Apraxia de fala e atraso de linguagem: a complexidade do diagnóstico e tratamento em quadros sintomáticos de crianças / Apraxia of speech and language delay: the complexity of diagnosis and treatment of symptomatic children

RESUMO Define-se apraxia de fala como a inabilidade de sequenciar os movimentos necessários a uma produção articulatória acurada, cuja explicação, tradicionalmente, é remetida a um déficit na programação motora da fala. Não é infrequente que clínicos de linguagem se defrontem com casos clínicos em que a inconsistência da fala coloca questões quanto ao diagnóstico diferencial entre apraxia e quadros considerados de linguagem. O reflexo desse impasse é observado na dificuldade em estabelecer uma direção de tratamento adequada ao problema apresentado. Neste trabalho, apresentamos o relato de um caso clínico em que tanto o diagnóstico quanto o tratamento mobilizam discussões a respeito da condição apráxica de fala na infância. Nas apraxias, partimos do reconhecimento de que o corpo colocado em evidência é aquele que ultrapassa sua configuração puramente orgânica. Consequências clínicas são retiradas da premissa de que o corpo humano é aquele cuja orelha pode escutar e a boca, falar, ou seja, é estrutura orgânica posta a funcionar de maneira especial pela incidência da música da linguagem a invocar o corpo falante.

ABSTRACT Apraxia of speech is defined as the inability to sequence the movements required for accurate articulatory production, traditionally involving a deficit in speech motor programming. Language clinicians often confront about speech inconsistency clinical cases, which raise questions concerning the differential diagnosis between apraxia and language disorders. Such problem often results in the difficulty to establish an adequate treatment decision. In this work, we discuss a clinical report in which both diagnosis and treatment raise questions about the apraxic speech condition in childhood. We start from the recognition that, in apraxia, it seems imperative to consider that the body to be considered is the one that surpasses its organic functions and structure. Clinical consequences are drawn from the premise that the human body is one whose ear can listen, and mouth can speak, i.e., the organic structure is a material realm open to the incidence of language and its "music", which creates the speaking body.

Effects of different types of auditory temporal training on language skills: a systematic review

Previous studies have investigated the effects of auditory temporal training on language disorders. Recently, the effects of new approaches, such as musical training and the use of software, have also been considered. To investigate the effects of different auditory temporal training approaches on language skills, we reviewed the available literature on musical training, the use of software and formal auditory training by searching the SciELO, MEDLINE, LILACS-BIREME and EMBASE databases. Study Design: Systematic review. Results: Using evidence levels I and II as the criteria, 29 of the 523 papers found were deemed relevant to one of the topics (use of software - 13 papers; formal auditory training - six papers; and musical training - 10 papers). Of the three approaches, studies that investigated the use of software and musical training had the highest levels of evidence; however, these studies also raised concerns about the hypothesized relationship between auditory temporal processing and language. Future studies are necessary to investigate the actual contribution of these three types of auditory temporal training to language skills. .