Orientador: Regina Yu Shon Chun / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T05:44:05Z (GMT). No. of bitstreams: 1 Ostroschi_DanieleTheodoro_M.pdf: 3160737 bytes, checksum: b30411e7977a6954e8e3a105701e2652 (MD5) Previous issue date: 2011 / Resumo: Introdução: Diversos fatores como a desnutrição materna, a prematuridade extrema e síndromes diversas, dentre outros, podem acarretar alterações no desenvolvimento infantil. Mediante as alterações, a intervenção oportuna pode favorecer o progresso global dessas crianças com risco, considerando-se que essa atuação envolve a participação de familiares/cuidadores e de uma equipe interdisciplinar, dentre os quais o fonoaudiólogo. No Brasil, são poucos os protocolos padronizados para avaliação de linguagem. Nas áreas de terapia ocupacional e fisioterapia, um dos instrumentos utilizados para avaliação pediátrica de incapacidade é o PEDI - Pediatric Evaluation of Disability Inventory que se mostrou viável para investigação dos aspectos de comunicação e interação social das crianças de risco que compõem este estudo. Objetivos: Analisar a interação social e comunicação de crianças com alterações neuromotoras sob a ótica de familiares/cuidadores e do fonoaudiólogo e caracterizar o perfil das crianças e dos familiares/cuidadores. Sujeitos e Método: A pesquisa foi aprovada pelo CEP-FCM/UNICAMP e submetida à anuência da Instituição e dos sujeitos do estudo. Participaram 35 familiares/cuidadores de 38 crianças de 12 a 36 meses, com alteração neuromotora e fatores de risco para o desenvolvimento, atendidas no Programa de Estimulação Precoce da APAE de uma cidade de médio porte do interior de São Paulo e uma fonoaudióloga (terapeuta e pesquisadora). A coleta de dados foi feita por meio de três fontes: (i) estudo dos prontuários para caracterização dos perfis das crianças quanto à idade, sexo, diagnóstico e tempo de atendimento na Instituição; (ii) levantamento de informações com familiares/cuidadores para caracterização dos seus perfis quanto à idade, escolaridade e profissão e (iii) aplicação do PEDI, tendo sido utilizada a primeira parte desse instrumento, voltada as habilidades de função social, em que se incluem os aspectos de comunicação e de interação social. Os procedimentos de coleta de dados envolveram, com os familiares/cuidadores, o método de entrevista e com a profissional, o método de julgamento clínico. Foi realizada análise estatística descritiva, inferencial e fatorial dos dados em comparação aos valores de referência do PEDI. Resultados: Em relação à distribuição por diagnóstico das crianças, a paralisia cerebral apresentou maior freqüência. A maioria dosfamiliares/cuidadores são mães (88%) e uma parcela pequena, avós (6%) e pais (3%), com idade variando entre 19 e 45 anos, com predominância de ensino médio completo e de profissão relatada como sendo profissional do lar (67%). As respostas dos familiares/cuidadores demonstraram maior concordância na habilidade de comunicação (68%), seguida das habilidades de casa/comunidade (56%) e de interação social (53%). As respostas do PEDI evidenciam atraso no desenvolvimento nas habilidades de comunicação e interação social das crianças estudadas em relação aos valores desse instrumento tanto na ótica dos familiares/cuidadores quanto na do profissional/pesquisador. Conclusões: De modo geral, a maioria das crianças do estudo apresenta valores abaixo daqueles de referencia do PEDI, evidenciando atraso em habilidades de interação social e comunicação. Os resultados demonstram o PEDI como um instrumento útil e complementar à avaliação clínica, no caso fonoaudiológica. Oferece subsídios ao conhecimento das habilidades funcionais referentes à função social (comunicação e interação), que podem auxiliar a nortear o profissional, assim como a equipe, no delineamento de estratégias de intervenção, obtendo-se dados junto à família e aos profissionais envolvidos tendo em vista o favorecimento da linguagem e interação, e conseqüente, autonomia e qualidade de vida do da criança com risco para o desenvolvimento. Tal perspectiva evidencia as possibilidades do instrumento em uma abordagem multi ou interdisciplinar tendo em vista a atenção integral à saúde do grupo populacional estudado / Abstract: Introduction: Several factors such as maternal malnutrition, extreme prematurity, and various syndromes, among others, could cause changes in child development. In this case, timely intervention can promote the overall progress of these children at risk, considering that this action involves the participation of family / carers and a multidisciplinary team, of which the audiologist. In Brazil, there are few standardized protocols for assessment of language. In the areas of occupational and physical therapy, one of the instruments used for pediatric evaluation of disability is the PEDI - Pediatric Evaluation of Disability Inventory that proved viable for investigation of aspects of communication and social interaction of children at risk making up this study. Objectives: To analyze the social interaction and communication of children with neuromotor from the perspective of family / caregivers and the Speech and Language Pathologist and to