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Background: Dysarthria is one of the most frequent communication disorders in patients with Multiple Sclerosis (MS), with an estimated prevalence of around 50%. However, it is unclear if there is a relationship between dysarthria and the severity or duration of the disease. Objective: Describe the speech pattern in MS, correlate with clinical data, and compare with controls. Methods: A group of MS patients (n = 73) matched to healthy controls (n = 37) by sex and age. Individuals with neurological and/or systemic conditions that could interfere with speech were excluded. MS group clinical data were obtained through the analysis of medical records. The speech assessment consisted of auditory-perceptual and speech acoustic analysis, from recording the following speech tasks: phonation and breathing (sustained vowel/a/); prosody (sentences with different intonation patterns) and articulation (diadochokinesis; spontaneous speech; diphthong/iu/repeatedly). Results: In MS, 72.6% of the individuals presented mild dysarthria, with alterations in speech subsystems: phonation, breathing, resonance, and articulation. In the acoustic analysis, individuals with MS were significantly worse than the control group (CG) in the variables: standard deviation of the fundamental frequency (p = 0.001) and maximum phonation time (p = 0.041). In diadochokinesis, individuals with MS had a lower number of syllables, duration, and phonation time, but larger pauses per seconds, and in spontaneous speech, a high number of pauses were evidenced as compared to CG. Correlations were found between phonation time in spontaneous speech and the Expanded Disability Status Scale (EDSS) (r = - 0.238, p = 0.043) and phonation ratio in spontaneous speech and EDSS (r = -0.265, p = 0.023), which indicates a correlation between the number of pauses during spontaneous speech and the severity of the disease. Conclusion: The speech profile in MS patients was mild dysarthria, with a decline in the phonatory, respiratory, resonant, and articulatory subsystems of speech, respectively, in order of prevalence. The increased number of pauses during speech and lower rates of phonation ratio can reflect the severity of MS.

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El bullying es un fenómeno definido como una forma de agresión intencional que incluye actos verbales, físicos o psicológicos que ocurren en una relación con otras personas de manera reiterada, sistemática y sostenida en el tiempo. La mayor parte de los estudios se concentran en el bullying y las consecuencias en población escolar normotípica, sin embargo, existe poca exploración en el bullying que es resultado de un trastorno comunicativo. Es por ello que la labor de los fonoaudiólogos insertos en ámbitos educativos no es clara en explicitar los lineamientos de acciones terapéuticas que favorezcan la prevención de este fenómeno. El propósito de esta investigación es conocer las principales concepciones que los fonoaudiólogos tienen sobre el bullying en personas con trastornos de la comunicación en edad escolar. Con este objetivo, se realizó una investigación con métodos cuantitativos y cualitativos, mediados por encuestas y entrevistas en profundidad respectivamente. Se encontró que más del 65% del bullying entre personas dentro de los establecimientos educacionales se relaciona con niños de entre 9 y 12 años de edad con trastornos de la comunicación. En cuanto a la autopercepción del rol fonoaudiológico en el tema de la prevención e/o intervención en temas de bullying, emergen los conceptos de favorecer los aspectos del lenguaje y/o del habla en los niños que tienen dificultad, la sensibilización de los actores involucrados, el refuerzo del autoestima y el trabajo en equipo interdisciplinario. Finalizando el tratamiento analítico de las entrevistas, se establece que la Fonoaudiología cumpliría un papel fundamental en el abordaje del bullying en poblaciones con trastornos de la comunicación, siendo el profesional que actúa directamente sobre la salud comunicativa.

Bullying is a phenomenon defined as a form of intentional aggression that includes verbal, physical or psychological acts that occur in a relationship with other people in a repeated, systematic and sustained manner over time. Most of the studies focus on bullying and its consequences in the normal school population, however, there is little exploration of bullying that is the result of a communication disorder. This is why the work of speech therapists inserted in educational settings is not clear in explaining the guidelines for therapeutic actions that favor the prevention of this phenomenon. The purpose of this research is to know the main conceptions that speech-language pathologists have about bullying in people with communication disorders at school age. With this objective, an investigation was carried out with quantitative and qualitative methods, mediated by surveys and in-depth interviews, respectively. It was found that more than 65% of bullying between people within educational establishments is related to children between 9 and 12 years of age with communication disorders. Regarding the self-perception of the speech-language pathology role in the issue of prevention and/or intervention in bullying issues, the concepts of favoring aspects of language and/or speech in children who have difficulty emerge, raising awareness of the actors involved, the reinforcement of self-esteem and interdisciplinary teamwork. Completing the analytical treatment of the interviews, it is established that speech therapy would play a fundamental role in addressing bullying in populations with communication disorders, being the professional who acts directly on communicative health.

