Made available in DSpace on 2016-04-27T18:12:09Z (GMT). No. of bitstreams: 1 Gisele Gouvea da Silva.pdf: 2202457 bytes, checksum: 6cbda52fa0cea126ca9c3ef9fe33e56a (MD5) Previous issue date: 2015-04-30 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This thesis was formulated around oodles of issues that have been the subject of research in speech therapy clinic structure which were gathered in a challenge to unravel: what are the epistemological and praxis conditions to empower the symptomatology and the speech diagnostic and thus reinvent its method of treatment? To care about these questions, it was decided to return to Demosthenes and establish the formalization of different logical, ethical and rhetorical functions that were assumed in overcoming its history of his stuttering, the invention of his healing and discursive strategies applied on public speaking. Define the specific characteristics of the position occupied by Demosthenes as stuttering, as a clinician and after as a speaker, represents a strategy for research on the place of capture of the speech therapist, the subject and the social in the field of speech and language. The construction of the clinical case had as support the version told by Plutarch and the speech by Demosthenes: Prayer of the Crown (BC), which enshrines the last as the great orator of antiquity. It was necessary to return to Demosthenes because it represented the possibility of making visible the mechanisms of their treatment method for the emergence of the speech therapy clinic as we know it today, in which it follows the practical experience and the limits of clinical strategy. After followed in the case of Demosthenes and in the history of the main movements of similarities and differences of speech therapy clinic to medical clinic, to the psychological and to the psychoanalytic clinic, we proposed a model of understanding of the subject articulation and language in determining speech therapy symptoms. With this subsidy, we made up an integrative way to meet the different requirements necessary to rethink the diagnostic and the speech therapy clinic intervention in relation to other clinical cases described in the literature. To verify etiological hypotheses, diagnostic and therapeutic, was used as the basis of linguistic reasons the structural analysis of language developed by Saussure, improved by Jakobson and inserted in the design of language acquisition proposed by De Lemos, and still the theory of the subject in Lacan. Finally, we discuss the process of autonomy of the symptoms language model, and we indicate the possible directions of reinvention of diagnostic reasoning and clinical method on the relationship between subject and language / Esta tese foi formulada em torno a uma série de questões que têm sido objeto de investigação da estrutura clínica fonoaudiológica, reunidas em uma espécie de desafio a desvendar: quais são as condições epistemológicas e práxicas para autonomizar a semiologia e a diagnóstica fonoaudiológica e, consequentemente, reinventar o seu método de tratamento? Para lidar com essas questões, optou-se por retornar a Demóstenes e estabelecer a formalização das diferentes funções lógicas, éticas e retóricas assumidas na história de superação da sua gagueira, na invenção de sua cura e nas estratégias discursivas empregadas diante do falar em público. Delimitar as características específicas da posição ocupada por Demóstenes como gago, como clínico e depois como orador representa uma estratégia de investigação sobre o lugar de captura do fonoaudiológo, do sujeito e do social, no campo da fala e da linguagem. A construção do caso clínico teve como suporte a versão contada por Plutarco e alguns discursos proferidos por Demóstenes, entre eles: Oração da Coroa (IV a.C.), que o consagra como grande orador da Antiguidade. Retornar a Demóstenes representou a possibilidade de tornar visíveis os mecanismos do seu método de tratamento para a emergência da clínica fonoaudiológica tal como a conhecemos hoje, pela qual se deduz a experiência prática e os limites da estratégia clínica. Acompanhamos, no caso de Demóstenes e na história dos principais movimentos de aproximações e distanciamentos da clínica fonoaudiológica à clínica médica, à psicológica e à psicanalítica e propusemos um modelo de entendimento da articulação sujeito e linguagem na determinação de sintomas fonoaudiológicos. Tendo isso em vista, formulamos um modo integrativo de reunir as diferentes exigências necessárias para repensar a diagnóstica e a intervenção clínica fonoaudiológicas, em relação a outros casos clínicos descritos na literatura. Para verificar hipóteses etiológicas, diagnósticas e terapêuticas, utilizamos como base de fundamentação linguística a análise estrutural da linguagem desenvolvida por Saussure, aprimorada por Jakobson e a inserida pela concepção de aquisição de linguagem proposta por De Lemos e, ainda, a teoria do sujeito em Lacan. Para finalizar, discutimos a autonomização do modelo de sintomas de linguagem e indicamos direções possíveis de reinvenção do raciocínio diagnóstico e método clínico, na articulação entre sujeito e linguagem

