Comprehension of clitic pronouns by children with cochlear implants: the role of sentence stress.

OBJECTIVES: This study investigates the role of sentence stress on the comprehension of sentences with clitic pronouns (unstressed morphemes and a typical feature of Romance languages) by children with cochlear implants (CIs). METHODS: Thirteen children (seven girls) with CIs and 15 children (seven girls) with NH between eight and 12 years who are monolingual speakers of Brazilian Portuguese participated on a computerized sentence comprehension task that involved manipulation of stress placement of possible antecedent words to clitic pronouns. RESULTS: Children with CIs were significantly less accurate than children with NH in comprehending sentences with clitics, regardless of sentence stress. For children with NH, stress on the correct antecedent significantly increased sentence comprehension accuracy. For children with CI, there was no significant effect of sentence stress on selecting the correct antecedent for clitic pronouns. DISCUSSION: Comprehension of sentences with clitic pronouns is challenging for children with CIs and this challenge holds cross-linguistically. Furthermore, children with CIs do not use prosodic information to support comprehension of sentences with clitics similarly to NH children. CONCLUSION: Language-specific syntactic, morphosyntactic, and prosodic contrasts affecting sentence comprehension need to be assessed in children with CIs to plan an effective intervention.

Longitudinal trends (2011-2020) of premature mortality and years of potential life loss (YPLL) and associated covariates of the 62 New York State counties.

BACKGROUND: New York State (NYS) is the 27th largest state and the 4th most populous state in the U.S., with close to 20 million people in 62 counties. Territories with diverse populations present the best opportunity to study health outcomes and associated covariates, and how these differ across different populations and groups. The County Health Ranking and Roadmaps (CHR&R) ranks counties by linking the population's characteristics and health outcomes and contextual factors in a synchronic approach. METHODS: The goal of this study is to analyze the longitudinal trends in NYS counties of age-adjusted premature mortality rate and years of potential life loss rate (YPLL) from 2011-2020 using (CHR&R) data to identify similarities and trends among the counties of the state. This study used a weighted mixed regression model to analyze the longitudinal trend in health outcomes as a function of the time-varying covariates and clustered the 62 counties according to the trend over time in the covariates. RESULTS: Four clusters of counties were identified. Cluster 1, which represents 33 of the 62 counties in NYS, contains the most rural counties and the least racially and ethnically diverse counties. Clusters 2 and 3 mirror each other in most covariates and Cluster 4 is comprised of 3 counties (Bronx, Kings/Brooklyn, Queens) representing the most urban and racial and ethnic diverse counties in the state. CONCLUSION: The analysis clustered counties according to the longitudinal trends of the covariates, and by doing so identified clusters of counties that shared similar trends among the covariates, to later examine trends in the health outcomes through a regression model. The strength of this approach lies in the predictive feature of what is to come for the counties by understanding the covariates and setting prevention goals.

Are prosodic effects on sentence comprehension dependent on age?

PURPOSE: to investigate prosodic boundary effects on the comprehension of attachment ambiguities in Brazilian Portuguese and to test two hypotheses relying on the notion of boundary strength: the absolute boundary hypothesis (ABH) and the relative boundary hypothesis (RBH). Manipulations of prosodic structure influence how listeners interpret syntactically ambiguous sentences. However, the role of prosody in spoken language comprehension of sentences has received limited attention in languages other than English, particularly from a developmental perspective. METHODS: Twenty-three adults and 15 children participated in a computerized sentence comprehension task involving syntactically ambiguous sentences. Each sentence was recorded in eight different prosodic forms with acoustic manipulations of F0, duration and pause varying the boundary size to reflect predictions of the ABH and RBH. RESULTS: Children and adults differed in how prosody influenced their syntactic processing and children were significantly slower than adults. Results indicated that interpretation of sentences varied according to their prosodic forms. CONCLUSION: Neither the ABH or the RBH explained how children and adults who speak Brazilian Portuguese use prosodic boundaries to disambiguate sentences. There is evidence that the way prosodic boundaries influence disambiguation varies cross-linguistically.

Are prosodic effects on sentence comprehension dependent on age? / Os efeitos prosódicos na compreensão de frases variam de acordo com a idade?

ABSTRACT Purpose to investigate prosodic boundary effects on the comprehension of attachment ambiguities in Brazilian Portuguese and to test two hypotheses relying on the notion of boundary strength: the absolute boundary hypothesis (ABH) and the relative boundary hypothesis (RBH). Manipulations of prosodic structure influence how listeners interpret syntactically ambiguous sentences. However, the role of prosody in spoken language comprehension of sentences has received limited attention in languages other than English, particularly from a developmental perspective. Methods Twenty-three adults and 15 children participated in a computerized sentence comprehension task involving syntactically ambiguous sentences. Each sentence was recorded in eight different prosodic forms with acoustic manipulations of F0, duration and pause varying the boundary size to reflect predictions of the ABH and RBH. Results Children and adults differed in how prosody influenced their syntactic processing and children were significantly slower than adults. Results indicated that interpretation of sentences varied according to their prosodic forms. Conclusion Neither the ABH or the RBH explained how children and adults who speak Brazilian Portuguese use prosodic boundaries to disambiguate sentences. There is evidence that the way prosodic boundaries influence disambiguation varies cross-linguistically.