characterize the profile of children and families / caregivers. Subjects and Methods: The study was approved by CEP-FCM/UNICAMP and submitted for approval at the institution of the study. Participated in 35 family members / caregivers of 38 children aged 12 to 36 months, with neuromotor and risk factors for the development, attended the Early Stimulation Programme of APAE of a midsize city in the interior of São Paulo and a Speech and Language Pathologist (therapist and researcher). Data collection was done through three sources: (i) study of medical records to characterize the profiles of children in age, sex, diagnosis and time of attendance at the institution, (ii) information gathering with family / caregivers to characterize their profiles as to age, education and occupation, and (iii) implementation of the PEDI, has been used the first part of this instrument, focused social function skills, which include aspects of communication and social interaction. The data collection procedures involved with the family / caregivers, the interview method and with the professional, clinical trial method. We performed descriptive statistics, inferential and factorial data compared to the reference values of the PEDI. Results: Regarding the distribution of diagnosis, children with cerebral palsy was more frequent. Most family members / caregivers were mothers (88%) and a small portion, grandparents (6%) and parents (3%), aged between 19 and 45 years, withpredominance of high school education and occupation as reported work from home (67%). The responses of family members / caregivers showed greater agreement on communication skills (68%), followed by the skills of home / community (56%) and social interaction (53%). The responses of the PEDI showed developmental delays in communication skills and social interaction of children studied in relation to the values of the instrument both in the perspective of family / caregivers and the professional / researcher. Conclusions: In general, the majority of children in the study presents reference values below those of the PEDI, showing delay in skills of social interaction and communication. The results demonstrate the PEDI as a useful and complementary to clinical evaluation, speech therapy in the case. Provides grants to the knowledge of functional skills related to social function (communication and interaction), which can help to guide the professional as well as the team, the design of intervention strategies, obtaining data from family and professionals involved, in light of language's and interaction's view and consequently, autonomy and quality of life of the child at risk for development. This perspective highlights the possibilities of the instrument in a multi-or interdisciplinary approach with a view to comprehensive health care for the population group studied / Mestrado / Mestre em Saúde, Interdisciplinaridade e Reabilitação

[pt] Crianças que, a partir dos 3 anos de idade, recebem o diagnóstico de transtorno autista, apresentam falhas nos comportamentos comunicativos nãoverbais, já no primeiro ano de vida. Isto as impede de engajar-se em trocas sociais recíprocas com os seus cuidadores, ocasionando prejuízos severos em todo o seu desenvolvimento. Intervenções precoces com base na abordagem desenvolvimentista focalizam estas dificuldades iniciais, de modo a impedir ou amenizar os prejuízos secundários causados pelas mesmas. O presente trabalho teve como objetivo avaliar a aplicabilidade de um programa de intervenção precoce, de abordagem desenvolvimentista, baseado no programa norte-americano de Klinger e Dawson (1992), atualizado por estudos de vídeos familiares de Osterling e Dawson (1994) e de pesquisas de atenção compartilhada de Carpenter, Nagell e Tomasello (1998). Os participantes foram duas crianças, de 2 anos e 09 meses, que apresentavam dificuldades iniciais características do transtorno do espectro autista e suas respectivas cuidadoras. O programa consistiu em desenvolver 16 comportamentos pré-verbais nestas crianças. Mostrou-se aplicável e eficaz, desenvolvendo 9 comportamentos em uma criança e 6 em outra. / [en] Children diagnosed with autism spectrum disorder around their third year usually present deficits in non-verbal communicative behaviors at one year of age. Such deficits keep them from engaging in reciprocal social exchanges with their caregivers, which causes severe impairments in their development. Early intervention based on a developmental approach focuses on these inicial deficits in order to minimize late impairments caused by them. The present study aims at assessing an early intervention program, which was based on the Klinger & Dawson (1992) program, modified according to the results from a homevideo study by Osterling & Dawson (1994) and a joint attention research by Carpenter, Nagell & Tomasello (1998). The participants were two 33- month-old children diagnosed with autism spectrum disorder and their respective caregivers. The intervention program consisted in facilitating the development of sixteen preverbal behaviors by these children. It was effective: one of the children developed nine behaviors while the other one developed six.

