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RESUMEN Objetivo Validar una propuesta de Entrevista Autobiográfica orientada al adulto mayor típico. Método Se diseñaron preguntas para una entrevista de memoria autobiográfica semiestructurada y se desarrolló un protocolo para la aplicación de esta. Se utilizaron 28 jueces; 14 fonoaudiólogos y 14 adultos mayores. Adicionalmente, se pilotaron 2 entrevistas. Posteriormente, la validez de contenido se obtuvo mediante el procedimiento clásico de Lawshe, utilizando complementariamente una evaluación para la comprensibilidad y extensión de la entrevista, así como un procedimiento de triangulación de datos con los jueces y participantes de la experiencia piloto. Resultados De los 22 ítems evaluados, solo 4 estuvieron por sobre el valor crítico de referencia (0.49). Conclusión Se discute sobre la necesidad de incorporar esta medida de análisis en el contexto del respeto, la identidad y la agencia de los adultos mayores, como parte de un cambio de paradigma bajo la mirada de las atenciones centradas en la persona y un modelo de competencia comunicativa. Así como la necesidad de incorporar paradigmas culturales diferentes y el uso de tecnologías digitales.
ABSTRACT Purpose To validate a proposal for an autobiographical interview oriented to the typical older adult. Methods Questions for a semi-structured autobiographical memory interview were designed and a protocol for its application was developed. Fourteen Speech and Language Pathologists judges and 14 older adults were used. Additionally, 2 interviews were conducted. Subsequently, content validity was obtained by means of Lawshe's classic procedure. Also, using a complementary evaluation for comprehensibility and length of the interview, as well as a data triangulation procedure with the judges and participants of the pilot experience. Results Of the 22 items evaluated, only 4 were above the critical reference value (0.49). Conclusion The need to incorporate this measure of analysis in the context of respect, identity and agency of older adults is discussed as part of a change in thinking under the gaze of person-centered care and a communicative competence model. As well as the need to incorporate different cultural paradigms and the use of digital technologies.
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RESUMEN Objetivo Determinar el efecto del programa de intervención cognitivo - comunicativo basado en la reminiscencia (PECC-R) sobre el procesamiento cognitivo global y la autopercepción de bienestar subjetivo. Método En una muestra intencional de 100 adultos mayores autovalentes, 65 conformaron el grupo estudio y 35 el grupo control. El programa se administró en el grupo de estudio. Mediante la prueba de Wilcoxon, se compararon las medidas de resultado de eficacia cognitiva global (MMSE) y bienestar subjetivo (SWLS) antes y después del programa, Asimismo, se compararon las diferencias del pre y postest de ambos grupos mediante U de Mann Whitney. Resultados Se observó una diferencia estadísticamente significativa entre el pre y post test del SWLS en el grupo estudio, no así en el grupo control. Este resultado se replicó en la variable eficacia cognitiva global. Se observó una diferencia entre los grupos en ambas medidas, con mayor beneficio en el grupo que recibió la intervención. Conclusión El PECC-R constituye una alternativa viable para la estimulación cognitivo-comunicativa de orden funcional. La evidencia de las diferencias en las actuaciones respalda su utilidad y validez para la intervención en Atención Primaria u otros contextos similares
ABSTRACT Purpose To determine the effect of the reminiscence-based cognitive-communicative intervention program (CCSP-R) on global cognitive processing and self-perception of subjective well-being. Methods A purposive sample of 100 self-care elderly adults, with 65 composing the study group and 35 in the control group. The study group was subjected to the proposed program. The Wilcoxon test compared the outcome measures of global cognitive efficacy (MMSE) and subjective well-being (SWLS) before and after the program, whereas the Mann-Whitney U test compared the pre- and post-test differences between the two groups. Results A statistically significant difference was found between the pre- and post-test of the SWLS in the study group, but not in the control group. This result was replicated in the global cognitive efficacy variable. A difference between the groups occurred in both measures, with greater benefit for the group that received the intervention. Conclusion The CCSP-R is a viable alternative for cognitive-communicative stimulation of functional order. The evidence of differences in performance supports its usefulness and validity for intervention in primary care or other similar contexts.