RESUMO Objetivo investigar os efeitos de fronteiras prosódicas na compreensão de ambiguidades sintáticas no português brasileiro além de testar duas hipóteses baseadas na noção de intensidade de fronteira: a hipótese de fronteira absoluta (ABH) e a hipótese de fronteira relativa (RBH). Manipulações da estrutura prosódica influenciam como os ouvintes interpretam frases sintaticamente ambíguas. No entanto, o papel da prosódia na compreensão da linguagem oral tem recebido atenção limitada em línguas além do inglês, particularmente do ponto de vista do desenvolvimento. Método Vinte e três adultos e 15 crianças participaram de uma tarefa computadorizada de compreensão de frases envolvendo frases sintaticamente ambíguas. Cada frase foi gravada em oito formas prosódicas diferentes com manipulações acústicas de F0, duração, e pausa, variando o tamanho da fronteira prosódica de modo a transparecer as previsões da ABH e RBH. Resultados Crianças e adultos diferiram em como a prosódia influenciou o processamento sintático; as crianças foram significativamente mais lentas que os adultos. Os resultados indicaram que a interpretação das frases variou de acordo com suas formas prosódicas. Conclusão Nenhuma das hipóteses (ABH ou RBH) explica como crianças e adultos falantes do Português brasileiro utilizam as fronteiras prosódicas para desambiguar frases. Há evidências de que a maneira com a qual os limites prosódicos influenciam a desambiguação de frases varia entre os idiomas.

How Word/Non-Word Length Influence Reading Acquisition in a Transparent Language: Implications for Children's Literacy and Development.

Decoding skills are crucial for literacy development and they tend to be acquired early in transparent languages, such as Brazilian Portuguese. It is essential to better understand which variables may affect the decoding process. In this study, we investigated the processes of decoding as a function of age of children who are exposed to a transparent language. To this end, we examined the effects of grade, stimulus type and stimulus extension on the decoding accuracy of children between the ages of six and 10 years who are monolingual speakers of Brazilian Portuguese. The study included 250 children, enrolled from the first to the fifth grade. A list of words and pseudowords of variable length was created, based on Brazilian Portuguese structure. Children assessment was conducted using the computer program E-prime® which was used to present the stimuli. The stimuli were programmed to appear on the screen in a random order and children were instructed to read them. The results indicate two important moments for decoding: the acquisition and the mastery of decoding skills. Additionally, the results highlight an important effect of the extent and type of stimuli and how it interacts with the school progress. Moreover, data indicate the multifactorial nature of decoding acquisition and the different interactions between variables that can influence this process. We discuss medium- and long-term implications of it, and possible individual and collective actions which can improve this process.

Prosodic Boundary Effects on Syntactic Disambiguation in Children With Cochlear Implants.

Purpose: This study investigated prosodic boundary effects on the comprehension of attachment ambiguities in children with cochlear implants (CIs) and normal hearing (NH) and tested the absolute boundary hypothesis and the relative boundary hypothesis. Processing speed was also investigated. Method: Fifteen children with NH and 13 children with CIs (ages 8-12 years) who are monolingual speakers of Brazilian Portuguese participated in a computerized comprehension task with sentences containing prepositional phrase attachment ambiguity and manipulations of prosodic boundaries. Results: Children with NH and children with CIs differed in how they used prosodic forms to disambiguate sentences. Children in both groups provided responses consistent with half of the predictions of the relative boundary hypothesis. The absolute boundary hypothesis did not characterize the syntactic disambiguation of children with CIs. Processing speed was similar in both groups. Conclusions: Children with CIs do not use prosodic information to disambiguate sentences or to facilitate comprehension of unambiguous sentences similarly to children with NH. The results suggest that cross-linguistic differences may interact with syntactic disambiguation. Prosodic contrasts that affect sentence comprehension need to be addressed directly in intervention with children with CIs.

Syntactic comprehension and working memory in children with specific language impairment, autism or Down syndrome.

