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ABSTRACT Purpose: to describe at which age do speech and language therapists consider the / l /, / ɾ /, / r / phonemes should be acquired; to describe the criteria used by speech and language therapists to consider a phoneme as acquired; and to investigate the diagnostic criteria used by these professionals. Methods: this is an analytical cross-sectional study in which an online questionnaire was completed by 151 speech and language therapists from the Metropolitan region of Chile. The questionnaire included questions regarding the aims of this study. Results: around a 30% of respondents considered the /l/ phoneme to be acquired between 3,6-4,6 years, a 72% agreed on the /ɾ/ phoneme to be acquired from 4,0 to 4,11 and a 40% declared the acquisition of the /r/ phoneme between 5,6-5,11. When determining a phoneme as acquired, a 46.3% of interviewees referred to do it only when it was produced always and a 30% declared to consider as such when produced more than 50% of the times. When exposed to a real case, respondents provided three different diagnostic options. Conclusion: results showed a wide age range in which speech and language therapists consider the lateral and rhotic phonemes to be acquired, showing no consensus. There are diverse criteria to determine when each phoneme is acquired. Similarly, different opinions were evidenced regarding when a disorder would be defined as phonologic or articulatory.
RESUMEN Objetivo: describir la edad en que consideran que deben estar adquiridos los fonemas / l /, / ɾ /, / r /; describir el criterio que utilizan fonoaudiólogos para considerar un fonema adquirido; e indagar sobre los criterios diagnósticos que utilizan estos profesionales. Métodos: se realizó un estudio transversal analítico mediante un cuestionario validado, presentado de manera online, a 151 fonoaudiólogos de la Región Metropolitana de Chile, con preguntas referidas a los objetivos presentados. Resultados: aproximadamente un 30% de los encuestados consideró que el fonema /l/ se adquiría entre 3,6-4,6 años, /ɾ/ entre 4,0-4,11 un 72% y /r/ entre 5,6-5,11 un 40%. El 46,3% considera que un fonema está adquirido cuando se dice siempre y un 30% cuando lo dice más del 50% de las veces. Ante el relato de un caso, los encuestados eligieron tres opciones diagnósticas diferentes Conclusión: se observa que existe una amplia variedad de rango etario en la que los fonoaudiólogos creen que deben adquirirse los fonemas lateral y róticos no encontrándose un consenso. Existe una alta variedad de criterios respecto a cuándo considerar un fonema como adquirido. También existen distintas concepciones sobre cuándo un trastorno se considerará articulatorio o fonológico.
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ABSTRACT Infants born prematurely have problems in developing feeding skills due to their immaturity. To describe this, a critical review of national and international literature was carried out from May to September 2016. The information was reviewed from Scielo, Pubmed and Cochrane, and also specialized journals using the following key words: "Feeding development preterm", "feeding skills preterm infants", "feeding transition preterm", "lumpy food babies", "solid food preterm", "transition solid food infant", "preterm children weaning food", "solids in preterm infants", also searched in Spanish and Portuguese. Publications were included if they shared similar purpose as the present revision, and published in the last 5 years, encompassing articles of systematic literature review or researches which studied preterm children aged between 0 and 10. Studies showed that transition food started earlier in preterm infants, who also showed more feeding problems. It is necessary to have common criteria in terms of assessment methodologies in order to be able to characterize this group in a better way. Parents of preterm infants would benefit from advise and information about developing eating skills, resulting in earlier intervention and management of feeding and eating problems.
RESUMEN Debido a la inmadurez que presentan los lactantes prematuros, el desarrollo de habilidades de alimentación se ve interferido. Mediante la revisión sistemática de la literatura internacional y nacional se intentó describir este proceso. Se realizó una búsqueda entre mayo y septiembre del 2016 en Scielo, Pubmed y Cochrame y revistas especializadas utilizando los descriptores: "Feeding development preterm", "feeding skills preterm infants", "feeding transition preterm", "lumpy food babies", "solid food preterm", "transition solid food infant", "preterm children weaning food", "solids in preterm infants", tanto en español como en portugués. Se consideraron publicaciones que tuvieran directa relación con el objetivo de esta revisión realizadas en los últimos 5 años, artículos de revisión sistemática de la literatura o investigaciones experimentales cuyo objeto de estudio fueran niños prematuros entre 0 y 10 años. Las investigaciones mostraron que la incorporación de consistencias es más temprana en niños prematuros que de término y que presentan mayores dificultades de alimentación. Se requiere aunar criterios en cuanto a metodologías de evaluación para poder caracterizar a este grupo de mejor manera. Padres y cuidadores de prematuros requieren manejar información completa en relación a la alimentación complementaria para que esta sea exitosa, logrando una pesquisa oportuna y un adecuado manejo.