This thesis describes an investigation into experiences connected to the implementation of educational behavior-analytic interventions (ABA) for children with autism in kindergartens. The research questions and the methodological choices in this investigation evolved based on new experiences over the course of the research project. Three sub-studies were conducted: a single case study on the implementation of ABA teaching programs specifically targeting joint attention skills for children with autism in kindergartens (Study 1); a questionnaire survey on the experiences of ABA supervisors in implementing ABA in kindergartens (Study 2); and an interview study on the experiences of ABA teachers in implementing ABA in kindergartens (Study 3). During Study 1, it appeared that the teaching intensity of the targeted ABA teaching programs varied largely from what was initially planned for all four of the participating children. Under those conditions, the learning outcomes of the children also varied. With regard to Study 2, the survey data obtained from 29 ABA supervisors indicated that many children with autism who receive ABA in Norwegian kindergartens do not receive the number of teaching hours being planned for them. There also seems to be quite a large number of kindergartens that lack teaching teams and who receive supervision less than what is generally recommended to obtain the optimal outcome from ABA. With regard to Study 3, the interview data obtained from 10 ABA teachers illustrated how implementation factors such as compatibility, complexity, client responsiveness, and supervision can be manifested when ABA is implemented in the kindergarten. A main finding was that in some cases there seem to be conflicting opinions within the kindergarten about whether ABA is right for the child, something that was interpreted to reflect a conflict between the categorical and the relational perspectives of special education. / Baksidestext This thesis describes an investigation into experiences connected with the implementation of educational behavior-analytic interventions (ABA) for children with autism in kindergartens. The three sub-studies that were conducted illustrated in different ways how ABA is not always implemented as intended. An important question that was addressed was what practitioners who work with ABA perceive as facilitating factors or barriers to the implementation of ABA in the kindergarten. The results of the study illustrated how implementation factors such as compatibility, complexity, client responsiveness, and supervision can be be manifested when ABA is implemented in the kindergarten. A main finding here was that in some cases there seem to be conflicting opinions within the kindergarten about whether ABA is right for the child, something that was interpreted to reflect a conflict between the categorical and the relational perspectives of special education.

The research investigation reported herein examined program outcomes of student problem behavior and social skills, based on teachers' perspectives, before and after early behavioral intervention services. The study targets students in kindergarten through grade five who are identified by the school system for being at-risk for being labeled with emotional and behavioral disorders. Students identified received early intervention services based on individualized positive behavioral supports (i.e., social skills training, functional behavioral assessment, and team collaboration). Teachers completed a teacher form of the Social Skills Rating System before and after the student received program services to determine differences in social skills and problematic behavior pre- and post- program early intervention services. An analysis was also made of the differences among gender, ethnicity, and grade according to the teachers' perspectives. Data indicated statistically significant results in the area of social skills and problem behavior. The results indicate early intervention services that teach social skills and use functional behavioral assessments to deal with problem behavior are beneficial to children displaying behavior challenges.