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RESUMO Objetivo O objetivo deste estudo foi analisar o impacto da implementação do Picture Exchange Communication System - PECS na compreensão de instruções de crianças com Transtorno do Espectro do Autismo (TEA). Método Trata-se de estudo longitudinal. A amostra foi constituída por 20 crianças com TEA não verbais, sendo 15 meninos e 5 meninas, na faixa etária de 6 a 12 anos, avaliadas e diagnosticadas por equipe multidisciplinar, segundo os critérios do DSM-5. Para avaliação da compreensão de instruções foram aplicadas 8 instruções visuais e 8 instruções orais, em dois momentos do Programa de Implementação do PECS: no início das fases II e IV. O programa foi composto por 24 sessões de terapia fonoaudiológica individual com a presença do familiar e obedeceu às seis fases propostas originalmente pelo Manual de Treinamento do PECS. Resultados Houve aumento expressivo na compreensão de todas as instruções, na comparação entre os dois momentos do estudo; sendo que em seis das instruções orais (p=0,001) e cinco das instruções visuais (p=0,002), esse aumento foi estatisticamente significante. Conclusão Foi possível observar o impacto positivo do uso do PECS na compreensão de instruções tanto visuais quanto orais, mostrando que esse sistema não apenas fornece uma ferramenta de comunicação aumentativa ou alternativa para a criança se expressar, mas também promove melhora significativa na compreensão das informações contextuais.
ABSTRACT Purpose The purpose of this study was to analyze the impact of the implementation of the Picture Exchange Communication System (PECS) on the comprehension of instructions by children with Autism Spectrum Disorder (ASD). Methods This is a longitudinal study (N° 0809/2018). The sample consisted of 20 children with nonverbal ASDs, 15 boys and 5 girls, aged 6 to 12 years, evaluated and diagnosed by a multidisciplinary team according to the DSM-5. For assessment of the comprehension of instructions, we used eight visual instructions and eight oral instructions, which were applied at two points in the PECS Implementation Program: early phases II and IV. The program consisted of 24 individual speech therapy sessions with the presence of a family member and followed the six phases originally proposed by the PECS Training Manual. Results There was an expressive increase in the comprehension of all instructions, in the comparison between the two moments of the study; and this increase was statistically significant in six of the oral instructions (p=0.001) and five of the visual ones (p=0.002). Conclusion It was possible to observe the positive impact of the use of PECS in the comprehension of both visual and oral instructions, showing that this system not only provides an augmentative or alternative communication tool for the children to express themselves but also promotes significant improvement in the understanding of contextual information.
Subject(s)
Humans , Male , Female , Child , Communication Aids for Disabled , Communication Disorders/diagnosis , Autism Spectrum Disorder , Longitudinal Studies , Communication , ComprehensionABSTRACT
Background: Hearing impairment is a factor that directly compromises the individual’s language which can affect emotional and academic defects by delayed development of communicative ability. This can vary according to the type and degree of hearing loss. Speech therapy intervention is important, along with the use of sound amplification devices, so that the child may have a chance to develop speech, consequently learning and re-habilitation to the society. Aims of the present study was performed to assess the effectiveness of early intervention of speech and language therapy after use of hearing aids to hearing impaired children on their syntactic and lexical development.Methods: This quasi-experimental study conducted on 100 children having different degree of hearing loss at department of Neurology and department of ENT, King George’s Medical University, Lucknow, Uttar Pradesh. After collecting socio-demographic data of subjects by observation, completion of questionnaires, and speech recording by audiologist; Speech and language therapy provide by audiologist for six month after providing hearing aids and improvement in their syntactic and lexical development recorded.Results: There is significant improvement in verbal response from 14% before therapy to 81% after therapy and non-verbal response before therapy was 86% and after therapy was 19%. Before giving speech and language therapy to subjects pointing score was 24%, sign language was 10% and words response was 0% which increases after therapy were 1%, 2% and 39% respectively. Early identified/intervened hearing-impaired children had a notable positive difference in all assessed lingual gains.Conclusions: This is study results definitely point to positive effects of intensive and continuous application of speech and language therapy to syntactic and lexical development of hearing impaired children.
