Development abilities in preterm

OBJETIVO: verificar o desempenho de habilidades do desenvolvimento linguístico, cognitivo, motor, de autocuidados e socialização em crianças prematuras. MÉTODOS: participaram 30 crianças nascidas prematuras, de ambos os sexos de seis a 24 meses. Os procedimentos de avaliação constaram de uma entrevista de anamnese e da aplicação do Inventário Portage Operacionalizado (IPO) (Wilhiams & Aiello, 2001). As crianças foram divididas em dois grupos, conforme a faixa etária, para análise estatística dos dados, considerando as idades de seis a 11 meses e de 12 a 24 meses. A análise dos dados foi realizada por meio da aplicação do teste Manny-Whitney comparando os valores obtidos no grupo de crianças prematuras com escores previstos para crianças típicas. RESULTADOS: os resultados indicam que a área mais defasada do grupo na faixa etária de seis a 12 meses foi à linguística e autocuidados e na faixa etária de 12 a 24 meses as áreas mais defasadas foram linguística, cognitiva e de autocuidados. CONCLUSÃO: ressalta-se a necessidade de um acompanhamento rigoroso de recém-nascidos prematuros, por meio do desenvolvimento de programas de acompanhamento e por uma equipe multidisciplinar para promover a detecção e intervenção precoce, minimizando assim o impacto de problemas no desenvolvimento global destas crianças.PURPOSE: to check the performance of the linguistic, cognitive, motor, self-care and socialization development abilities in premature children. METHODS: 30 premature children participated, of both genders, from 6 to 24 months. The evaluation procedures consisted of an anamnesis interview and Operating Portage Inventory (OPI) (Wilhiams & Aiello, 2001) application. The children were divided in two groups, according to age group, for statistical data analysis, considering the age groups from 6 to 11 months and from 12 to 24 months. Data analysis was accomplished through Manny-Whitney test application, comparing the values obtained in the premature children's group with scores foreseen for typical children. RESULTS: the results indicate that the more altered areas of the group in the age group from 6 to 12 months were linguistics and self-care and in the age group from 12 to 24 months the more altered areas were linguistic, cognitive and self-care. CONCLUSION: the need for a newly born premature rigorous attendance, through the development of continuation programs and a multidisciplinary team is emphasized in order to promote precocious detection and intervention, minimizing the impact of problems in these children's global development

Development skills in children with congenital hypothyroidism: focus on communication

TEMA: o hipotireoidismo congênito pode acarretar alterações no desenvolvimento global infantil. OBJETIVO: traçar o perfil do desenvolvimento em crianças com hipotireoidismo congênito, enfocando a comunicação, e verificar influências da história clínica no perfil traçado. MÉTODO: foram avaliadas, por meio da Early Language Milestone Scale (ELM) e do Inventário Portage Operacionalizado (IPO), 35 crianças de 2 a 36 meses com hipotireoidismo congênito detectado na triagem neonatal, que realizavam tratamento com reposição hormonal há pelo menos um mês. A história clínica foi obtida por meio de entrevista com familiares e análise de prontuário. RESULTADOS: na ELM, onze crianças apresentaram desempenho alterado na função auditiva expressiva, duas na visual e uma na auditiva receptiva. No IPO, sete crianças apresentaram desempenho alterado na área da linguagem, cinco na cognitiva, quatro nas áreas motora e social e três na de autocuidados. Não houve correlação entre os resultados e a história clínica. CONCLUSÃO: a maioria das crianças apresentou desempenho adequado para as habilidades avaliadas. Paras as crianças com desempenho alterado, observou-se maior déficit na área de linguagem, nos aspectos expressivos, e na área cognitiva. Não ficou comprovada a influência da história clínica no perfil do desenvolvimento. Observou-se, entretanto, tendência para desempenho adequado nas habilidades avaliadas entre as crianças que realizaram a triagem neonatal, receberam o diagnóstico e o tratamento para o hipotireoidismo congênito mais precocemente e que receberam dosagem mais elevada de levotiroxina no início do tratamento. Ressaltase a importância do acompanhamento fonoaudiológico longitudinal do desenvolvimento da comunicação nessa população.BACKGROUND: congenital hypothyroidism may cause alterations in the child's global development. AIM: to outline the development profile in children with congenital hypothyroidism, focusing on communication, and to verify the influence of clinical history on the outlined profile. METHOD: 35 children, with ages between 2 to 36 months, with congenital hypothyroidism detected by neonatal screening, and who were in treatment for at least one month using hormonal replacement were assessed using the Early Language Milestone Scale (ELM) and the Portage Operation Inventory (POI). The clinical history was obtained in an interview with the family and from the analysis of medical records. RESULTS: in the ELM, eleven children presented a poor performance in the expressive auditory function, two in the visual function and one in the receptive auditory function. In the POI, seven children presented a poor performance in the language section, five in cognitive section, four in the motor and social sections and three in the self-care section. There was no correlation between the results obtained in the assessments and the clinical history. CONCLUSION: most of the children presented adequate performances in the evaluated skills. For the children with altered performance, larger deficits were observed in the language section, for the expressive aspects, and in the cognitive section. The influence of clinical history on the development profile was not confirmed. However, a tendency for an adequate performance was observed in those children who underwent neonatal screening, received an early diagnosis and treatment for the congenital hypothyroidism and who received higher doses of thyroxine at the beginning of treatment. The importance of a speech-language follow-up for communication development in this population is highlighted

