ABSTRACT Purpose: to evaluate the validity and reliability of the Protocol for Functional Evaluation of Swallowing by Nasal Endoscopy as a multidisciplinary assessment tool for dysphagia. Methods: a protocol including six items related to structural and functional aspects of the pharyngeal phase with an instrumental study conducted in two phases. In the first phase, content validity was assessed using the Content Validity Index (CVI), based on the judgment of seven dysphagia experts. In the second phase, the instrument's reliability was analyzed through a pilot test applied to 120 patients diagnosed with oropharyngeal dysphagia, calculating Cronbach's alpha coefficient and item-total correlations. Results: the protocol demonstrated adequate content validity, with item CVI values greater than 0.78 and an overall CVI of 0.94. Internal consistency was good (α = 0.86), with item-total correlations greater than 0.65 (p < 0.001). The sample consisted primarily of patients with neurological dysphagia (64.2%), predominantly due to stroke sequelae, and with moderate severity (73.3%). Pharyngeal residue (71.7%) was the most frequent finding in the functional assessment. Conclusion: the Protocol for Functional Evaluation of Swallowing by Nasal Endoscopy demonstrated adequate content validity and reliability. It allows for a structured clinical evaluation, contributing to the detection of functional alterations and to therapeutic decision-making.
ABSTRACT Purpose: to investigate the strategies adopted by parents of children with autism spectrum disorder in implementing the DHACA® method. Methods: cross-sectional, qualitative, exploratory study using primary data collected through structured interviews with caregivers of children undergoing speech-language-hearing intervention with the DHACA® method. The interviews were transcribed, categorized, and coded to identify patterns according to the content analysis proposed by Bardin. Results: the analysis showed that family members adopted various communication support strategies. They used the DHACA® book, articulated with the child's interests, and made it constantly available and accessible at home. Communication partners also demonstrated engagement with the method and the appropriation of the proposed strategies, favoring its functional use in the child's daily life. Other categories emerged during the interview, such as barriers, context of use, communication partners, and impact on the family. Conclusion: family members used strategies suggested by therapists, such as modeling and physical, visual, and verbal cues, and provided daily communication opportunities using the DHACA® communication book. These strategies enhanced the development of children's communication skills and the participation and engagement of close communication partners.
ABSTRACT Purpose: to obtain evidence of the content validity of the TRILHAR instrument. Methods: a cross-sectional and quantitative study using the TRILHAR instrument aimed to screen the receptive and expressive vocabulary of children between three and seven years old. The sample was composed of 15 judges specializing in the area of children, who evaluated the instrument in terms of theoretical rationale, screening principles and materials, in addition to filling out a form to evaluate the figures. For data analysis, the content validity index (CVI), the content validity index per item (CVI-I) and the content validity coefficient (CVC), were calculated. For the figures, the cutoff point adopted was 75% positive evaluations. Results: all the criteria presented adequate CVI and CVC. However, in the IVC-I, the subcriteria graphic aspects and clarity in the description of the application booklet, were below expectations. In the analysis of the figures, 17 out of 100 presented a need for reformulation. Conclusion: the TRILHAR has adequate content validity for screening the vocabulary of children between three and seven years of age. Its items have an adequate semantic structure, appropriate figures and an application booklet suitable for use in clinical and educational contexts.
RESUMO Objetivo: analisar a modificação na autopercepção do comportamento auditivo, após o treinamento auditivo, por meio da Escala de Autopercepção de Habilidades do Processamento Auditivo Central expandida. Métodos: 26 indivíduos entre 18 e 59 anos, de ambos os sexos, com Transtorno do Processamento Auditivo Central, sem perda auditiva bem como alteração timpanométrica, psiquiátrica e/ou neurológica, realizaram 12 sessões de treinamento auditivo on-line. Os sujeitos preencheram a escala antes e após a intervenção. Utilizaram-se os testes Shapiro-Wilk, Qui-Quadrado e T pareado com nível de significância de 5%. Resultados: a maioria era do sexo feminino, com idade média de 25,5 anos, cursavam o ensino superior (65,4%) e apresentavam alteração no processamento temporal (61,5%). Houve diferença significativa entre os autorrelatos de queixas antes e após o treinamento auditivo, com diminuição da frequência de indivíduos com dificuldade de aprendizagem relacionada à compreensão e aumento da queixa de dificuldade em compreender a informação quando parte dela não era ouvida. Não houve diferença significativa entre a pontuação média da escala antes e após a intervenção. Conclusão: houve variação em apenas duas queixas autorreferidas, sendo estas, dificuldade para compreender a fala quando parte da informação não era ouvida e dificuldade de aprendizagem relacionada à compreensão. Não houve diferença significativa nas pontuações totais antes e após o treinamento auditivo, o que limita o uso da escala para monitoramento terapêutico.