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En el modelo de la Práctica Basada en la Evidencia el fonoaudiólogo debe conocer los criterios diagnósticos y el nivel de evidencia de los procedimientos de intervención para ofrecer un tratamiento adecuado. En la literatura se describe un bajo grado de formación académica y un escaso uso de la Práctica Basada en la Evidencia como fuente de acceso a diagnósticos y tratamientos. Este estudio investigó las dificultades de los fonoaudiólogos para acceder a los criterios para el diagnóstico fonoaudiológico. Se realizó una encuesta masiva online a 384 fonoaudiólogos, usando un método cuantitativo, descriptivo y transeccional. Los resultados indican que, independiente de los años de ejercicio laboral, un 79,7% de los encuestados utiliza fuentes secundarias para el acceso a criterios para el diagnóstico fonoaudiológico, un 46% no conoce fuentes de información fiables para acceder a diagnósticos y un 73,4% afirma haber tenido dificultades para acceder a criterios diagnósticos. Los sujetos encuestados no utilizan fuentes primarias que les permitan acceder a criterios que apoyen los diagnósticos fonoaudiológicos. Por lo anterior, se considera relevante educar sobre Práctica Basada en la Evidencia en el contexto universitario.
In the Evidence-Based Practice model, the speech and language therapist must know the diagnostic criteria and be aware of the evidence supporting the intervention procedures, to provide an effective treatment. However, the literature describes both low levels of academic training and scarce use of evidence-based practices as a base of speech and language diagnosis and treatments. This study probes into the difficulties speech and language therapists face to access the diagnostic criteria and their bibliographic references. A massive online survey was conducted with 384 speech therapists, using a quantitative, descriptive and transectional method. Results show that 79.7% of respondents use secondary sources to access criteria on which subsequently base their speech and language diagnoses, 46% do not know reliable sources of information to access criteria for diagnoses and 73.4% maintain that they had difficulties in accessing diagnostic criteria. These difficulties do not recede with years of practice. Based on these results it is possible to conclude that surveyed therapists presented difficulty to find information on which to establish their diagnostic criteria and they do not use primary sources for access information. All of this supports training students on Evidence Based Practice when in their University programs.
Subject(s)
Humans , Speech Therapy , Evidence-Based Practice , Language Disorders/diagnosis , Language Therapy , Chile , Surveys and Questionnaires , Access to InformationABSTRACT
El fonoaudiólogo en Chile es el profesional encargado de la evaluación, diagnóstico, rehabilitación, promoción y prevención de los trastornos del lenguaje, el habla, la deglución, la audición, la voz y la comunicación. Actualmente, 29 casas de estudio superior dictan la carrera de Fonoaudiología y otorgan el título profesional de Fonoaudiólogo en Chile. Dada la evolución de la profesión, es necesario que se reflexione respecto de su quehacer formador. Los objetivos del presente trabajo son: a) Describir las características de los fonoaudiólogos que se dedican a la academia en diferentes universidades chilenas y b) exponer los aspectos de autorreflexión de la formación de pregrado y formación continua en Fonoaudiología. Para ello, se realizó un estudio observacional descriptivo mediante la aplicación de una encuesta estructurada a 33 académicos representantes de 12 universidades chilenas. Los resultados mostraron que el 60,6% de los académicos asistentes ostenta el grado de Magíster. Un 59,4% de los docentes tienen una dedicación laboral completa, centrando su carga en la gestión o la docencia. Sólo un 12,1% de los informantes reporta el desarrollo de actividades vinculadas con la investigación. El 87,9% de los consultados refiere que la formación de pregrado en Chile es de calidad y un 57,6% considera que la oferta nacional de posgrado no es pertinente para el desarrollo de la profesión.Según estos antecedentes, se discuten aspectos relacionados con: afiliación, actividades académicas, distribución de carga laboral, formación en el pregrado y formación continua en Fonoaudiología.
