I dagens globaliserade samhälle blir det allt vanligare att barn växer upp med fler än ett språk i sin omgivning. Det kräver en ökad kunskap om flerspråkighet och vad som särskiljer flerspråkiga barn från enspråkiga barn. Då de mätinstrument som idag används i Sverige för att utröna om ett barn har en språkstörning endast är utformade för enspråkiga barn riskerar flerspråkiga barn att över- eller underdiagnostiseras. För att råda bot på den problematik som uppkommit i samband med diagnostisering av flerspråkiga barn och språkstörning har ett europeiskt forskningsnätverk bildats, kallat COST Action IS0804. Syftet med nätverket är att kartlägga SLI (specific language impairment) hos flerspråkiga barn genom att koordinera forskning inom lingvistisk och kognitiv förmåga över ett stort antal länder. Denna studie syftar till att samla in och analysera referensdata för enspråkigt svensktalande barn med typisk språkutveckling, samt jämföra resultatet med referensdata från andra grupper som använt samma material i Sverige på flerspråkiga barn i jämförlig ålder. Det övergripande syftet är att referensdatan på sikt kan användas för att öka kunskapen om skillnader och likheter mellan en- och tvåspråkiga barn med målet att differentiera dessa från flerspåkiga barn med SLI genom COST projektet. Då tidigare studier i Sverige endast använt materialet till att studera berättande, syftar denna studie även till att samla in referensdata för både berättande och återberättande. Deltagarna är fjorton barn mellan 5:6 och 7:5 år som fått berätta och återberätta kring fyra bildberättelser samt besvara ett antal förståelsefrågor till varje bildberättelse. Resultatet visar att det finns tydliga skillnader mellan hur barnen presterar på berättande och på återberättande, vilket är intressant då narrativerna eliciterades med bildsekvenser som är makrostrukturellt lika. Dessa skillnader manifesteras både beträffande makrostrukturen i form av story grammar poäng, då återberättande både ger högre min - och maxpoäng samt total poäng överlag, och på mikrostrukturen då återberättande ger något längre och mer varierade texter än berättande. Vid en jämförelse av resultaten vid berättande från tidigare studier inom COST som studerat flerspråkiga barn i Sverige föreligger en mikrostrukturell skillnad, då de enspråkiga deltagarna i denna studie producerar något längre texter på svenska än de flerspråkiga barnen i samma ålder. Denna skillnad verkar dock inte ha någon makrostrukturell påverkan då antalet story grammar poäng på deltagarnas narrativer är relativt likvärdig över de olika studierna. Resultatet stödjer tidigare forskning som påvisat att den narrativa makrostrukturen är språkligt obunden. Mer forskning kring skillnader i narrativförmåga mellan barn med och utan språkstörning behövs dock innan det går att dra mer långtgående slutsatser om makrostruktur som klinisk markör för språkstörning hos flerspråkiga barn. / As society today is becoming more and more globalized, the number of children growing up with several languages is ever increasing. This calls for better and deeper knowledge of bilingualism in general and for a better understanding of developmental language differences between bilingual and monolingual children in particular. However, methods for assessing whether a bilingual child suffers from language impairment are developed and standardized for monolingual children only, and there is a rising need for tools that can reliably assess bilingual children. To meet this need, a European research network (COST Action IS0804) has been established, with the aim to map specific language impairment in bilingual children by coordinating research on linguistic and cognitive skills across 30 countries. Within this network, a new multilingual assessment tool for narratives has been developed. The aim of the present study is to collect and analyze narratives by Swedish monolingual children with typical language development with this assessment tool and compare their results with data from recent studies of Swedish bilingual children of a comparable age. The long-term objective is for the results to be used to increase our knowledge about similarities and differences between monolingual and bilingual children with and without language impairment through the COST network. Since previous narrative studies in Sweden have only used the tool for telling, the aim of the present study has been to collect data on both telling and retelling. Participants were fourteen children between 5;6 and 7;6 years. Narratives were elicited with the help of four parallel sets of stimulus pictures; two for which the participants were instructed to tell a story, and two for which the task was to retell after listening to a model story. Participants also answered a number of comprehension questions after each story. Narratives were analysed for macrostructure and microstructure. The results show some pronounced differences between how the participants performed in telling and retelling, which is noteworthy since the stimulus materials were parallel in macrostructure. Differences between telling and retelling manifested themselves in macrostructure in terms of story grammar points, with higher minimum and maximum points for retelling, and on some (but not all) microstructural measures, with longer and lexically more varied texts in retelling than telling. Comparing the results to previous studies on age-matched bilingual Swedish children of similar socio-economic status using the same assessment tool, monolinguals and bilinguals differed slightly: The monolingual participants in the present study produced longer texts in Swedish than their bilingual peers. This difference in microstructure did however not have any impact at the macrostructural level, where monolinguals and bilinguals in the previous studies scored fairly similar. These results underpin findings of earlier research which have shown that narrative macrostructure is largely languageindependent and may thus be a more appropriate measure of narrative ability in bilingual children than language-dependent microstructural measures. However, more research is necessary before any far-reaching conclusions can be drawn as to whether macrostructure can be used as a clinical marker for specific language impairment in bilingual children.