ABSTRACT Purpose: to analyze changes in self-perception of auditory behavior, following auditory training using the Expanded Scale of Self-Perception of Central Auditory Processing Skills (In Portuguese EAPAC). Methods: twenty-six individuals between the ages of 18 and 59, of both sexes, with Central Auditory Processing Disorder, without hearing loss or tympanometric, psychiatric, and/or neurological abnormalities, underwent 12 sessions ofonlineauditory training. The subjects completed the scale before and after the intervention. The Shapiro-Wilk, chi-square, and paired t-tests were used, with a significance level of 5%. Results: the majority were females, with a mean age of 25.5 years; they were enrolled in higher education (65.4%) and exhibited abnormalities in temporal processing (61.5%). There was a significant difference between self-reported complaints before and after auditory training, with a decrease in the frequency of individuals reporting learning difficulties related to comprehension and an increase in complaints of difficulty understanding information when part of it was not heard. There was no significant difference between the mean scale scores before and after the intervention. Conclusion: there was variation in only two self-reported complaints: difficulty understanding speech when part of the information was not heard and learning difficulties related to comprehension. There was no significant difference in total scores before and after auditory training, which limits the scale’s usefulness for therapeutic monitoring.
ABSTRACT Purpose: to systematize stress factors related to work changes during the pandemic and the implications for the mental health of Primary Healthcare workers in the post-pandemic period. Methods: an integrative literature review of the BVS, CAPES Journals, PubMed, SciELO, ScienceDirect, and Web of Science databases, with a score of 80% or higher, according to the Critical Appraisal Skills Programme checklist. Data processing and analysis considered personal, organizational, and social aspects in the study design. Literature Review: a total of 17 studies were included, which indicated that, during the pandemic, workers faced significant stressors, such as increased working hours and absenteeism, adaptation to new technologies, resource shortages, high levels of anxiety, depression, and stress, as well as negative social implications, such as discrimination and stigmatization, which contributed to high levels of burnout and other mental health problems. In the post-pandemic period, high prevalences of mental health problems persisted, indicating the lasting nature of impacts. Conclusion: the findings show that the organizational and psychosocial stressors, during the pandemic, continue to have a negative impact on the mental health of Primary Healthcare (PHC) workers, highlighting the need for support policies and ongoing interventions focused on the well-being of these professionals.
RESUMO Os efeitos da epilepsia podem comprometer o desenvolvimento linguístico de indivíduos e impactam a aprendizagem e no desempenho acadêmico. O estudo examina dificuldades enfrentadas por estudantes com epilepsia e comorbidades como o Transtorno do Déficit de Atenção e Hiperatividade (TDAH) e o Transtorno do Desenvolvimento Intelectual (TDI). A pesquisa qualitativa e descritiva analisa casos clínicos de escolares com idade de 11 a 16 anos, 2 do sexo masculino e 2 do feminino, matriculados do 5º ao 8º ano do Ensino Fundamental I, avaliando competências e habilidades, tais como vocabulário, consciência fonológica, memória de trabalho fonológica, leitura, escrita, discurso narrativo oral e escrito. Os resultados mostram que quadros de epilepsia com comorbidades prejudicam significativamente o desempenho acadêmico, afetando a memória, a organização discursiva e o processamento linguístico. O impacto da epilepsia varia conforme o tipo de crise e a presença de comorbidades. Casos com controle adequado das crises e sem comorbidades graves apresentaram desempenhos mais próximos do esperado. O estudo conclui que há déficits na linguagem, nos aspectos de vocabulário, processamento fonológico, consciência sintática, leitura, escrita e discurso em pacientes com comorbidades. Ressalta-se a importância do diagnóstico precoce, intervenções terapêuticas personalizadas e estratégias educacionais adaptadas para reduzir os prejuízos causados pela epilepsia. Além disso, destaca-se a necessidade de ampliar as investigações sobre a relação entre epilepsia e desenvolvimento linguístico.