In Chile, Speech and Language therapists (SLT) are the professionals in charge of topics as diverse as evaluation, diagnosis, rehabilitation and health promotion of language disorders, speech, swallowing, hearing, voice, and communication. Currently, 29 higher education institutions include majors in SLT in Chile. Given the evolution of the profession, some reflections and considerations on the practices of SLT training are in order.The objective of this study was to describe some aspects related with the characteristics of speech therapists in academic activity in Chile and present a discussion about practices of SLT training. A descriptive observational study was conducted by applying a structured survey to 33 academic representatives of 12 Chilean universities. The results showed that 60.6% of the attending academics hold the Master's degree. A 59.4% of the teachers consulted have a complete work dedication, focusing their load on management or teaching. Only 12.1% of the informants report the development of activities related to research. An 87.9%, of respondents say that undergraduate training in Chile is of quality and 57.6% consider that the national postgraduate offer is not useful for the development of the profession. According to this background, aspects related to: affiliation, academic activities, workload distribution, undergraduate training and continuing training in speech therapy are discussed.
Subject(s)
Humans , Speech Therapy , Universities , Faculty , Language Therapy , Chile , Surveys and Questionnaires , Workload , Education, ContinuingABSTRACT
A comunicação apresenta-se gravemente afetada em crianças e jovens com multideficiência e surdocegueira, constituindo-se como uma área de intervenção prioritária. Objetivo: Analisar e sistematizar a literatura no que diz respeito a intervenção com comunicação aumentativa / alternativa com crianças e jovens com multideficiência e surdocegueira, considerando o modo de implementação e avaliação da eficácia destas intervenções. Método: Revisão sistemática da literatura baseada no PRISMA Statement. A pesquisa foi realizada nas bases de dados SciELO, LILACS, PubMed e B-On, até à data de 31 de maio de 2018, utilizando os termos "multideficiência", "surdocegueira" e "comunicação aumentativa e alternativa", em português e em inglês, combinados entre si. Resultados: Um total de nove artigos foram selecionados após cuidadosa análise e atendendo a rigorosos critérios de inclusão e exclusão. Conclusão: Algumas discrepâncias foram identificadas quanto ao modo de implementação e avaliação da eficácia de comunicação aumentativa e alternativa, tendo-se concluído que é necessário desenvolver mais investigação que evidencie o impacto do uso desta ferramenta relativamente aos múltiplos contextos naturais, funcionalidade comunicativa mais complexa, instrução de parceiros de comunicação, frequência da intervenção e percepções de pais / profissionais.
Communication is seriously affected in children and young people with multiple disabilities and deafblindness, which makes it a priority area of intervention. Objective: Analyse and systematise the literature regarding the intervention with augmentative and alternative communication in children and young people with multiple disabilities and deafblindness, considering the mode of implementation and evaluation of the effectiveness of that intervention. Methods: Systematic review of the literature following the PRISMA Statement. The research was carried out in the databases SciELO, LILACS, PubMed and B-On, until May 31st, 2018, using the terms "multiple disabilities", "deafblindness" and "augmentative and alternative communication" in Portuguese and in English, combined between them. Results: A total of nine articles were selected after careful analysis and the application of strict inclusion and exclusion criteria. Conclusion: Some differences have been identified concerning the implementation and evaluation of augmentative and alternative communication effectiveness, revealing that further research is needed in order to demonstrate the impact of the use of this tool in the following aspects: multiple natural settings, complex communicative function, communicative partners, frequency of intervention and perceptions of parents / professionals.