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BACKGROUND: Single implant mandibular overdentures (SIMOs) can improve mastication in edentulous elderly people. However, little attention has been paid to their effects on articulation disorders and the swallowing threshold relative to those of conventional complete dentures (CDs). OBJECTIVE: To compare the effects of new conventional CD set and SIMOs on articulation disorders, mandibular movements during speech and swallowing threshold using a paired study design. METHODS: Twenty-two edentulous Brazilian Portuguese-speaking elderly people (mean age 66.7 ± 4.6 years) were first evaluated whilst wearing their old conventional CDs. Articulation disorders were analysed by audio and video recordings, mandibular movements during speech were measured by kinesiography, and the swallowing threshold was assessed by masticatory cycle counting and medium particle size (X50 ) calculation. Participants then received new conventional CDs, and evaluations were repeated 2 months later. Subsequently, single implants were installed in the midlines of subjects' mandibles, and the conventional CDs were converted to SIMOs. After 2 months of SIMOs use, the evaluations were repeated. Data were submitted to the Cochran-Mantel-Haenszel and ANOVA. RESULTS: No difference in articulation disorders was found between new conventional CD and SIMO use. The frequency of anterior lisp during /s/ and /z/ phoneme pronunciation was reduced with new conventional CD use relative to old conventional CD use (p < .05). The X50 decreased progressively with new conventional CD and SIMO use (both p < .05). CONCLUSION: SIMOs do not alter speech relative to new well-fitted conventional CDs, but improved the swallowing threshold, in edentulous elderly people.

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OBJECTIVE: To examine predictors of speech disorder resolution versus persistence at age 7 years in children with speech errors at age 4 years. STUDY DESIGN: Participants were drawn from a longitudinal, community cohort. Assessment at age 4 years (N?=?1494) identified children with speech errors. Reassessment at age 7 years allowed categorization into resolved or persistent categories. Logistic regression examined predictors of speech outcome, including family history, sex, socioeconomic status, nonverbal intelligence, and speech error type (delay vs disorder). RESULTS: At age 7 years, persistent errors were seen in over 40% of children who had errors at age 4 years. Speech symptomatology was the only significant predictor of outcome (P?=?.02). Children with disordered errors at age 4 years were twice as likely to have poor speech outcomes at age 7 years compared with those with delayed errors. CONCLUSIONS: Children with speech delay at age 4 years seem more likely to resolve, and this might justify a "watch and wait" approach. In contrast, those with speech disorder at age 4 years appear to be at greater risk for persistent difficulties, and could be prioritized for therapy to offset long-term impacts.

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Introducción: el lenguaje es un mecanismo primordial en la comunicación humana, el cual ejerce una influencia positiva en la esfera psicológica del individuo. En los niños con síndorme de Down son frecuentes los trastornos del lenguaje y aunque existen programas diseñados para padres y educadores, estos deben ser extensivos y ajustados para aplicar a las familias de estos niños.Objetivo: incrementar el conocimiento sobre los trastornos del lenguaje en los padres y/o madres de niños con síndorme de Down de un círculo infantil especial, a través de una estrategia educativa.Métodos: se aplicó una estrategia educativa con un diseño ambispectivo de estudio pre-test y post-test, para explorar el conocimiento que poseían un grupo de padres y/o madres sobre el desarrollo del lenguaje de sus hijos con síndorme de Down, matriculados en un círculo Infantil especial. El estudio se dividió en tres fases: en la fase inicial se aplicó una encuesta; en la segunda fase se aplicaron los talleres a todos los padres y/o madres; y la tercera fase consistió en la aplicación de la encuesta inicial.Resultados: después de los talleres todos los padres y/o madres reconocían los trastornos del lenguaje en sus hijos, la participación en la estimulación aumentó significativamente al lograrse que 19 (90,5 porciento) de ellos cooperaran y las perspectivas de mejoría futura mejoraron significativamente pues estuvieron presentes en 14 (66,7 porciento) progenitores.Conclusiones: aumentó el conocimiento de los padres y/o madres sobre los trastornos del lenguaje, a partir de la estrategia educativa desarrollada por los mismos