RESUMO Objetivo: investigar as estratégias adotadas pelos pais de crianças com Transtorno do Espectro do Autismo na implementação do método DHACA®. Métodos: estudo transversal de abordagem qualitativa e de natureza exploratória, com uso de dados primários, coletados por meio de entrevista estruturada com responsáveis de crianças submetidas à intervenção fonoaudiológica com o método DHACA®. As entrevistas foram transcritas, categorizadas e codificadas, permitindo a identificação de padrões, conforme a análise do conteúdo proposta por Bardin. Resultados: a análise evidenciou que os familiares adotaram diversas estratégias de apoio à comunicação. Observou-se ainda a utilização do livro DHACA® articulada aos interesses da criança, bem como sua oferta constante e acessível no ambiente domiciliar. Além disso, os parceiros de comunicação demonstraram engajamento no método e na apropriação das estratégias propostas, favorecendo o uso funcional no cotidiano da criança. Outras categorias, surgiram durante a entrevista, como: barreiras, contexto de uso, parceiros de comunicação e impactos no contexto familiar. Conclusão: os familiares utilizaram estratégias sugeridas pelos terapeutas, como modelagem, dica física, visual, verbal, além de oferecer oportunidades diárias para comunicação com uso do livro de comunicação DHACA®. As estratégias potencializaram o desenvolvimento das habilidades de comunicação das crianças e a participação e engajamento dos parceiros de comunicação próximos.
RESUMO Objetivo: sistematizar os fatores estressores relacionados às mudanças no trabalho durante a pandemia e as implicações para a saúde mental dos trabalhadores da Atenção Primária à Saúde no período pós-pandêmico. Métodos Trata-se de uma revisão integrativa da literatura nas bases de dados BVS, CAPES Journals, PubMed, SciELO, ScienceDirect e Web of Science, com uma pontuação igual ou superior a 80%, de acordo com a lista de verificação do Critical Appraisal Skills Programme. Revisão da Literatura: foram incluídos 17 estudos, os quais indicam que, durante a pandemia, os trabalhadores enfrentaram estressores como aumento das jornadas e do absenteísmo, adaptação a novas tecnologias, escassez de recursos, altos níveis de ansiedade, depressão e estresse, além de implicações sociais negativas, como discriminação e estigmatização, que contribuíram para níveis elevados de Burnout e outros problemas de saúde mental. No período pós-pandêmico, observa-se a persistência de altas prevalências dos agravos à saúde mental, indicando a natureza duradoura dos impactos. Conclusão: os achados demonstram que os estressores organizacionais e psicossociais durante a pandemia continuam a repercutir negativamente na saúde mental dos trabalhadores da Atenção Primária à Saúde (APS) evidenciando a necessidade de políticas de apoio e intervenções contínuas voltadas para o bem-estar desses profissionais.
RESUMO Objetivo: obter as evidências de validade de conteúdo do instrumento TRILHAR. Métodos: trata-se de um estudo transversal e quantitativo, utilizando o instrumento TRILHAR, destinado à triagem do vocabulário receptivo e expressivo de crianças entre três e sete anos. A amostra foi composta por 15 juízes especialistas na área infantil, que avaliaram o instrumento quanto ao Racional Teórico, Princípios da Triagem e Materiais, além de preencherem um formulário para avaliação das figuras. Para a análise dos dados, calcularam-se o Índice de Validade de Conteúdo (IVC), o Índice de Validade de Conteúdo por Item (IVC-I) e o Coeficiente de Validade de Conteúdo (CVC). Para as figuras, o ponto de corte adotado foi de 75% de avaliações positivas. Resultados: todos os critérios apresentaram IVC e CVC adequados. Contudo, no IVC-I, os subcritérios aspectos gráficos e clareza na descrição do caderno de aplicação ficaram abaixo do esperado. Na análise das figuras, 17 das 100 apresentaram necessidade de reformulação. Conclusão: o TRILHAR apresenta validade de conteúdo adequada para a triagem do vocabulário de crianças entre três e sete anos de idade. Seus itens apresentam estrutura semântica adequada, figuras apropriadas e caderno de aplicação adequado para o seu uso nos contextos clínicos e educacionais.
