Orientador: Satoshi Kitamura / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T11:47:36Z (GMT). No. of bitstreams: 1 Luchesi_KarenFontes_D.pdf: 2231982 bytes, checksum: 2f5ef1dbfa543808275311de510df643 (MD5) Previous issue date: 2013 / Resumo: A Doença de Parkinson (DP) é uma das doenças neurodegenerativas mundialmente mais prevalentes. Dentre as doenças do neurônio motor, a Esclerose Lateral Amiotrófica (ELA) é a mais frequente. A qualidade de vida e o prolongamento da expectativa de vida dos sujeitos com doenças neurodegenerativas, como ELA e DP, são foco da intervenção fonoaudiológica, visto que uma das maiores causas de morte são as pneumonias aspirativas. Esta pesquisa teve por objetivo analisar e descrever aspectos relacionados à disfagia e à sua progressão em sujeitos diagnosticados com ELA e DP. Ao todo, participaram 49 sujeitos com ELA e 24 sujeitos com DP. Todos foram avaliados e acompanhados no ambulatório de Otorrinolaringologia/Disfagia do Hospital de Clínicas da Universidade Estadual de Campinas. Foram incluídos no estudo, apenas os sujeitos que estavam em acompanhamento periódico no ambulatório de neurologia do referido hospital e em tratamento medicamentoso. Foram excluídos os sujeitos sem queixa de deglutição ou que apresentassem outras doenças que pudessem causar alteração na deglutição. Todos foram submetidos à entrevista estruturada, videoendoscopia da deglutição, avaliação clínica da deglutição e intervenção fonoaudiológica, além de terem a funcionalidade de ingestão oral classificada pela Functional Oral Intake Scale. Foi realizada uma análise descritiva dos dados com apresentação de frequência das variáveis categóricas e medidas de tendência central e dispersão das variáveis numéricas. Na análise exploratória foram utilizados: Regressão de Cox, teste Exato de Fisher, teste de Kruskal-Wallis, Qui-quadrado, teste de Mann-Whitney e análise de sobrevivência de Kaplan-Meier. As análises foram realizadas por meio do software SPSS versão 13.0 para Windows, tendo sido adotado o nível de significância para os testes estatísticos de 0,05. Na ELA, foi identificado como fator associado à disfagia moderada ou grave, a odinofagia (p=0,01). Foram identificados como fatores que influenciaram na progressão da disfagia na ELA a idade de início da doença (p=0,02) e o início bulbar (p=0,04). A idade de início avançada (p=0,03) e o menor tempo de doença até a primeira avaliação (p=0,004) foram identificados como fatores que levaram à necessidade de indicação de uma via alternativa de alimentação em menor tempo na ELA. Não foram identificados fatores que influenciassem a progressão da disfagia na DP. Observou-se melhora e estabilização da função de deglutição na maioria dos sujeitos com DP estudados. Conclui-se que a idade de início e o início bulbar da ELA são fatores associados à piora rápida da disfagia. Não houve fatores associados à progressão da disfagia na PD e a funcionalidade na deglutição destes pacientes foi caracterizada por melhora e manutenção / Abstract: Parkinson's disease (PD) is one of the most prevalent neurodegenerative diseases worldwide. Among the motor neuron diseases, the Amyotrophic Lateral Sclerosis (ALS) is the most common. The quality of life and longer life expectancy for these individuals with neurodegenerative diseases are the purpose of speech-language therapy, as the leading cause of death are aspirative pneumonias. The objective of this study was to analyze and describe aspects related to dysphagia and its progression in patients diagnosed with ALS and PD. Altogether, 49 patients with ALS and 24 patients with PD participated in the study. All patients were evaluated and followed by at the Otolaryngology/Dysphagia services of the Clinical Hospital of the University of Campinas. The study included only patients who have been regularly monitored at the neurology service and undergoing drug treatment. Patients who had other conditions that could cause changes in swallowing or with no complaints concerning swallowing were excluded. All patients underwent a structured interview, Fiberoptic Endoscopic Evaluation of Swallowing, clinical evaluation of swallowing and swallowing management. Furthermore, they had the swallowing functionality classified by the Functional Oral Intake Scale. We performed a descriptive analysis with presenting the frequency of categorical variables, central measures tendency and dispersion of numerical variables. In exploratory data analysis were applied Cox Regression, Kruskal-Wallis, Chi-square, Mann-Whitney and survival analysis of Kaplan-Meier. The analyses were performed using SPSS version 13.0 for Windows and the significance level for statistical tests was 5%. Odynophagia was identified as an associated factor with moderate or severe dysphagia in ALS. The onset age of ALS (p = 0.02) and the bulbar onset ALS (p = 0.04) were identified as factors that influence the progression of dysphagia in ALS. Advanced onset age (p = 0.03) and shorter disease duration (p = 0.004) were identified as factors that lead to sooner need for non-oral feeding. We did not identify any associated factors with the progression of dysphagia in PD. We noticed an improvement and stabilization of the swallowing function in most patients with PD. We conclude that the onset age and bulbar onset of ALS are factors associated with rapid worsened dysphagia / Doutorado / Epidemiologia / Doutora em Saúde Coletiva