This study examined syntactic assignment for predicates and reflexives as well as working memory effects in the sentence comprehension of children with Specific Language Impairment (SLI), Down syndrome (DS), high functioning Autism (HFA) and Typical Language Development (TLD). Fifty-seven children (35 boys and 22 girls) performed a computerised picture-selection sentence comprehension task. Predicate attachment and reflexive antecedent assignment (with working memory manipulations) were investigated. The results showed that SLI, HFA and DS children exhibited poorer overall performance than TLD children. Children with SLI exhibited similar performance to the DS and HFA children only when working memory demands were higher. We conclude that children with SLI, HFA and DS differ from children with TLD in their comprehension of predicate and reflexive structures where the knowledge of syntactic assignment is required. Working memory manipulation had different effects on syntactic comprehension depending on language disorder. Intelligence was not an explanatory factor for the differences observed in performance.

Aspectos da fluência da fala em crianças com distúrbio específico de linguagem / Aspects of speech fluency in children with specific language impairment

Objetivo Avaliar aspectos específicos da fluência da fala em crianças com DEL, quanto à tipologia de rupturas comuns e velocidade de fala (em palavras e sílabas por minuto), considerando as diferentes faixas etárias. Métodos Participaram 50 crianças de ambos os gêneros, na faixa etária de 3 a 7 anos, com QI não verbal e limiares auditivos dentro da normalidade e ausência de gagueira. As crianças foram divididas em dois grupos: G1 (DEL), com 25 crianças (sete meninas e 18 meninos, com idades entre 3 e 7 anos) e G2 (desenvolvimento típico), com 25 crianças pareadas em idade e gênero ao GI. Foi apresentada uma figura à criança e solicitado que falasse o que quisesse sobre ela. Cada amostra de fala foi composta por 200 sílabas fluentes ou 100 palavras fluentes. Resultados A análise intergrupos demonstrou que crianças de 3 e 4 anos do G1 apresentaram menor velocidade de fala que seus pares em desenvolvimento típico. Na análise intragrupos, no que se refere à tipologia de rupturas, o G1 não apresentou diferenças em nenhuma das faixas etárias. Já o G2, para as faixas etárias de 4 e 5 anos, a hesitação foi mais frequente e aos 6 e 7 anos, a hesitação e a repetição de palavras se diferenciaram das demais tipologias. Conclusão Crianças com suspeita de DEL nas idades de 3 e 4 anos, aqui estudadas, apresentaram redução da produção de palavras e sílabas. As rupturas de fala, do tipo hesitação, foram recursos usados pelas crianças com desenvolvimento típico de todas as faixas etárias, o que não ocorreu nas crianças com DEL. .

Purpose The present study aimed to assess specific aspects of speech fluency in children with specific language impairment (SLI). This included examining the typology of speech disruption and rate (in words and syllables per minute), across different age groups. Methods A total of 50 children, aged 3 to 7 years old, presenting with nonverbal IQ and hearing thresholds within normal limits (without the presence of stuttering) participated in the study. Children were divided into two groups: G1 (SLI) included 25 children (7 girls and 18 boys) and G2 (typical development) included 25 children matched on age and gender with G1. Each child was shown a figure and asked to discuss what s/he liked about the figure. Each speech sample included 200 fluent syllables or 100 fluent words. Results Between-group analyses demonstrated that children aged 3 to 4 years old in G1 had lower speech rate than their age-matched peers from G2. Within-group analyses revealed no differences in disruption typologies between age groups in G1 participants. In contrast, hesitation was the most frequent typology for 4- to 5-year-old G2 children, whereas hesitation and word repetition typologies were observed in 6- to 7-year-old G2 children. Conclusion Children with suspected SLI between the ages of 3 to 4 years old showed a reduction in word and syllable production. Hesitation-type speech disruptions were prominently used by typically developing children, regardless of age, and were not observed in SLI children. .

Evolução audiométrica em usuários de implante coclear multicanal / Audiometric evolution in multichannel cochlear implant users

OBJETIVO: analisar em quanto tempo após a ativação é possível alcançar os limiares auditivos desejados nos indivíduos usuários de implante coclear (IC) multicanal de diferentes faixas etárias. MÉTODO: estudo seccional retrospectivo a partir de banco de dados, aprovado pelo CEP/HCFMUSP, sob número 779/06. Foram incluídos indivíduos implantados no período de Janeiro de 2005(início da formação do banco de dados) a Setembro de 2008(término da coleta de dados), cujos prontuários possuíam dados dos limiares audiométricos pré-implante e 3, 6 e 12 meses após o IC. Setenta e dois pacientes contemplaram os critérios, divididos em dois grupos por faixa etária: GI (até 17 anos) e GII (18 a 66 anos). Foi utilizada a Análise de Variância (ANOVA) de um fator para verificar a interação entre as médias dos limiares audiométricos e o tempo após o IC. RESULTADOS: observou-se que 15 do grupo GI já alcançaram limiares em torno de 30dBNA aos 3 meses pós implante. O mesmo aconteceu com 26 pacientes do grupo GII. Encontrou-se interação significante entre tempo (F(3,140)=91,973, p=0,00) e a média de limiares auditivos. Nas análises Post-hoc do grupo GI foram observadas diferenças estatisticamente significantes para as comparações entre AASI e 3 meses pós implante (p=0,00) e entre 3 e 12 meses (p= 0,28), para o grupo GII, somente para a comparação entre AASI e 3 meses (p=0,00). CONCLUSÃO: uma mudança significante da audição pode ser observada a partir de três meses após o IC, porém este resultado não se encontra em todos os implantados.

