Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / In the pediatric population, the speech disorder is one of the most frequent changes that involve human communication disorders. But, in this area, there is a significant shortage of formal and objective instruments available and suitable to evaluate and diagnose. The goals of an evaluation process just can be achieved when adequate tools and procedures are used. Thus, this study aims to validate an instrument of phonological assessment. In the first stage, a list of words was created, through vocabulary lists child and phonological assessment instruments most commonly used in PB. This list of 722 words was sent to 11 expert judges - three clinical speech therapists, five doctors in speech therapy and three doctors in linguistics that through chosen analysis and criteria, was possible to indicate the most appropriate words to compose the phonological assessment instrument. From these results, was calculated the Kappa agreement obtained between the groups of expert judges and created a new list of words with the most suitable ones. As a result of the previous step, 316 words were shown to be judged by not expert judges. These judges were 72 children, male and female, by public and private schools, aged between 3:0 and 8:11 years. They rated the word by familiarity and naming of the illustration. Words with highest number of correct naming were reanalyzed as theoretical-linguistic another list of words was created with 193 considered best words to make the instrument of child s phonological assessment. / Na população infantil, o desvio fonológico é umas das mais frequentes alterações que envolvem os distúrbios da comunicação humana. Porém, há uma escassez significativa de instrumentos formais e objetivos disponíveis e indicados para avaliação e diagnóstico na área da Fonoaudiologia. Sabemos que os objetivos de um processo de avaliação só podem ser atingidos quando instrumentos e procedimentos adequados são utilizados. Este estudo tem como objetivo realizar a validação do conteúdo de um instrumento de avaliação fonológica. Na primeira etapa, por meio de instrumentos de avaliação fonológica utilizados com mais frequência no PB e listas de vocabulário infantil, foi criada uma lista de palavras. Esta lista de 722 palavras foi enviada a 11 juízes especialistas três fonoaudiólogos-clínicos, cinco fonoaudiólogos doutores em linguística aplicada, e três linguistas doutores para que, através de análise e critérios escolhidos por eles, indicassem as palavras que julgassem mais adequadas para compor o instrumento de avaliação fonológica. A partir desses resultados, foi calculada a concordância Kappa obtida entre os grupos de juízes especialistas, e criada uma nova lista de palavras com as mais indicadas por eles. Como resultado da etapa anterior, 316 palavras foram ilustradas para serem julgadas pelos juízes não especialistas. Estes juízes eram 72 crianças do gênero feminino e masculino, de escolas pública e privada, com idade entre 3:0 e 8:11 anos. Os juízes não especialistas classificaram a palavra quanto à familiaridade e à eliciação, a partir da ilustração individual desta. As palavras com maior número de acertos quanto à familiaridade e eliciação foram posteriormente analisadas conforme referencial teórico-linguístico e, a partir daí, foi elaborada uma lista com palavras consideradas melhores para compor o instrumento de avaliação fonológica infantil, resultando num total de 193 palavras.

Essa pesquisa foi realizada com o objetivo de avaliar os componentes da matriz extracelular da cartilagem, ligamentos, tendão e sinóvia em modelo experimental de diabetes. Metodologia: Ratos Wistar jovens foram divididos em grupo diabético (DG n = 15) induzido por estreptozotocina (STZ, 35 mg / kg) e grupo controle (CG, n = 15). Foram avaliados o peso, a glicemia e o anticorpo anticarboximetil-lisina plasmática, durante o experimento e após 70 dias da indução. As articulações do joelho, os ligamentos colateral lateral, colateral medial e tendão calcâneo foram isoladas, corados com hematoxilina-eosina e Picrosírius. O teor de colágeno total foi determinado por morfometria. Avaliamos ainda a metaloproteinase 9 e os inibidores de metaloproteinases (TIMP) 1 e 2 da cartilagem articular. Na sinóvia analisamos a expressão de endotelina-1. Os colágenos dos tipos I, III, V nos ligamentos e tecido sinovial e II e XI na cartilagem foram avaliados pela técnica de imunofluorescência. Resultados: Os níveis elevados de glicemia e anticorpo anticarboximetil-lisina plasmática foram observados no GD quando comparado com o CG. O peso final foi menor nos ratos GD do que nos ratos do CG. Avaliação histomorfométrica mostrou uma grande quantidade de fibras colágenas finas fibrilas, mais grossa nos ligamentos e cartilagens da GD ratos, bem como o aumento de colágeno e diminuição da espessura das fibras colágenas finas do tecido sinovial. Houve uma diminuição no proteoglicanos na DG ratos, quando comparados com os ratos do GC. Imunofluorescência demonstrou um aumento de colágeno III e V em ligamentos, colágeno XI em cartilagem, e colágeno I no tecido sinovial de ratos DG comparados com ratos do GC. Conclusão: O diabetes está fortemente relacionado com a remodelação do colágeno e ocorre de formas diferentes nos componentes articulares. Estes resultados podem contribuir para o desenvolvimento de novas terapias correlacionadas com as complicações articulares em pacientes diabéticos / The aim of this study was to evaluate the extracellular matrix components in cartilage, ligaments and synovia in experimental model of diabetes. In this way Young Wistar rats were divided into diabetic group (DG; n = 15) induced by streptozotocin (STZ; 35 mg/kg) and control group (CG; n=15). Weight, blood glucose and plasmatic anti-carboxymethyllysine were measured 70 days after STZ. Knee joints, patellar, collateral lateral, and collateral medial ligaments were isolated, stained with hematoxylin-eosin and Picrosírius. The total collagen content was determined by morphometry. The types I, III, and V collagens in ligaments and synovial tissue and II and XI in cartilage were evaluated by immunofluorescence. Higher blood glucose levels and plasmatic anti-carboxymethyllysine were observed in DG rats when compared with CG rats. The final weight was lower in DG rats than in CG rats. Histomorphometric evaluation depicted a large quantity of thin collagen fibers over thick fibrils in ligaments and cartilage in DG rats as well as increased thick collagen and decreased thin collagen fibers in synovial tissue. There was a decrease in proteoglycans in DG rats when compared with CG rats. Immunofluorescence demonstrated increases of collagen III and V in ligaments, collagen XI in cartilage and collagen I in synovial tissue of DG rats compared with CG rats. In conclusion diabetes is strongly related with collagen remodeling and occurs differently in joint components. These results may contribute to the development of new therapies correlated with joint complications in diabetic patients

