Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Objective: to verify the growth, nutritional status, the prevalence and duration of breastfeeding and the introduction of complementary foods in preterm infants which participated in a program of sensory-oral motor stimulation during the neonatal period. Methodology: 36 infants between 9 and 23 months of corrected age were enrolled. Of total, 21 received sensory-oral motor stimulation and 15 were controls. The assessment of growth and nutritional status included: anthropometric measurements (weight, length, head circumference and triceps skinfold thickness), body composition analysis (Bioelectrical Impedance (BIA)) and biochemical evaluation. We also investigated the breastfeeding duration, the age and difficulties to introduce complementary foods and some family and maternal variables. Results: Most of infants had weight and length appropriate for age and sex, however there was a significant reduction in the percentage of stimulated infants with length and head circumference below the 10th percentile in relation to birth, compared with controls. The results from BIA were similar in both groups, with phase angle values equivalent to those found in term and healthy infants. Serum iron was lower in stimulated infants compared with controls (p<0,05). No significant differences were found for the others biochemical values. The prevalence of iron deficiency anemia was 14.3% in stimulated infants and in 6.7% of controls (p>0.05). 52.4% of the stimulated infants were breastfeeding compared with 40% of controls. The duration of breastfeeding was 88.6 ± 72.3 days and 101.67 ± 67.3 days for stimulated and controls infants, respectively. The complementary foods were introduced before six month of age, in both groups, with a higher percentage of difficulties in controls. Conclusion: Sensory-oral motor stimulation had no influence in the infant s nutritional status, but it showed a positive influence in length and head circumference since there was a significant reduction in the percentage of stimulated infants under 10th percentile for this variables. / Objetivos: verificar o crescimento, o estado nutricional, a introdução dos alimentos complementares, a prevalência e a duração do aleitamento materno exclusivo em crianças nascidas pré-termo participantes de um programa de estimulação sensório-motora oral (ESMO), no período neonatal. Metodologia: Amostra composta por 36 crianças, com idades entre 9 e 23 meses de idade corrigida. Do total, 21 receberam ESMO (GE) e 15 foram controles (GC). A avaliação do crescimento e estado nutricional incluiu: avaliação antropométrica (peso, comprimento, perímetro cefálico e dobra cutânea tricipital), análise da composição corporal (Bioimpedância elétrica (BIA)) e avaliação bioquímica. Foi investigada também a duração do aleitamento materno exclusivo, época de introdução dos alimentos complementares, dificuldades na introdução e algumas variáveis maternas e familiares. Resultados: A maioria das crianças apresentou peso e estatura adequados para a idade e sexo, no entanto houve uma redução significativa no percentual de crianças com comprimento e perímetro cefálico abaixo do percentil 10, em relação ao nascimento, no GE. Os resultados obtidos através da BIA foram semelhantes entre os grupos, sendo os valores do ângulo de fase semelhantes aos encontrados em crianças nascidas a termo e saudáveis. O ferro sérico foi menor nas crianças do GE quando comparadas as controles (p<0,05). As demais variáveis bioquímicas não mostraram diferenças significantes entre os grupos. A prevalência de anemia ferropriva foi de 14,3% no GE e de 6,7% no GC (p>0,05). Aleitamento materno exclusivo ocorreu em 52,4% das crianças do GE e em 40% das do GC, sendo a duração do mesmo de 88,6 (±72,3) dias para o GE e 101,67 (±67,3) dias para GC. A introdução da alimentação complementar ocorreu em média antes dos 6 meses, nos dois grupos, sendo que um percentual maior de crianças do GC apresentou algum tipo de dificuldade, nesta introdução. Conclusão: Embora a ESMO não tenha interferido no estado nutricional das crianças avaliadas, parece ter influenciado positivamente no comprimento e perímetro cefálico, uma vez que houve uma redução significante no percentual de crianças com crescimento menor do que o percentil 10 para estas variáveis, no grupo que recebeu estimulação motora-oral, no período neonatal.

This study aimed to validate an instrument designed to assess the oral motor skills in children at 9 months of age, as well as to assess the influence of oral behaviors and breastfeeding on them. Six judges with oralfacial motricity experience and 125 children belonging to the 4th Regional Health of Rio Grande do Sul State participated in this study. For the content analysis, the instrument was sent to judges in order to verify the agreement about its relevance and pertinence. In a second moment, the instrument was applied in children. A questionnaire answered by parents investigated the presence of oral behaviors in this population. The results showed satisfactory content validity and reliability; however, the factorial validity indicated a need for revision since five of the eleven items not shown to be contributing to assess the oral motor skills in children at this age. Regarding the influence of oral behaviors and breastfeeding, the pacifier negatively affected the abilities of suction while breastfeeding positively affected them. It was also found that although most children did not present ability to use the cup, the behavior of putting objects in mouth has promoted the development of such ability. We concluded that the instrument proposed can be use to evaluate the oral motor skills in children at 9 months of age. The oral motor skills developed well when breastfeeding was present. / Este trabalho teve como objetivo validar um instrumento elaborado para avaliar as habilidade orais de crianças, aos 9 meses de idade, bem com verificar a influência de hábitos orais e do aleitamento materno sobre as mesmas. O estudo contou com a participação de 6 juízes, com formação e experiência na área da Motricidade Orofacial, e de 125 crianças com cerca de 9 meses de idade, pertencentes à região da 4ª Coordenadoria Regional de Saúde do Rio Grande do Sul. Para a análise de conteúdo, o instrumento foi enviado aos juízes com o objetivo de verificar a concordância sobre a pertinência e validade dos itens propostos. Em um segundo momento, o instrumento foi aplicado às crianças participantes. Através de questionário aplicado aos pais foi investigada a presença de hábitos orais na população estudada. O instrumento elaborado apresentou validade de conteúdo e de fidedignidade satisfatórias, no entanto, a análise fatorial indicou a necessidade de reformulação do instrumento, uma vez que cinco dos onze itens avaliados não acrescentaram contribuição para avaliar as habilidades orais de crianças aos 9 meses de idade. Em relação à influência de hábitos orais e do aleitamento materno, verificou-se que o uso da chupeta influenciou negativamente as habilidades de sucção. Já o aleitamento materno favoreceu o desenvolvimento das habilidades orais na sucção, no grupo estudado. Verificou-se também que, embora a maioria das crianças não apresentasse habilidade para usar o copo, o hábito de introduzir objetos na boca favoreceu o desenvolvimento de tal habilidade. Conclui-se que o instrumento elaborado pode ser utilizado na avaliação das habilidades orais de crianças, aos 9 meses de idade. As habilidades orais desenvolveram-se de forma mais adequada na presença do aleitamento materno.

