Made available in DSpace on 2016-04-28T20:38:06Z (GMT). No. of bitstreams: 1 Roberta Bomfim Pedro Bom.pdf: 444192 bytes, checksum: bd7ed7bb19c497991df9222c51dee28a (MD5) Previous issue date: 2012-05-15 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / In the speech therapy clinical practice, the relation between the feeding and language disorders became object of researches due to the frequence with that these disorders co-occur in children. Actually, studies indicate the co-occurrence of feedind an language disorders as an orality problem. The purpose of this research was to investigate the nature of the manifestation of the co-occurrence between the feeding and language disorders, in the childhood, and the action of the parental desire and speech in the subject s constitution and your relation with the assumption of a self without body and psychic autonomy. To achieve it, the method was clinical-qualitative carried out by means of one clinical case study, Guilherme, four years. Joined to it, there was a bibliographic revision of the speech therapy and psychoanalytic literatures. Knowing of the relation between the theoretical and clinical material, I formulated the thesis of that the co-occurrence of feeding and language disorders can be understood like a fixation on the oral stage of the organization of the libido; promoted by the maternal desire of that nothing changes desire that denies the birth of a singular and autonomous subject. Thus, it can be concluded that the treatments that aim to adapt, of the dichotomous way, the oral functions can bring superficial results, without the guarantee of the understanding of the pathological manifestations. From the transference, concept of the Psychoanalysis, the speech therapy setting must allows the transit of the affects presents on the parental and children s speech, which, from my point of view, to permit better results on the therapeutic intervention / Na clínica fonoaudiológia, a relação entre problemas de linguagem e de alimentação tornou-se alvo de pesquisas devido à frequência com que tais manifestações co-ocorrem em pacientes infantis. Atualmente, estudos ressaltam a importância de se considerar a articulação entre problemas de linguagem e de alimentação enquanto problemas na oralidade. Objetivei investigar, nesta tese, a natureza da manifestação da co-ocorrência entre os problemas de linguagem e de alimentação, na primeira infância e a ação do desejo e do discurso parental na constituição do sujeito e sua relação com a assunção de um Eu desprovido de autonomia no registro corporal e psíquico. Para tal, o método empregado foi de natureza clínica- qualitativa e consistiu no estudo do caso clínico de Guilherme, quatro anos. Os aspectos levantados por meio da experiência clínica foram fundamentados em dialogia com o aparato teórico selecionado a partir das literaturas psicanalítica e fonoaudiológica. A partir da articulação entre a fundamentação teórica e clínica, formulei a tese de que, em alguns casos, a manifestação da co-ocorrência dos problemas de linguagem e de alimentação pode ser entendida enquanto uma fixação na fase oral canibalística do desenvolvimento libidinal, fomentada por um desejo materno de que nada mude desejo que nega o nascimento de um sujeito singular e autônomo. Nesse sentido, pôde-se concluir que os tratamentos que visam adequar, de modo dicotômico, as funções e condutas orais podem trazer resultados superficiais, sem garantir a compreensão e o alcance mais profundos das manifestações patológicas. A partir do conceito de transferência, presente na teoria psicanalítica, o setting fonoaudiológico deve permitir o trânsito dos afetos presentes no discurso dos pais e das crianças, o que, a meu ver, possibilita melhores resultados na intervenção terapêutica