Several studies have been conducted on the features of African-American English (AAE). Findings have generally been limited to descriptions of those surface level features used by adult or adolescent AAE speakers. Little emphasis has been placed on how AAE emerges as a linguistic system in young children. Consequently, much of the information gained on AAE surface features are limited to lists of how AAE features used by adults and teenagers contrast with those used by speakers of Standard American English (SAE). There has been limited information gathered on the underlying grammatical and syntactic principles of AAE. An informed perspective is that in order to differentiate normal language functioning from disordered language functioning in AAE speaking children, there is the need for a greater understanding of the underlying linguistic systems governing the functioning of AAE grammar. This research investigation represents a step in understanding the linguistic systems of AAE which govern its surface level representations. The purpose of this study was to investigate AAE speaking children's knowledge of the specific aspectual properties that comprise the meaning of aspectual "be" in AAE. These linguistic properties included: habituality, iterativity, imperfective viewpoint, and the marker "be." Thirty-five normal AAE speaking children and eighteen normal SAE speaking children served as subjects. The children were between the ages of five and six years. The results of this study confirmed that AAE speaking children understand the targeted aspectual contours of aspectual "be" and do not confuse aspectual "be" with SAE regular forms of "be," but rather are able to identify aspectual "be" as a separate additional lexical item (marking specific aspectual contours) in their linguistic repertoires. Findings also revealed that AAE speaking subjects could correctly manipulate aspectual "be" in the deep structure of their grammar. Finally, it was demonstrated that with the exception of aspectual "be," AAE and SAE children share essentially equivalent aspectual abilities. The AAE subjects' ability to recognize two separate linguistic meanings of "be" (regular and aspectual) provided clear evidence that at a young age AAE speaking children are able to control the subtle features of their dialect.

No description available.