PURPOSE: to evaluate how long after activation one can achieve the desired auditory thresholds in individuals multichannel cochlear implant users from different age groups. METHOD: a retrospective cross-sectional from a database, approved by CEP / FMUSP, under number 779/06. Individuals implanted between January 2005 and September 2008, whose files had preoperative audiometric data and 3, 6 and 12 months after CI were included. Seventy-two patients fulfilled the criteria, and they were divided in two groups according to age: group I (17 year old) and GII (18-66 year old). Analysis of variance (ANOVA) of one factor in order to verify the interaction between the mean threshold and time after CI were used. RESULTS: we observed that 15 of the GI have reached around 30dBNA thresholds at 3 months after implant. The same happened to 26 patients of GII. We found significant interaction between time (F (3.140) = 91.973, p = 0.00) and the average hearing thresholds. Post-hoc analysis in the GI group were statistically significant differences for comparisons between HA and 3 months after implantation (p = 0.00) and between 3 and 12 months (p = 0.28). For GII only for comparison between HA and 3 months (p = 0.00). CONCLUSION: a significant hearing change may be observed beginning from three months after IC, but this result is not found in all implanted subjects.

Lexical priming in fluent and with developmental stuttering children.

PURPOSE: To examine the possible relationship between lexical variables (categorization and naming) and developmental stuttering. METHODS: Thirty Brazilian Portuguese speaking children with ages ranging from 7 to 9 years and 11 months participated in the study. We applied a lexical priming paradigm to experimentally investigate whether children with developmental stuttering (Research Group) differed from their fluent peers (Control Group), with respect to reaction time in three conditions - control (without prime); semantically related prime, and semantically independent prime - of two experimental tasks: categorization and naming of the target stimulus. RESULTS: No difference between groups was observed in reaction time on the categorization task. However, there was a condition effect showing that, for both groups, reaction time was shorter in the semantically related prime condition when compared to the no prime condition. In the naming task, a between-group difference was observed in reaction time, indicating a longer reaction time in the Research Group than the Control Group. There was no condition effect on naming, i.e. the Research Group showed slower reaction time regardless of prime type. CONCLUSIONS: The results confirm the hypothesis that, in children with developmental stuttering, readiness in motor programming of speech is slowed when compared to fluent children. There is no difference between groups when the lexical function does not require speech readiness.

Priming lexical em crianças fluentes e com gagueira do desenvolvimento / Lexical priming in fluent and with developmental stuttering children

OBJETIVO: Examinar a possível relação entre variáveis lexicais (categorização e nomeação) e gagueira do desenvolvimento. MÉTODOS: Participaram do estudo 30 crianças falantes do português brasileiro, entre 7 a 9 anos e 11 meses. Foi utilizado o paradigma de priming lexical para investigar experimentalmente se as crianças com gagueira do desenvolvimento (Grupo Pesquisa) se diferenciam de seus pares fluentes (Grupo Controle), em relação ao tempo de reação em três condições de pesquisa - condição controle (sem prime); condição de prime semanticamente relacionado e condição de prime semanticamente independente -, em duas tarefas experimentais: categorização e nomeação do estímulo-alvo. RESULTADOS: Na tarefa de categorização, não houve diferença no tempo de reação entre os grupos. O tempo de reação foi diferente para cada condição, porém, a variação foi similar em ambos os grupos. Houve efeito de prime entre as condições sem prime e prime relacionado indicando que, para ambos os grupos, o tempo de reação foi menor na condição de prime relacionado. Na tarefa de nomeação, houve diferença no tempo de reação entre os grupos. O tempo de reação no Grupo Pesquisa foi maior em relação ao Grupo Controle. Não houve efeito de prime, ou seja, em qualquer condição, o Grupo Pesquisa apresentou tempo de reação maior. CONCLUSÕES: Os resultados da pesquisa confirmaram a hipótese de que, nas crianças com gagueira do desenvolvimento, a prontidão na programação motora da fala - input - é lentificada, em relação ao Grupo de Controle de crianças fluentes. Não há diferença entre os grupos quando a função lexical não exige prontidão para a fala.