Background: language is a fundamental mechanism in human communication which has a positive influence on the psychological sphere of the individual. In children with Down syndrome, language disorders are common although there are programs which have been designed for parents and educators, which should be extended and adjusted to apply them to the families of these children.Objectives: to increase knowledge about language disorders through an educational strategy for the parents of children with Down syndrome in a special nursery.Methods: we applied an educational strategy with a pre-test / post- test ambispective design study to explore the knowledge that a group of parents had on language development of children with Down syndrome, enrolled in a special nursery. The study was divided into three phases: the initial phase in which a survey was applied, the second phase in which workshops were applied to all parents, and the third phase which consisted on the implementation of the initial survey.Results: after the workshops, all parents recognized language disorders in their children. The participation in the stimulation increased significantly achieving that 19 (90.5 per cent) of them were very cooperative. The perspectives for future development improved significantly because 14 (66.7per cent) parents were present.Conclusions: parents´ knowledge about language disorders increased after the education strategy that was developed for them

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TEMA: avaliação da inteligibilidade de fala. OBJETIVO: esta pesquisa objetivou desenvolver e validar itens para uma escala de inteligibilidade de fala a partir da fala de sujeitos com distúrbios fonológicos (DF) que apresentassem estratégias de reparo (ER) frequentes em Português Brasileiro (PB), através da testagem de sua eficácia para classificar a fala desses sujeitos. Também observou a inteligibilidade de fala gerada pelo uso das distintas ER e a possível interferência de variáveis como sexo, idade, escolaridade e contato com crianças entre os julgadores das amostras de fala. MÉTODO: assim, narrativas espontâneas de cinco crianças cujas falas representassem casos clínicos típicos e a de um sujeito controle foram apresentadas em compact disc (CD) a 103 juízes adultos, com habilidades auditivas normais, entre 18 e 39 anos de idade, com escolaridade fundamental, média e superior. RESULTADOS: os resultados demonstraram a validade estatística dos itens da escala e que o tipo de ER é fundamental no processo de inteligibilidade. Não houve interferência estatística das variáveis sexo, idade, escolaridade ou contato com crianças nos julgamentos realizados. CONCLUSÃO: os itens da escala foram validados e demonstraram eficácia na avaliação da inteligibilidade de fala dos casos estudados.

BACKGROUND: speech intelligibility evaluation. AIM: to develop and validate items for a speech intelligibility assessment scale based on the speech of individuals with phonological disorder (PD) who present common phonological repair strategies (RS) in the Brazilian Portuguese language (BP), through the testing of its effectiveness in classifying the speech of these subjects. Also to observe the speech intelligibility generated by the use of RS and possible interference of factors such as gender, age, literacy and contact of the judges with children. METHOD: spontaneous narratives of five children with typical PD and one control subject were recorded in a compact disc (CD) and presented to 103 judges, with normal hearing abilities, with ages ranging from 18 to 39 years and with elementary, high-school and undergraduate backgrounds. RESULTS: results indicate the statistical validity of the scale and that the type of RS if fundamental for speech intelligibility. There was no statistical interference of the investigated variables of gender, age, literacy and contact with children in the performed judgments. CONCLUSION: the scale items were validated and demonstrated efficacy in the assessment of speech intelligibility of the studied cases.

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TEMA: terapia fonológica. OBJETIVO: avaliar a eficácia do tratamento em três diferentes modelos de terapia quanto às mudanças no sistema fonológico de sujeitos com diferentes gravidades do Desvio Fonológico (DF). MÉTODO: a amostra constituiu-se de 66 sujeitos, com idades entre 4:4 e 8:2, sendo 43 do sexo masculino e 23 do feminino, integrantes do banco de dados de uma clínica escola. Todos foram avaliados, antes e após um período de 15 a 25 sessões de terapia fonológica, utilizando-se a Avaliação Fonológica da Criança, a partir da qual foi determinada a gravidade do DF conforme o Percentual de Consoantes Corretas - PCC, o número de Segmentos Não Adquiridos - SNA , e o percentual de Segmentos Adquiridos (SA) após o período de tratamento. Os sujeitos foram tratados pelos modelos ABAB-Retirada e Provas Múltiplas, Oposições Máximas Modificado e Ciclos Modificado. Posteriormente, realizou-se análise estatística dos dados, utilizando o Teste T para amostras iguais, considerando-se p < 0,05. RESULTADOS: verificou-se um aumento do PCC e do percentual de SA, bem como redução do número de SNA em todos os grupos tratados pelos diferentes modelos de terapia. Estes resultados foram estatisticamente significativos para a maioria dos grupos. CONCLUSÃO: os resultados permitem afirmar que os três modelos de terapia aplicados foram eficazes no tratamento de crianças com DF, para as diferentes gravidades do desvio. Além disso, as maiores mudanças no sistema fonológico ocorreram para os grupos com DF de grau mais acentuado.