Motor, linguistic, personal and social aspects of children with Down syndrome

AbstractA global developmental delay is expected from Down syndrome, affecting motor, cognitive, linguistic and personal-social skills. However, not always these delays are proportional; different conditions occur due to several intrinsic and extrinsic variables that must be controlled to form groups of greater homogeneity.Objective To enhance personal-social, fine motor-adaptive, gross motor and linguistic skills among children with Down syndrome and compare them with typically developing children, matched for gender, socioeconomic status and mental age, while controlling some variables that interfere with the global development.Methods The ethical aspects were fulfilled (Case No. 040/2009). The following inclusion criteria were considered: participants without a history of prematurity, very low birth weight, congenital hypothyroidism, significant hearing and vision problems, and signs of Autism Spectrum Disorder. After the inclusion criteria were considered, 40 children participated in the study, of which 20 had Down syndrome (experimental group - EG), these being of both genders and with chronological ages ranging from 38 to 63 months, and the other 20 being typically developing children (control group - CG), matching the EG in terms of gender, socioeconomic status and mental age, with this age ranging from 13 to 50 months. The evaluation consisted in applying the Denver Developmental Screening Test II, a test that assesses areas such as personal-social, fine motor-adaptive, linguistic and gross motor development. The results were subjected to statistical analysis using Student’s t-test.Results A statistically significant difference was verified between the groups for the language and fine motor-adaptive areas.Conclusion Children with Down syndrome showed lower performance in language and fine motor skills when compared with typically developing children. There was no statistically significant difference in gross motor and personal-social areas. It is worth mentioning the importance of controlling the variables to deal with more homogeneous groups

Speech and language pathologist importance in the attendance of individuals with congenital hypothyroidism

TEMA: o hipotireoidismo congênito é uma alteração metabólica que traz conseqüência graves para indivíduos não tratados e mesmo as crianças que realizam o tratamento podem apresentar distúrbios do desenvolvimento. O Programa Nacional de Triagem Neonatal, instituído pelo Ministério da Saúde, prevê o acompanhamento longitudinal de indivíduos com equipe multidisciplinar. Entretanto, a Fonoaudiologia não é incluída nesta equipe. Deste modo, considerando a ocorrência de distúrbios da comunicação nestes indivíduos, realizou-se levantamento bibliográfico nas bases de dados Lilacs, MedLine e PubMed, no período de 1987 a 2007, referente às alterações em habilidades do desenvolvimento decorrentes do hipotireoidismo congênito. OBJETIVO: verificar, na literatura científica, presença de alterações do desenvolvimento em indivíduos com hipotireoidismo congênito e refletir sobre a importância da atuação fonoaudiológica, em conjunto com equipe multidisciplinar especializada, no acompanhamento dos mesmos. CONCLUSÃO: a literatura relata alterações nas habilidades do desenvolvimento (motoras, cognitivas, lingüísticas e de autocuidados) e destaca que crianças com hipotireoidismo congênito são de risco para alterações no desenvolvimento lingüístico e, portanto, necessitam do acompanhamento longitudinal do desenvolvimento comunicativo. Torna-se evidente a importância da atuação do fonoaudiólogo nos Programas de Triagem Neonatal credenciados pelo Ministério da Saúde. Ressalta-se ainda a necessidade de investigações referentes às outras alterações metabólicas contempladas nestes programas, nas quais o fonoaudiólogo pode atuar de modo a prevenir, habilitar e reabilitar os distúrbios da comunicação, contribuindo para o trabalho em equipe, promovendo saúde nesta população.BACKGROUND: congenital hypothyroidism is a metabolic disturbance that causes severe consequence for non-treated individuals and even the children thataccomplish the treatment can present development disturbances. The National Neonatal Screening Program, instituted by Health Ministry, foresees the individuals' longitudinal attendance with multidisciplinary team. However, the Speech and Language Pathologist is not included in this team. This way, considering the occurrence of communication disturbances in these individuals, a bibliographical assessment was carried out in Lilacs, MedLine and PubMed databases, in the period from 1987 to 2007, regarding the disturbances in development abilities arising from congenital hypothyroidism. PURPOSE: to check, in the scientific literature, for the presence of development alterations in individuals with congenital hypothyroidism and contemplate the importance of the speech and language pathologist performance, together with a multidisciplinary team specialized in their attendance. CONCLUSION: the literature reports disturbances in development abilities (motor, cognitive, linguistics and self-care) and stresses out that children with congenital hypothyroidism are under risk for disturbances in the linguistic development and, therefore, they need the longitudinal attendance of the communicative development. The importance of the speech and language pathologist performance in credential Neonatal Screening Programs by the Health Ministry becomes evident. It still fits to emphasize the need for investigations regarding the other metabolic alterations meditated in these programs, in which the speech and language pathologist can act in such a way to prevent, enable and rehabilitate the communication disturbances, contributing to the work in team, promoting health in this population.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) - Conselho Nacional de Pesquisa (CNPq