PURPOSE: To examine the possible relationship between lexical variables (categorization and naming) and developmental stuttering. METHODS: Thirty Brazilian Portuguese speaking children with ages ranging from 7 to 9 years and 11 months participated in the study. We applied a lexical priming paradigm to experimentally investigate whether children with developmental stuttering (Research Group) differed from their fluent peers (Control Group), with respect to reaction time in three conditions - control (without prime); semantically related prime, and semantically independent prime - of two experimental tasks: categorization and naming of the target stimulus. RESULTS: No difference between groups was observed in reaction time on the categorization task. However, there was a condition effect showing that, for both groups, reaction time was shorter in the semantically related prime condition when compared to the no prime condition. In the naming task, a between-group difference was observed in reaction time, indicating a longer reaction time in the Research Group than the Control Group. There was no condition effect on naming, i.e. the Research Group showed slower reaction time regardless of prime type. CONCLUSIONS: The results confirm the hypothesis that, in children with developmental stuttering, readiness in motor programming of speech is slowed when compared to fluent children. There is no difference between groups when the lexical function does not require speech readiness.

Children with cochlear implants: communication skills and quality of life.

UNLABELLED: Given the multidimensional scope of cochlear implants, there is a growing need to assess clinical measures related communicative abilities and more general aspects involved in the effectiveness of treatment, such as quality of life. AIM: To translate and adapt an international questionnaire of quality of life to Brazilian Portuguese; to apply the questionnaire in parents of children with cochlear implant to assess quality of life of children after cochlear implantation; to analyze correlations among factors related to quality of life; to analyze correlations between quality of life and clinical measures of outcome. METHOD: Prospective study in which parents of children with cochlear implants responded to validated instruments on quality of life and communication abilities. RESULTS: The translation and adaptation of the questionnaire was satisfactorily completed. According to the data, cochlear implants had a positive effect on quality of life of the implanted children and their families. Observed correlations for the variable communication demonstrate a direct relationship between oral communication and other variables of quality of life. CONCLUSIONS: This study makes this questionnaire available in Brazilian Portuguese. For parents of Brazilian children with cochlear implants, lexical development(acquisition and use of words) is the variable that relates most to the quality of life of their children.

Crianças com implante coclear: habilidades comunicativas e qualidade de vida / Children with cochlear implants: communication skills and quality of life

Dado o âmbito multidimensional do implante coclear, há crescente necessidade em avaliar não somente medidas clínicas de eficácia relacionadas às habilidades comunicativas, mas também aspectos mais genéricos envolvidos na efetividade do tratamento, como a qualidade de vida. OBJETIVOS: Tradução e adaptação de questionário internacional para o Português Brasileiro; análise das correlações entre fatores relacionados à qualidade de vida; análise das correlações entre qualidade de vida e medidas clínicas de resultado. MATERIAL E MÉTODO: Estudo prospectivo realizado com pais de crianças com implante coclear consistindo na aplicação de instrumentos validados para avaliar aspectos de qualidade de vida e habilidades comunicativas. RESULTADOS: A tradução e adaptação cultural do questionário foi satisfatoriamente realizada e este estudo proporciona a disponibilização do questionário em versão para o Português Brasileiro. Pelos dados obtidos, o implante coclear apresentou efeito positivo na qualidade de vida das crianças implantadas e de suas famílias. As correlações observadas para a variável comunicação demonstram uma relação direta entre comunicação oral e outras variáveis de qualidade de vida. CONCLUSÃO: Este estudo disponibiliza o questionário em versão para o Português Brasileiro. Para os pais de crianças brasileiras usuárias de implante coclear, a habilidade lexical (aquisição e uso das palavras) é a variável de maior impacto na qualidade de vida de seus filhos.

Given the multidimensional scope of cochlear implants, there is a growing need to assess clinical measures related communicative abilities and more general aspects involved in the effectiveness of treatment, such as quality of life. AIM: To translate and adapt an international questionnaire of quality of life to Brazilian Portuguese; to apply the questionnaire in parents of children with cochlear implant to assess quality of life of children after cochlear implantation; to analyze correlations among factors related to quality of life; to analyze correlations between quality of life and clinical measures of outcome. METHOD: prospective study in which parents of children with cochlear implants responded to validated instruments on quality of life and communication abilities. RESULTS: The translation and adaptation of the questionnaire was satisfactorily completed. According to the data, cochlear implants had a positive effect on quality of life of the implanted children and their families. Observed correlations for the variable communication demonstrate a direct relationship between oral communication and other variables of quality of life. CONCLUSIONS: This study makes this questionnaire available in Brazilian Portuguese. For parents of Brazilian children with cochlear implants, lexical development(acquisition and use of words) is the variable that relates most to the quality of life of their children.

