The oral motor capacity and feeding performance of preterm newborns at the time of transition to oral feeding

The objective of the present study was to determine the oral motor capacity and the feeding performance of preterm newborn infants when they were permitted to start oral feeding. This was an observational and prospective study conducted on 43 preterm newborns admitted to the Neonatal Intensive Care Unit of UFSM, RS, Brazil. Exclusion criteria were the presence of head and neck malformations, genetic disease, neonatal asphyxia, intracranial hemorrhage, and kernicterus. When the infants were permitted to start oral feeding, non-nutritive sucking was evaluated by a speech therapist regarding force (strong vs weak), rhythm (rapid vs slow), presence of adaptive oral reflexes (searching, sucking and swallowing) and coordination between sucking, swallowing and respiration. Feeding performance was evaluated on the basis of competence (defined by rate of milk intake, mL/min) and overall transfer (percent ingested volume/total volume ordered). The speech therapist's evaluation showed that 33 percent of the newborns presented weak sucking, 23 percent slow rhythm, 30 percent absence of at least one adaptive oral reflex, and 14 percent with no coordination between sucking, swallowing and respiration. Mean feeding competence was greater in infants with strong sucking fast rhythm. The presence of sucking-swallowing-respiration coordination decreased the days for an overall transfer of 100 percent. Evaluation by a speech therapist proved to be a useful tool for the safe indication of the beginning of oral feeding for premature infants.

A generalização baseada nas relaçoes implicacionais em sujeitos submetidos a terapia fonológica / Generalization based on implicational relations in subjects treated with phonological therapy

BACKGROUND: Generalization based on implicational relations. AIM: To analyze generalization based on implicational relations in subjects with mild-moderate phonological disorder, who underwent therapy based on the Maximal Oppositions Model. METHOD: The initial phonological system of four subjects was analyzed, taking in consideration sounds that were not completely acquired and their changes in probes. A final phonological assessment was made. RESULTS: All subjects presented generalizations based on implicational relations and expanded their phonological systems. CONCLUSION: The Maximal Oppositions Model favored generalizations based on implicational relations.

Tema: a generalização baseada nas relações implicacionais. Objetivo: analisar a generalização baseada nas relações implicacionais de sujeitos com desvio fonológico médio-moderadosubmetidos ao Modelo de Oposições Máximas. Método: foram analisados os sistemas fonológicos iniciais de quatro sujeitos considerando-se os sons não adquiridos e suas mudanças nas sondagens e na avaliação fonológica final. Resultados: todos os sujeitosapresentaram generalizações baseadas nas relações implicacionais e expandiram seus sistemas fonológicos. Conclusão: o Modelo de Oposições Máximas proporcionou a ocorrência de generalizações baseadas em relações implicacionais.