Made available in DSpace on 2015-07-22T20:49:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-02-27 / Objetivo: Verificar a eficácia da intervenção terapêutica fonoaudiológica para os quadros de Autismo Infantil e Síndrome de Asperger. Métodos: Trata-se de ensaio clínico piloto. A amostra constituiu-se de 11 meninos, na faixa etária de 4 a 10 anos, atendidos no Laboratório de Investigação Fonoaudiológica de Linguagem e Fala – Transtornos Globais do Desenvolvimento do Departamento de Fonoaudiologia da UNIFESP e diagnosticados por equipe multidisciplinar, com Autismo Infantil (6) e Síndrome de Asperger (5). As crianças foram divididas aleatoriamente em dois grupos: Grupo GT constituído por seis crianças assistidas em intervenção terapêutica fonoaudiológica direta e indireta; Grupo GO com cinco crianças acompanhadas apenas indiretamente. Utilizamos as partes do ASIEP-2 (Krug et al, 1993), compostas pelo Autism Behavior Checklist (ABC/ICA), Avaliação da Interação (AI/IA) e a Avaliação do Comportamento Vocal (ACV/SVB), aplicados em três momentos: tempo zero, após seis (tempo 1) e doze meses (tempo 2). Resultados: Verificamos tendência de melhor desempenho do Grupo GT, tanto na análise dos valores totais do Autism Behavior Checklist (ABC/ICA) e nas áreas que o compõem, quanto na Avaliação da Interação (AI/IA) e do Comportamento Vocal (ACV/SVB). Ou seja, foi possível comparar o desempenho evolutivo das crianças sob a perspectiva tanto das mães quanto da fonoaudióloga. A interferência do diagnóstico multidisciplinar, da faixa etária e do quociente social, no processo evolutivo, também foi analisada. O desempenho das crianças diagnosticadas com Síndrome de Asperger foi considerado mais positivo, quando comparado ao das crianças autistas. Houve padrão evolutivo mais acentuado, de modo geral, nas crianças na faixa etária entre 73 meses ou mais, consideradas neste estudo como as mais velhas. As crianças classificadas como xxix portadoras de quociente social de grau normal, leve e moderado registraram padrão evolutivo maior. Conclusão: A tendência de melhor desempenho das crianças assistidas em ambas as intervenções mostrou a eficácia da associação de ações terapêuticas diretas e indiretas. / Purpose: Evaluate the efficacy of the speech and language therapy for Autistic Spectrum Disorders. Methods: The design of this study is the Clinical Trial. The sample was composed of 11 children diagnosed with Autism (6) and Asperger Syndrome (5) attended in the Language and Speech Laboratory – Autistic Spectrum Disorders at Federal University of São Paulo. These children were randomly divided into two groups: Six were receiving both direct and indirect intervention (Therapy Group-TG), and five were receiving exclusively indirect intervention (Orientation Group-OG). We used the following parts of ASIEP-2 (Krug et al, 1993): Autism Behavior Checklist (ABC), Interaction Assessment (IA) and Sample of Vocal Behavior (SVB) on three occasions: at the beginning, six months later and 12 months later. Results: We observed there was greater evolution of Therapy Group –TG in the Autism Behavior Checklist, Interaction Assessment and Sample of Vocal Behavior. The mothers and the Speech and Language Therapist perceived behavioral changes. The influence of the multidisciplinary diagnosis, age and measures of the adaptive functioning was analysed. The performance of children with Asperger Syndrome was considered more positive. There was greater evolution in the children with age 73 month or more, and in the children with normal, mild and moderate adaptive functioning. Conclusions: The tendency of better performance of the children attended in direct and indirect intervention showed that this association was fundamental. / TEDE / BV UNIFESP: Teses e dissertações

Nos dias atuais, a clínica fonoaudiológica brasileira, com pacientes autistas, ainda permanece impregnada do uso de procedimentos corretivos/normativos, visando fundamentalmente à comunicação. Assumindo um afastamento dessa percepção objetivista, segmentada e comportamentalista, e adotando uma concepção mais subjetiva (onde se valoriza o particular) de linguagem como forma de ação e do jogo interacional como uma construção conjunta da significação, investigou-se, nesse estudo o papel dos recursos lingüísticos verbais, prosódicos e paralingüísticos na construção da linguagem da criança autista, na clínica fonoaudiológica. Especificamente, esta pesquisa teve como objetivo investigar o papel dos aspectos lingüísticos verbais (marcadores conversacionais basicamente interacionais e seqüenciadores), lingüísticos prosódicos (alongamentos vocálicos, entonações, alterações no ritmo, alterações na altura vocal) e paralingüísticos (a cinésica, a tacêsica, a proxêmica, a correção, o parafraseamento, a repetição, a pausa, a hesitação, a interrupção e o silêncio) na construção da linguagem da criança autista. Verificou-se, também, como objetivos específicos, a incidência do uso de elementos lingüísticos verbais, lingüísticos prosódicos e paralingüísticos na relação fonoaudiólogo/criança autista na prática fonoaudiológica. Os participantes do estudo foram duas fonoaudiólogas e seus