Adaptation of the picture exchange communication system in a school context

BACKGROUND: alternative communication. AIM: to evaluate the efficacy of the adapted Pecs and Picture Communication Symbols (PCS) in the communication of a child with cerebral palsy. METHOD: the participant of this study was a 9 year and 10 months old girl, with athetoid quadriplegia. All stages of the adapted Pecs were applied (Walter, 2000), using the PCS pictures (Johnson, 1998), associated with the functional curriculum proposed by LeBlanc (1991). An experimental AB Design was used in order to test the procedures. RESULTS: the subject was able to pass through all of the adapted Pecs phases and to use her communication board in school activities. CONCLUSION: the adapted Pecs proved to be effective in improving the subject's communication abilities.TEMA: comunicação alternativa. OBJETIVO: avaliar a eficácia do Sistema de Comunicação por Intercâmbio de Figuras (Pecs-Adaptado) e do Picture Communication Symbols (PCS) na comunicação de paralítico cerebral. MÉTODO: participou uma menina de 9a e 10m, com quadriplegia atetóide. Aplicou-se todas as fases do Pecs-Adaptado (Walter, 2000), usando figuras do PCS (Johnson, 1998), tendo como programa o currículo funcional (LeBlanc, 1991). Utilizou-se o delineamento experimental AB, tendo o sujeito como seu próprio controle. RESULTADOS: a participante passou por todas as fases propostas e usou sua prancha de comunicação nas atividades curriculares escolares. CONCLUSÃO: o Pecs-Adaptado mostrou-se efetivo para melhorar as habilidades comunicativas e escolares da participante.Universidade Federal de São CarlosUniversidade Vale do ItajaíUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUniversidade de São Paulo Faculdade de Odontologia de BauruUNIFESP, EPMSciEL

Assessment of receptive and expressive auditory and visual functions in pre-term children

TEMA: prematuridade como fator de risco para atraso no desenvolvimento da linguagem. OBJETIVO: verificar o desempenho de crianças prematuras quanto às áreas auditiva receptiva, expressiva e visual. MÉTODO: participaram da amostra 40 crianças de idade cronológica entre 12 e 24 meses. O grupo experimental (G1) foi composto por 20 crianças que apresentaram em seu histórico de vida os fatores de risco prematuridade e baixo peso ou muito baixo peso. A idade gestacional das crianças variou de 22 a 34, semanas todas com peso abaixo de 2500g; este grupo foi dividido em função do peso, ou seja, crianças de baixo peso e de muito baixo peso. O grupo controle (G2) foi composto por 20 crianças nascidas a termo com peso superior a 2500g, sem histórico para atraso do desenvolvimento. Os procedimentos constaram de entrevista com os pais e aplicação da Escala Early Language Milestone Scale (ELM). RESULTADOS: na comparação entre grupos, os resultados mostraram ser estatisticamente significativos. As crianças do G1 apresentaram prejuízo na área auditiva expressiva, auditiva receptiva e visual, embora algumas crianças tivessem apresentado resultados esperados para sua faixa etária, em alguma das funções avaliadas. A área mais prejudicada foi a área expressiva. CONCLUSÃO: as crianças do G1 apresentaram alteração nas áreas auditiva receptiva, auditiva expressiva e visual. As crianças prematuras com muito baixo peso apresentaram maiores prejuízos nas áreas avaliadas.BACKGROUND: prematurity as a risk factor for delay in language development. AIM: to verify the performance of premature children regarding their receptive and expressive auditory and visual abilities. METHOD: participants were 40 children with chronological ages between 12 and 24 months. The experimental group (G1) was composed by 20 children who presented report of prematurity and low or very low weight. The birth age varied from 22 to 34 weeks and weight was below 2500gr. This group was divided according to weight, i.e. children with low and very low weight. The control group (G2) was composed by 20 children born at term, with weight above 2500gr and with no report of development delay. The procedures consisted of an interview with the parents and the application of the Early Language Milestone Scale - ELM. RESULTS: when comparing the groups, the results indicate statistically significant differences. Children of G1 presented a poorer performance in the Expressive Hearing (EH), Receptive Hearing (RH) and Visual (V) areas, although a few children of this group presented the expected results for their age group in some of the tested abilities. The expressive auditory ability was the most affected. CONCLUSION: children of G1 presented deficits in the expressive and receptive auditory and visual functions. Premature children with very low weight presented higher deficits in the tested abilities