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Research examining bilinguals who stutter (BWS) is limited; in particular there are few studies that have considered examining features of speech motor control in BWS. The present study was designed to examine features of speech motor control in bilingual speakers of Mandarin and English. Speech motor control was examined through the acoustic analysis of speaking rate, voice onset time (VOT) and stuttering adaptation. Participants ranged from age between 9 and 27 years. Upon completion of a language dominance questionnaire, two BWS participants were found to be English dominant and three were Mandarin dominant. Each BWS participant was matched to age/sex matched control participants (BWNS). Results for the BWS participants found more stuttering in the less dominant language based on a measure of percentage of syllables stuttered. All of the BWS participants demonstrated stuttering adaptation and there was no significant difference in the amount of adaptation for Mandarin and English. There was no difference found between BWS and BWNS for speaking rate and VOT. In spite of the similarity between BWS and BWNS, speaking rate in Mandarin appeared to be faster compared to English. These findings suggest that speech motor control in BWS and BWNS are similar and current application of these findings to the clinical setting is discussed.

INTRODUÇÃO: A gagueira é um distúrbio da fluência multidimensional que resulta da interação de múltiplos processos fisiológicos, refletindo mais de um fator causal. Evidências científicas atuais sustentam a hipótese de que pessoas que gaguejam possuem conexões anômalas em regiões auditivas do hemisfério esquerdo, envolvidas no feedback sensorial dos sons da fala. Desta forma, é prudente pensar que déficits na sincronia neural, identificados por meio de alterações em testes comportamentais do processamento temporal e nos potenciais evocados auditivos (PEA), possam estar relacionados a este tipo de distúrbio. OBJETIVO: caracterizar os resultados do teste Gaps in Noise (GIN) e dos PEA com estímulos de diferentes complexidades em crianças gagas e em crianças em desenvolvimento típico. MÉTODOS: Dez crianças gagas com idades entre sete e 11 anos (grupo estudo - GE) e seus pares nãogagos (grupo controle - GC) foram submetidos a avaliações audiológicas e eletrofisiológicas da audição por meio dos seguintes testes: medidas de imitância acústica, audiometria tonal, logoaudiometria, teste GIN, potencial evocado auditivo de tronco encefálico (PEATE) com estímulos clique e de fala e potencial evocado auditivo de longa latência (PEALL) com estímulo tone burst e de fala. Os resultados obtidos no GC e GE foram comparados por meio de testes estatísticos. RESULTADOS: Ambos os grupos apresentaram resultados normais no teste GIN, de acordo com os critérios de normalidade adotados, contudo, observou-se melhor desempenho no GE. Não foram encontradas diferenças significantes entre os grupos para os resultados do teste GIN. No PEATE com estímulo clique, todos os sujeitos avaliados apresentaram resultados dentro dos padrões de normalidade. Observou-se no GE maior variabilidade nos tempos de latência, bem como tendência à diferença estatisticamente significante entre as orelhas direita e esquerda para o interpico I-III. No PEATE com estímulo de fala, verificaram-se valores de latência da onda C e de amplitude do complexo VA significantemente maiores no GE. No PEALL com estímulo tone burst não foi observada diferença estatisticamente significante entre os grupos. Contudo, observaram-se alterações (ausência de componentes do PEALL) em três sujeitos do GE e em um do GC. No PEALL com estímulo de fala, em ambos os grupos, verificou-se diferença estatisticamente significante entre as orelhas direita e esquerda no que tange a latência da onda N2 e amplitudes P2-N2 e da onda P300. Foram observadas alterações (ausência de componentes do PEALL) em um sujeito do GE. CONCLUSÃO: Embora não tenham sido