf: 417057 bytes, checksum: 5c74d5788d784dd76f8a65c843c14de8 (MD5) Previous issue date: 2012-01-27 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The advance of clinical researches and experiences in treating children with disabilities points to the need of development of therapeutic projects which promote the integration of different professional views on the cases. From clinical experiences and reflections the cotherapy was thought, in the present research, as a device to serve this population through the joint action of speech therapy, physiotherapy and occupational therapy. The purpose of this investigation was to map such cotherapy experiences in order to analyze potential and limits of this device. To this end, we carried out the mapping and analysis of the clinical trials proposed in two cases: a seven-year-old with Down syndrome, and another four-year old one with cerebral palsy. The cartography was constructed from actual experiences with patients, scores made by their parents, and perceptions recorded by the professionals involved in the experiment. These processes of cotherapy have been well evaluated by the families as well as the patients. Some conditions of possibility were highlighted on them: the care and attention to the setting which this type of meeting requires and produce; multiple and singular composition of the therapeutic relationships, and articulation among the therapists. Considering the need for training of professionals and the care in the management of the work processes, the cotherapy proved to be an effective tool in the treatment of disabled children, promoting integrated vision, construction of more comprehensive clinical listening, and the elaboration of interdisciplinary singular therapeutic projects. It also collaborated with the expansion of capacity to meet the specific needs of each case investigated. It was also possible to note that the disciplinary backgrounds of the professionals had to be open to the reinvention of values and positions, based on how the knowledge of a discipline affected and was affected by the others. Taking into account and being submitted to such intersections this clinical practice can be considered inventive, creative / O avanço das experiências e pesquisas clínicas no atendimento a crianças com deficiências aponta para necessidade de construção de projetos terapêuticos que favoreçam a integração de diferentes olhares profissionais. A partir de experiências e reflexões clínicas, a coterapia foi pensada, na presente pesquisa, como dispositivo de atendimento a essa população, por meio da ação conjunta da fonoaudiologia, fisioterapia e terapia ocupacional. O objetivo da investigação foi cartografar tais experiências em coterapia, de modo a analisar potencialidades e limites desse dispositivo clínico. Para tanto, realizou-se o mapeamento e a análise dos arranjos clínico-terapêuticos propostos em dois casos: uma menina de 7 anos de idade, com Síndrome de Down, e outra de 4 anos, com paralisia cerebral. A cartografia foi construída a partir de situações vividas com os pacientes; de pontuações realizadas por seus pais; e por registros das percepções dos profissionais envolvidos na experiência. Esses processos de coterapia foram bem avaliadas pelas famílias e também pelas pacientes. Neles se destacaram algumas condições de possibilidade: atenção e cuidado com o setting que este tipo de encontro exige e produz; composição singular e múltipla das relações terapêuticas; e articulação entre os terapeutas. Considerando a necessidade de preparação dos profissionais e os cuidados no manejo dos processos de trabalho, a coterapia se mostrou dispositivo efetivo na terapia de crianças com deficiências, favorecendo visão integrada; construção de escuta clínica mais abrangente; e elaboração de projetos terapêuticos singulares interdisciplinares. Colaborou também com a ampliação da capacidade de responder às necessidades específicas de cada caso pesquisado. Foi possível verificar ainda que a formação disciplinar dos profissionais precisou se abrir à reinvenção de posições e valores, a partir dos modos como saberes de uma disciplina afetaram e foram afetados pelos das outras. Esta prática clínica, ao considerar e se dispor a tais intersecções, pode ser considerada inventiva, criativa

Speech perception is a unique audiovisual experience in part because timing of the speech signal is influenced by simultaneous overlapping gestures in coarticulation. Apraxia of speech (AOS) is a motor planning disorder that impairs coarticulation. Imaging studies show that brain regions damaged in AOS are critical to audiovisual speech perception. Although AOS is a motor planning disorder, individuals with AOS may have a disruption to the perceptual system for speech gestures. To evaluate this hypothesis we investigated audiovisual mismatch negativity (MMN) brain responses in adults with damage to Broca’s area (n =5) compared to a healthy age-matched comparison group (n = 5). We utilized the McGurk effect, in which incongruent auditory and visual information alters perception. Participants viewed videos of a speaker articulating the syllable /ba/ (standard) for 80% trials and /ga/ (deviant) for 20% of the trials while the auditory stimulus /ba/ remained consistent throughout. Responses to this McGurk audiovisual condition were compared to an inverse McGurk audiovisual condition in which the visual stimulus remained constant while the auditory stimulus changed, and a visual-only condition without sound to control for evoked activity from changes to the visual stimulus. Incongruent McGurk deviants elicited an MMN over left hemisphere electrodes in the comparison group, while the AOS group exhibited a later, attention-based response, a P300. The AOS group similarly responded to inverse McGurk deviants, which do not require fusion of the percept, with a P300 response, indicating that auditory and visual aspects of the incongruent McGurk deviants were not integrated. In the visual-only control condition, the AOS group showed a left-lateralized MMN, suggesting greater influence of visual processing when confronted with conflicting multisensory information compared to the comparison group. Overall, the comparison group’s responses were indicative of early and automatic audiovisual integration of incongruent McGurk percepts while the responses of the AOS group showed contributions of both attentional and visual processing. The timing of the response in the AOS group was correlated with speech production characteristics of apraxia, as well as performance on taxing motor speech tasks. Results of this study support the hypothesis that AOS is a disorder beyond motor planning, with implications for higher-level linguistic and cognitive systems.