Syntactic structural assignment in Brazilian Portuguese-speaking children with specific language impairment.

PURPOSE: In this study, the authors examined the comprehension of sentences with predicates and reflexives that are linked to a nonadjacent noun as a test of the hierarchical ordering deficit (HOD) hypothesis. That hypothesis and more modern versions posit that children with specific language impairment (SLI) have difficulty in establishing nonadjacent (hierarchical) relations among elements of a sentence. The authors also tested whether additional working memory demands in constructions containing reflexives affected the extent to which children with SLI incorrectly structure sentences as indicated by their picture-pointing comprehension responses. METHOD: Sixteen Brazilian Portuguese-speaking children (8;4-10;6 [years;months]) with SLI and 16 children with typical language development (TLD) matched for age (± 3 months), gender, and socioeconomic status participated in 2 experiments (predicate and reflexive interpretation). In the reflexive experiment, the authors also manipulated working memory demands. Each experiment involved a 4-choice picture selection sentence comprehension task. RESULTS: Children with SLI were significantly less accurate on all conditions. Both groups made more hierarchical syntactic construction errors in the long working memory condition than in the short working memory condition. CONCLUSION: The HOD hypothesis was not confirmed. For both groups, syntactic factors (structural assignment) were more vulnerable than lexical factors (prepositions) to working memory effects in sentence miscomprehension.

Deglutição e consistências alimentares pastosas e sólidas: revisão crítica de literatura / Deglutition of pasty and solid food: a critical review of the literature

OBJETIVO: Levantar artigos científicos internacionais sobre a fisiologia da deglutição de alimentos nas consistências néctar, mel, pudim, pastosa heterogênea, semissólida e sólida, nas fases oral e faríngea. MÉTODOS: Trata-se de estudo de revisão qualitativa da literatura. Para a seleção dos artigos, foi utilizada a base de dados PubMed com emprego dos descritores "Swallowing and consistency", "Swallowing and solid" e "Swallowing and pasty", limitando-se a pesquisas publicadas no idioma inglês, entre os anos de 2005 e 2010, realizadas com seres humanos maiores de 18 anos. A metodologia empregada envolveu formulação da pergunta, localização e seleção dos estudos, e avaliação crítica dos artigos, conforme os preceitos do Cochrane Handbook. RESULTADOS: Foram identificados 211 estudos, dos quais 18 foram analisados, pois permitiam acesso ao texto completo e eram diretamente relacionados ao tema. CONCLUSÃO: Os estudos apresentam metodologia pouco uniforme, não havendo padronização, principalmente quanto aos métodos de avaliação. Em geral, as pesquisas foram realizadas com sujeitos saudáveis ou remeteram a um tipo de patologia, sem utilização de casos-controle. A heterogeneidade dos estudos possibilita que diferentes grupos de patologias sejam avaliados, porém, a variabilidade metodológica dificulta a definição e generalização dos padrões encontrados. Sendo assim, não é possível evidenciar dados que embasem a prática clínica fonoaudiológica no que diz respeito à fisiologia normal ou alterada da deglutição de diferentes consistências alimentares, tanto para sujeitos normais quanto para os acometidos por alguma desordem.

PURPOSE: To analyze published international scientific papers on the physiology of deglutition in oral and pharyngeal phases, considering different food consistencies: nectar, honey, pudding, pasty heterogeneous, semi-solid, and solid. METHODS: This is a qualitative literature reviews. The studies considered were selected on PubMed, using the keywords "Swallowing and consistency", "Swallowing and solid", and "Swallowing and pasty", limiting the search to manuscripts published in English in the period between 2005 and 2010, and conducted with human beings over 18 years old. The methodology involved question formulation, location and selection of studies, and critical analyses of the manuscripts, according to the concepts of the Cochrane Handbook. RESULTS: Two hundred and eleven studies were identified, out of which only 18 allowed access to the full text and were directly related to the theme. CONCLUSION: The studies presented very few similarities between the applied methodologies, especially when considering assessment methods. Overall, the studies were conducted with healthy individuals or with a specific pathology, without presenting the comparison with control cases. The heterogeneity of studies allows the investigation of different swallowing disorders. However, methodological variability makes it difficult to define and generalize the identified swallowing patterns. For this reason, it is not possible to identify parameters on which to base the clinical practice of speech-language therapists, especially when considering the normal or altered physiology of swallowing different food consistencies.

Speech and myofunctional exercise physiology: a critical review of the literature.