pacientes, de 08 e 12 anos, com diagnóstico de autismo, caracterizados nesse estudo como díade 1 e 2. A coleta de dados foi feita semanalmente, através de gravações de vídeo dos atendimentos fonoaudiológicos. Os dados foram interpretados com base na transcrição das gravações de vídeo, e nos recortes discursivos, como propostos pela Análise da Conversação. Os resultados mostraram o papel desempenhado pelos recursos lingüísticos verbais, prosódicos e paralingüísticos nas interações dialogadas, tanto nos turnos das terapeutas como nos turnos dos sujeitos. Observou-se um equilíbrio na utilização dos recursos pesquisados nos turnos das terapeutas e um desequilíbrio, como maior prevalência de utilização dos recursos paralingüísticos nos turnos dos sujeitos. De forma complementar, verificou-se a ocorrência de ecolalias nos turnos das crianças. Tendo em vista sua semelhança com as repetições, recurso fundamental na elaboração do texto falado, recorreu-se à observação minuciosa das gravações de vídeo, no intuito de se estabelecer uma diferenciação entre tais recursos. Percebeu-se que, nas crianças autistas pesquisadas, a diferenciação entre a repetição e a ecolalia centrava-se em três características nas emissões ecolálicas: ausência de contato visual, atividade motora constante e reprodução fiel de recursos como alongamento vocálico, entonação e alteração de tom. Como conclusão, percebeu-se que os recursos lingüísticos verbais e prosódicos desempenharam o papel de articular os segmentos do discurso, destacar aspectos importantes do texto falado, facilitar a compreensão, orientar o interlocutor durante a interação, traduzir o estado emocional dos interactantes e facilitar o acesso ao significado do discurso. Os recursos paralingüísticos operaram no processamento do texto falado, na organização do pensamento dos interactantes, na delimitação dos tópicos, na ênfase, e chamaram a atenção de forma decisiva na manutenção da interação. Destaca-se, ainda, que a utilização equilibrada dos recursos estudados, como observada nos turnos das terapeutas, permitiu uma melhor formulação do texto falado. Constatou-se, também, que, diante do imediatismo da interação face a face, é extremamente difícil estabelecer a diferença entre a ecolalia e a repetição, sugerindo, portanto, que ambas devam ser significadas no processo terapêutico, permitindo ao seu usuário maiores possibilidades discursivas / Nowadays, the brazilian speech therapy clinic, with autistics, is still dominated by the use of corrective and normative procedures, aiming at communication basically. Moving away from the positivisms point of view and adopting the subjectivism ideas (that values the particular), beyond the language conception as a mean of action and the dialogic game as a joint construction of meanings, this research investigated the role of the verbal-linguistic resources, prosodics and paralinguistics in the construction of the autistic child language, in the speech therapy clinic. Specifically, this study had the objective of searching the conversation marks basically the interactionals and the catenation ones, the vowels prolongations, intonations, rhythm and vocal pitches alterations, the cinesic, the tacesic, the prosemic, the correction, the paraphrasing, the repetition, the pause, the hesitation, the interruption and the silence. It was also verified the incidence of these resources en the relation between the autistic child and the speech therapist. The participants of the study were two speech therapists and their patients, among eight and twelve years old, with autism diagnostic, characterized, in this research, as 1 and 2 diade. The data collection was done weekly, through video recorders, gotten during the speech therapy sections. The data were analyzed by means of the video recorders transcriptions, with basis in the discursive fragments, in agreement to the purposes of the Conversation Analysis. The results demonstrated the role played by the resources in the dialogic interactions in the therapists speech turns and in their patients turns. It was observed an equilibrium in the use of the resources by the speech therapists and an inaquality with prevalence of paralinguistic resources by the patients. This study noticed the use of babbling or echolalia by the patients, considering the relation with the repetitions (essencial resource to the speech). With the intention of establish a contrast between the resources, it was required a detailed overlook from the video recorders, and, later, an analisys about the echolalia behavior all along the interactions analysed. As a conclusion, the verbal-linguistic resources, prosodics and paralinguistics were current during the díades interactions. The balanced use of the resources envolved, as the observed in the therapists speech turn, allowed a better speech constructuion. It was also evidenced the imediatism existent in the face-to-face interaction, and that it is very hard to certify the difference between the echolalia or babbling and the repetition. Therefore, this difficulty suggests that both must be meaned in the therapy process, allowing big discursive possibilities to the speakers.

