Test and measurement bias in special education diagnosis has been well documented. Boys, linguistic and ethnic minorities, and children with behavior problems are among those overrepresented in several handicap categories, including speech impairment. Recent evidence indicates that variables associated with test interpretation or diagnostician background (non-measurement factors) may be better predictors of diagnostic bias. This study investigated the ability of non-measurement factors to predict the diagnostic decisions made for 345 speech impaired children enrolled in Head Start. Computer Assisted Telephone Interviews and Case File Review were used to collect data about (1) child characteristics, (2) diagnostic criteria, and (3) diagnostician background. Hierarchical regression procedures were used to test the predictive power of these three blocks of variables and of specific variables within each block. The diagnostician's rating of articulation severity was the criterion variable. The test score was the best predictor of articulation severity rating; non-measurement factors were not found to be effective predictors of the articulation component of speech diagnosis. There was some indication, however, that non-measurement factors may be related to the language component of speech assessment. Further investigation of the language severity rating and of other non-measurement factors was suggested. / Ph. D.

published_or_final_version / Speech and Hearing Sciences / Doctoral / Doctor of Philosophy

The purposes of this investigation were to identify, via the Pragmatic Protocol, the incidence of pragmatic disorders within public school articulation and language caseloads and a control group of normal students and to specify the pragmatic areas, i.e., utterance propositional, and/or illocutionary/perlocutionary act categories in which deficits occur.

A heterogeneidade do Transtorno Fonológico tem suscitado muitas discussões e despertado a atenção dos pesquisadores quanto a importância de se descrever detalhadamente as características fonológicas dos sujeitos que o apresentam. Instrumentos específicos que contribuem para o diagnóstico diferencial desse Transtorno de outras alterações de linguagem possibilitam maior precisão na sua identificação. O presente estudo teve como objetivo descrever o desempenho de crianças com Transtorno Fonológico no Test of Language Development Primary 3 adaptado para o Português Brasileiro. Participaram da pesquisa 91 sujeitos, de ambos os gêneros, com idades variando de 4:0 a 8:10 anos, sendo 76 crianças com desenvolvimento típico de fala e linguagem (grupo controle) e 15 crianças com Transtorno Fonológico (grupo pesquisa). Foram aplicados os subtestes do Test of Language Development Primary 3 adaptado em todos os sujeitos, e analisados os escores padrão dos subtestes e os quocientes dos índices compostos. Também foram analisadas as correlações entre os índices Percentage of Consonants Correct - Revised do ABFW e o Percentage of Consonants Correct - Revised do Test of Language Development Primary 3 adaptado, e, entre cada um desses índices e os escores padrão dos subtestes e os quocientes do teste. Foi ainda analisada a associação entre histórico de otite, audiometria e o Percentage of Consonants Correct - Revised do Test of Language Development Primary 3 adaptado nas crianças com Transtorno Fonológico. Os sujeitos do grupo pesquisa apresentaram desempenho semelhante ao grupo controle nos subtestes de Semântica, porém o desempenho daquele grupo foi inferior, quando comparado ao grupo controle, nos subtestes de Sintaxe e de Fonologia. Quanto aos subtestes verificou-se que seis deles discriminaram os dois grupos, para os quais foram determinados valores de corte. Apenas o subteste Articulação de Palavra teve contribuição adicional significativa na discriminação dos dois grupos, permitindo classificar o indivíduo em um deles. No grupo pesquisa foi verificado um desempenho inferior ao grupo controle, em todos quocientes; também foram observadas diferenças significativas entre os grupos em todos quocientes, exceto no Quociente Compreensão. Foi verificada correlação positiva apenas entre dois subtestes de Fonologia e o Percentage of Consonants Correct - Revised do ABFW e o Percentage of Consonants Correct - Revised do Test of Language Development Primary 3 adaptado, porém não houve correlação entre os quocientes e os índices. Não se verificou associação entre o Percentage of Consonants Correct - Revised do Test of Language Development Primary 3 adaptado, o histórico de otite e os resultados da audiometria no grupo pesquisa; todos os sujeitos desse grupo apresentaram resultados dentro dos padrões de normalidade na audiometria. Os dados desse estudo mostraram que as crianças do grupo pesquisa não apresentam dificuldades em tarefas de vocabulário, contudo, além das dificuldades fonológicas, foram observadas alterações das habilidades sintáticas dessas crianças. Possivelmente essa alteração no domínio