PURPOSE: To analyze the scientific literature about the physiology and effects of exercises used in the treatment of oral myofunctional disorders. RESEARCH STRATEGY: The methodology used followed the concepts of the Cochrane Handbook and involved question formulation related to the topic of investigation, identification and selection of the studies, and a critical evaluation of the selected articles. SELECTION CRITERIA: Papers were selected on PubMed database using the following keyword combinations: "physiology exercise AND speech, language and hearing science", "exercise physiology AND speech therapy", "exercise physiology AND myofunctional therapy", and "physiology exercise AND swallowing therapy". Only papers written in English and published between the years of 2000 and 2010 were included in the analysis. DATA ANALYSIS: Manuscripts were analyzed according to their objectives, research design, participants, inclusion of a control group, assessment criteria, therapeutic proposal, results and existence about physiology of the chosen exercises. RESULTS: One hundred and eight studies were identified, out of which 38 had access to the full text and were directly related to the investigated topic. The articles were classified as clinical trials and experimental research, case studies, literature reviews and theoretical articles, letters to the editor and critical analyses. CONCLUSION: This review concluded that there is a lack of knowledge about the effects of the myofunctional exercises used by clinicians. Also there is a lack of scientific evidence to determine the frequency at which they should be performed. Generally, the articles investigate the efficacy of treatment programs without inquiring whether the included exercises are individually effective.

Fisiologia do exercício fonoaudiológico: uma revisão crítica da literatura / Speech and myofunctional exercise physiology: a critical review of the literature

OBJETIVO: Analisar literatura científica sobre fisiologia e efeitos dos exercícios fonoaudiológicos utilizados nos tratamentos de alterações da Motricidade Orofacial. ESTRATÉGIA DE PESQUISA: Foram seguidos os preceitos do Cochrane Handbook que envolveu a formulação da questão a ser investigada, a localização e seleção dos estudos e a avaliação crítica dos artigos. CRITÉRIOS DE SELEÇÃO: Os artigos foram selecionados por meio da base de dados PubMed, utilizando-se os seguintes descritores: "physiology exercise AND speech, language and hearing science", "exercise physiology AND speech therapy", "exercise physiology AND myofunctional therapy", e "physiology exercise AND swallowing therapy". Foram incluídos somente artigos de língua inglesa publicados no período de 2000 a 2010. ANÁLISE DOS DADOS: Os textos foram analisados quanto aos seus objetivos; desenho da pesquisa; características do grupo pesquisa; existência de grupo controle; critérios de avaliação; terapêutica proposta; resultados encontrados; e verificação da existência de discussão sobre a fisiologia muscular dos exercícios. RESULTADOS: Foram identificados 108 estudos e destes, 38 foram analisados, pois permitiam acesso ao texto completo e relacionavam-se ao tema proposto. Os artigos foram classificados em: ensaios clínicos e pesquisas experimentais, estudos de casos, revisões de literatura e textos teóricos, cartas ao editor e críticas aos artigos. CONCLUSÃO: A revisão permite concluir que o conhecimento sobre os efeitos musculares dos exercícios empregados pelos clínicos é pouco aprofundado. Ainda não há evidência cientifica suficiente para determinar a frequência em que estes devem ser realizados. Em geral, tem-se pesquisado a eficácia de programas terapêuticos, sem investigar se os exercícios propostos são efetivos individualmente.

PURPOSE: To analyze the scientific literature about the physiology and effects of exercises used in the treatment of oral myofunctional disorders. RESEARCH STRATEGY: The methodology used followed the concepts of the Cochrane Handbook and involved question formulation related to the topic of investigation, identification and selection of the studies, and a critical evaluation of the selected articles. SELECTION CRITERIA: Papers were selected on PubMed database using the following keyword combinations: "physiology exercise AND speech, language and hearing science", "exercise physiology AND speech therapy", "exercise physiology AND myofunctional therapy", and "physiology exercise AND swallowing therapy". Only papers written in English and published between the years of 2000 and 2010 were included in the analysis. DATA ANALYSIS: Manuscripts were analyzed according to their objectives, research design, participants, inclusion of a control group, assessment criteria, therapeutic proposal, results and existence about physiology of the chosen exercises. RESULTS: One hundred and eight studies were identified, out of which 38 had access to the full text and were directly related to the investigated topic. The articles were classified as clinical trials and experimental research, case studies, literature reviews and theoretical articles, letters to the editor and critical analyses. CONCLUSION: This review concluded that there is a lack of knowledge about the effects of the myofunctional exercises used by clinicians. Also there is a lack of scientific evidence to determine the frequency at which they should be performed. Generally, the articles investigate the efficacy of treatment programs without inquiring whether the included exercises are individually effective.

