Introduction: Une respiration buccale est souvent associée à une faible musculature oro-faciale et à une position basse de la langue, pouvant mener aux malocclusions et au potentiel de développer des problèmes de respiration pendant le sommeil chez les enfants. Objectifs: Évaluer l’efficacité de la thérapie oro-faciale myofonctionnelle sur le rétablissement d’une déglutition physiologique et d’une respiration nasale en développant une posture linguale et labiale normale au repos. Méthodes: Cette étude contrôlée randomisée prospective à simple aveugle a évalué 37 patients (six à quatorze ans) divisés en deux groupes où un groupe a reçu une thérapie complète (7 séances), comprenant des exercices pour la correction du patron de déglutition et de la posture linguale, et l’autre groupe a reçu une thérapie sommaire, corrigeant seulement la posture linguale (3 séances). Des suivis à trois mois et à un an post-traitement ont été effectués pour les deux groupes. Résultats: Les résultats des deux traitements, soient la thérapie complète et la thérapie sommaire, sont similaires (p = 0.59) et également efficaces pour la correction de la déglutition atypique et le rétablissement d’une respiration nasale, avec une différence significative entre les évaluations avant et après traitement (p = 0.001), qui demeure stable après un an post-traitement. Conclusion: Le traitement avec des exercices spécifiques pour une correction d’une propulsion linguale ne serait pas une composante absolue d’une thérapie oro-faciale myofonctionnelle afin de rétablir une posture linguale adéquate au repos et un patron de respiration nasale chez les enfants n’ayant pas d’autre problème fonctionnel connu. / Introduction: Mouth breathing is often associated with a weak orofacial musculature and a low resting tongue position, leading to malocclusion and potentially sleep-disordered breathing in children. Objective: To evaluate the effect of orofacial myofunctional therapy on the reestablishment of a mature pattern of swallowing and nasal breathing by stabilizing a proper position of the tongue and lips at rest. Methods: This prospective randomized single-blind controlled study evaluated 37 patients (age six to fourteen years) divided into two groups who received either a complete orofacial myofunctional therapy (7 sessions) including swallowing pattern and tongue posture, or a simplified therapy modifying their tongue posture (3 sessions). Both groups were seen at three months and one year following treatment completion. Results: Results suggested that treatment outcomes were similar when treating tongue-lip posture at rest along with tongue thrust, and treating without addressing tongue thrust (p = 0.59). Both treatments were efficacious as there was a significant difference between the pre- and post- evaluations for both groups (p < 0.001), and these differences remained stable at the one year follow-up. Conclusion: Treating a tongue thrust habit with specific related exercises, may not be a necessary component of an orofacial myofunctional therapy to reestablish tongue posture at rest and nasal breathing in children with no other functional problems.

The present study explored the effect of the birth of a child with a cleft lip and palate on family functioning within the context of family systems theory. Five families, each with a child who was born with a cleft lip and palate, were included in the study. The five couples were all married and they were the biological parents of their children whose ages ranged from two months to five years. All five sets of parents were initially interviewed together and then had separate individual interviews where the Family Assessment Measure-III was administered. The results reflected each family's distinctive patterns of interaction and how they adapted to the birth of a child with an orofacial cleft. Factors found to affect family functioning included: External support systems, individual coping skills, family rules and boundaries, open communication and cohesion among family members. / Psychology / M. A. (Psychology)