The traditional role of speech-language therapists as feeding specialists appears to have focused primarily on the mechanics of feeding disorders, without fully considering the impact of nutritional needs on a child's development and communication. The aim of the study was to investigate the experiences and perceptions of a group of speech-language therapists regarding nutritional issues in children requiring feeding therapy or early communication intervention. A qualitative research design was employed in the form of a descriptive survey and a questionnaire was compiled as the data collection instrument. Forty-nine questionnaires were delivered to speech-language therapists within the Johannesburg and Pretoria geographical areas, of which 32 were suitable for analysis. Closed ended questions were analyzed quantitatively using descriptive statistics while responses to open-ended questions were categorized thematically. Results indicated that all respondents came into contact with clients who had, or who were at risk for, feeding disorders and nutritional deficiencies. However, findings revealed that during assessment and treatment of these clients, respondents tended to neglect issues related to nutrition, as well as psychosocial issues pertinent to feeding disorders. Furthermore, respondents appeared not to have fully realized the importance of their role as communication specialists within the feeding context. It was found that the majority of respondents were involved within a multidisciplinary team approach; however, the application of the more effective transdisciplinary approach was limited. This was confirmed by results revealing that collaboration with other professionals, such as dieticians, did not consistently occur. In terms of training, it was evident that respondents received the majority of their training in feeding therapy from continued education, which included aspects of nutrition. However, undergraduate training was perceived as having limitations within the theoretical content as well as practical application, and did not incorporate nutritional aspects. In light of the apparent need for a more holistic view of paediatric clients with feeding disorders, suggestions were made regarding the inclusion of vital nutritional issues and psychosocial factors within training and transdisciplinary service delivery in South Africa. Furthermore, relevant research topics within the field of paediatric feeding were presented. Broadening perspectives by means of holistic research and training may enhance service delivery to children with paediatric feeding disorders. / Dissertation (MCommPath)--University of Pretoria, 2002. / tm2015 / Speech-Language Pathology and Audiology / MCommPath / Unrestricted

According to the DSM-IV- TR (American Psychiatric Association, 2000), one of the core deficits in autism is in the impairment of social interaction. Some have suggested that underlying these deficits is the reality that individuals with autism do not find social stimuli to be as reinforcing as other types of stimuli (Dawson, 2008). An interesting and growing body of literature supports the notion that symptoms in autism may be caused by a general reduction in social motivation (Chevallier et al., 2012). A review of the literature suggests that social orienting and social motivation are low in individuals with autism, and including social motivation as a target for therapeutic intervention should be pursued (Helt et al., 2008). Through our understanding of learning processes, researchers in behavior analysis and related fields have been able to use conditioning procedures to change the function of neutral or ineffective stimuli, including tokens (Ayllon & Azrin, 1968), facial expressions (Gewirtz & Pelaez-Nogueras, 1992) and praise (Dozier et al., 2012). The current study aimed to use operant and respondent procedures to condition social stimuli that were empirically shown to not be reinforcing prior to conditioning. Further, this study aimed to compare the two procedures in their effectiveness to condition social stimuli to function as reinforcers, and in their maintenance of effects over time. Using a multiple-baseline, multi-element design, one social stimulus was conditioned under each procedure to compare the different response rates following conditioning. Finally, the study sought to determine if conditioning social stimuli to function as reinforcers had any effect on the social functioning of young children with autism. Six children diagnosed with autism between the ages of 18 months and 3 years participated. Results show that the respondent procedure (pairing) resulted in more robust and enduring effects than the operant procedure (Sd procedure). Results of a social communication assessment (ESCS, Mundy et al., 2003) before and after conditioning demonstrate gains in all areas of social communication, particularly in the areas of initiating and responding to joint attention.