Made available in DSpace on 2016-06-02T19:46:03Z (GMT). No. of bitstreams: 1 2281.pdf: 993624 bytes, checksum: d5e3c2cfb49295c73eaf64052ec31dc5 (MD5) Previous issue date: 2009-02-12 / Universidade Federal de Sao Carlos / Speech Pathology and Special Education establish relations of proximity due to similar objects of studies. Besides, the integrated work between professionals maximizes opportunities of growth for both areas. Therefore, the overall objective suggested in this research is to understand how Speech Pathology was taken as the object of research in Special Education based on the analysis of scientific production of dissertations and thesis of the Graduate Program in Special Education of Universidade Federal de São Carlos (PPGEEs/UFSCar). For that reason, the scientific production in Special Education with interface in Speech Pathology was mapped and the main aspects that support such integration were identified. The data source were thesis and dissertations defended in PPGEEs/UFSCar between 1981 and 2005. This program was chosen for being the first and only of the area in the country. The methodological procedures to develop the research involved the following steps: a) review of literature in Special Education and Speech Pathology; b) survey and data collection of dissertations and thesis in Special Education held in PPGEES/UFSCar that had interface with Speech Pathology c) categorization and bibliometric analysis. The results obtained through bibliometric analysis revealed that 74 studies analyzed refer to the interface between Special Education and Speech Pathology; hearing disability was the most investigated; the pieces work were focused on the theme "Teaching and learning" and while conducting a quantitative analysis of the references used on the pieces of work that have the co-relation with the area of Speech Pathology, it was observed that they were indexed in the magazine Pro-fono: Revista de Atualização Científica and in the Journal of Speech and Hearing Disorders; the pieces of work of Special Education in the magazine Revista Brasileira de Educação Especial. Finally, this study aimed to promote the interdisciplinarity between these areas, identified trends and emerging themes that may favor the joint action of these professionals. Moreover, the dissertation aimed to contribute to the construction of a process of reflection and assessment of information produced in Special Education consolidated in scientific production of thesis and dissertations and its interface with Speech Pathology. / A Fonoaudiologia e a Educação Especial estabelecem relações de proximidade por possuírem objetos de estudos semelhantes, além de que o trabalho integrado entre os profissionais maximiza possibilidades de crescimento para ambas as áreas de conhecimento. Nesta perspectiva, o objetivo geral proposto nesta pesquisa encontra-se em compreender como a Fonoaudiologia foi tomada como objeto de pesquisa na Educação Especial com base na análise da produção científica de dissertações e teses do Programa de Pós-Graduação em Educação Especial da Universidade Federal de São Carlos (PPGEEs/UFSCar). Para tanto, mapeou-se a produção científica em Educação Especial com interface em Fonoaudiologia e identificou os principais aspectos que favorecem essa integração. As fontes de dados foram às dissertações e teses defendidas no PPGEEs/UFSCar no período de 1981 a 2005. Este Programa foi escolhido por ser o primeiro e único da área no país. Os procedimentos metodológicos para desenvolver a pesquisa envolveram os seguintes passos: a) revisão de literatura em Educação Especial e Fonoaudiologia; b) levantamento e coleta de dados das dissertações e teses em Educação Especial defendidas no PPGEES/UFSCar que possuam interface com a Fonoaudiologia; c) categorização e análise bibliométrica. Os resultados obtidos, por meio da análise bibliométrica, revelaram que 74 trabalhos analisados fazem referência à interface entre Educação Especial e a Fonoaudiologia; a deficiência auditiva foi a mais investigada; a temática focada nos trabalhos foi Ensino-aprendizagem e ao realizar a análise quantitativa das referências utilizadas nos trabalhos que fazem co-relação com a área de Fonoaudiologia observou-se que se encontraram indexados na Pro-fono: Revista de Atualização Científica e no Journal of Speech and Hearing Disorders; os da área de Educação Especial na Revista Brasileira de Educação Especial. Enfim, este estudo caminhou na direção de valorizar a interdisciplinaridade existente entre estas áreas de conhecimento, apontou tendências e temas emergentes que podem favorecer a atuação conjunta desses profissionais. Além disso, a dissertação pretendeu contribuir para a construção de um processo salutar de reflexão e avaliação do conhecimento produzido em Educação Especial consolidado na produção científica de teses e dissertações e sua interface com a Fonoaudiologia.