This Masters thesis focuses on issues of Specific Language Impairment - SLI of children of pre-school age. It monitors and evaluates development of their communication and motor skills during their time in kindergarten. The theoretical part focuses on defining basic terms which relate to communication and communication disorder with the emphasis on SLI. The psychomotor and communicational development of child from birth to entering school is described too. Also how this all affected creating the Framework Educational Programme for preschool education. The aim of the empirical part was to observe four children with SLI during their attendance at a pre-school for children with specific needs. Speech and psychomotor development of these children and its changes in connection to their teachers' intervention was observed. Part of the research included interviews with children's parents and those are also evaluated. The survey was done by the qualitative method. We get four case histories. At the end was evaluated the aims of the survey and answered questions asked and summarized the results of my investigation.

Children with pronunciation difficulties are at risk of consequences later on, such as reading and writing difficulties. Problems with pronunciation could make a child less intelligible and affect their ability to discriminate between different speech sounds. To facilitate the assessment of pronunciation difficulties it is necessary to use appropriate and updated assessment tools suitable to analyze the children’s phonological development. The Swedish pronunciation test, Bedömning Av Fonologi (B.A.F.), has therefore been developed. This new test can be used by professionals to evaluate the phonological realisations of children. The purpose of this study was to gather normative data of 4 and 5 year olds for B.A.F. and to investigate if girls and boys performed differently concerning the pronunciation of the words in B.A.F. Furthermore, the intention was to investigate if there was any correlation in the performance of the words in B.A.F. with oral motor precision (by oral motor movements tasks), oral motor speed (by repeating syllables) as well as auditory perception (by repetition of nonwords). 63 children (36 girls and 27 boys) in the ages of 48 to 71 months participated in the study. The results showed that by using B.A.F. it is possible to see that the number of correctly pronounced words increases with age. Further, the results indicated that children in the ages of four and five had established /p, t, k, d, f, v, j, h, l, m, n/ and /ŋ/ and all the vocals except /y:/ and /Y/. The only speech sound that did not prove to be established was /r/. Neither the 4 nor the 5 year olds had established consonant clusters containing /r/. A significant correlation was found between oral motor speed and correctly pronounced words in B.A.F. The children’s auditory perception also correlated with the number of correctly pronounced words in B.A.F. This study suggests that skills concerning auditory perception and oral motor speed have more effect on pronunciation skills than oral motor precision. The results gave no indication of a difference in pronunciation between girls and boys. / Barn med uttalssvårigheter löper risk för senare konsekvenser, som exempelvis läs- och skrivsvårigheter. Problem med uttal kan göra ett barn svårförståeligt för omgivningen och kan påverka förmågan att särskilja mellan språkljud. För att underlätta bedömningen av uttalssvårigheter behövs uttalstest som är aktuella och anpassade efter barns utveckling. Därför har det nya uttalstestet Bedömning Av Fonologi (B.A.F.) producerats. Med hjälp av B.A.F. kan barns fonologi undersökas genom uttal av språkljud i ord. Denna studie syftade till att ta fram normativa data för testet hos 4- och 5-åringar. Studien syftade även till att undersöka om några skillnader mellan könen gällande prestationen på B.A.F. fanns samt om något samband mellan uttal av orden i B.A.F. och ett antal uppgifter som mätte oralmotorisk precision (oralmotoriska rörelser) och snabbhet (upprepning av stavelser), samt auditiv perception (repetition av nonord) kunde påvisas. I studien deltog 63 barn (36 flickor och 27 pojkar) i åldrarna 4;0 år till 5;11 år. Under analysen delades barnen in i grupper av halvårsintervall. Resultaten visade att man i B.A.F. kan se att antal korrekt uttalade ord ökar i linje med stigande ålder. Det påvisades även att barn i fyra- och fem årsåldern etablerat /p, t, k, d, f, v, j, h, l, m, n/ och /ŋ/ samt alla vokaler utom /y:/ och /Y/. Det enda konsonantfonem som ej visade sig vara etablerat i dessa åldrar var /r/. Ingen av åldersgrupperna hade heller etablerat kluster innehållandes /r/. Ett signifikant samband kunde påvisas mellan oralmotorisk snabbhet och antal korrekt uttalade ord i B.A.F. Även barnens auditiva perception korrelerade signifikant med antal korrekt uttalade ord i B.A.F. Föreliggande studie tyder på att auditiv perception och oralmotorisk snabbhet har ett större samband med uttalet än oralmotorisk precision. Inga uttalsskillnader mellan könen framkom.