sintático seja decorrente de alterações na representação fonológica presentes nesse transtorno. O Test of Language Development Primary 3 adaptado mostrou-se um instrumento eficaz na diferenciação de crianças com e sem Transtorno e poderá ser usado como prova complementar no diagnóstico do Transtorno Fonológico. / The heterogeneity of the phonological disorder has raised discussion and attention of researchers regarding the importance of describing in a detailed manner the phonological characteristics of the subjects. Specific tools that contribute to the differential diagnosis of phonological disorder from other language disorders provide more accuracy in their identification. This study aimed to describe the performance of phonological disordered children in the Test of Language Development Primary 3 adapted to Brazilian Portuguese. Participants were 91 boys and girls, with age ranging from 4:0 to 8:10 years, divided into two groups: 76 typically developing speech and language children (control group) and 15 phonological disordered children (phonological disordered group). Subtests of the Test of Language Development Primary 3 adapted were conducted to all subjects and the subtests\' standard scores and the composite quotients of the test were analyzed. It was also analyzed correlations between the Percentage of Consonants Correct - Revised of the ABFW and the Percentage of Consonants Correct - Revised of the Test of Language Development Primary 3 adapted, and correlation of both indexes with subtest and with the composite quotient of the Test of Language Development Primary 3 adapted. Also, association between otitis background, audiometry and Percentage of Consonants Correct - Revised of the Test of Language Development Primary 3 adapted in children with phonological disorder was analyzed. Subjects of the phonological disordered group showed similar performance to the control group in Semantics subtests, however the performance of this group was lower compared to the control group, in the Syntax and Phonology subtests. It was found that six subtests discriminated the two groups and cutoff values were determined. Only the Word Articulation subtest had a significant additional contribution in the discrimination of the two groups allowing the classification of the individual in one of them. The phonological disordered group performed lower than the control group in all quotients; significant differences were observed between groups in all quotients except for the Listening quotient. Positive correlation was only found between two Phonology subtests with the Percentage of Consonants Correct - Revised of the ABFW and the Percentage of Consonants Correct - Revised of the Test of Language Development Primary 3 adapted, but there was no correlation between the quotient and these indexes. There was no association between the Percentage of Consonants Correct - Revised of the Test of Language Development Primary 3 adapted, otitis background and audiometry in the phonological disordered group; all subjects of this group presented results within normal range in the audiometry. Data from this study showed that children of the phonological disordered group did not present difficulties on vocabulary tasks, however, in addition to phonological difficulties it was observed impaired syntactic skills. Perhaps this impairment in the syntactic domain may be result of changes in the phonological representation of this disorder. The Test of Language Development Primary 3 adapted proved to be an effective tool in the differentiation of children with and without phonological disorder and may be used as an additional test for the diagnosis of phonological disorder.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2016-08-05T12:13:18Z No. of bitstreams: 1 Nayara Thais de Oliveira Costa.pdf: 1071808 bytes, checksum: f97bb08403576a1534a911329fa2a041 (MD5) / Made available in DSpace on 2016-08-05T12:13:18Z (GMT). No. of bitstreams: 1 Nayara Thais de Oliveira Costa.pdf: 1071808 bytes, checksum: f97bb08403576a1534a911329fa2a041 (MD5) Previous issue date: 2016-03-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Purpose: The main purpose of this study was to establish he relation between audibility for speech sounds and speech recognition in children with neurosensory hearing loss using hearing aid. Method: The subjects of this study were 40 children with moderate to severe hearing loss, of both sexes, with chronological age between tive and 12 years. Initially, the factors that may influence the analyzed subjects' performances in speech recognition tests were assessed. The investigated factors were: audibility for speech, according to Speech intelligibility index (SII); chronological age; audiometric characteristics; information regarding audiologic rehabilitation; means of communication and test material. Finally, groups composed by children with similar SII values were compared in order to identify the individual characteristics of each group and