Thesis advisor: Mary E. Walsh / Poverty has many deleterious effects on child development, including negative impacts on social-emotional health, a developmental domain schools refer to as non-cognitive skills (Dearing, 2008). Unfortunately, children growing up poor often have underdeveloped non-cognitive skills, which significantly predict academic success and well-being (Farrington et al., 2012). Integrated Student Support (ISS) is one emerging approach that holistically supports cognitive and non-cognitive student development (Moore & Emig, 2014). While ISS has been found to improve academic outcomes, limited research examines its impact on social-emotional outcomes. This study focused on one ISS intervention, City Connects, which provides tailored student support plans to every child in a school via school and community-based services (Walsh et al., 2014). The study had three aims. The first was to examine the percentage of City Connects students with and without a social-emotional-behavioral (SEB) Need across levels of risk and service characteristics (i.e., domains, intensity levels, types) in second grade (N=896). The second was to examine improvement in three teacher-rated non-cognitive student outcomes (Prosocial Behavior, Self-Regulated Learning, Academic Effort) from second-fifth grade for City Connects students with and without a SEB Need (N=896). The third was to compare improvement in the same three non-cognitive student outcomes from second-fifth grade for students with a SEB Need in City Connects schools and comparable schools without the intervention (N=1,778). Multilevel modeling assessed aims 2 and 3. Significantly more students with a SEB Need were deemed higher risk and received more health, early intervention, and SEB/counseling services compared to students without a SEB Need in City Connects schools. Further, significant improvements from second-fifth grade were found in Self-Regulated Learning and Academic Effort for City Connects students with a SEB Need compared to those without a SEB Need. Significant improvements were also found over time in Academic Effort for students with a SEB Need in City Connects schools compared to those in comparison schools. Findings support that ISS improves non-cognitive functioning for students attending high-poverty schools. / Thesis (PhD) — Boston College, 2020. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.

Within the scope of all that is expected to be accomplished in education, what difference does a tardy make? This study was designed to examine the significance of tardiness, as it relates to student achievement, as measured by the results of the state math test. It also investigated the generation of change by the campus administrator to improve punctuality, with a new method of enforcing the tardy policy with the use of an electronic data system. This study used archived data from the one high school in a suburban school district in Texas. From a student population of 2,631, two subject groups of 919 and 1,310 were determined. Spearman rho results confirmed a moderate inverse relationship between student tardiness and results on the state math test. Descriptive discriminant analysis indicated that tardiness contributed to 25% of the variance in the results on the state math test, when considered alone, and had a smaller contribution when considered with other variables. A visual review of the data portrayed an inverse relationship between the occurrences of tardiness and the pass/fail results on the state math test; as tardiness increased, passing rates decreased. Wilcoxon signed rank test results revealed a reduction in the magnitude of tardiness with the implementation of a new method of enforcing the tardy policy. Tardiness does impact academic achievement, as affirmed in this study. Also, the campus administrator can implement changes that improve punctuality. This study signified that the phenomenon of tardiness should be given greater consideration as a factor impacting both cognitive and non-cognitive development and endorsed that minutes do matter.

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abstract: The purpose of this study is to evaluate the effects of parent training in the Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) intervention program, using a secure internet-based conferencing software (telepractice), on parent strategy use and child speech and language outcomes for children with repaired cleft lip and/or palate (CL/P). Three participant dyads composed of a parent and child participated in this study. Children ranged in age from 21 to 27 months at the beginning of this study and all had a diagnosis of nonsyndromic CL/P. Participating dyads received three in- person training sessions and three weekly telepractice intervention sessions. Assessment and intervention sessions were administered by a trained Speech Language Pathologist (SLP) and a graduate SLP student clinician. Parents demonstrated a positive intervention effect by significantly increasing their use of EMT+PE intervention strategies during training. Based on preliminary results, parents were able to maintain their increased use of strategies following the conclusion of intervention as well. Telepractice proved to be a valid service delivery model for conducting early intervention sessions and for supporting the early speech and language development for children with CL/P. / Dissertation/Thesis / Masters Thesis Communication Disorders 2020