Conselho Nacional de Desenvolvimento Científico e Tecnológico / Considering the hypothesis that GABA and oxidative stress are involved in the development of oral movements associated with important neuropathologies, the present study investigated the possible ability of V. officinalis in the prevention of vacuous chewing movements (VCMs) induced by reserpine in rats. Adult male rats were treated with reserpine (1 mg/kg, s.c.) and/or with V. officinalis (in the drinking water). VCMs, locomotor activity and oxidative stress measurements were evaluated. The neuroprotective effect of V. officinalis against iron-induced cell toxicity was investigated in brain cortical slices. Furthermore, we carried out the identification of valeric acid and gallic acid by HPLC in the V. officinalis tincture. Our findings demonstrate that reserpine caused a marked increase on VCMs and the co-treatment with V. officinalis was able to reduce the intensity of VCM. Reserpine did not induce oxidative stress in cerebral structures (cortex, hippocampus, striatum and substantia nigra). However, a significant positive correlation between DCF-oxidation (an estimation of oxidative stress) in the cortex and VCMs (p<0.05) was observed. Moreover, a tendency for a negative correlation between Na+K+- ATPase activity in substantia nigra and the number of VCMs was observed (p= 0.06). In vitro, V. officinalis protected brain cortical slices viability against Fe(II)-induced neurotoxicity. In conclusion, V. officinalis had in vitro and in vivo neuroprotective effects in rats, i.e., reduced Fe(II) neurotoxicity and reserpine-induced VCMs, probably via modulation of oxidative stress in specific brain nucleus and its GABA-mimetic action. However, the mechanisms involved in this protective activity needs to further investigated to better understand the action of V. officinalis. / Considerando as hipóteses do papel da neurotransmissão gabaérgica e do estresse oxidativo no desenvolvimento de movimentos orais associados a neuropatologias importantes, o presente estudo investigou a possível habilidade da tintura de V. officinalis na prevenção dos movimentos de mascar no vazio (MMV) induzidos por reserpina em ratos. Os animais foram tratados com reserpina (1 mg/Kg, s.c.) e/ou com V. officinalis (na água de beber). MMV, atividade locomotora e medidas de estresse oxidativo foram avaliadas. O efeito neuroprotetor da V. officinalis contra a toxicidade celular induzida por ferro foi investigada em fatias de córtex cerebral. Além disso, fez-se a identificação do ácido valérico e do ácido gálico por HPLC na tintura de V. officinalis. Os resultados demonstram que a reserpina causou um aumento nos MMV quando comparado com o seu veículo e o co-tratamento com V. officinalis foi capaz de reduzir a intensidade dos MMV. A reserpina não alterou de forma significativa alguns parâmetros de estresse oxidativo analisados nas estruturas do cérebro (córtex, hipocampo, estriado e substantia nigra). Porém, uma correlação positiva entre os níveis de oxidação da DCF (uma estimativa do estresse oxidativo) no cortex e o número de MMV (p<0.05) foi observada. Além disso, foi observada uma tendência a haver uma correlação negativa entre a atividade da Na+/K+- ATPase na substantia nigra e o número de MMV (p= 0.055). In vitro, V. officinalis protegeu as fatias de córtex cerebral contra a neurotoxicidade induzida por ferro. Desta forma, pode-se concluir que a V. officinalis apresentou efeitos neuroprotetores em ratos tanto in vitro quanto in vivo, ou seja, reduziu a neurotoxicidade induzida por ferro e os MMV induzidos por reserpina, provavelmente via modulação do estresse oxidativo em núcleos específicos do cérebro e sua ação gabamimética. Porém, os mecanismos envolvidos nesta atividade protetora necessitam de mais investigações para melhor entender a ação da V. officinalis.

The thesis discusses the specific therapeutic methods and techniques that can be used in the context of speech therapy for children with Down syndrome who suffer from symptomatic speech disorder. The thesis includes the complete terminological definition of Down syndrome etiology, diagnosis and detailed elaboration of the therapeutic methods. It also includes complementary therapies that contribute to the overall development of the child's communication skills. The main objective of the thesis is to analyze the speech therapy. It may be an inspiration for speech therapists, parents, teachers in kindergartens and primary schools who take care of children with Down syndrome and want to contribute to improvement of communication skills of the children. The thesis can be a starting point for further scientific work that deals with similar issues. KEYWORDS: Down syndrome, development of communication skills, speech disorder, speech therapy, therapeutic methods and techniques, orofacial stimulation, myofunctional therapy, complementary therapies, case study.