Introduccion: La comunicación se ve gravemente afectada en niños y jóvenes con multideficiencia y sordoceguera, constituyéndose como una área de intervención prioritaria. Objetivo: Analizar y sistematizar la literatura en lo que se refiere a la intervención con comunicación aumentativa y alternativa con niños y jóvenes con multideficiencia y sordoceguera, en lo que se relaciona con el modo de implementación y evaluación de la eficacia en estas intervenciones. Metodos: Revisión sistemática de la literatura atendiendo a las conceptualizaciones establecidas por el PRISMA Statement. La búsqueda se realizó en las bases de datos SciELO, LILACS, PubMed y B-On, al 31 de mayo, 2018, com los términos "multidiscapacidad", "sordoceguera" y "comunicación aumentativa y alternativa" en portugués y en inglés, combinados entre sí. Resultados: Un total de nueve artículos fueron seleccionados después de un cuidadoso análisis y atendiendo a rigurosos criterios de inclusión y exclusión. Conclusión: Algunas discrepancias se identificaron en lo que se refiere al modo de aplicación y evaluación de la eficacia de la comunicación aumentativa y alternativa y se concluyó que es necesario desarrollar más investigación que evidencie el impacto del uso de esta herramienta en lo que respecta a los múltiples contextos naturales, funcionalidad comunicativa compleja, de socios de comunicación, frecuencia de la intervención y percepciones de padres / profesionales.
Subject(s)
Humans , Male , Female , Child , Adolescent , Communication , Deaf-Blind Disorders , Parents , Perception , Child , AdolescentABSTRACT
ABSTRACT The nonfluent/agrammatic variant of primary progressive aphasia is characterized by apraxia of speech and agrammatism. Apraxia of speech limits patients' communication due to slow speaking rate, sound substitutions, articulatory groping, false starts and restarts, segmentation of syllables, and increased difficulty with increasing utterance length. Speech and language therapy is known to benefit individuals with apraxia of speech due to stroke, but little is known about its effects in primary progressive aphasia. This is a case report of a 72-year-old, illiterate housewife, who was diagnosed with nonfluent primary progressive aphasia and received speech and language therapy for apraxia of speech. Rate and rhythm control strategies for apraxia of speech were trained to improve initiation of speech. We discuss the importance of these strategies to alleviate apraxia of speech in this condition and the future perspectives in the area.
RESUMO A variante não-fluente/agramática da afasia progressiva primária caracteriza-se por apraxia de fala e agramatismo. A apraxia de fala limita a comunicação devido a redução no fluxo de fala, substituição de sons, tentativas articulatórias, falsos inícios de fala e reinícios, segmentação de sílabas, e aumento da dificuldade conforme o aumento do enunciado. A terapia fonoaudiológica é benéfica em casos de apraxia de fala decorrentes de acidente vascular cerebral, porém pouco se sabe sobre seus efeitos na afasia progressiva primária. Este artigo é um relato de caso de uma mulher de 72 anos, analfabeta e trabalhadora do lar, que foi diagnosticada com afasia progressiva não-fluente e recebeu terapia fonoaudiológica para apraxia de fala. Estratégias de controle do ritmo e da taxa de fala foram utilizadas a fim de melhorar a iniciação da fala. A importância de estratégias para minimizar a apraxia de fala e as perspectivas futuras na área são discutidas neste artigo.