Introdução: As articulações compensatórias são alterações de fala decorrentes da tentativa do indivíduo com fissura palatina/disfunção velofaríngea gerar pressão intraoral para a produção das consoantes de alta pressão. Essas alterações se iniciam por causa da alteração estrutural e podem passar a fazer parte do sistema fonológico do indivíduo, sendo a fonoterapia a intervenção indicada para sua correção. Desta maneira a hipótese deste trabalho é que um programa de fonoterapia intensiva (PFI) estruturado reúne as condições facilitadoras para a correção da oclusiva glotal, que é o tipo de articulação compensatória (AC) mais comumente encontrado na fala desses indivíduos. Objetivo: Investigar a influência de um PFI sobre a ocorrência da oclusiva glotal (OG) na fala de indivíduos com fissura palatina. Material e Métodos: As gravações de fala de 37 indivíduos, de ambos os sexos (média de idade = 19 anos), com fissura palatina foram julgadas por três fonoaudiólogas (avaliadoras) experientes na identificação da ocorrência de OG em 24 consoantes-alvo com recorrência das seis consoantes oclusivas do Português (p, t, k, b, d, g), antes de serem submetidos a um PFI (condição pré-PFI) e após o PFI (condição pós-PFI), para comparação. Resultados: A presença de OG, na condição pré-PFI, foi encontrada em 325 consoantes-alvo de 36 das 37 gravações, dentre as quais, na condição pós-PFI, 149 (46%) continuaram a apresentar OG e 176 (54%) não. Considerando a ocorrência de OG nas 24 consoantes-alvo das frases dos 36 pacientes, observou-se que após o PFI 5 (14%) conseguiram eliminar a OG em todas as consoantes-alvo; 4 (11%) não apresentaram mudança e 27 (75%) apresentaram redução da ocorrência de OG. Conclusão: O PFI teve influência sobre a ocorrência da oclusiva glotal na fala de indivíduos com fissura palatina, sendo esta menor após a intervenção. / Introduction: Compensatory articulations are speech disorders due to the attempt of the individual with cleft palate/velopharyngeal dysfunction to generate intraoral pressure for the production of high-pressure consonants. These disorders happen because structural alteration and can become part of the phonological system of the individual. Speech therapy is the indicated intervention for their correction. The hypothesis of this study is that a structured intensive speech therapy program (PFI) meets the facilitating conditions for the correction of the glottal stops, which is the most common compensatory articulation in the speech of these individuals. Objective: To investigate the influence of a PFI on the occurrence of glottal stop (OG) in the speech of individuals with cleft palate. Material and Methods: Speech recordings of 37 cleft palate individuals, both genders (mean age = 19 years), were judged by three experienced speech pathologists (judges) to identify the occurrence of OG in 24 target consonants with a recurrence of the six occlusive consonants of the Portuguese Language (p, t, k, b, d, g). For the purpose of comparison, the judgements were accomplished before PFI (pre-PFI condition) and after the individuals have been undergone to the PFI (post-PFI condition). Results: Presence of OG in the pre-PFI condition was found in 325 target consonants of 36 out of the 37 recordings. In the pos-PFI condition, out of the 325, 149 (46%) continued to present OG and 176 (54%) did not. Considering the occurrence of OG in the 24 target consonants of the sentences of the 36 patients, it was observed that after the PFI 5 (14%) of them were able to eliminate the OG in all the target consonants; 4 (11%) presented no change and 27 (75%) had a reduction in the occurrence of OG. Conclusion: The PFI had influence on the occurrence of the OG in the speech of cleft palate, which reduction was smaller after the PFI.

This study investigated the advisability of utilizing parents to provide treatment for their dysfluent preschoolers. It involved the development, implementation and evaluation of a specific treatment program involving indirect language stimulation techniques. The primary question asked was whether or not parents can be successful in significantly reducing or eliminating dysfluent speech in their children. The secondary question was whether or not parents can be trained successfully to provide treatment.

Thesis (D. Phil.(Communication Pathology))--University of Pretoria, 2005. / Summary in English and Afrikaans. Includes bibliographical references.

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2008. / Title from first page of PDF file (viewed July 10, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 332-356).

Thesis (Ph.D.)-Umeå Universitet, 2006. / Includes bibliographical references and index.

Thesis (M.Communication Pathology) -- University pf Pretoria, 2000. / Summary in English and Afrikaans.

Thesis (M.S.)--University of Nevada, Reno, 2001. / Includes bibliographical references. Online version available on the World Wide Web.

Purpose: The purpose of the present study is to determine the treatment strategies that male-to-female transgender individuals consider to be critical to passing as their true gender as well as the unique factors that may contribute to these individuals seeking speech therapy services. This study also seeks to determine awareness of the transgender population in regards to the availability and scope of speech therapy services relative to transitioning or passing as their true gender. Method: A 38-question electronic survey (N= 17 respondents in final data corpus) was developed to address our research questions and was distributed via email to various transgender listervs, organizations, etc. Results: Although male to female individuals, regardless of their age or geographic location, reported speech therapy to be an important part of the transition, they did not seek speech therapy for themselves. They are highly motivated to achieve an overall feminine presentation, specifically a more feminine vocal quality. These individuals are aware of speech therapy services but are not familiar with specific factors targeted in therapy or the breadth of services available. Conclusion: Preliminary results revealed the rated importance of speech therapy services for the male to female transgender population as well as the lack of awareness and availability of the breadth of speech therapy services available to transgender clients. These findings will further enhance our ability to meet the needs of the male to female transgender client. / text