Processamento linguístico e processamento auditivo temporal em crianças com distúrbio específico de linguagem / Linguistic and auditory temporal processing in children with specific language impairment

TEMA: diversos estudos sugerem a associação do distúrbio específico de linguagem (DEL) ao déficit no processamento auditivo. Pesquisas fornecem evidência de que a discriminação de estímulos breves estaria comprometida em crianças com DEL. Este déficit levaria a dificuldades em desenvolver habilidades fonológicas necessárias para mapear fonemas e decodificar e codificar palavras e frases efetiva e automaticamente. Entretanto, a correlação entre processamento temporal (PT)e distúrbios de linguagem tem recebido pouca atenção. OBJETIVO: analisar a correlação entre duas as áreas: PT (teste de padrão de freqüência - TPF) e Processamento Lingüístico (complexidade sintática). MÉTODO: Dezesseis crianças com desenvolvimento típico de linguagem (8;9 ± 1;1) e sete crianças diagnosticadas com DEL (8;1 ± 1;2) e participaram de TPF e Testes de Compreensão de Complexidade Sintática (TCCS). RESULTADOS: A porcentagem de acerto no TCCS decresceu com o aumento da complexidade sintática (p < 0,01). Na comparação inter-grupos, a diferença no desempenho no TCCS foi estatisticamente significante (p = 0,02). Como esperado, crianças com DEL apresentaram desempenho no TPF fora dos valores de referência.No grupo DEL, as correlações entre os resultados do TPF e do TCCS foram positivas e maiores para frases de alta complexidade sintática (r = 0,97) do que para frases com baixa complexidade sintática (r = 0,51). CONCLUSÃO: Resultados sugerem que o TPF está correlacionado positivamente com habilidades de complexidade sintática. O baixo desempenho no TPF pode servir de um indicativo adicional sobre déficits em processamento lingüístico complexo.Estudos futuros devem considerar, além do aumento da amostra,a análise do efeito do treinamento auditivo temporal de freqüência no desempenho em tarefas de compreensão sintática de alta complexidade.

BACKGROUND: several studies suggest the association of specific language impairment (SLI) to deficits in auditory processing.It has been evidenced that children with SLI present deficit in brief stimuli discrimination. Such deficit would lead to difficulties in developing phonological abilities necessary to map phonemes and to effectively and automatically code and decode words and sentences. However, the correlation between temporal processing (TP) and specific deficits in language disorders - such as syntactic comprehension abilities - has received little or no attention. AIM: to analyze the correlation between: TP (through the Frequency Pattern Test - FPT) and Syntactic Complexity Comprehension (through a Sentence Comprehension Task). METHOD: Sixteen children with typical language development (8;9 ± 1;1 years) and seven children with SLI (8;1 ± 1;2 years) participated on the study. RESULTS: Accuracy of both groups decreased with the increase on syntactic complexity (both p < 0.01). On the between groups comparison, performance difference on the Test of Syntactic Complexity Comprehension (TSCC) was statistically significant (p = 0.02).As expected, children with SLI presented FPT performance outside reference values. On the SLI group, correlations between TSCC and FPT were positive and higher for high syntactic complexity (r = 0.97) than for low syntactic complexity (r = 0.51). CONCLUSION: Results suggest that FPT is positively correlated to syntactic complexity comprehension abilities.The low performance on FPT could serve as an additional indicator of deficits in complex linguistic processing. Future studies should consider, besides the increase of the sample, longitudinal studies that investigate the effect of frequency pattern auditory training on performance in high syntactic complexity comprehension tasks.

Linguistic and auditory temporal processing in children with specific language impairment.

BACKGROUND: Several studies suggest the association of specific language impairment (SLI) to deficits in auditory processing. It has been evidenced that children with SLI present deficit in brief stimuli discrimination. Such deficit would lead to difficulties in developing phonological abilities necessary to map phonemes and to effectively and automatically code and decode words and sentences. However, the correlation between temporal processing (TP) and specific deficits in language disorders--such as syntactic comprehension abilities--has received little or no attention. AIM: To analyze the correlation between: TP (through the Frequency Pattern Test--FPT) and Syntactic Complexity Comprehension (through a Sentence Comprehension Task). METHOD: Sixteen children with typical language development (8;9 +/- 1;1 years) and seven children with SLI (8;1 +/- 1;2 years) participated on the study. RESULTS: Accuracy of both groups decreased with the increase on syntactic complexity (both p < 0.01). On the between groups comparison, performance difference on the Test of Syntactic Complexity Comprehension (TSCC) was statistically significant (p = 0.02).As expected, children with SLI presented FPT performance outside reference values. On the SLI group, correlations between TSCC and FPT were positive and higher for high syntactic complexity (r = 0.97) than for low syntactic complexity (r = 0.51). CONCLUSION: Results suggest that FPT is positively correlated to syntactic complexity comprehension abilities.The low performance on FPT could serve as an additional indicator of deficits in complex linguistic processing. Future studies should consider, besides the increase of the sample, longitudinal studies that investigate the effect of frequency pattern auditory training on performance in high syntactic complexity comprehension tasks.