Introdução: O autismo, classificado como Transtorno Global do Desenvolvimento, é descrito pela American Psychiatric Association como um complexo conjunto de inabilidades, as quais afetam a comunicação, o comportamento e a interação social dos indivíduos. As evidências sugeridas, de que os pais das crianças autistas tenham um risco consideravelmente aumentado de experimentar dificuldades psicológicas, estão totalmente relacionadas à ajuda que estes recebem. Outro fato importante que se dá com a associação entre o comportamento da criança e a aflição materna é a situação econômica enfrentada pelas famílias e pelos níveis baixos de suporte recebido que, quando adequado, pode proporcionar melhor adaptação e aceitação. Objetivos: verificar o suporte social formal e informal disponibilizado para as famílias com crianças e adolescentes com diagnósticos inseridos no espectro autístico nas situações de atendimento ambulatorial e institucional e a qualidade de vida informada/percebida por elas. Método: Foram sujeitos, 150 cuidadores de crianças/adolescentes incluídos no espectro autístico, com idade entre 24 e 65 anos, os quais responderam a um questionário referente ao suporte social recebido por eles e às questões feitas através do instrumento de avaliação da qualidade de vida WHOQOL-brief, proposto pelo Programa de Saúde Mental da Organização Mundial de Saúde. Resultados: A categoria de participantes mais satisfeitos em relação ao suporte social recebido não se difere por questões econômicas ou sociais, mas sim pelo que referem em relação à qualidade de vida. / Introduction: The autism, classified as a Pervasive Developmental Disorder, is described by the American Psychiatric Association as a complex set of inabilities that include communication, behavior and social interaction of the affected individuals. Evidence suggest that the parents of autistic individuals are at considerably more risk of experiencing psychological impairments that are completely related to the assistance they receive. Another important issue to the association between the child’s behavior and mother discomfort is the economic stress faced by the families and the low amount of support provided. This support, when adequate, may allow better adaptation and acceptance. Purposes: to assess the formal and informal support provided to families with children and adolescents of the autism spectrum that are receiving institutional or clinical services and verify the reposted Quality of Life. Method: subjects were 150 caretakers of children and adolescents of the autism spectrum, with ages between 24 and 65 years. They answered a questionnaire about the social support available to them and to the World Health Organization Quality of Life – Brief questionnaire. Results: The group of participants that report the better social support is also the group with better Quality of Life.

A American Speech-Language-Hearing Association ASHA define a linguagem como um sistema complexo e dinâmico de símbolos convencionais, utilizados de várias maneiras durante a comunicação. Alterações nas regiões cerebrais responsáveis pela fala e linguagem, podem trazer como consequência a afasia, que é definida como a perda ou debilidade da função de linguagem causada por um prejuízo do cérebro. Indivíduos afásicos podem necessitar de recursos da Comunicação Suplementar e/ou Alternativa para complementar ou substituir a transmissão de uma mensagem, que não pode ser transmitida de maneira eficiente pela comunicação verbal. Segundo von Tetzchner e Jensen, a Comunicação Suplementar e/ou Alternativa envolve o uso de modos não verbais de comunicação, para suplementar ou substituir a linguagem oral, que pode estar ausente ou comprometida. Desta forma, o presente estudo teve o objetivo de descrever o uso da Comunicação Suplementar e/ou Alternativa em dois casos de afasia pós Acidente Vascular Encefálico. Para tanto, foi realizada intervenção fonoaudiológica com dois participantes afásicos, utilizando os recursos da Comunicação Suplementar e/ou Alternativa. A intervenção fonoaudiológica foi dividida em quatro etapas, que abrangeu desde a visualização e confecção das fichas para o álbum de comunicação até a utilização efetiva deste recurso. Em todas as etapas, foi utilizado o sistema pictográfico sistema pictográfico de comunicação, por se tratar de um sistema que possui maior iconicidade. Por meio da reaplicação de testes, foi possível constatar melhora nas capacidades de compreensão oral, escrita, leitura e denominação dos dois participantes. Com este estudo pôde-se concluir que a intervenção fonoaudiológica com o uso da Comunicação Suplementar e/ou Alternativa nos dois casos de afasia pós Acidente Vascular Encefálico, trouxe benefícios para a comunicação funcional dos participantes, sendo que estes recursos tiveram função facilitadora, tornando a comunicação mais eficiente e trazendo benefícios no processo de reabilitação, promovendo evolução das habilidades de leitura e nomeação. / The American Speech-Language-Hearing Association defines language as a complex and dynamic system of conventional symbols, used in various ways during the communication. Changes in brain regions responsible for speech and language, can bring the aphasia, which is defined as the as the loss or impairment of language function caused by brain disease. Aphasic individuals may require supplementary resources of communication and/or alternative to supplement or replace the transmission of a message, which cannot be transmitted through verbal communication. According to von Tetzchner and Jensen, the Augmentative and Alternative Communication implicate the use of alternative modes of nonverbal communication, to supplement or replace the oral language which may absent or impaired. Thus, this study aimed to describe the use of the Augmentative and Alternative Communication in two cases of aphasia after stroke. The speech therapy was divided in four stages that approached since the display of forms of communication for the album until the effective use this resource. In all stages, was used the pictographic system Picture Communication Symbols, because it is a system that has greater iconicity. By reapplication of tests, was possible to show improvement in oral ability, writing, reading and denomination the two participants. To this end, the speech therapy was performed with two aphasic participants, using the Augmentative and Alternative Communication. This study allows conclude that the speech therapy using the Augmentative and Alternative Communication in two case of aphasia after stroke, brought benefits to functional communication the participants, and these resources had a augmentative role making communication more efficient and brought benefits in the rehabilitation process, promoting development of skills in reading e naming.