A aquisição e o desenvolvimento da linguagem são primordiais na vida de uma criança, especialmente porque a linguagem possibilita a comunicação com o mundo, sendo um dos principais meios de integração social. Por isso é de grande importância que se assegure que as crianças tenham um bom desenvolvimento da linguagem e, quando necessário, uma boa intervenção em suas dificuldades. Atualmente, em linguagem infantil no Brasil, discute-se diferentes abordagens terapêuticas, mas se verifica a necessidade da elaboração de programas terapêuticos estruturados, confeccionados com qualidade técnica e cientifica que, estimulem as diversas habilidades de linguagem, de forma a considerar as especificidades de cada criança, a fim de minimizar as dificuldades na comunicação destas. Programas de intervenção deste tipo norteariam os fonoaudiólogos a planejarem suas terapias e proporcionaria maior eficácia no processo terapêutico. O objetivo principal deste trabalho foi elaborar, e testar a aplicabilidade de um programa de estimulação de linguagem oral para crianças com atraso de linguagem, na faixa-etária de 3 a 6 anos. Para isso, após a elaboração do programa de estimulação, o mesmo foi julgado por dois juízes, fonoaudiólogos mestres em Linguagem com experiência em Intervenção em Linguagem Infantil, quanto: (a) coerência das estratégias propostas com relação a meta de estimulação; e, (b) com relação ao nível de dificuldade de tais estratégias para o perfil das crianças. Em seguida o programa foi aplicado em 10 crianças com atraso de linguagem sem outros comprometimentos (sensoriais e/ou neurológicos), este programa foi composto de 20 sessões terapêuticas, realizadas com frequência de três vezes por semana, durando em média 60 minutos. As crianças realizaram uma pré-testagem e foram submetidas ao programa de estimulação proposto, ao termino foi realizada uma pós-testagem. Nesta avaliação pré e pós-estimulação, foram avaliados a organização fonológica, vocabulário receptivo e expressivo, habilidades pragmáticas e habilidades psicolinguísticas da criança. O programa foi julgado como adequado pelos juízes e as crianças submetidas à ele tiveram desempenho de acordo com esperado durante as sessões de estimulação. Observou-se também melhora estatisticamente significante (p<0,05) na pós-testagem na Linguagem Global, Linguagem Receptiva, Linguagem Expressiva, Vocabulário Expressivo, Memória de trabalho fonológica e habilidades comunicativas verbais. Conclui-se que o programa atingiu seus objetivos, sendo que o mesmo pode vir a nortear e aprimorar a estimulação fonoaudiológica nos casos de alterações em linguagem infantil, enfatizando a estimulação dos níveis fonético-fonológico, sintático, semântico-lexical e pragmático da linguagem e habilidades psicolinguisticas. / The acquisition and development of language are primary in a child\'s life, especially because language is one of the main means of social interaction. Therefore, it is of great importance that a good language development has been assured to children and, when necessary, a good intervention in their difficulties. Currently, in the field of children\'s language in Brazil, different therapeutic approaches are argued, but the necessity of development of structured therapeutic programs is verified, elaborated with technical and scientific quality so that they may stimulate the different abilities of language, aiming to consider the specifics of each child in order to minimize the difficulties. Such intervention programs would guide speech-language pathologists to plan their therapies and provide more effective in the therapeutic process. The aim of this study was elaborate and tests the applicability of a program of stimulation of verbal language for children with language delay from the ages of three to six years old. For this reason, the stimulation program was judged by peers (speech pathologists who are master in Language and have experience with Child Language Intervention) after it was design. The judges verified if the strategies was coherent about (a) the stimulation target and (b) the complexity level. In order to follow up children with language delay at the program, it was applied into 10 children with language delay without any other difficulties (sensorial and/or neurological) covered 20 stimulation sessions. This program was applied during seven weeks with three sessions each week. Children was submitted to a pre-stimulation assessment and then to stimulation program, after to a post-stimulation assessment. In pre-stimulation and post-stimulation assessment the phonetic inventory, and phonological organization, the receptive and expressive vocabulary and pragmatic abilities of the child was analyzed. As a result, the program was classified as adequate by the judges and the children was capable to done the tasks and manifest the communication behaviors adequately. Moreover, was observed that the children had a statistically significant improvement (p< 0,05) in the global language, receptive language, expressive language, expressive vocabulary, phonological work memory and communicative abilities in the post-stimulation assessment. In conclusion, the program reach the goal, since it could give direction and enhance to the speech-language pathologists in cases of difficulties in verbal language, emphasizing the stimulation of phonetic-phonological, syntactic, lexical-semantic and pragmatic language levels and psycholinguistic skills.

Physical objects with digital properties are being used more and more by the public. One such term for these artefacts include "the Internet of Things''. Most of these objects are often impossible to further modify or customise, and thus serve just the single purpose intended by their creators. This thesis explores the possibility of customising physical objects in order to provide an affordable and flexible way of interacting with them. A prototype, involving a mobile phone application (Android) and wireless sensor technology (NFC tags), was developed for the medical domain of speech and language therapy. The system, developed in close association with two therapists, allows the customisation of current speech and language exercise and associated material. It is designed to also assist with logging the patient interactions during the conduction of such exercises. The proposed solution has been tested and validated by medical experts, and its user interface evaluated by non-patient users.

