Auditory evoked potentials: predicting speech therapy outcomes in children with phonological disorders.

OBJECTIVES: This study investigated whether neurophysiologic responses (auditory evoked potentials) differ between typically developed children and children with phonological disorders and whether these responses are modified in children with phonological disorders after speech therapy. METHODS: The participants included 24 typically developing children (Control Group, mean age: eight years and ten months) and 23 children clinically diagnosed with phonological disorders (Study Group, mean age: eight years and eleven months). Additionally, 12 study group children were enrolled in speech therapy (Study Group 1), and 11 were not enrolled in speech therapy (Study Group 2). The subjects were submitted to the following procedures: conventional audiological, auditory brainstem response, auditory middle-latency response, and P300 assessments. All participants presented with normal hearing thresholds. The study group 1 subjects were reassessed after 12 speech therapy sessions, and the study group 2 subjects were reassessed 3 months after the initial assessment. Electrophysiological results were compared between the groups. RESULTS: Latency differences were observed between the groups (the control and study groups) regarding the auditory brainstem response and the P300 tests. Additionally, the P300 responses improved in the study group 1 children after speech therapy. CONCLUSION: The findings suggest that children with phonological disorders have impaired auditory brainstem and cortical region pathways that may benefit from speech therapy.

Auditory evoked potentials: predicting speech therapy outcomes in children with phonological disorders

OBJECTIVES: This study investigated whether neurophysiologic responses (auditory evoked potentials) differ between typically developed children and children with phonological disorders and whether these responses are modified in children with phonological disorders after speech therapy. METHODS: The participants included 24 typically developing children (Control Group, mean age: eight years and ten months) and 23 children clinically diagnosed with phonological disorders (Study Group, mean age: eight years and eleven months). Additionally, 12 study group children were enrolled in speech therapy (Study Group 1), and 11 were not enrolled in speech therapy (Study Group 2). The subjects were submitted to the following procedures: conventional audiological, auditory brainstem response, auditory middle-latency response, and P300 assessments. All participants presented with normal hearing thresholds. The study group 1 subjects were reassessed after 12 speech therapy sessions, and the study group 2 subjects were reassessed 3 months after the initial assessment. Electrophysiological results were compared between the groups. RESULTS: Latency differences were observed between the groups (the control and study groups) regarding the auditory brainstem response and the P300 tests. Additionally, the P300 responses improved in the study group 1 children after speech therapy. CONCLUSION: The findings suggest that children with phonological disorders have impaired auditory brainstem and cortical region pathways that may benefit from speech therapy. .

Procesos de simplificación fonológica en niños de 4, 5 y 6 años con dificultades fonológicas / Phonological simplification processes by children aged 4, 5 and 6 years with phonological difficulties

Se estudia a niños con dificultades fonológicas (DF) desde la perspectiva de la teoría de la fonología natural. Según ella, el desarrollo consiste en la paulatina eliminación de procesos fonológicos de simplificación (PSF) que afectan a la producción de palabras. Los niños con DF no eliminan adecuadamente los PSF y, por ello, sus emisiones son poco inteligibles y similares a la de niños de menor edad. Existe información en español acerca de la eliminación de PSF en el desarrollo típico, pero es escasa en menores con DF. Objetivo: comparar el manejo de PSF en niños con DF de 4, 5 y 6 años. Método: Se trabajó con 34 menores, con DF y diagnóstico de TEL, alumnos de escuela de lenguaje, distribuidos en tres grupos: 4.0 a 4.11 años (n12); 5.0 a 5.11 años (n11) y 6.0 a 6.11 años (n11). Fueron evaluados individualmente en su establecimiento educacional con el Test para evaluar procesos de simplificación fonológica (TEPROSIF-.‐R). Resultados: Se constató que la eliminación de PSF en los niños con problemas fonológicos es evidente entre los 4 y 5 años, pero se lentifica entre los 5 y 6 años, en especial, en los relacionados con la estructura de la sílaba y de la palabra.