Dificuldades pragmáticas podem ocorrer em diferentes transtornos da comunicação, desde aqueles em que a dificuldade vai além da comunicação social e afeta habilidades para manter relacionamentos e interesses variados, como no Transtorno do Espectro Autista (TEA), até alterações que afetam a compreensão e expressão linguística sem prejuízo intelectual ou sensorial, como no Distúrbio Específico de Linguagem (DEL). O estudo teve como objetivo investigar a eficácia de questionário sobre habilidades pragmáticas e comunicação social APLSC - na identificação de alterações pragmáticas de crianças com transtornos de comunicação. Foram selecionadas 40 crianças entre 3;0 e 6;11 anos, 10 com TEA, 10 com DEL e 20 com desenvolvimento típico de linguagem DTL (grupo comparativo). Os sujeitos foram seus pais e professores. Foi aplicado o questionário APLS (Assessment of Pragmatic Language and Social Communication: Parent and Professional Report Beta Research Version) sobre comunicação social e linguagem pragmática em pais e professores. Os 80 questionários foram submetidos à análise estatística descritiva, também foi utilizado o teste t paramétrico e os testes não-paramétricos de Kruskal-Wallis e de Mann-Whitney U, além da aplicação do One-Sample Kolmogorov-Smirnov Test para verificar se os dados obedeciam à distribuição normal. Ainda. Os resultados indicaram pior desempenho das crianças com TEA em relação ao grupo comparativo, com diferença significante tanto na percepção dos pais como dos professores. Não houve diferença significante entre os grupos DEL e DTL, mas o grupo com DEL teve pior desempenho em relação aso seus pares comparativos. As respostas dos pais das crianças com TEA e DEL foram comparadas, havendo diferença significante. Quanto às respostas dos professores, o grupo DEL apresentou maior pontuação em relação ao grupo TEA. A comparação das respostas dos pais e dos professores das crianças com TEA, DEL e DTL não indicou diferença significante. Concluindo, crianças com TEA apresentaram prejuízos mais significativos nas habilidades pragmáticas e sociais em relação às crianças DEL, e tanto as com TEA como as com DEL apresentaram maiores limitações nestas habilidades em relação aquelas com desenvolvimento típico de linguagem. Desta forma, o questionário APLSC mostrou-se sensível à investigação pragmática de acordo com o esperado para cada grupo de sujeitos. Considerando as perguntas feitas para pais e professores do questionário, a percepção de ambos se mostrou semelhante. / Pragmatic language impairments may occur in different communication disorders. They include from those cases as Autism Spectrum Disorder (ASD) in which the difficulty extrapolates the social communication and affects skills concerning maintaining relationships and various interests to cases which alterations affect the understanding and linguistic expression without intellectual disability or sensory impairments as Specific Language Impairment (SLI).The study aimed to investigate the effectiveness of questionnaires about pragmatic language and social communication skills, known as APLSC, concerning the identification of pragmatic alterations in children with communication disorders. In this benchmarking research, 40 children between the ages of three to six years and 11 months old were selected comprising 10 cases with ASD, 10 cases with SLI and, 20 cases with Typically Developing Language (TDL) as reference group. There was the application of APLS questionnaire (Assessment of Pragmatic Language and Social Communication: Parent and Professional Report Beta Research Version) to parents and teachers as investigations subjects. The 80 questionnaires were submitted to the analysis based on descriptive statistics. Besides, the parametric t-test, the non-parametric tests developed by Kruskal-Wallis and by Mann-Whitney U and the application of One-Sample Kolmogorov-Smirnov Test were used to verify whether the data followed the normal distribution. The results indicated that children with ASD presented worse performance in relation to the reference group showing significant difference both in terms of the parents and teachers perception. There was no significant difference between SLI and TDL groups. However, the group with SLI presented worse performance in relation to their pairwise comparison. The answer of parents of children with ASD and those parents of children with SLI were compared and showed significant difference. Concerning the answers from teachers, the SLI group presented higher score compared to the ASD group. There was no significant difference regarding the comparison of answers elaborated by parents and by teachers of children with ASD, SLI and TDL. In conclusion, children with ASD presented disorders more significant in pragmatic and social skills in relation to the children with SLI. Besides, both the ASD and the SLI group presented more limitations concerning these skills than the results presented by the group with Typically Developing Language. Therefore, the APLSC questionnaire proved its responsiveness to the pragmatic investigation according to the results expected to each groups of subjects. Regarding the questions asked to the investigations subjects of this questionnaire, there were similarities of perception between parents and teachers.