Made available in DSpace on 2017-06-01T18:24:20Z (GMT). No. of bitstreams: 1 Andrea_Ferraz.pdf: 824960 bytes, checksum: dd32468b3f4b82d29d5e72b2c7592be5 (MD5) Previous issue date: 2007-05-03 / Nowadays, the brazilian speech therapy clinic, with autistics, is still dominated by the use of corrective and normative procedures, aiming at communication basically. Moving away from the positivism s point of view and adopting the subjectivism ideas (that values the particular), beyond the language conception as a mean of action and the dialogic game as a joint construction of meanings, this research investigated the role of the verbal-linguistic resources, prosodics and paralinguistics in the construction of the autistic child language, in the speech therapy clinic. Specifically, this study had the objective of searching the conversation marks basically the interactionals and the catenation ones, the vowels prolongations, intonations, rhythm and vocal pitches alterations, the cinesic, the tacesic, the prosemic, the correction, the paraphrasing, the repetition, the pause, the hesitation, the interruption and the silence. It was also verified the incidence of these resources en the relation between the autistic child and the speech therapist. The participants of the study were two speech therapists and their patients, among eight and twelve years old, with autism diagnostic, characterized, in this research, as 1 and 2 diade. The data collection was done weekly, through video recorders, gotten during the speech therapy sections. The data were analyzed by means of the video recorders transcriptions, with basis in the discursive fragments, in agreement to the purposes of the Conversation Analysis. The results demonstrated the role played by the resources in the dialogic interactions in the therapists speech turns and in their patients turns. It was observed an equilibrium in the use of the resources by the speech therapists and an inaquality with prevalence of paralinguistic resources by the patients. This study noticed the use of babbling or echolalia by the patients, considering the relation with the repetitions (essencial resource to the speech). With the intention of establish a contrast between the resources, it was required a detailed overlook from the video recorders, and, later, an analisys about the echolalia behavior all along the interactions analysed. As a conclusion, the verbal-linguistic resources, prosodics and paralinguistics were current during the díades interactions. The balanced use of the resources envolved, as the observed in the therapists speech turn, allowed a better speech constructuion. It was also evidenced the imediatism existent in the face-to-face interaction, and that it is very hard to certify the difference between the echolalia or babbling and the repetition. Therefore, this difficulty suggests that both must be meaned in the therapy process, allowing big discursive possibilities to the speakers. / Nos dias atuais, a clínica fonoaudiológica brasileira, com pacientes autistas, ainda permanece impregnada do uso de procedimentos corretivos/normativos, visando fundamentalmente à comunicação. Assumindo um afastamento dessa percepção objetivista, segmentada e comportamentalista, e adotando uma concepção mais subjetiva (onde se valoriza o particular) de linguagem como forma de ação e do jogo interacional como uma construção conjunta da significação, investigou-se, nesse estudo o papel dos recursos lingüísticos verbais, prosódicos e paralingüísticos na construção da linguagem da criança autista, na clínica fonoaudiológica. Especificamente, esta pesquisa teve como objetivo investigar o papel dos aspectos lingüísticos verbais (marcadores conversacionais basicamente interacionais e seqüenciadores), lingüísticos prosódicos (alongamentos vocálicos, entonações, alterações no ritmo, alterações na altura vocal) e paralingüísticos (a cinésica, a tacêsica, a proxêmica, a correção, o parafraseamento, a repetição, a pausa, a hesitação, a interrupção e o silêncio) na construção da linguagem da criança autista. Verificou-se, também, como objetivos específicos, a incidência do uso de elementos lingüísticos verbais, lingüísticos prosódicos e paralingüísticos na relação fonoaudiólogo/criança autista na prática fonoaudiológica. Os participantes do estudo foram duas fonoaudiólogas e seus pacientes, de 08 e 12 anos, com diagnóstico de autismo, caracterizados nesse estudo como díade 1 e 2. A coleta de dados foi feita semanalmente, através de gravações de vídeo dos atendimentos fonoaudiológicos. Os dados foram interpretados com base na transcrição das gravações de vídeo, e nos recortes discursivos, como propostos pela Análise da Conversação. Os resultados mostraram o papel desempenhado pelos recursos lingüísticos verbais, prosódicos e paralingüísticos nas interações dialogadas, tanto nos turnos das terapeutas como nos turnos dos sujeitos. Observou-se um equilíbrio na utilização dos recursos pesquisados nos turnos das terapeutas e um desequilíbrio, como maior prevalência de utilização dos recursos paralingüísticos nos turnos dos sujeitos. De forma complementar, verificou-se a ocorrência de ecolalias nos turnos das crianças. Tendo em vista sua semelhança com as repetições, recurso fundamental na elaboração do texto falado, recorreu-se à observação minuciosa das gravações de vídeo, no intuito de se estabelecer uma diferenciação entre tais recursos. Percebeu-se que, nas crianças autistas pesquisadas, a diferenciação entre a repetição e a ecolalia centrava-se em três características nas emissões ecolálicas: ausência de contato visual, atividade motora constante e reprodução fiel de recursos como alongamento vocálico, entonação e