the aspects able to distinguish on group from the other. The studied variables were: audiologic and hearing aid use characteristics (time of sensory deprivation and mean hours of daily use) and performance in recognition of words and consonants. Results: The analysis showed that the SII values had a weak to moderate relation with speech recognition results. Regarding the other variables concerning the child, only the audiometric thresholds were also related to the child's behavior on the test, though this relation ,was always weak. There were statistical differences identified in the performances on the speech material, better for words with greater linguistic content. Finally, children in the group with better audibility - GrSII-1 had better performances in the speech recognition test, however, with more heterogeneous results among its members n compared to the group with lower audibility - GrSII-2. GrSII-1's recognition performance was more susceptible to the influence of other factors, such as time of sensory deprivation. The results of the group with lower audibility was more influenced by ifs audiometric limitations since children in this group had more errors than those in the first group, and these errors were mainly for speech segments with low acoustic energy. Conclusion: Audibility for speech, measured based on SII values is related to the performances of neurosensory hearing impaired children using individual hearing aid in speech recognition tests. However, it must be considered that, although this relation exists, SII represents only the speech signal that is accessible and useful through the hearing aid, and is incapable of expressing adverse factors that may influence the performance of children, such as adequate auditory stimulation deprivation or the test's material characteristic / Objetivo: O objetivo geral desta pesquisa foi estabelecer a relação entre audibilidade para sons de fala e reconhecimento de fala em crianças com deficiência auditiva neurossensorial usuárias de Aparelho de Amplificação Sonora Individual (AASI). Método: Participaram deste estudo 40 crianças com perda auditiva de grau moderado a severo, de ambos os sexos e idade cronológica entre cinco e 12 anos. Inicialmente, foram pesquisados os fatores que poderiam influenciar o desempenho dos sujeitos analisados em teste de reconhecimento de fala, sendo investigados: audibilidade para fala, a partir de valores de Índice de Inteligibilidade de Fala - mais comumente denominado de SII; idade cronológica; características audiométricas; informações relacionadas à reabilitação auditiva; meio de comunicação e material de teste. Por último, grupos formados por crianças que possuíam valores de SII similares foram comparados buscando-se identificar as características individuais de cada grupo e os aspectos capazes de distinguir um grupo do outro, sendo pesquisadas como variáveis: as características audiológicas, de uso de AASI (tempo de privação sensorial e média de horas de uso por dia) e desempenho de reconhecimento de palavra e consoantes. Resultados: A análise mostrou que valores de SII tiveram relação fraca a moderada com resultados de reconhecimento de fala. Em relação às demais variáveis relacionadas à criança, foram identificadas que somente os limiares audiométricos também tiveram relação com o comportamento das crianças no teste, porém essa relação foi sempre fraca. Quanto ao material de fala, foram identificadas diferenças estatísticas entre os desempenhos, sendo melhores para palavras com maior conteúdo linguístico. Por último, foi observado que crianças pertencentes ao grupo com melhor audibilidade - GrSII-1, possuíam melhor desempenho em teste de reconhecimento de fala, porém, com resultados mais heterogêneos entre seus membros, se comparado ao grupo com menor audibilidade - GrSII-2. O desempenho de reconhecimento do GrSII-1 se mostrou mais suscetível à influencia de outros fatores, como o tempo de privação sensorial, já os resultados do grupo com menor audibilidade se mostrou mais influenciado por suas limitações audiométricas, sendo que crianças desse grupo tiveram mais erros do que do primeiro grupo, e esses erros foram principalmente para segmentos de fala com baixa energia acústica. Conclusão: A audibilidade para fala, mensurada a partir de valores de SII, tem relação com desempenhos de crianças com deficiência auditiva neurossensorial usuárias de AASI em teste de reconhecimento de fala. No entanto, deve-se levar em consideração que, apesar dessa relação existir, o SII representa apenas que o sinal de fala está acessível e útil por meio do AASI, sendo incapaz de expressar fatores adversos que podem ter influencia sobre o desempenho das crianças, como a privação de estimulação auditiva adequada ou característica do material de teste

Thesis (Ph.D.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 1981. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND ENGINEERING. / Bibliography: leaves 185-192. / by Marcia Ann Bush. / Ph.D.