This session is developed by, and presenters invited by, Speech Sound Disorders in Children and Language in Infants Toddlers and Preschoolers. This invited session provides an overview of early speech/language development with a focus on identifying delay/disorders in toddlers. Types of speech/language behaviors in prelinguistic/ early linguistic development that serve as “red flags” for possible disorders will be discussed. The need for developmentally appropriate assessments will be highlighted.

The questions posed in this study were: l) Is there a significant difference in the prevalence of behavioral problems between speech and/or language impaired children and normal children as reported by parents and teachers? and 2) Is there a significant difference in the types of behavioral problems between speech and/or language impaired children and normal children, as reported by parents and teachers?

One of the more widely-used methods for pinpointing children in need of more in-depth language evaluation is screening. One language screening instrument designed to accomplish this in an effective and efficient way was the Clinical Evaluation of Language Functions Elementary Screening Test (CELF-S) (Semel & Wiig, 1980). The purpose of this study was to determine the effectiveness of the CELF-S in identifying those children in a second grade setting, who were in need of more thorough evaluation. This study sought to answer the following questions: 1) What is the percentage of false negatives produced by the CELF-S?, and 2) What is the percentage of false positives produced by the CELF-S?

Researchers have successfully labeled specific patterns of expressive language development as it appears in children developing language normally. Little research has identified particular patterns of expressive language in children who display expressive language disorders or delays. Longitudinal studies of expressively language impaired children indicate that linguistic, educational and social impairments exist long after the language impairment was first identified (Aram, Eckelman and Nation, 1984; Aram and Nation, 1980; Fundudis, Kolvin and Garside, 1979; Stark, Berstein, Condino, Bender, Tallal and Catts, 1984). If patterns of delayed or disordered language development are researched and possibly labeled in the early stages of language development, strategies for assessment and intervention can be made more efficient and the effects of early language impairment on later academic achievement may be prevented. The present study was part of the Portland Language Project, a longitudinal study of early language delay. Lee's Developmental Sentence Scoring (DSS) was used to attempt to identify syntactic patterns used by children exhibiting early language delay. The DSS is a standardized measure for analyzing children's standard English expressive language abilities in the following eight grammatical categories: 1) indefinite pronouns; 2) personal pronouns; 3) main verbs; 4) secondary verbs; 5) negatives; 6) conjunctions; 7) interrogative reversal; and 8) Wh-Questions. Using the DSS, specific syntactical areas of deficit can be identified by analysis of an audiotaped speech sample. A comparison of expressive language in the eight subcategories in the DSS was completed among three groups of preschool children; 1) children developing language normally (the NL group); 2) children who did not meet criteria for normal language development at 20 months, but later fell within the normal range of language development as measured by the DSS (Lee, 1974). This is referred to as the history of expressive language delay group (HELD); and 3) children who did not meet criteria for normal language development at 20 months and again, did not meet criteria for normal language development as measured by the DSS (Lee, 1974) at later ages. This is referred to as the expressive language delay group (ELD). The purpose of this study was to determine if significant differences exist in each of the eight subcategory group scores from the DSS between those children identified as expressively language delayed and those identified as developing language normally at ages three and four. At age three, significant differences were found among the three groups in all eight subcategory scores of the DSS. By age four, the significant differences were found between the delayed group and the normal developing group in the main verb category and the personal pronoun category only. There were no significant differences between the normal developing and the history of delay groups on any of the eight categories at age four. The delayed group exhibited marked improvement and narrowed the deficits in expressive language to a specific area of language. The present study suggested that children with early language delay appear to "catch up" with normal peers in most areas of syntactic production by age four. The DSS (Lee, 1974) provides information about specific areas of syntactic development. Due to the length and complexity of the DSS, it is not a tool that practicing clinicians often use. A study such as this may help the practicing clinician quickly screen a preschool child in a specific syntactic category, such as verb marking, in order to check for possible early language delay. In addition to providing clinical assistance, this study has opened up the door for future research in syntactic development. This study could be expanded to examine the specific verb markers that are being used by the delayed subjects. This may lead to more efficient identification and remediation of early language delays.