Background: Diagnostic accuracy and reliability of acquired apraxia of speech (AOS) in the presence of co-occurring aphasia and/or dysarthria is crucial for appropriate treatment selection and clinical decision making. However, overlapping symptomology and lack of operationalization of AOS assessment methods have contributed to inadequate interrater reliability of perceptual measures differentially diagnostic of AOS. Purpose: This study investigated factors influencing the operationalization of AOS assessment methods, primarily interrater reliability of perceptual characteristics of differentially diagnostic (i.e., phonetic and prosodic errors) measures in order to inform assessment methods in AOS with concomitant aphasia. In addition, several other factors influencing the operationalization of AOS assessment methods were explored including: the utility of a pre-existing stimulus readily available in a standardized aphasia assessment (WAB-R), interrater reliability of non-discriminatory characteristics of AOS (i.e., auditory groping and false starts), the influence of alternating motion rates (AMRs) and sequential motion rates (SMRs) on a diagnosis of AOS, and the influence of the WAB-R subtests on error production by diagnostic group. Methods: Forty participants presenting with varying aphasia subtypes and severities and potential motor speech impairment were included. Speech production errors were analyzed by four raters using narrow transcription methods in response to the WAB-R spoken language subtest stimuli (Naming, Repetition, and Spontaneous Speech subtests) of the WAB-R. Interrater reliability of perceptual measurement of both differentially diagnostic and non-discriminatory features of AOS when using consistent stimuli (WAB-R), measures (Apraxia of Speech Rating Scale) and trained raters using narrow transcription methods were examined. In addition, percentage agreement of AOS diagnoses with and without the inclusion of AMRs/SMRs, as well as the influence of WAB-R subtest on error production across groups with AOS with concomitant aphasia and those with aphasia only were also examined. Results: Both differentially diagnostic as well as non-discriminatory speech characteristics were shown to demonstrate adequate interrater reliability across a variety of aphasia subtypes and severities of both AOS and aphasia. Adequate agreement between a diagnosis of AOS with and without the inclusion of AMRs/SMRs was reported as well as a lack of significant differences of phonetic and prosodic error production between subtests. Conclusion: The current work provides preliminary evidence of adequate interrater reliability of perceptual features of AOS using consistent stimuli (WAB-R), measures (Apraxia of Speech Rating Scale), and trained raters using narrow transcription. Findings from this work also support the inclusion of the AMRs/SMRs in AOS assessment and highlight the importance of their role when assessing individuals with borderline/mild motor speech impairments. These preliminary results support the consistency and operationalization of assessment methods through the investigation of reliability of perceptual measurements of differentially diagnostic characteristics of AOS in the presence of aphasia.

abstract: Children with cleft palate with or without cleft lip (CP+/-L) often demonstrate disordered speech. Clinicians and researchers have a goal for children with CP+/-L to demonstrate typical speech when entering kindergarten; however, this benchmark is not routinely met. There is a large body of previous research examining speech articulation skills in this clinical population; however, there are continued questions regarding the severity of articulation deficits in children with CP+/-L, especially for the age range of children entering school. This dissertation aimed to provide additional information on speech accuracy and speech error usage in children with CP+/-L between the ages of four and seven years. Additionally, it explored individual and treatment characteristics that may influence articulation skills. Finally, it examined the relationship between speech accuracy during a sentence repetition task versus during a single-word naming task. Children with CP+/-L presented with speech accuracy that differed according to manner of production. Speech accuracy for fricative phonemes was influenced by severity of hypernasality, although age and status of secondary surgery did not influence speech accuracy for fricatives. For place of articulation, children with CP+/-L demonstrated strongest accuracy of production for bilabial and velar phonemes, while alveolar and palatal phonemes were produced with lower accuracy. Children with clefting that involved the lip and alveolus demonstrated reduced speech accuracy for alveolar phonemes compared to children with clefts involving the hard and soft palate only. Participants used a variety of speech error types, with developmental/phonological errors, anterior oral cleft speech characteristics, and compensatory errors occurring most frequently across the sample. Several factors impacted the type of speech errors used, including cleft type, severity of hypernasality, and age. The results from this dissertation project support previous research findings and provide additional information regarding the severity of speech articulation deficits according to manner and place of consonant production and according to different speech error categories. This study adds information on individual and treatment characteristics that influenced speech accuracy and speech error usage. / Dissertation/Thesis / Doctoral Dissertation Speech and Hearing Science 2020

