Understanding speech disorders for clinical practice

Speech is the vocal utterance of language and it is considered disordered in three underlying ways: voice, articulation, and fluency, its disorder is to be studied from same pattern. The features that should be considered in determining a voice disorder are: Volume: how loudly or softly we speak, Pitch: how pleasant or unpleasant Quality: the highness or lowness of one’s voice, Rate: the speed at which one speaks. Homeoapthic repertory shows these symptoms, but caution is mechanical problem should not consider as dynamic derangement.

Bullying a personas con trastornos de la comunicación integradas en establecimientos escolares: rol de la fonoaudiología y sus implicancias en la salud comunicativa / Bullying of people with communication disorders integrated in schools: role of speech therapy and its implications for communicative health

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.

Prevention and treatment of osteoradionecrosis of the jaws / 口腔疾病防治

@#Radioactive jaw necrosis is a serious complication of head and neck radiotherapy. This complication's main characteristics are chronic necrosis and infection, and its clinical manifestations are local pain, mouth opening re'striction, speech disorder, dysphagia, exposure of dead bone, prolonged healing of facial and neck soft tissue fistula, and even pathological fracture, which brings great pain to the patient's body and mind. Radioactive jaw necrosis has become a clinical problem in the field of medicine, specifically for maxillofacial surgery of the external head and neck. The pathogenesis of radiation-induced jaw necrosis is still unclear, but high radiotherapy dose, extraction of teeth after radio-therapy and surgical trauma are recognized as high-risk factors. The diagnosis of radiation-induced jaw necrosis needs to be combined with the patient's radiotherapy history, clinical symptoms and imaging examination. Conservative or sur-gical treatment should be selected according to its clinical classification and stages, and the prevention of radiation-in- duced jaw necrosis should be emphasized. The key points are to remove dental caries, residual roots and crowns before radiotherapy; improve radiotherapy technology; and take preventive measures against high-risk factors. In recent years, the diagnosis and treatment of radiation-induced jaw necrosis has gradually become standardized and individualized.This article reviews the progress of treatment and research on radiation-induced jaw necrosis at home and abroad in terms of its definition, etiology, risk factors, diagnosis, treatment and prevention to provide reference for clinical treat-ment.

Characteristics, Evaluation and Mechanism of Apraxia of Speech (review) / 中国康复理论与实践

Apraxia of speech (AOS) is a motor speech disorder presented with characteristic speech performance and related brain loca-tion. This article reviewed the characteristic speech performance of AOS and common assessments, discussed the mechanism and provided neurological bases of AOS in order to understand the relationship between speech performance and imaging.

Characteristics, Evaluation and Mechanism of Apraxia of Speech (review) / 中国康复理论与实践

@#Apraxia of speech (AOS) is a motor speech disorder presented with characteristic speech performance and related brain location.This article reviewed the characteristic speech performance of AOS and common assessments, discussed the mechanism and provided neurological bases of AOS in order to understand the relationship between speech performance and imaging.

Conocimientos de padres de niños con síndrome de Down sobre trastornos del lenguaje antes y después de una estrategia educativa / Parent's knowledge about language disorders of children with Down syndrome before and after an educational strategy

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

Comparison of Oral-pharyngeal Resonance Function between Spastic and Athetoid Cerebral Palsy Children / 中国康复理论与实践

@#Objective To explore whether there is significant difference in the oral-pharyngeal resonance function between children with spastic and athetoid cerebral palsy. Methods The acoustic parameters (F1、F2) of /ɑ/、/i/、/u/ were compared between these two kinds of children. Results The incidence of oral-pharyngeal resonance disorder were 71% and 95% in the children with spastic cerebral palsy and athetoid cerebral palsy respectively. There was no significant difference in F1 and F2 of /ɑ/、/i/、/u/ between these two kinds of children. Conclusion The incidence of oral-pharyngeal resonance disorder is high in both two kinds of children, and there is no significant difference in the oral-pharyngeal resonance function between them.

Effect of Meridian Balancing on Speech Disorder after Cerebral Palsy / 中国康复理论与实践

@#Objective To observe the effect of meridian balancing on speech disorder in children with cerebral palsy. Methods 130 childrenaged 1.5~7 years old were divided into the control group (n=62) and treatment group (n=68). The control group received routine rehabilitationwhile the treatment group received meridian balancing in addition. Results The rate of improvement was 89.7% in treatmentgroup and 79% in control group (P<0.05). The rate was more for those with language retardation than with anarthria in the treatment group(P<0.01). Conclusion The meridian balancing is effective on speech disorder in children with cerebral palsy, especially for those with languageretardation.

Validação de itens para uma escala de avaliação da inteligibilidade de fala / Validation of items for a speech intelligibility assessment scale

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.

Speech Rehabilitation for Children after Cerebral Palsy in China (review) / 中国康复理论与实践

@# This article has introduced the causes, characteristics, examination and evaluation, rehabilitation training, and effects of speech disorder after cerebral palsy.

Eficácia da terapia para desvios fonológicos com diferentes modelos terapêuticos / Therapy effectiveness for phonological disorders with different therapeutic approaches

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.

Dysarthrias:Acoustic or Resonance Mechanism and Treatment(review) / 中国康复理论与实践

@#Dysarthrias are speech disorders that result from neurological impairments associated with weakness,slowness,or incoordination of the musculature used to produce speech.According to the lesion sites and the severity of the speech impairments,it is identified 6 types of dysarthria:spastic,flaccid,mixed spastic-flaccid,ataxic,hypokinetic,and hyperkinetic.And spastic is the most common.The incidence of dysarthria in cerebrovascular disease is 30%～40%.There are many researches and data on this speech disorder abroad.But because of different language,most of the data is not appropriate to Chinese.