Subject(s)
Humans , Apraxias , Rehabilitation , Aphasia, Primary Progressive , Speech, Language and Hearing SciencesABSTRACT
La atención clínica y educativa que se ofrece a niños bilingües es actualmente un reto para los profesionales. Es necesario investigar sobre la conceptualización del bilingüismo, su naturaleza y su relación con los diferentes entornos de aprendizaje. El objetivo del presente trabajo es revisar la literatura científica con el fin de explorar el papel del entorno familiar y las competencias del fonoaudiólogo/logopeda para garantizar una intervención fonoaudiológica/logopédica funcional en población bilingüe. Para ello, se ha estudiado la información más representativa disponible sobre el enfoque naturalista de intervención en multilingüismo. Así, se pretende reflexionar sobre los modelos de intervención que mejor se adecúan a las necesidades específicas de los niños bilingües y el papel que puede adoptar la familia para contribuir al desarrollo comunicativo de los niños en contacto con varias lenguas.En primer lugar, se ofrece una aclaración terminológica, así como una visión del marco naturalista de intervención. A continuación, se presentan la metodología y los resultados de la revisión efectuada para niños bilingües con diversidad funcional y alteraciones del lenguaje oral. Se incluyen también recomendaciones en relación a las competencias del fonoaudiólogo que trabaje con población bilingüe. Finalmente, se concluye con una propuesta de futuras líneas de investigación aplicada en este campo considerando los modelos naturalistas centrados en la familia para proponer su adaptación a las intervenciones realizadas con niños bilingües
The clinical and educative response required for bilingual children continues to be a challenge for professionals. It is necessary to research the conceptualization of bilingualism, its nature, and its relationship with different learning environments. The purpose of this paper is to review the literature to explore the role of the family environment and the speech & language therapist's (SLT) competence in guaranteeing a functional language intervention in the bilingual population. To this end, the most significant information available about multilingualism and the naturalistic intervention approach has been reviewed. With this evidence, the best models of bilingual intervention are presented, as well as a reflection on how families can contribute to improve the language development of children speaking different languages.In the first section, a terminological clarification of bilingualism is given, alongside the naturalistic frame of intervention, followed by research developed with bilingual children with functional diversity and oral language disorders. In that sense, recommendations about competence of the Speech and Language Therapist working with bilingual special needs children are also included. Finally, this paper provides a suggestion of future applied research in this field on naturalistic family-centered approaches used in language intervention with bilingual children
Subject(s)
Humans , Child , Adult , Multilingualism , Speech, Language and Hearing Sciences , Family Relations , Language Disorders/physiopathologyABSTRACT
Al revisar la literatura nacional chilena no se vislumbra claramente cuál es el rol que debe cumplir el fonoaudiólogo en el ámbito educativo, aceptando que este sector tiene características particulares que implican otros desafíos además de la rehabilitación de alteraciones asociadas al lenguaje, la comunicación y/o la deglución. El presente estudio tiene como objetivos establecerla relación existente entre los años de experiencia del profesional fonoaudiólogo(a) en el sector educativo y su nivel de desempeño profesional y establecerla relación entre el sector de trabajo (educación especial, proyectos de integración y subvención escolar preferencial)y el desempeño profesional reportado por los especialistas en cada uno de ellos. El estudio utilizó un enfoque cuantitativo y un diseño no experimental descriptivo correlacional de corte transversal. Se aplicó el protocolo Autorreflexión del desempeño profesional del fonoaudiólogo en educación a 59 fonoaudiólogos(as). Los resultados indican que los fonoaudiólogos(as) reportan fortaleza en funciones de identificación, evaluación, intervención y gestión, declarando un menor desarrollo en ámbitos de prevención, conocimiento de la cultura escolar e investigación; no existe una relación significativa entre el nivel de desempeño declarado por los profesionales y los años de experiencia, así como tampoco entre el ámbito de trabajo del fonoaudiólogo(a)en educación y su rendimiento profesional. Se discute el rol educativo nacional desde una perspectiva internacional. Como conclusión se destaca la necesidad de iniciar una autorreflexión como gremio que permita retroalimentar a la academia y al propio sector educativo, facilitando la descripción y delimitación de la práctica fonoaudiológica en este ámbito...