RESUMEN Objetivo: evaluar la validez y confiabilidad del Protocolo de evaluación funcional de la deglución por nasofibroscopía, como un instrumento de evaluación multidisciplinar para la disfagia. Metodos: el protocolo incluye 6 ítems relacionados con aspectos estructurales y funcionales de la fase faríngea. Se realizó un estudio instrumental en dos fases. En la primera, se evaluó la validez de contenido mediante el Índice de Validez de Contenido (IVC), a partir del juicio de 7 expertos en disfagia. En la segunda, se analizó la confiabilidad del instrumento mediante una prueba piloto aplicada a 120 pacientes con diagnóstico de disfagia orofaríngea, calculando el coeficiente alfa de Cronbach y las correlaciones ítem-total. Resultados: el protocolo mostró una adecuada validez de contenido, con valores de IVC por ítem superiores a 0,78 y un IVC global de 0,94. La consistencia interna fue buena (α = 0,86), con correlaciones ítem-total superiores a 0,65 (p < 0,001). La muestra estuvo conformada principalmente por pacientes con disfagia de origen neurológico (64,2%), predominando las secuelas de accidente cerebrovascular, y con severidad moderada (73,3%). En la evaluación funcional, el hallazgo más frecuente fue la presencia de residuos faríngeos (71,7%). Conclusión: el protocolo de evaluación funcional de la deglución por nasofibroscopía, ha mostrado una adecuada validez de contenido y confiabilidad; y permite una valoración clínica estructurada, contribuyendo a la detección de alteraciones funcionales y a la toma de decisiones terapéuticas.
ABSTRACT The effects of epilepsy may compromise language development and negatively impact learning and academic performance. This study investigated the difficulties experienced by students with epilepsy and comorbidities such as Attention-Deficit/Hyperactivity Disorder (ADHD) and Intellectual Developmental Disorder (IDD). This qualitative and descriptive study analyzed clinical cases of four school-aged children and adolescents, aged 11 to 16 years, including two males and two females enrolled in the 5th to the 8th grades of elementary education. The assessment focused on vocabulary, phonological awareness, phonological working memory, reading, writing, and oral and written narrative discourse. The results indicated that epilepsy, when comorbid with other disorders, significantly impaired academic performance, especially regarding memory, discourse organization, and language processing. The impact of epilepsy varied according to seizure type and the presence of associated comorbidities. Participants with adequate seizure control and without severe comorbidities showed performances closer to expectations. The findings revealed deficits in expressive vocabulary, phonological processing, syntactic awareness, reading, writing, and discourse abilities. Early diagnosis, individualized therapeutic intervention, and adapted educational strategies are essential to minimize language and academic impairments associated with epilepsy. Further investigations regarding the relationship between epilepsy and language development are warranted.
ABSTRACT Purpose: to analyze and relate the perception of parents of students with hearing loss (HL) and their teachers regarding the impact of HL on school relationships. Methods: 26 parents/guardians and 16 teachers of schoolchildren linked to a Hearing Health Program participated. A structured questionnaire with objective questions was applied. Data were analyzed with descriptive and inferential statistics. Results: most parents (53.8%) considered that school favors the social life of their children, although 34.6% report difficulties in school relationships. Among teachers, 100% indicated that school favors social relationships and friendship, but 75% reported difficulties in the teaching process. There was agreement between the groups regarding the presence of school inclusion and the existence of barriers, especially related to communication and teaching resources, although without statistically significant differences. Conclusion: parents and teachers recognize the importance of school in promoting the social interaction of schoolchildren presented with HL and share similar perceptions about the impacts of disability on school interactions. Teachers indicate challenges in the teaching process and in the use of assistive technologies, pointing to the need for continuing education and inclusive strategies that favor the permanence, accessibility and participation of these students.