Objective: The purpose of this study is to determine whether a novel, user-friendly rating system, visual sort and rate (VSR) provides comparable ratings to the currently used direct magnitude estimation (DME) rating system for rating perceptions of audible nasal emission (ANE) and hypernasality in cleft palate speakers. Methods: Twelve naïve listeners rated 152 speech samples of speakers with cleft palate across four conditions: rating hypernasality and ANE using either a VSR or DME rating scale. Raters were provided with a short training session, prior to rating each day. Inter- and intra-rater reliabilities, as well the line of best fit between scores using VSR and scores using DME was calculated to determine usability of VSR as a novel rating system. Results: Direct magnitude estimation resulted in the highest levels of inter-rater reliability, when rating hypernasality (DME r= .48; VSR r=.14), as well as ANE (DME r= .27; VSR r=.15). Most raters demonstrated high intra-rater reliabilities across conditions. A curvilinear line of best fit most accurately captured the relationship between DME and VSR scores when rating hypernasality (r=.64) and ANE (r=.66). Conclusions: A curvilinear relationship between ratings suggests that both variables are prothetic, and therefore, best captured using a DME rating scale (Eadie & Doyle, 2002). The use of DME is supported for continued use rating hypernasality, even amongst naïve listeners given a training session. Rating ANE was difficult, as ratings yielded low inter-rater reliabilities, regardless of the scale used. Further research regarding perceptions of audible nasal emission is warranted.

No description available.

This study examines Spanish gender assignment among mixed bilingual children with 121 English Language Learners and 17 Spanish Language Leaners from North and South Florida through the results of a receptive gender marking task. Two groups of younger (ages 4 to 6) and older (7 to 10) students participated and were tested on their accuracy of gender markers (el and la) on picture naming task of overtly and non-overtly marked feminine and masculine nouns. All participants demonstrated greater accuracy with overtly marked versus non-overtly marked nouns and with feminine versus masculine marked nouns. Greater overall gender assignment accuracy and the accuracy of marked markers was seen with older bilinguals compared to younger bilinguals. Comparisons regarding overall accuracy of gender assignment were made according to location. The results showed greater accuracy for overall gender assignment and marked nouns (overtly, non-overtly, masculine and feminine) for the participants from the South Florida compared to North Florida. For South Florida, years studying Spanish was significantly related to overall gender assignment accuracy. Equivalently, for North Florida, the number of years of exposure to Spanish was significantly related to overall gender assignment accuracy. / A Thesis submitted to the Department of Communication Science and Disorders in partial fulfillment of the requirements for the degree of Master of Science. / Spring Semester 2015. / March 27, 2015. / bilingual, gender assignment, language, non-overtly, overtly, Spanish / Includes bibliographical references. / Carla Wood, Professor Directing Thesis; RaMonda Horton, Committee Member; Gretchen Sunderman, Committee Member.

Auditory maskers, whether intelligible speech or unintelligible noise, can make it difficult to hear and/or process a target sentence. These maskers can present challenges to peripheral processing as well as central processing. Change in pupil size is a physiological index of listening effort and can be measured using eye tracking technology. The aim of the study was to compare listening effort, as measured by changes in pupil size in individuals with normal hearing, between the conditions of Intelligible Speech Masker (ISM), Speech Shaped, Speech Envelope-Modulated Noise Maskers (SSSNM), and Stationary Noise Masker (SNM). Spatial separation between target and maskers was used throughout all conditions. The study design used adaptive tracks that varied the Target to Masker Ratios (TMRs) in each of the 3 conditions in order to identify the TMR corresponding to the 75% correct point on the psychometric function for each participant. Once the TMR corresponding to the 75% correct point was identified, this TMR was held constant for 24 trials while pupil size was recorded. The results show that the ISM condition elicited a higher degree of listening effort compared to either of the noise conditions (SNM and SSSNM). These results reveal that more effort is required to ignore background speech than to ignore background noise at equivalent TMRs. Understanding the amount of effort that young, normal-hearing listeners must exert in these different types of situations will provide a foundation for later measuring the amount of effort that individuals with hearing loss and/or cognitive-linguistic deficits (e.g., aphasia) must exert in the same situations. / 2023-05-19T00:00:00Z

No description available.