This paper studies children who have phonological difficulties (PD) from the theoretical principles of natural phonology. This theory holds that the development consists in the gradual loss of the phonological simplification processes (PSP) which affect the production of words. Children with PD do not delete properly the PSP and therefore their speech is unintelligible and similar to that of younger children. Studies on the loss of phonological simplification processes in children with typical language development have been carried out in Spanish. However, far too little attention has been paid to this loss in children with PD. Objective: to compare the management of phonological simplification processes by children aged 4, 5 and 6 years with PD. Method: 34 children with PD and diagnosed with Specific Language Impairment (SLI), students enrolled in a language school, divided into three groups: 4.0 to 4.11 years (n12); 5.0 to 5.11 years (n11) and 6.0 to 6.11 years (n11). Children were assessed individually in their schools using the Test para Evaluar Procesos de Simplificación Fonológica (TEPROSIF-.‐R). Results: it was observed that the loss of PSP in children with PD is evident between children aged 4 and 5 years, but it is slower between children aged 5 and 6 years, especially, those related to the structure of the syllable and the word.

Lingual frenectomy and alveolar tap production: an acoustic and perceptual study.

In this phonetic study, productions of the consonant in the stressed syllable position of the word arara as produced by 13 subjects with short and/or anterior lingual frenulum were compared before and after lingual frenectomy. The results from the measurement of the stressed consonant duration and from the identification of the consonant manners of articulation based on the inspection of spectral characteristics are discussed and related to the answers to a perceptual identification test. After surgery, the number of tap productions did not increase, but alveolar productions did. These clinically relevant findings show frenectomy improved tongue mobility, but, as temporal controls were not totally re-established after surgery and 6-month speech therapy sessions, the production of the alveolar tap remained largely unchanged.

Lingual frenulum: changes after frenectomy.

PURPOSE: To describe the changes after frenectomy concerning mobility and functions of the tongue. METHODS: Participants were 53 subjects who had never undergone speech therapy or lingual frenulum surgery. A specific lingual frenulum protocol with scores was used by speech-language pathologists when there was evidence of frenulum alteration. Ten subjects had abnormal frenulum and were referred to an otolaryngologist for frenectomy. After surgery, the subjects were re-evaluated using the same protocol. Photos and videos were taken for comparison. RESULTS: Thirty days after surgery, the subjects had the shape of the tip of the tongue and its movements improved. Lip closure and speech were also improved. CONCLUSION: Frenectomy is efficient to improve tongue posture, tongue mobility, oral functions, and oral communication.

A Spanish pilot investigation for a crosslinguistic study in protracted phonological development.

A crosslinguistic study is underway concerning children's protracted phonological development (i.e. speech sound disorders). The current article reports pilot Spanish data for this study from two 4-year-old boys with protracted phonological development. The purposes of the pilot study were to: (1) develop and evaluate a word list for elicitation that could be used across Spanish dialects and that sufficiently sampled Spanish word lengths, stress patterns, word shapes and phonemes; and (2) to derive hypotheses for the larger study, based on patterns found in these children's speech, and a review of the literature. The two speakers showed some developmental patterns reported for other languages (e.g. constraints on production of liquids and word-initial consonants in unstressed syllables) but also patterns that may reflect Spanish phonological inventories, allophony and frequencies. These data helped consolidate the Spanish word list for elicitation and led to questions for the ongoing study concerning word structure, multisyllabic words, liquids, fricatives and vowel sequences.

Frênulo lingual: modificações após frenectomia / Lingual frenulum: changes after frenectomy

OBJETIVO: Descrever as mudanças ocorridas após a frenectomia com relação à mobilidade e funções da língua. MÉTODOS: Foram avaliados 53 sujeitos, os quais nunca haviam se submetido a fonoterapia ou a cirurgia do frênulo. Um protocolo com escores específicos para avaliação do frênulo lingual foi utilizado para avaliar os sujeitos com evidências de alteração neste aspecto. Foi encontrada alteração em dez sujeitos, que foram encaminhados a um otorrinolaringologista para frenectomia. Após a cirurgia, esses sujeitos foram reavaliados pelo fonoaudiólogo utilizando-se o mesmo protocolo. Fotos e vídeos foram usados para comparação. RESULTADOS: Trinta dias após a cirurgia, os sujeitos apresentaram a forma da ponta da língua modificada, assim como os movimentos melhorados. O fechamento labial e a fala também melhoraram. CONCLUSÃO: A frenectomia é eficiente para melhorar a mobilidade e a postura da língua, assim como suas funções, incluindo a produção da fala.