alteração de tom. Como conclusão, percebeu-se que os recursos lingüísticos verbais e prosódicos desempenharam o papel de articular os segmentos do discurso, destacar aspectos importantes do texto falado, facilitar a compreensão, orientar o interlocutor durante a interação, traduzir o estado emocional dos interactantes e facilitar o acesso ao significado do discurso. Os recursos paralingüísticos operaram no processamento do texto falado, na organização do pensamento dos interactantes, na delimitação dos tópicos, na ênfase, e chamaram a atenção de forma decisiva na manutenção da interação. Destaca-se, ainda, que a utilização equilibrada dos recursos estudados, como observada nos turnos das terapeutas, permitiu uma melhor formulação do texto falado. Constatou-se, também, que, diante do imediatismo da interação face a face, é extremamente difícil estabelecer a diferença entre a ecolalia e a repetição, sugerindo, portanto, que ambas devam ser significadas no processo terapêutico, permitindo ao seu usuário maiores possibilidades discursivas

Philosophiae Doctor - PhD / This thesis investigated the education support services provided by occupational therapists, physiotherapists and speech and language therapists in the Western Cape Province of South Africa. Changes in the education policy in South Africa to an inclusive education system have major implications for the way therapists provide support. Therapists have been challenged to move from a medical model of support with a focus on highly specialised treatment for a small number of individual learners with disabilities, to a systemic and health promoting model which focuses on support for the education system, including all learners, teachers and parents. The aim of this research was to develop an appropriate and integrated approach for therapists to support schools within an inclusive and health promoting schools framework in South Africa. Participatory action research using quantitative and qualitative methodology was used. Two surveys were conducted in the Western Cape Province. The first was a survey of all therapists to determine who was working with pre-school and school-aged learners and where. The second survey was of all therapists working in special schools and a small number of private practitioners to identify the roles of the therapists in providing direct and indirect support. In two of the seven education districts in the province, focus group discussions were held with 45 teachers from special and ordinary schools, and 21 parents of school-aged learners - to identify the support they needed. Workshops, incorporating focus groups, were also held with the therapists to, firstly, identify the support they needed to give to learners, teachers, parents and the education system and, secondly, to identify the competencies they needed to give this support. The data from the surveys were subjected to simple descriptive statistical analysis. These analyses reveal that therapists have a very wide range of roles relating to direct support, including: assessment, intervention with individual learners and learners in groups, and evaluation. Interventions include the development of hearing, speech and communication skills; skills for activities of daily living; life skills; home management skills; work related skills; motor function skills; and play and leisure skills. Therapists from different disciplines frequently provide the same type of support. Indirect support provided includes support for the schools system, teachers and parents. Thirty six percent of the therapists in this study want to increase the proportion of time they spent on indirect support. The study also revealed that multidisciplinary collaboration and teamwork were Teachers involved in the study identified that they need an enormous amount of support in fulfilling their crucial roles in identifying barriers to learning; identifying the support learners need; and addressing the barriers. This includes the need for support to teach a diverse group of learners; adapting content, presentation and evaluation of the curriculum; adapting the physical environment; accepting new roles of teachers and therapists; making changes to the school system; developing relationships with the parents; addressing challenges related to socio-economic problems; networking with the community; facilitating positive attitudes to diversity; developing supportive relationships with therapists; and further training poorly developed. Teachers involved in the study identified that they need an enormous amount of support in fulfilling their crucial roles in identifying barriers to learning; identifying the support learners need; and addressing the barriers. This includes the need for support to teach a diverse group of learners; adapting content, presentation and evaluation of the curriculum; adapting the physical environment; accepting new roles of teachers and therapists; making changes to the school system; developing relationships with the parents; addressing challenges related to socio-economic problems; networking with the community; facilitating positive attitudes to diversity; developing supportive relationships with therapists; and further training. Parents in this study indicated that they need access to education and support for their children, including direct support for their children; effective means of communicating with their children; specific competencies to facilitate caring for their children; emotional support; advocates to work with them in support of their children addressing environmental physical and attitudinal barriers, and developing a supportive community; and supportive relationships with therapists.