verificadas alterações de resolução temporal no grupo de crianças gagas por meio do teste comportamental realizado, os resultados dos testes eletrofisiológicos sugerem a presença de diferenças nos processos neurais envolvidos no processamento da informação acústica, entre crianças em desenvolvimento típico e crianças gagas, principalmente em se tratando de elementos de maior complexidade, como a fala / INTRODUCTION: Stuttering is a multidimensional speech disorder that results from the interaction of multiple physiological processes, which means there is more than one causal factor. Current scientific evidence supports the hypothesis that people who stutter have anomalous connections in auditory regions of the left hemisphere, involved in the sensory feedback of speech sounds. Thus, it is reasonable to suppose that deficits in neural synchrony, showed by abnormal results in behavioral tests of temporal processing and auditory evoked potentials (AEP), may be related to this type of disorder. OBJECTIVE: to characterize the results of the Gaps in Noise Test (GIN) and the AEP using stimuli of different complexity, in children who stutter and in typically developing children. METHODS: Ten children who stutter aged between seven and 11 years (study group - SG) and their non-stuttering peers (control group - CG) underwent audiological and electrophysiological evaluation using the following tests: acoustic immittance measures, tonal audiometry, speech audiometry, GIN test, speech- and click-evoked Auditory Brainstem Response (ABR), and Long Latency Response (LLR) with tone burst and speech stimuli. Statistical tests were carried out for comparisons between CG and SG. RESULTS: Both groups presented normal results in the GIN test, according to the normality criteria. However, the SG showed better performance. No significant differences were found between groups for the GIN test results. In the click-evoked ABR, all subjects presented results within the normal range. The SG showed greater variability concerning the latency values, as well as a statistical trend toward significance regarding differences between the right and left ears for the interpeak I-III. In speech-evoked ABR, the latency values of wave C and the amplitude of VA complex were significantly higher in SG. No statistically significant difference between groups was observed in LLR with tone burst stimulus. However, abnormal results were observed (absence of LLR components) in three subjects from the SG and in one subject from the CG. In the LLR with speech stimuli, statistically significant differences were found for both groups, regarding the N2 latency, P2-N2, and P300 amplitudes, when the right and left ears were compared. Abnormal results were observed (absence of LLR components) in one subject from the SG. CONCLUSION: Although auditory temporal resolution deficits were not evidenced by the GIN test in the group of children who stutter, the results of the electrophysiological tests suggest the presence of differences in neural processes related to the acoustic information processing, when compared to typically developing children, especially when more complex elements, such as speech, are considered

The aim of this dissertation thesis is to develop a complex diagnostic-therapeutic programme for adults who stutter. The thesis is divided into two parts: theoretical and empirical. The theoretical part consists of 4 chapters and is based on an analysis of foreign and Czech specialized literature, studies and electronic media. This part presents the theoretical basis of the dissertation and shows the topic of stuttering from a broader perspective. It describes how people who stutter (PWS) are affected by this disorder, its effect on speech, how PWS try to cope with it and how their perception, opinions and feelings change. The dissertation describes stuttering in children, adolescents and adults. It deals with the critical period of the onset of stuttering by specifying various risk factors. It also includes a description of other fluency disorders. A special attention is paid to the personality of the therapist and his/her impact on the therapy process. The dissertation also explains the application of ICF (International Classification of Functioning, Disability and Health) model as a starting point for diagnosis and therapy of PWS as proposed by Yaruss and Quesal (2004). The empirical part is divided into two chapters. The first part consists of a case study which presents the experimental use of...

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