PURPOSE: To describe the changes after frenectomy concerning mobility and functions of the tongue. METHODS: Participants were 53 subjects who had never undergone speech therapy or lingual frenulum surgery. A specific lingual frenulum protocol with scores was used by speech-language pathologists when there was evidence of frenulum alteration. Ten subjects had abnormal frenulum and were referred to an otolaryngologist for frenectomy. After surgery, the subjects were re-evaluated using the same protocol. Photos and videos were taken for comparison. RESULTS: Thirty days after surgery, the subjects had the shape of the tip of the tongue and its movements improved. Lip closure and speech were also improved. CONCLUSION: Frenectomy is efficient to improve tongue posture, tongue mobility, oral functions, and oral communication.

Occurrence of consonant production errors in liquid phonemes in children with operated cleft lip and palate

Information about the prevalence of consonant production errors, including compensatory articulations (CA), in individuals with cleft lip and palate (CLP) who speak Brazilian Portuguese is limited, particularly regarding liquid sounds. The literature primarily reports the occurrence of CA for plosive and fricative sounds, since occurrence of CAs in sounds that require higher amounts of oral air pressure is expected. While the use of CA during liquid sound production is not expected, clinical experience suggests that individuals with CLP present with inadequate backing, elevation, and anteriorization of the tongue as well as tongue clicks during production of /r/ and /l/. Objectives: Describe the occurrence of consonant error productions during liquid sounds for children with CLP; compare the occurrence between children operated with the Furlow and von Langenbeck techniques for palatoplasty; and compare the occurrence between children operated between 9-12 months and 15-18 months of age at primary palatoplasty. Material and Methods: A sample of 397 children (237 males and 160 females) with operated unilateral CLP was studied. In this group, 163 underwent palatoplasty with the Furlow procedure and 234 with the modified von Langenbeck procedure. Age at palatoplasty was between 9 and 12 months for 189 children and between 15 and 18 months for 208 children. Data about production of /l/, /r/, /R/, /λ/ and consonant clusters /l/ and /r/ were obtained from speech pathology records. Speech pathologists registered the speech findings after an auditory-perceptual evaluation of the participants at the sixth year of age. Results: The use of middorsum palatal place (MDP) of production was identified for 2 percent of the sample. Tongue anteriorization of the /l/ production was observed for 55 percent of the children. No significant difference was found related to surgical technique, but children operated earlier developed the use of the consonant cluster /r/ sooner than children operated later (p=0.040). Conclusion: We found a low occurrence of use of cleft related CA during attempts of production of liquid phonemes, and the variable age at primary palatoplasty significantly interfered with the acquisition of consonant cluster /r/.

Speech inconsistency index in Brazilian Portuguese-speaking children.

OBJECTIVE: Speech inconsistency is characterised by variable productions of the same lexical items within the same context. This study aimed to describe inconsistencies among Brazilian Portuguese (BP)-speaking children with and without phonological disorder (PD) as well as the effectiveness of a speech inconsistency test (SIT). METHODS: The study sample included children between 5 years 0 months (5;0 years) and 10;10 years of age, both genders, 51 children with PD and 50 without speech-language disorders. The SIT includes 25 pictures, each named 3 times in different sequences within the same session. RESULTS: The inconsistency average of children with PD (27.4%) was higher than that of typically developing children (9.8%). Linear regression showed age and gender effects, receiver operating characteristic curves were built for speech inconsistency with combined gender and age cutoff values. Inconsistent subjects among typically developing children included 2 younger boys and 2 older girls. Inconsistencies were found among children with PD, including 10 boys up to 7;6 years and 11 over this age, and 7 girls up to 7;6 years and 6 over this age. CONCLUSION: Speech inconsistency in BP-speaking children seems to be an effective measure for differentiating children with PD from those with typically developing phonology.

Occurrence of consonant production errors in liquid phonemes in children with operated cleft lip and palate.