The Chilean national literatura does not clearly show the role that the speech and language therapist has to accomplish in education, accepting that this area has specific characteristics which go beyond the intervention of language, communication or swallowing impairments. This study aims to establish the relation between years of professional experience as speech and language therapist in education with the standard of professional performance; and to establish the relation between such areas as special education, integration programs and preferential school subsidy with the professional performance reported by specialists working in each one of them. The study adopted a quantitative approach, with a non-experimental descriptive correlational and cross-sectional design. The protocol Self-reflection of the professional practice of the speech and language therapist in education was applied to 59speech and language therapists. The results showed that speech and language therapists stated strength in functions of identification, assessment, intervention and management. At the same time they declared less development in areas of prevention, school culture knowledge and research. There is no significant relation between the standards of performance declared by the professionals and the years of experience, or between the work area in education and professional performance. The national educational role is discussed from an international perspective. In conclusion, it is highlighted the need to initiate a self-reflection as a professional union allowing to provide feedback to the academy and to the educational area. This would also facilitate the description of the speech and language therapy practice in the educational area...
Subject(s)
Humans , Education , Language Therapy , Professional Competence , Professional Role , Speech, Language and Hearing SciencesABSTRACT
The non-fluent and agrammatic variant of Primary Progressive Aphasia (NFPPA) is characterized by reduced verbal production with deficits in building grammatically correct sentences, involving dysfunctions in syntactic and morphological levels of language. There are a growing number of studies about non-pharmacological alternatives focusingon the rehabilitation of functional aspects or specific cognitive impairments of each variant of PPA. This study reports a shortterm treatment administered to a patient with NFPPA focusing on the production of sentences. The patient had significant reduction in verbal fluency, use of keywords, phrasal and grammatical simplifying as well as anomia. Using the method of errorless learning, six sessions were structured to stimulate the formation of sentences in the present and past with the cloze technique. The patient had improvement restricted to the strategy, with 100% accuracy on the trained phrases and generalization to untrained similar syntactic structure after training. These results persisted one month after the treatment.
A variante não fluente e agramática da Afasia Progressiva Primária (APPNF) caracteriza-se por redução da produção verbal com falhas para construir sentenças gramaticalmente corretas, envolvendo disfunções nos níveis sintático e morfológico da linguagem. É crescente o número de pesquisas sobre alternativas não farmacológicas enfocando areabilitação de aspectos funcionais ou comprometimentos cognitivos específicos de cada variante das APP. Relatar um tratamento de curta-duração administrado a um paciente com APPNF enfocando a produção de sentenças. O paciente apresentava redução importante da fluência verbal, uso de palavras-chave, simplificação frasal e gramatical, além deanomia. Utilizando o método de aprendizado sem erros, foram estruturadas seis sessões para estimular a formação de frases no presente e no passado com a técnica de cloze. O paciente apresentou melhora restrita à estratégia, com 100% de acerto nas frases treinadas e generalização para as não-treinadas de estrutura sintática semelhante após o treinamento.Os resultados foram mantidos um mês após o tratamento.
Subject(s)
Humans , Rehabilitation , Therapeutics , Aphasia, Primary Progressive , Speech, Language and Hearing SciencesABSTRACT
ABSTRACT This study provided a systematic review on nonpharmacological interventions applied to patients diagnosed with Primary Progressive Aphasia (PPA) and its variants: Semantic (SPPA), Nonfluent (NFPPA) and Logopenic (LPPA) to establish evidence-based recommendations for the clinical practice of cognitive rehabilitation for these patients. Methods: A PubMed and LILACS literature search with no time restriction was conducted with the keywords PPA (and its variants) AND rehabilitation OR training OR intervention OR therapy OR treatment OR effectiveness. To develop its evidence-based recommendations, a research committee identified questions to be addressed and determined the level of evidence for each study according to published criteria (Cicerone et al., 2000). Overall evidence for treatments was summarized and recommendations were derived. Results: Our search retrieved articles published from 1995 to 2013: 21 for SPPA, 8 for NFPPA, 3 for LPPA and 8 for PPA with no specification. Thirty-five studies were rated as Class III, consisting of studies with results obtained from one or more single-cases and that used appropriate single-subject methods with adequate quantification and analysis of results. The level of evidence of three functional interventions could not be established. One study was rated as Class II and consisted of a nonrandomized case-control investigation. Conclusion: Positive results were reported in all reviewed studies. However, in order to be recommended, some investigation regarding the intervention efficacy was required. Results of the present review allows for recommendation of some nonpharmacological interventions for cognitive deficits following PPA as Practice Options. Suggestions for further studies on PPA interventions and future research are discussed.