RESUMEN Objetivo: validar la versión peruana del cuestionario Eating Assessment Tool-10 (EAT-10pe) para evaluar la autopercepción de disfagia en la población adulta de Perú. Incluyendo la traducción, adaptación cultural y evaluación de sus propiedades psicométricas en adultos peruanos con sospecha o diagnóstico de disfagia orofaríngea. Métodos: el proceso de adaptación cultural se incluyeron traducción directa e inversa, síntesis de la traducción, revisión por un comité de expertos multidisciplinario y una prueba piloto con 30 adultos peruanos. Para la evaluación psicométrica en una muestra de 120 participantes (edad media 64,7 años, 71,67% mujeres), se calculó la consistencia interna, la validez de constructo, la validez concurrente, y la reproducibilidad test-retest. Resultados: el EAT-10pe mostró una excelente consistencia interna (Alfa de Cronbach = 0,89) y una estructura unidimensional que explicó el 58,4% de la varianza total. La reproducibilidad fue excelente con un coeficiente de correlación intraclase de 0,92. Se encontraron correlaciones significativas con el test volumen-viscosidad (r = 0,67, p < 0,001) y signos clínicos de aspiración (r = 0,53, p < 0,01). Conclusión: la traducción, adaptación cultural y la valoración de sus propiedades psicométricas del Eating Assessment Tool-10 (EAT-10pe) en adultos peruanos con sospecha o diagnóstico de disfagia orofaríngea, resultó ser un instrumento breve, confiable y válido para evaluar la autopercepción de disfagia en adultos.
ABSTRACT Purpose: to determine measures derived from the fundamental frequency (f₀) of spontaneous speech of oral deaf children, described according to age, sex, and the type of hearing technology they used. Methods: a prospective cross-sectional study with 25 oral deaf children, aged 7 months to 10 years and 10 months, with severe to profound sensorineural hearing loss. Acoustic analysis was performed using a multiparametric measurement script: measures derived from f₀: mean, median, standard deviation (SD), minimum, and maximum values. Descriptive statistical procedures with the Mann-Whitney test were applied to observe effects per group of sex, age, and type of hearing technology. Statistical significance was set at p ≤ 0.05. Results: f₀ values in Hertz (mean; median; SD; minimum; maximum) were as follows: 7m-3y11m (345.4; 363; 61.17; 267.00; 424.20); 4y-5y11m (328.2; 326.4; 32.77; 285; 385.80); 6y-7y11m (289.2; 270.6; 47.25; 257.4; 358.2); 8y-10y10m (270.6; 276.6; 14.32; 245.6; 280.2). There was no significant difference between sex and the type of technology. Values derived from f₀ differed significantly between age groups; values decreased as age increased. Conclusion: values derived from f₀ of spontaneous speech (mean, median, SD, minimum, and maximum) differed statistically between age groups, decreasing with increasing age.
ABSTRACT Purpose: to verify which possible motor speech characteristics can be observed in verbal children with an exclusive diagnosis of autism spectrum disorder (ASD) without motor speech complaints. Methods: the final sample consisted of 20 verbal children, all Brazilian Portuguese speakers, of both sexes, aged 36 to 72 months (3 to 6 years), with an exclusive medical diagnosis of ASD. The speech-language-hearing version of the Childhood Apraxia of Speech (CAS) Checklist was applied to all children included in the study in a playful context to verify their speech characteristics. The scoring was based on a numerical scale, assigning a value of 0 for "never presented" and 1 for the categories "presented" or "currently presents". Finally, a descriptive analysis of the data was performed. Results: speech characteristics indicative of CAS or other motor speech disorders had a lower incidence in children with ASD, while language and sensory issues were more frequently observed in the study sample. Conclusion: children with a sole diagnosis of ASD, without global motor and/or speech complaints, obtained low scores on a checklist developed to detect CAS characteristics.