BACKGROUND: phonological therapy. AIM: to evaluate the effectiveness of three different therapy models regarding changes in the phonological system of subjects with different phonological disorder (PD) severity levels. METHOD: the research group was composed by 66 subjects, 43 males and 23 females, with ages between 4:4 and 8:2 years, who were part of a school clinic database. All subjects were evaluated, before and after a period of 15 to 25 sessions of phonological therapy, using the Child's Phonological Assessment. Based on this assessment, the severity level of the PD was determined using the Percentage Consonants Correct - PCC, and by calculating the number of Non-Acquired Segments -NAS and the percentage of Acquired Segments (AS) after treatment. The subjects were treated using the following approaches: ABAB-Withdrawal and Multiple Probes, Modified Maximum Opposition and Modified Cycles Models. For the statistical analysis the T-Test was used with a significance level of 5 percent. RESULTS: the statistical analysis indicated an increase in the PCC and in the percentage of AS, as well as a reduction in the number of NAS for all groups. These results were statistically significant for the majority of the groups. CONCLUSION: the results indicate that the three therapy approaches were effective in the treatment of children with PD, and were effective in treating different severity levels. Besides that, most of the changes occurred in the phonological system of the groups with more severe PD.

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Although dyslexia is a common consequence of brain damage there are few studies about therehabilitation of this disorder. Cognitive Neuropsychology models of reading have been used to describe severalsyndromes of acquired dyslexia. Phonological dyslexia is a reading disorder characterized by a dysfunctionalgrapheme-to-phoneme conversion procedure, which affects the ability to read low frequency words and nonwords. Lexical reading is preserved and patients can read frequent words (regular and irregular). OBJECTIVE: Verify the application of the cognitive model in the characterization of the reading disorder of a patient with acquired dyslexia and in the devising and implementation of a rehabilitation plan. METHODS: This study presents OCS, a 57-year-old patient who suffered from acquired phonological dyslexia after a left temporo-parietooccipital ischemic stroke. A rehabilitation program based on the principles of Cognitive Neuropsychology was devised non-words and low frequency words with controlled lengths were used and the patient was stimulated to read them aloud in a 22-session treatment. RESULTS: The post-test evaluation showed quantitative and qualitative improvements Significant improvements were verified in the total number of correct responses including self-correction attempts (p<0.01) and in the reading of trisyllabic and polysyllabic non-words of simple syllabic structure (p=0.0007 and p=0.02 respectively). CONCLUSIONS: The use of the cognitive model to devise a rehabilitation program was successful and we observed significant improvement of reading skills in a short period of treatment. The achievements over this period provided the patient with functional reading performance.

Embora a dislexia seja uma seqüela comum após lesões cerebrais há poucos estudos sobre a reabilitação deste distúrbio. Modelos de leitura da Neuropsicologia Cognitiva têm sido utilizados para descrever diversas síndromes de dislexia adquirida. A dislexia fonológica é um distúrbio de leitura caracterizado por disfunção do procedimento de conversão grafema-fonema que afeta a capacidade de leitura de palavras de baixa freqüência e de não-palavras. A leitura lexical está preservada e os pacientes podem ler palavras freqüentes (regulares e irregulares). OBJETIVO: Verificar a aplicação do modelo cognitivo na caracterização do distúrbio de leitura de uma paciente com dislexia adquirida e na elaboração e implementação de um programa de reabilitação. MÉTODOS: Este estudo apresenta OCS, uma paciente de 57 anos, com dislexia do tipo fonológica adquirida após acidente vascular cerebral isquêmico temporo-parieto-occipital à esquerda. Um programa de reabilitação baseado nos princípios da Neuropsicologia Cognitiva foi elaborado. Não-palavras e palavras de baixa freqüência com tamanhos controlados foram usadas e a paciente era estimulada a ler os estímulos em voz alta em um tratamento realizado em 22 sessões. RESULTADOS: A avaliação pós-teste mostrou melhoras quantitativas e qualitativas.Melhoras significativas foram verificadas no total de respostas corretas, incluindo autocorreções (p<0.01) e na leitura de palavras trissílabas e polissílabas de estrutura silábica simples (p=00007 e p=002 respectivamente). CONCLUSÕES: O uso do modelo cognitivo para propor um programa de reabilitação foi bem sucedido e pudemos observar melhora significativa das habilidades de leitura em um período curto de tratamento. As melhoras atingidas nesse período resultaram em desempenho funcional de leitura.