Observation of Communicative Behavior: an updated protocol from 0 to 72 months

ABSTRACT Purpose: to describe the updating of the Observation of Communicative Behavior protocol in the age group from 0 to 72 months. Methods: the Observation of Communicative Behavior protocol was revised and updated, with the insertion of the child development milestones in its various areas, becoming a child development screening tool. Results: the protocol includes 188 items, distributed in 10 age groups from zero to 72 months. The items were organized as follows: from zero to 24 months, divided by quarter (four age groups); from 24 to 36 months per semester (two age groups); and from 36 to 72 months, divided by year (four age groups). The items covered the areas of child development and its main milestones. The score is registered in the protocol and a score of 0 - does not perform the action or behavior, 1 - performs the action in an atypical, restricted manner or it is being acquired, 2 - properly performs the action/behavior, is attributed to the response, after analysis. Few materials and a structured environment are needed to apply the protocol. Conclusion: the updating of the Observation of Communicative Behavior protocol has a direct impact on the initial assessment of children with or without suspected delay in child development and should be used by health professionals in monitoring typical child development (routine) or in cases where the child receives specific stimulation

Case report: Guillain-Barre syndrome - language development delay

The aim of the study was to describe the Guillain-Barré syndrome development and speech and language pathology manifestations. It describes the clinical picture of a speech and language pathology, and the revaluation 7 months after the symptoms beginning, through formal and informal tests application and auditory evaluation. In the revaluation, the results showed intentional communication, primary functions, restricted participation in dialogic activity, isolated words productions, orders understanding linked to the context, alimentary abilities return. Peripheral audition normality. Hospitalization, family conducts front to the disease and absence of school activities influenced in the communicative acting. The Guillain-Barré syndrome emergence, as well as the family answer to the child’s condition, influenced in a negative way the language development.O objetivo deste estudo foi descrever o desenvolvimento da síndrome de Guillain-Barré e manifestações fonoaudiológicas. É relatado breve histórico do quadro clínico e reavaliação fonoaudiológica 7 meses após o início dos sintomas, por meio de aplicação de testes formais, informais e avaliação audiológica. Na reavaliação, os resultados indicaram comunicação intencional, funções primárias, restrita participação em atividade dialógica, produções de palavras isoladas, compreensão de ordens ligadas ao contexto, retorno das habilidades alimentares. Foi constatada normalidade da audição periférica. Hospitalização, condutas familiares frente à doença e ausência de atividades escolares influenciaram no desempenho comunicativo. O aparecimento da Síndrome de Guillain-Barré influenciou de forma negativa no desenvolvimento da linguagem, assim como a resposta familiar à condição da criança