The motivation of this study was to examine the effects of intensive speech treatment on the conversational intelligibility of Spanish speakers with Parkinson’s Disease (PD). It also aimed at investigating several acoustic variables in the speech of this population. Sixteen speakers with a medical diagnosis of PD participated in this study and their voice recordings were analyzed pre- and post-treatment. The intelligibility measures of transcription accuracy and median ease-of-understanding ratings increased significantly immediately post-treatment and gains were maintained at the one-month follow-up. The acoustic variables of vowel space and voice onset time did not change significantly pre-to-post treatment, whilst the prosodic targets of intensity and mean fundamental frequency increased significantly as a result of treatment. These findings support the implementation of intensive voice intervention to improve intelligibility in Spanish dysarthria. Clinical and theoretical considerations are discussed.

Objetivo: Analisar, em indivíduos com mordida cruzada total, a influência da cirurgia ortognática na produção dos diferentes fonemas da língua portuguesa, agrupados quanto ao ponto articulatório. Modelo: Estudo prospectivo, que comparou a fala de sujeitos submetidos à cirurgia ortognática, nas fases pré e pós-cirúrgica. Local: Laboratório de Fisiologia- HRAC/USP. Participantes: 19 homens e 11 mulheres (média de 21 anos) com mordida cruzada total, que apresentavam fissura labiopalatina reparada. Intervenções: Avaliação da fala, antes e, em média, 4 meses após a cirurgia ortognática. Variáveis: Ponto articulatório dos grupos de fonemas bilabiais, labiodentais, linguodentais, alveolares, palatais e velares, sendo considerada presença ou ausência de alteração. Resultados: Houve o predomínio de permanência sem alteração para os grupos de fonemas bilabiais e velares, permanência com alteração para os labiodentais e linguodentais, e melhora para os alveolares. Já, no grupo de fonemas palatais, houve uma maior distribuição entre os resultados, com equilíbrio entre permanência com e sem alteração. Apesar de raros, houveram casos de piora para esses quatro grupos. Conclusão: Em sujeitos com mordida cruzada total, a cirurgia ortognática não exerceu influência nos fonemas bilabiais e velares, corretos na fase pré-cirúrgica; influência positiva foi observada em menos de 1/3 no grupo de fonemas labiodentais, e ao redor de 50% nos linguodentais, alveolares e palatais; influência negativa ocorreu nos quatro grupos, ao redor de 5%. À exceção dos casos de adequação automática de todos os fonemas do grupo e de permanência sem alteração, os demais resultados evidenciaram a necessidade de terapia miofuncional orofacial. / Objective: To evaluate, in individuals with anterior and posterior crossbite, the influence of orthognathic surgery on the production of different Portuguese phonemes grouped as to the place of articulation. Model: Prospective study for comparison of the speech of individuals submitted to orthognathic surgery, before and after surgery. Setting: Physiology Laboratory – HRAC/USP. Participants: 19 males and 11 females (mean age 21 years) with anterior and posterior crossbite with repaired cleft lip and palate. Interventions: Speech evaluation before and about four months after orthognathic surgery. Variables: Place of articulation of the groups of bilabial, labiodental, dental, alveolar, palatal and velar phonemes, considering the presence or absence of alteration. Results: There was predominance of permanence without alteration for the groups of bilabial and velar phonemes, permanence with alteration for the labiodental and dental phonemes, and improvement in the alveolar phonemes. As regards the group of palatal phonemes, there was a greater distribution among the outcomes with balance between permanence with and without alteration. Though rare, there were cases of worsening for these four groups. Conclusion: In subjects with anterior and posterior crossbite, the orthognathic surgery did not yield any influence on the bilabial and velar phonemes, which were correct in the pre-surgical phase; a positive influence was observed in less than 1/3 in the group of labiodental phonemes and close to 50% in the dental, alveolar and palatal phonemes; the negative influence in the four groups was close to 5%. Except for the cases with automatic adaptation of all phonemes in the group and permanence without alteration, the other results indicated the need of orofacial myofunctional therapy.