Intelligible speech is a primary component for successful communication. However, the speech of children with disordered phonologies is often unintelligible. Therefore, when assessing the speech intelligibility of children in order to determine whether they qualify for intervention services, speech-language pathologists need reliable evaluation tools. The focus of this investigation was the measurement of speech intelligibility. The purpose of this study was to examine the relationship between two methods for measuring speech intelligibility. The first, identification method, involves the listener transcribing a speech sample from which the percentage of words understood is calculated. The second, scaling procedure, involves the listener estimating the percentage of words understood from a continuous speech sample. The secondary purpose of this study was to examine the accuracy of the scaling method as measured by ear estimation compared to the identification method as measured through orthographic transcription for each of three groups of children with: (a) the most intelligibility, (b) average intelligibility, and ( c) least intelligibility. Four unsophisticated listeners rated the speech intelligibility of 48 speakers aged 4:0 to 5:6 who comprised three groups with varying levels of phonological proficiency. The listeners who were unfamiliar with the speakers, but familiar with the topic, rated the children's continuous speech samples using ear estimation. The data collected were then compared with intelligibility ratings as measured in a previous study (Gordon-Brannan, 1994) via orthographic transcription. The two methods of measuring speech intelligibility examined in this study were found to be positively correlated (r = .86). However, the t-test analysis revealed significant differences between the two measures for the most and least intelligible groups, indicating discrepancies between the two methods when measuring the speech intelligibility of some children. Additional statistical analysis revealed poor intrajudge reliability which should be considered when interpreting the results presented. It does appear, however, that when measuring speech intelligibility, using ear estimation, is reflective of the orthographic transcription measure, although the actual estimated percentages of intelligibility appear to differ from the percentages derived from orthographic transcription.

A single subject, diagnosed as having severe oral apraxia and dysarthria, participated in an eight-week research experiment designed to study the effects of singing on speech articulation. A simultaneous treatment design was used in which the subject participated in both the e xperimental and control conditions. In the control condition spoken words were repeated by the subject, while in the experimental condition the words were sung. The words used were the lyrics to two popular folk songs. Articulatory accuracy (intelligibility) was judged by two graduate level speech therapists, based on audiotape samples of the subject's responses, recorded on a "Language Master" machine. Judges were also asked to rate their degree of confidence about their judgements. Results indicated significantly higher scores at the .05 level for the singing condition than for the non-singing condition. Degree of confidence ratings were similar for both conditions. It was also observed that a significantly greater number of consonant blends were correctly articulated in the singing condition than in the nonsinging condition.

Choosing an effective and efficient phonological treatment approach is an important decision for clinicians when treating children with phonological deviations. Current research supports the effectiveness of phonological treatment, but few studies have compared two approaches. More comparative studies are essential to support clinical intervention for children who are highly unintelligible. This single-subject study was designed to compare the effectiveness of two phonologically-based treatment approaches in facilitating an intelligible speech production system for one highly unintelligible preschool female. Multiple baselines across behaviors with an alternating treatment design were used in this descriptive study. This study sought to answer the following questions: (a) Is there a clinically significant difference between the effectiveness of the cycling approach and the minimal pairs approach in treating a child with phonological disorders? and (b) Do the phonological cycling and/or the minimal pairs treatment approaches result in generalization of treated sounds in a targeted pattern to untrained words containing the treated sounds and to untreated sounds/sound contexts in the same phonological pattern? Using the phonological assessment instrument, the APP-R in conjunction with the CAPD, four phonological deviations were chosen for phonological remediation. Two deviations were assigned to the phonological cycling approach (Hodson & Paden, 1991) and two to the minimal pairs approach (Blache, 1989; Fokes, 1982). Remediation alternated between the two approaches every 6 sessions, beginning with the cycling approach, for a total of 24 sessions. Treated sounds from each targeted deviation were taught and reassessed using the APP-R to compare treatment effectiveness. To examine generalization of targeted phonological patterns to phonemes in other contexts, periodic probes of treated sounds within untrained words and untreated sounds/sound contexts in the same pattern were administered. Results of the CAPD indicate that both treatment methods were effective in improving some of the treated phonological deviations for this subject though neither method was more effective than the other. Probe words indicated generalization to untrained words and untreated sounds/sound contexts in some phonological patterns. These findings support the phonologically-based theory of remediation: the goal of phonological treatment is developing a whole phonological system, rather than perfecting targeted deviations.