Many children with emotional and/or behavioral disorders also present with speech and language disorders (Baker & Cantwell, 1982; Prizant et al., 1990). Children with attention deficits, in particular, have shown a much higher incidence of speech and language disorders than does the general population (Camarata et al., 1988; Cantwell & Baker, 1987) . Traditionally, school speech-language pathologists have been responsible for conducting mass screenings to determine which children should be further evaluated for speech and language disorders. An increasing number of school districts are relying on teacher referrals to determine which children require speech-language evaluations. It was hypothesized that if teachers were able to identify children with attention deficits, these children may be appropriate for referral to speech-language pathologists for speech and language evaluation. The purpose of this study was to determine the effectiveness of the School Situations Questionnaire-Revised {SSQ-R) {Barkley, 1991) in identifying children in the second grade, aged 7:0 to 8:11, who are speech and/or language disordered. This study sought to answer the following primary question: is there an association between the diagnosis of speech and/or language disorders {SLD), and detection by the SSQ-R as at risk for attention and behavior disorders {ABD)? The sample population consisted of 91 students from six second-grade classrooms who met the selection criteria. The SSQ-R, a rating scale designed for teachers to rate behavior related to attention and concentration, was used by classroom teachers to evaluate the subjects to determine if they were at risk for attention and behavior disorders. These results were tabulated along with the number of children diagnosed with speech and/or language disorders in this population. Chi Square analysis showed no significant association for the two measures. It was found that of the 11 SLO subjects, 3 of them, or 27%, were also ABO. Only 3 of the 17 ABO subjects (18%) were also SLO. The 18% of SLO subjects in the ABO population and the 27% of ABO subjects in the SLO group represent a higher percentage of ABD and SLO than is expected in the general population. The higher than average incidence of SLO in the ABO population warrants an awareness of this relationship and the realization that this will impact service delivery. The results of this study indicate that the SSQ-R is not an appropriate measure for teachers to use in determining which children in their classroom would benefit from an assessment for speech and/or language disorders. The high number (82%) of children identified by the SSQ-R as ABD who were not SLD would identify many children who did not require speech and language evaluation. Conversely, the high number (73%) of children not identified as ABD who were SLD by the SSQ-R would neglect many children who require speech/language intervention. The results of this study are not to discount previous research that has suggested an association between attention deficit hyperactivity disorder, and speech and language disorders. It is likely that an association exists, but the present study was not able to demonstrate a significant correlation.

Alzheimer's disease, the most common form of dementia, is estimated to occur in up to sixteen percent of people between the ages of 75 and 84. Deficits in linguistic skills that effect communication are a hallmark of the disease and have been the primary focus of past Alzheimer's research. Among other deficits, researchers have found that people with Alzheimer's often use indexical expressions without clear referents and convey less information that is relevant to the task they have been asked to perform than healthy subjects. Relatively little research has examined how Alzheimer's subjects use their linguistic knowledge to communicate with others in natural, open-ended interaction. The purpose of the present study was to identify what communication skills remain intact that enable an Alzheimer's subject to maintain conversational fluency despite lexical and pragmatic deficits. The study focused specifically on language skills that play a functional role in facilitating conversation. The data used in this study consisted of eight naturally occurring conversations between the subject and three interlocutors who had a close relationship with the subject. The interactions were recorded in the Alzheimer's wing of the subject's nursing home. The transcribed conversations were analyzed according to three types of functional language drawn from Nattinger and DeCarrico's (1992) work on lexical phrases: (1) conversational maintenance; (2) conversational purpose; and (3) familiar topics. The role played by lexical phrases in facilitating each of these functional categories was also examined. This study found that the subject had an intact knowledge of functional language skills that allowed her to successfully participate in conversation despite serious language deficits. Within the category of conversational maintenance, the subject retained skills necessary to share control in opening and closing conversations as well as nominating and shifting topics and requesting and offering clarification. In the category of conversational purpose, the subject used functional language to signal utterances intended to convey general politeness, gratitude and compliments as well as informing the interlocutor of her attitude in relation to the content of utterances. The study also found that lexical phrases played a central role in facilitating the subject's use of functional language.