Among Swedish speech and language pathologists there is a need for extended knowledge of existing treatment methods for aphasia. Currently, there is an ongoing process to develop clinical guidelines for aphasia rehabilitation. Therefore, a knowledge base is needed, including a description of existing treatment methods, their theoretical foundation and evidence base. The aim of the present study was to compose an evidence-based summation of treatment methods for auditory comprehension disorder in people with aphasia. A systematic literature search was conducted using the following databases: PubMed, PsycINFO, Cochrane Library, CINAHL and Speechbite. Additionally, several studies were found by manual searches. Twenty-three articles were chosen and assessed. A total of 13 different treatment methods were described. Most of the included studies had a poor quality and few participants. The majority of the treatment methods were found to have an insufficient evidence base, with the exception of CIAT and Hand-action observation treatment. They were found to have moderate and limited evidence. Most of the included studies have shown a significant improvement of auditory comprehension following speech and language therapy. Although, for speech and language pathologists to be able to choose a specific treatment method based on evidence, larger studies with higher quality will be needed. / Bland svenska logopeder finns behov av utökad kunskap om vilka specifika metoder som finns för behandling av afasi. För närvarande pågår ett arbete med att ta fram kliniska riktlinjer för afasi. Syftet med studien var att ta fram ett evidensbaserat kunskapsunderlag med en beskrivning av olika metoder för behandling av hörförståelse hos personer med afasi. Resultatet av den aktuella studien ämnas användas till arbetet med de kliniska riktlinjerna. En systematisk litteratursökning genomfördes i databaserna PubMed, PsycINFO, Cochrane Library, CINAHL samt Speechbite. Utöver detta handsöktes ytterligare artiklar. Sammanlagt 23 artiklar kvalitetsgranskades och evidensstyrkan för varje metod bedömdes enligt SBU:s beskrivning av GRADE-systemet. I kunskapsunderlaget presenteras sammanlagt 13 olika behandlingsmetoder för behandling av hörförståelse. De flesta av de ingående studierna hade en bristande studiekvalitet med lågt antal deltagare. Majoriteten av behandlingsmetoderna bedömdes ha otillräcklig evidens, med undantag för CIAT och Hand-action observation treatment som bedömdes ha måttlig respektive begränsad evidens. De ingående studierna har övervägande visat att logopedisk behandling ger ett signifikant förbättrat resultat på hörförståelse. Större behandlingsstudier med bättre kvalitet behövs dock för att kliniska logopeder ska kunna välja en behandlingsmetod framför en annan på en evidensbaserad grund.

Multilingualism in classrooms is currently prompting debate and has significantly impacted on schooling in South Africa over the last decade. At present South African educators face the challenge of coping with and finding solutions to culturally and linguistically diverse urban school contexts that did not exist before. In many South African communities young learners, without any prior knowledge of English, are placed in English preschools. Preschool teachers have the demanding task of preparing these multilingual preschoolers for formal schooling in English, and, in addition, are pressurised by parents or caregivers who expect their children to be fluent in English by the time they enter primary school. A group of preschool teachers in a specific urban, multilingual preschool context expressed concern about multilingual preschool learners’ academic performances and their future, and requested advice and support. Consequently a need was identified for speech-language therapists to make their expertise available to multilingual preschool learners, as well as to their preschool teachers. To address this need, an exploratory, descriptive, contextual research design, incorporating the quantitative perspective, was selected to describe the specific educational context of multilingual preschools in the Pretoria Central Business District (CBD) and Sunnyside area. A descriptive survey was conducted and two survey techniques were employed to collect the data, namely a questionnaire and a test battery. The questionnaire was used to collect information from 32 teacher participants to investigate the needs and strengths of preschool teachers and multilingual preschool learners. The test battery was utilised to collect data on the language and communication proficiency in English of 30 learner participants. Results indicated that the teacher participants perceived certain personal challenges while supporting the preschool learners acquiring English as Language of Learning and Teaching (ELoLT). These teachers expressed a need for knowledge and support. They also reported that the multilingual preschool learners in the research context had to communicate in ELoLT despite it being an unfamiliar language. Some of the multilingual preschool learners displayed behaviours that could be indicative of negative influences on their self-esteem. The language and communication assessment revealed that many learner participants’ comprehension and expression in ELoLT were insufficient for learning and that they required support for academic success. In addition, the results support the claim that an integrated view of the multilingual learners’ communication abilities need to be established across contexts, by combining assessment strategies, such as naturalistic and structured assessment, as well as interdisciplinary perspectives. The results of the empirical research was used to propose a service delivery model for the acquisition of ELoLT in the research context. This proposed model may be an effective approach to provide supportive intervention to multilingual preschool learners with linguistic barriers to learning. In addition, initial stage intervention guidelines for the basic level ELoLT learner were offered in response to the needs of the specific community. These guidelines may provide a basis for the planning of intervention strategies to preschool teachers who were concerned about the education and future of multilingual preschool learners. / Thesis (DPhil (Communication Pathology))--University of Pretoria, 2007. / Speech-Language Pathology and Audiology / Unrestricted