UNLABELLED: Information about the prevalence of consonant production errors, including compensatory articulations (CA), in individuals with cleft lip and palate (CLP) who speak Brazilian Portuguese is limited, particularly regarding liquid sounds. The literature primarily reports the occurrence of CA for plosive and fricative sounds, since occurrence of CAs in sounds that require higher amounts of oral air pressure is expected. While the use of CA during liquid sound production is not expected, clinical experience suggests that individuals with CLP present with inadequate backing, elevation, and anteriorization of the tongue as well as tongue clicks during production of /r/ and /l/. OBJECTIVES: Describe the occurrence of consonant error productions during liquid sounds for children with CLP; compare the occurrence between children operated with the Furlow and von Langenbeck techniques for palatoplasty; and compare the occurrence between children operated between 9-12 months and 15-18 months of age at primary palatoplasty. MATERIAL AND METHODS: A sample of 397 children (237 males and 160 females) with operated unilateral CLP was studied. In this group, 163 underwent palatoplasty with the Furlow procedure and 234 with the modified von Langenbeck procedure. Age at palatoplasty was between 9 and 12 months for 189 children and between 15 and 18 months for 208 children. Data about production of /l/, /r/, /R/, /λ/ and consonant clusters /l/ and /r/ were obtained from speech pathology records. Speech pathologists registered the speech findings after an auditory-perceptual evaluation of the participants at the sixth year of age. RESULTS: The use of middorsum palatal place (MDP) of production was identified for 2% of the sample. Tongue anteriorization of the /l/ production was observed for 55% of the children. No significant difference was found related to surgical technique, but children operated earlier developed the use of the consonant cluster /r/ sooner than children operated later (p=0.040). CONCLUSION: We found a low occurrence of use of cleft related CA during attempts of production of liquid phonemes, and the variable age at primary palatoplasty significantly interfered with the acquisition of consonant cluster /r/.

[Brainstem auditory evoked potentials and vertex potentials in 5-year-old children with defective articulation of the phonemes /l/, /r/, /rr/ and /s/]. / Potenciales evocados auditivos de tallo cerebral y potenciales de vertice en ninos de 5 anos con fallos articulatorios para los fonemas /l/, /r/, /rr/ y /s/.

AIMS: In children with articulatory defects it is important to evaluate the central auditory level. We compared the results of the interwave intervals of brainstem auditory evoked potentials (BAEP) at 80 dB SPL (sound pressure level) and the latencies of the waves of long latency auditory evoked potentials (LLAEP) (vertex) in 5-year-old children with articulatory defects for /l/, /r/, /rr/ and /s/, and in controls. SUBJECTS AND METHODS: Fifty cases of 5-year-old children of both sexes were evaluated; 25 had articulatory defects and 25 with no articulatory defects were used as controls. Melgar's articulation test was applied to both groups. The following aspects were considered in the two groups: normal bilateral audition by means of tone audiometry, tympanometry and the revised Wechsler Intelligence Scale for preschool and primary school children, which were normal; there was no history of neurological damage. Interwave intervals for waves I-III, I-V and III-V of the BAEP and the latencies of the LLAEP (vertex) were evaluated. RESULTS: Data were analysed using SPSS 12, and descriptive statistics and Student's t test were carried out to appraise the differences between the two groups. No differences were found between the control group and the study group. CONCLUSIONS: It is important to determine whether children with articulatory defects have alterations in the auditory receptor or in their central auditory function. It can be concluded that the variables analysed in the two groups behave in the same way; no significant differences were found, which suggests that neither the auditory receptor nor the central auditory function are affected in the study group. Further studies are to be conducted to investigate the meaning of the difference in central nervous conduction between the two afferences in the study group.

Avaliação dos aspectos fonológicos em indivíduos paralíticos cerebrais / Assessment of phonological aspects in individuals with cerebral palsy

Objetivo: verificar os aspectos fonológicos em indivíduos paralíticos cerebrais espásticos. Métodos:o grupo experimental foi composto por 22 indivíduos do gênero feminino e masculino, com idadesentre 3 e 7 anos, sendo 11 do grupo de pesquisa com paralisia cerebral do tipo espástica e 11 docontrole. Foi utilizada para a avaliação uma lista de 125 palavras englobando 5 figuras temáticas paranomeação, que foram analisadas descrevendo-se cada processo fonológico e seus desvios de acordocom a proposta de Wertzner adaptada. Resultados: o grupo de pesquisa apresentou desempenhofonológico inferior quando comparado com o grupo controle. Conclusão: a presença de alteraçõesfonológicas foi evidenciada em indivíduos com paralisia cerebral.

Purpose: to check the phonologic aspects of individuals with cerebral palsy spastic. Methods: 22individuals, of both genders, male and female, aging between 3 and 7 years, being 11 in experimentalgroup with cerebral palsy spastic and 11 in control. A list with 125 words for nomination that wereanalyzed was used for this evaluation, describing each phonological process and its diversions accordingto the adapted propose of Wertzner. Results: the research group demonstrated a lower performancewhen compared to the control group. Conclusion: presence of phonological disorders in individualswith cerebral palsy spastic.