Essa pesquisa foi realizada com o objetivo de avaliar os componentes da matriz extracelular da cartilagem, ligamentos, tendão e sinóvia em modelo experimental de diabetes. Metodologia: Ratos Wistar jovens foram divididos em grupo diabético (DG n = 15) induzido por estreptozotocina (STZ, 35 mg / kg) e grupo controle (CG, n = 15). Foram avaliados o peso, a glicemia e o anticorpo anticarboximetil-lisina plasmática, durante o experimento e após 70 dias da indução. As articulações do joelho, os ligamentos colateral lateral, colateral medial e tendão calcâneo foram isoladas, corados com hematoxilina-eosina e Picrosírius. O teor de colágeno total foi determinado por morfometria. Avaliamos ainda a metaloproteinase 9 e os inibidores de metaloproteinases (TIMP) 1 e 2 da cartilagem articular. Na sinóvia analisamos a expressão de endotelina-1. Os colágenos dos tipos I, III, V nos ligamentos e tecido sinovial e II e XI na cartilagem foram avaliados pela técnica de imunofluorescência. Resultados: Os níveis elevados de glicemia e anticorpo anticarboximetil-lisina plasmática foram observados no GD quando comparado com o CG. O peso final foi menor nos ratos GD do que nos ratos do CG. Avaliação histomorfométrica mostrou uma grande quantidade de fibras colágenas finas fibrilas, mais grossa nos ligamentos e cartilagens da GD ratos, bem como o aumento de colágeno e diminuição da espessura das fibras colágenas finas do tecido sinovial. Houve uma diminuição no proteoglicanos na DG ratos, quando comparados com os ratos do GC. Imunofluorescência demonstrou um aumento de colágeno III e V em ligamentos, colágeno XI em cartilagem, e colágeno I no tecido sinovial de ratos DG comparados com ratos do GC. Conclusão: O diabetes está fortemente relacionado com a remodelação do colágeno e ocorre de formas diferentes nos componentes articulares. Estes resultados podem contribuir para o desenvolvimento de novas terapias correlacionadas com as complicações articulares em pacientes diabéticos / The aim of this study was to evaluate the extracellular matrix components in cartilage, ligaments and synovia in experimental model of diabetes. In this way Young Wistar rats were divided into diabetic group (DG; n = 15) induced by streptozotocin (STZ; 35 mg/kg) and control group (CG; n=15). Weight, blood glucose and plasmatic anti-carboxymethyllysine were measured 70 days after STZ. Knee joints, patellar, collateral lateral, and collateral medial ligaments were isolated, stained with hematoxylin-eosin and Picrosírius. The total collagen content was determined by morphometry. The types I, III, and V collagens in ligaments and synovial tissue and II and XI in cartilage were evaluated by immunofluorescence. Higher blood glucose levels and plasmatic anti-carboxymethyllysine were observed in DG rats when compared with CG rats. The final weight was lower in DG rats than in CG rats. Histomorphometric evaluation depicted a large quantity of thin collagen fibers over thick fibrils in ligaments and cartilage in DG rats as well as increased thick collagen and decreased thin collagen fibers in synovial tissue. There was a decrease in proteoglycans in DG rats when compared with CG rats. Immunofluorescence demonstrated increases of collagen III and V in ligaments, collagen XI in cartilage and collagen I in synovial tissue of DG rats compared with CG rats. In conclusion diabetes is strongly related with collagen remodeling and occurs differently in joint components. These results may contribute to the development of new therapies correlated with joint complications in diabetic patients

Language delay and phonological delay have been shown to coexist. Because they so often co-occur, it is possible that they may interact, sharing a relationship during the child's development. A group of children who were "late talkers" as toddlers, achieved normal development in their syntactic ability by the preschool period. Because their language abilities are known to have increased rapidly, data on their phonological development could provide information on the relationship between phonological and syntactic development. The purpose of this study was to compare the percentage of phonological process usage of the eight most commonly used simplification processes in four-year-old expressive language delayed (ELD) children, children with a history of slow expressive language development (HX), and normally developing (ND) children. The questions this study sought to answer were: do ELD children exhibit a higher percentage of phonological process usage than ND children, and are HX children significantly different in their percentage of phonological process usage than ND and/or ELD children.