Psycholinguistic and school performance of brothers with myelomeningocele

TEMA: mielomeningocele e consequências para o desenvolvimento de habilidades psicolinguísticas e escolares. PROCEDIMENTOS: o objetivo deste estudo foi descrever e refletir sobre o desempenho psicolinguístico e escolar de irmãos com mielomeningocele lombar baixa. Participaram do estudo um menino de 14 anos e 5 meses (P1) e sua irmã de 6 anos e 6 meses (P2). Os procedimentos constaram de entrevista com familiares, Observação do Comportamento Comunicativo (OCC), Teste de Vocabulário por Imagens Peabody - TVIP, Teste Illinóis de Habilidades Psicolinguísticas (ITPA), Perfil de Habilidades Fonológicas (PHF), Teste de Desempenho Escolar (TDE), e Reconhecimento de letras e números (RLN). A análise dos resultados foi descritiva respeitando os manuais dos instrumentos. RESULTADOS: a linguagem oral encontra-se sem alteração evidente. No ITPA e PHF, verificou-se que P1 e P2 apresentaram dificuldade nas habilidades de memória, closura auditiva, expressão verbal, combinação de sons e consciência fonológica. P1 ainda apresentou dificuldade na habilidade de recepção visual e P2 nas habilidades de associação auditiva e closura gramatical. Ambas as crianças apresentaram alteração nas atividades de aprendizagem. CONCLUSÃO: os participantes do estudo apresentaram comportamento comunicativo, habilidades de linguagem oral e vocabulário receptivo sem alterações evidentes. P1 e P2 apresentaram alterações nas habilidades psicolinguísticas bem como no desempenho de atividades envolvendo leitura, escrita e aritmética. As dificuldades apresentadas causam impacto importante nas atividades acadêmicas, demonstrando vulnerabilidade cerebral no sistema de suporte para atividade de aprendizagem.BACKGROUND: meningomyelocele and consequences on the development of psycholinguistic and school abilities. PROCEDURES: the purpose of this study was to describe and reflect on the psycholinguistic and school performance of siblings with low lumbar myelomeningocele. The study included a boy, 14 years and 5 months (P1) and his sister, 6 years and 6 months (P2). The procedures consisted of an interview, Communicative Behavior Observation (CBO), Vocabulary Test Peabody Picture - PPVT, Illinois Test of Psycholinguistic Abilities (ITPA), Phonological Abilities Profile (PAP), School Performance Test (SPT), and recognition of letters and numbers (RLN). The analysis was descriptive and respecting the manuals of the instruments. RESULTS: the oral language has no obvious change. In ITPA and PAP, we found that P1 and P2 had difficulty in memory skills, closure listening, verbal, combination of sounds and phonological awareness. P1 still had difficulty in the ability of visual reception and P2 in the abilities of auditory association and closure grammar. Both children showed difficulties in the learning activities. CONCLUSION: the study subjects performed quite well in communicative skills, oral language and receptive vocabulary without obvious changes. P1 and P2 had changes in psycholinguistic skills and performance of activities involving reading, writing and arithmetic. Difficulties cause major impact on academic activities, demonstrating the vulnerability of the brain in the system supporting learning activity

Communicative and psycholinguistic abilities in children with phenylketonuria and congenital hypothyroidism

The Neonatal Screening for Inborn Errors of Metabolism of the Association of Parents and Friends of Special Needs Individuals (APAE) - Bauru, Brazil, was implanted and accredited by the Brazilian Ministry of Health in 1998. It covers about 286 cities of the Bauru region and 420 collection spots. Their activities include screening, diagnosis, treatment and assistance to congenital hypothyroidism (CH) and phenylketonuria (PKU), among others. In 2005, a partnership was established with the Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, University of São Paulo, Bauru, seeking to characterize and to follow, by means of research studies, the development of the communicative abilities of children with CH and PKU. OBJECTIVE: The aim of this study was to describe communicative and psycholinguistic abilities in children with CH and PKU. MATERIALS AND METHODS: Sixty-eight children (25 children aged 1 to 120 months with PKU and 43 children aged 1 to 60 months with CH) participated in the study. The handbooks were analyzed and different instruments were applied (Observation of Communication Behavior, Early Language Milestone Scale, Peabody Picture Vocabulary Test, Gesell & Amatruda's Behavioral Development Scale, Portage Operation Inventory, Language Development Evaluation Scale, Denver Developmental Screening Test, ABFW Child Language Test-phonology and Illinois Test of Psycholinguistic Abilities), according to the children's age group and developmental level. RESULTS: It was observed that the children with PKU and CH at risk for alterations in their developmental abilities (motor, cognitive, linguistic, adaptive and personal-social), mainly in the first years of life. Alterations in the psycholinguistic abilities were also found, mainly after the preschool age. Attention deficits, language and cognitive alterations were more often observed in children with CH, while attention deficits with hyperactivity and alterations in the personal-social, language and motor adaptive abilities were more frequent in children with PKU. CONCLUSION: CH and PKU can cause communicative and psycholinguistic alterations that compromise the communication and affect the social integration and learning of these individuals, proving the need of having these abilities assisted by a speech and language pathologist