The motor speech disorder of dysarthria is present in a substantial number of children with cerebral palsy (CP), leading to speech intelligibility deficits, which may negatively affect the children’s communication and quality of life. Few studies to date have examined strategies for increasing intelligibility in children with dysarthria, and most have focused on English speakers. Thus, questions regarding the effects of speech cueing strategies in speakers of other languages are under-explored. The purpose of this study was to determine if (Korean translations of) two cues, “speak with your big mouth,” targeting greater articulatory excursion, and “speak with your strong voice,” targeting greater vocal intensity, would elicit changes in speech acoustics and intelligibility in Korean-speaking children with dysarthria secondary to CP. Fifteen Korean-speaking children with dysarthria repeated word- and sentence-level stimuli in habitual, big mouth, and strong voice conditions. Intelligibility was assessed through the ease-of-understanding (EoU) ratings and percentage of words correctly transcribed (PWC) by 90 blinded listeners. Results indicated significantly greater vocal intensity and greater utterance duration in the cued conditions, demonstrating the children’s ability to vary their speech styles in response to the two cues. Furthermore, word-level EoU gains following both cues and sentence-level EoU gains following the strong voice cue suggest potential intelligibility benefits of the cues in this population. Gains in PWC were not statistically significant, and considerable variability in the children’s responses to the cues was noted overall. These findings contribute to the limited knowledge base for speech-language pathologists working with Korean speaking children. The variability in responses points to the importance of assessing each child’s stimulability to cues aimed to enhance intelligibility. Further clinical and theoretical considerations, including cross-linguistic implications, are discussed.

Developing strategies to promote effective carryover is one of the most difficult tasks a clinician faces. Mention has been made in the literature of possible activities to use in the clinical setting to promote carryover. Suggestion has been made in the literature that operant conditioning is a technique which can be employed to achieve carryover. The purpose of this investigation was to determine whether there is a difference in relative effectiveness between operant and non-operant techniques for achieving carryover of /1/.

Clinicians report that carryover management is one of the most difficult and time consuming problems they face (Johnson, 1972) yet the literature offers little data to assist clinicians in determining what methodologies should be used and which are effective in facilitating carryover. The purpose of this investigation was to determine the type of methodologies utilized by public school clinicians in Oregon to facilitate carryover with clients originally diagnosed as having articulation disorders. A secondary question dealt with the perceived effectiveness of these methodologies.

This study investigated the relationship of auditory short-term memory and articulation ability of eight-year-old children to determine if a relationship existed between auditory short-term memory ability and articulation ability. The specific question posed was: Is there a statistically significant difference in the auditory short-term memory ability of eight-year-olds with three or more phoneme errors and eight-year-olds with no phoneme errors?

Assessment of speech sound production in young children provides the basis for diagnosis and treatment of speech sound disorders. Standardized single-word articulation tests are typically used for identification of speech sound errors because they can provide an efficient means of obtaining a speech sample for analysis and comparison to same-age peers. A major criticism of single-word articulation tests is that they may not accurately reflect speech sound production abilities in conversation. Comparison of performance in single-word and conversational contexts has produced conflicting results in the available research. The purpose of the present study was to compare speech samples obtained using an extensive single-word naming task with samples of continuous speech elicited by sentence imitation. It was hypothesized that there would be differences in overall speech sound production accuracy as well as differences in types and frequency of errors across the two sampling conditions. The present study is a pilot investigation as part of the development of the Phonological and Bilingual Articulation Assessment, English Version (PABA-E; Gildersleeve-Neumann, unpublished). Twelve preschool children ages 3;11 to 4;7 (years;months) from the Portland Metropolitan area participated in this study. Participants were monolingual native English speakers and exhibited typical speech sound development as measured by the GFTA-2 (Goldman-Fristoe, 2000). Hearing acuity for participants was within acceptable limits, and participants' families reported no significant illnesses or developmental concerns that would impact speech sound production abilities. Mean t-scores for percentage of consonants correct (PCC) in the single-word samples were significantly higher at the .05 level than those for the sentence imitation samples. There was no significant difference between the percentage of vowels produced correctly (PVC) in the two sampling conditions. Similar types of error patterns were found in both the single-word and continuous speech samples, however error frequency was relatively low for the participant population. Only the phonological process of stopping was found to be significantly different across sampling conditions. The mean frequency of occurrence for stopping was found to be significantly higher in continuous speech as compared with the production of single-words.