Habilidades de memória de trabalho e o grau de severidade do desvio fonológico / Working memory abilities and the severity of phonological disorders

TEMA: memória de trabalho. Objetivo: verificar o desempenho das habilidades de memória de trabalho e sua relação com o grau de severidade do desvio fonológico. MÉTODO: foram avaliadas 45 crianças com desvio fonológico evolutivo (DFE), com idades entre 5:0 a 7:11, sendo que 17 eram do sexo feminino e 18 do masculino. Todos os sujeitos foram avaliados utilizando-se a Avaliação Fonológica da Criança proposta por Yavas et al. (1991). O grau de severidade do desvio estabelecido por Shriberg e Kwiatkowski (1982), foi determinado pelo cálculo do Percentual de Consoantes Corretas (PCC), o qual foi utilizado para classificar o desvio fonológico em severo, moderado-severo, médio-moderado e médio. A seguir, foi aplicado o subteste 5 do ITPA (Bogossian e Santos, 1977) e o teste de repetição de palavras sem significado (Kessler, 1997). RESULTADOS: verificou-se ao aplicar o teste estatístico Kruskal Wallis e o teste de Duncan, que o desempenho na repetição de palavras sem significado no grau moderado-severo e no grau severo foi inferior ao desempenho no desvio médio-moderado e médio, mas o desempenho na repetição de seqüência de dígitos não apresentou relação positiva com o grau de severidade do desvio. CONCLUSAO: o desempenho da memória fonológica apresenta relação positiva com o grau de severidade do desvio fonológico. Isso permite aceitar a idéia, de que a memória fonológica está relacionada com a produção da fala. Com relação ao executivo central, os resultados permitem concluir, que o desempenho na repetição de seqüência de dígitos, que vem sendo utilizado para avaliar o executivo central, não teve relação com o grau de severidade do desvio. Pode-se justificar estes resultados, pelo fato de o executivo central estar mais relacionado com a aquisição do vocabulário e ser responsável pelo processamento e armazenamento de informações.

Proposta de classificação da função velofaríngea na avaliação perceptivo-auditiva da fala / Proposal for velopharyngeal function rating in a speech perceptual assessment

TEMA: a avaliação perceptivo-auditiva da função velofaríngea apresenta limitações em função de sua subjetividade. OBJETIVO: propor um método de classificação baseado nos escores atribuídos à hipernasalidade, emissão de ar nasal e distúrbios articulatórios compensatórios. CONCLUSÃO: o uso do método traz inúmeras vantagens em termos de documentação clínica e de pesquisa e para acompanhamento de resultados terapêutico-cirúrgicos.

Immediate and sustained changes in tongue movement with an experimental palatal "fistula": a case study.

OBJECTIVE: To determine the immediate and longer-term effect(s) on tongue movement following the placement of an experimental opening through a palatal obturator (replicate of subject's prosthesis) worn by an adult male with an unrepaired cleft of the hard and soft palate. METHODS: Tongue movements associated with an anterior experimental opening of 20 mm(2) were examined under three conditions: a control condition in which the subject wore the experimental obturator completely occluded, a condition immediately after drilling the experimental openings through the obturator, and a condition after 5 days in which the subject wore the experimental obturator with the experimental opening. An Electromagnetic Articulograph was used for obtaining tongue movements during speech. RESULTS: The findings partly revealed that the immediate introduction of a perturbation to the speech system (experimental fistula) had a temporary effect on tongue movement. After sustained perturbation (for 5 days), the system normalized (going back toward control condition's behavior). Perceptual data were consistent with kinematic tongue movement direction in most of the cases. CONCLUSIONS: Although the immediate response can be interpreted as indicative of the subject's attempts to move the tongue toward the opening to compensate for air loss, the findings following a sustained perturbation indicate that with time, other physiological adjustments (such as respiratory adjustments, for example) may help reestablish the requirements of a pressure-regulating system.

[Proposal for velopharyngeal function rating in a speech perceptual assessment]. / Proposta de classificação da função velofaríngea na avaliação perceptivo-auditiva da fala.

BACKGROUND: The perceptual assessment of velopharyngeal function during speech presents some limitations due to its subjectivity. AIM: To propose a method for velopharyngeal function rating based on hypernasality, nasal air emission and compensatory articulation deficits scores. CONCLUSION: The proposed method shows several advantages in terms of clinical and research documentation and for an adequate follow-up of therapeutic and surgical outcomes.