RESUMO Este estudo ofereceu uma revisão sistemática de intervenções não-farmacológicas aplicadas a pacientes com Afasia Progressiva Primária (APP) e suas variantes: Semântica (APPS), Não-fluente (APPNF) e Logopênica (APPL) com o objetivo de estabelecer recomendações baseadas em evidências para a prática clínica de reabilitação cognitiva para estes pacientes. Métodos: Conduziu-se busca por literatura, sem restrição de período, no PubMed e LILACS com as palavras-chave PPA (e variantes) AND rehabilitation OR training OR intervention OR therapy OR treatment OR effectiveness. Para desenvolver recomendações baseadas em evidências um comitê de pesquisadores identificou as questões relevantes para investigação e determinou o nível de evidência para cada estudo de acordo com critérios publicados (Cicerone et al., 2000). A evidência total para os tratamentos foi sumarizada e recomendações redigidas. Resultados: Foram encontrados artigos publicados de 1995 a 2013: 21 para APPS, 8 para APPNF, 3 para APPL e 8 para APP sem especificações. Trinta e cinco estudos foram classificados como Classe III, consistindo de resultados obtidos com um ou mais indivíduos e utilizando metodologia apropriada para estudo de casos. O nível de evidência de três intervenções funcionais não pôde ser estabelecido. Um estudo foi classificado como Classe II e consistiu de pesquisa caso-controle não-randomizada. Conclusão: Resultados positivos foram reportados em todos os trabalhos analisados mas, para serem recomendados, os tratamentos requerem investigação em relação a sua eficácia. Resultados da presente revisão permitiram recomendação de algumas intervenções como Opções Práticas. Ademais, apresentamos sugestões para futuros estudos de intervenção em APP.
Subject(s)
Humans , Therapeutics , Aphasia, Primary Progressive , Speech, Language and Hearing SciencesABSTRACT
PURPOSE: Treatment efficacy for children with speech and language delay has been the subject of considerable debate in recent years. We evaluated the clinical features of children with delayed speech and language and their prognoses according to their etiologies after 6 months of speech and language therapy. METHODS: From January, 2000 to March, 2004, we retrospectively reviewed 56 children with speech and language delay who were administered speech and language therapy for 6 months in Uijongbu St. Mary's Hospital. RESULTS: Of 56 cases, the proportion of developmental language disorder was 66.1 percent, structural malformation 19.6 percent, mental retardation 12.5 percent, hearing defect 1.8 percent. The ratio of male to female was 4.6: 1 and the most frequent age group was over 47 months. The mean age of first spontaneous words with useful meaning was 15.9 months. The mean gestational age of the subjects was 39.8 weeks. The proportion of full-term infants was 96.4 percent and of premature infants was 3.6 percent. As for the birth order, the proportion of the first baby was 51.8 percent, the one of second babies it was 42.9 percent, and percent of third babies it was 7.1 percent. After 6 months of language intervention, 32.4 percent of patients with developmental language disorder showed normal linguistic development. All the patients with mental retardation showed sustained language and speech delay. As for the patients with structural malformations, five out of 11 patients showed normal linguistic development. CONCLUSION: The relatively advanced old age of majority of participants in this study suggests the necessity of screening test for language delay in this local community.