[Working memory abilities and the severity of phonological disorders]. / Habilidades de memória de trabalho e o grau de severidade do desvio fonológico.

BACKGROUND: Working memory. AIM: To verify the performance of working memory abilities and their relation with the severity of phonological disorders. METHOD: 45 children, with ages between 5.0 and 7.11 years, with evolutional phonological disorders (EFD), 17 female and 18 male, were evaluated. All subjects were assessed using the Child Phonological Evaluation proposed by Yavas et al. (1991). The severity of the disorder was determined by the Percentage of Correct Consonants (PCC) proposed by Shriberg and Kwiatkowski (1982), classifying the phonological disorder as severe, moderate-severe, average-moderate and average. After that, subtest 5 of the Psycholinguistic Abilities Test (ITPA--Bogossian & Santos, 1977) and the non-word repetition test (Kessler, 1997) were applied. RESULTS: After analyzing the data according the statistical tests of Kruskal Wallis and Duncan, it was verified that the performance of moderate-severe and severe individuals in the non-word repetition test was inferior to that of average-moderate and average individuals. However, performance results in the digit repetition test did not present a positive correlation with severity. CONCLUSION: The performance of phonological memory has a relation with the severity of phonological disorders. This allows us to accept the idea that the phonologic memory is related to speech production. Regarding the central executor, the results indicate that the performance in digit repetition, used to assess the central executor, did not present a correlation with the severity of the disorder. This can be justified by the fact that the central executor is more directly related to vocabulary acquisition and is responsible for processing and storing information.

Desempenho fonológico de leitura e escrita em indivíduos com paralisia cerebral congênita hemiparética / Phonological performance in reading and writing in people with congenital cerebral palsy

Os objetivos deste estudo foram caracterizar e comparar o desempenho fonológico e de leitura e escrita em indivíduos com Paralisia Cerebral Hemiparética à direita e à esquerda (PC-H). Participaram deste estudo 16 indivíduos com PC-H, com idade entre 7 e 13 anos, que freqüentam ensino fundamental regular público. Os indivíduos foram divididos em dois grupos : GSd (grupo de indivíduos com PC-H á direita) e GSe (grupo de indivíduos com PC-H à esquerda). Os resultados demonstraram que os indivíduos avaliados apresentam diagnóstico fonaudiológico de distúrbio de aprendizagem, porém, os indivíduos do GSe apresentaram melhor desempenho nos resultados do que os indivíduos do GSd no que se refere à emissão e recepção da linguagem escrita...

[Working memory in children with phonological deviation]. / Memória de trabalho em crianças com desvio fonológico.

BACKGROUND: working memory. AIM: to verify the performance of children with normal speech development (NSD) and with evolutional phonological deviation (EPD), in tasks which demand the use of working memory. METHOD: as a research instrument, subtest 5 of the Illinois Test of Psycholinguistics Abilities (ITPA) was used, as well as the meaningless word repetition test. The answers were analyzed based on the results of the digit repetition test and the meaningless word repetition test, comparing the performance of both groups. RESULTS: when comparing the groups, it was verified that the performance of children with EPD is lower than children with NSD in both of the analyzed tests. CONCLUSION: the obtainded results confirm that the working memory is fundamental for the development of speech and for the phoneme choice when producing words.

Memória de trabalho em crianças com desvio fonológico / Working memory in children with phonological deviation

Tema: memória de trabalho. Objetivo: verificar o desempenho de crianças com desenvolvimento normal de fala (DNF) e com desvio fonológico evolutivo (DFE), em tarefas que demandem o uso da memória de trabalho (MT). Método: como instrumento de pesquisa foi utilizado o subteste 5 do Illinois Test of Psycholinguistics Abilities (ITPA) e o teste de repetição de palavras sem significado. As respostas foram analisadas nas provas de dígitos e de palavras sem significado, comparando os resultados obtidos entre as crianças com DNF e as com DFE. Resultados: ao comparar ambos os grupos verificou-se que o desempenho na repetição de seqüência de dígitos e de palavras sem significado, das crianças com DFE é inferior quando comparado ao de crianças com DNF. Conclusão: os resultados confirmam que a MT é fundamental para o desenvolvimento da fala e para a escolha dos fonemas para a produção das palavras.