ABSTRACT Purpose To identify the presence of different types of anxiety disorders in transgender men and women and to examine a possible relationship with vocal self-perception. Methods This was a cross-sectional, exploratory study with a quantitative approach, conducted with 15 transgender men and 15 transgender women aged 18 and 45 years. The following instruments were applied: (a) a sociodemographic questionnaire; (b) the Transgender Woman Voice Questionnaire (TWVQ); (c) an adaptation of the TWVQ for the male gender; (d) the Vocal Symptoms Scale (VSS); and (e) a selected section of the Mini International Neuropsychiatric Interview (M.I.N.I.), focused on anxiety disorders. Data were processed and analyzed using descriptive and inferential statistics, with the significance level set at p < 0.05. Results Transgender men and women showed vocal dissatisfaction and similar scores in the physical domain of the VSS, indicating vocal symptoms with physical impact in both groups. Transgender women presented higher scores on the TWVQ and on the total VSS. Significant correlations were observed between psychological alterations and vocal symptoms, particularly between agoraphobia and the total VSS score. Conclusion The TWVQ, originally developed for transgender women, indicates vocal dissatisfaction in both groups studied, with no direct association with the presence of anxiety disorders. The VSS showed significant correlations between vocal symptoms and the presence of anxiety disorders such as agoraphobia and social phobia.
RESUMO Objetivo Identificar se há presença de tipos de ansiedade em homens e mulheres transgênero e verificar uma possível relação com a autopercepção vocal. Métodos Estudo transversal, exploratório, com abordagem quantitativa, realizado com 15 homens e 15 mulheres transgênero, entre 18 e 45 anos de idade. Foram aplicados: questionário sociodemográfico; protocolo Trans Woman Voice Questionnaire (TWVQ); TWVQ adaptado para o gênero masculino; Escala de Sintomas Vocais (ESV) e recorte da escala Mini International Neuropsychiatric Interview, focado em transtornos de ansiedade. Os dados foram tratados e analisados por meio de estatística descritiva e inferencial, considerando p=0,05. Resultados Homens e mulheres transgênero apresentaram insatisfação vocal e pontuações semelhantes no domínio físico da ESV, indicando sintomas vocais com impactos físicos em ambos os grupos. Mulheres transgênero apresentaram escores mais elevados no TWVQ e na ESV total. Foram observadas fortes correlações entre alterações psicológicas e sintomas vocais, especialmente entre agorafobia e pontuação total no ESV. Conclusão O TWVQ, originalmente desenvolvido para mulheres trans, sugere insatisfação vocal para ambos os grupos estudados, sem associação direta com a presença dos tipos de ansiedade. A ESV apresenta correlações significativas entre sintomas vocais e presença de transtornos de ansiedade, como agorafobia e fobia social.
ABSTRACT Purpose To compare the level of empathy reported by medical students to that perceived by evaluators during simulated medical consultations. Methods This was a cross-sectional observational study conducted with 41 medical students. To assess self-perceived empathy, the Empathy Inventory (EI) was used—a 40-item self-report protocol that evaluates empathy based on four factors: Affective Sensitivity (AS), Altruism (AL), Perspective Taking (PT), and Interpersonal Flexibility (IF). To assess empathy from the perspective of others, simulated consultations were conducted in which students performed medical appointments with professional actors. The simulations were video-recorded and evaluated by external judges who were instructed to respond to an adapted version of the CARE Scale (Consultation and Relational Empathy). Results Regarding EI scores, the sample showed higher mean scores, respectively, for the following factors: Affective Sensitivity, Altruism, Interpersonal Flexibility, and Perspective Taking. The CARE scale showed a moderate overall mean among the three evaluators. The emotions most frequently identified were fear, sadness, and doubt. No correlation was found between EI and CARE scores. Good internal consistency was observed among the evaluators. Conclusion The study showed that although medical students report higher levels of empathy, this skill is not consistently manifested in simulated practice. The absence of correlation between self-reported empathy and observer-rated empathy suggests a possible gap between internal perception and the observable expression of empathy.
RESUMO Objetivo Verificar os níveis de empatia relatados por estudantes de Medicina e sua relação com a empatia percebida por avaliadores durante simulações de atendimento médico. Métodos Estudo observacional com delineamento transversal, realizado com 41 estudantes de Medicina. Para avaliar a habilidade de empatia autopercebida, foi utilizado o Inventário de Empatia, protocolo de autopercepção com 40 itens que avalia a empatia a partir de quatro fatores: Sensibilidade Afetiva, Altruísmo, Tomada de Perspectiva e Flexibilidade Interpessoal. Para avaliar a habilidade de empatia sob a perspectiva do outro, foram realizadas simulações de atendimento nas quais os estudantes simularam um atendimento médico com atores profissionais. As simulações foram registradas em vídeo e avaliadas por juízes externos que foram orientados para responder à escala Consultation and Relational Empathy (CARE) de forma adaptada. Resultados Em relação à pontuação do Inventário de Empatia, a amostra apresentou maiores médias nos fatores, respectivamente de: Sensibilidade Afetiva, Altruísmo, Flexibilidade Interpessoal e Tomada de Perspectiva. A escala CARE apresentou média geral moderada entre os três avaliadores. As emoções mais identificadas foram medo, tristeza e dúvida. Não houve correlação entre a pontuação do Inventário de Empatia e da escala CARE. Houve boa consistência interna entre os avaliadores. Conclusão Embora os estudantes de Medicina relatem maiores níveis de empatia, essa habilidade não se manifesta de forma consistente nas práticas simuladas. A ausência de correlação entre a empatia autorrelatada e a avaliada por observadores sugere uma possível lacuna entre a percepção interna e a expressão observável da empatia.
ABSTRACT The letter discusses the importance of the conscious development of therapeutic resources in speech-language pathology for children, highlighting them as mediators of the clinical process and not as ends in themselves. It reflects on the need for personalized resources, considering the child's unique characteristics and therapeutic objectives. It warns against the risks of uncritically using standardized and commercially available materials, which can shift the focus of the intervention. Finally, it emphasizes the importance of technical-scientific rigor and critical academic training in the creation and use of these resources.
ABSTRACT Purpose To compare hearing thresholds obtained with narrowband noise (NBN) and pure tone in individuals with and without complaints of tinnitus, considering the presence or absence of hearing loss. Methods A descriptive and cross-sectional study was conducted with 35 participants, selected for convenience, aged between 19 and 82 years (mean 47.5±18.4). The study group (SG) consisted of 25 individuals with tinnitus, 15 with sensorineural hearing loss and 10 without hearing loss, and the control group (CG) consisted of 10 individuals without tinnitus, five with sensorineural hearing loss and five with normal hearing thresholds. Pure tone and NBN audiometry were performed, along with the application of the Tinnitus Handicap Inventory (THI) and the Visual Analog Scale (VAS) for tinnitus. The order of the tests was randomized, and the data were analyzed using the Jamovi software, with p<0.05. Results In the GE, hearing thresholds were lower with RBE than with pure tone audiometry, both in individuals without loss (12.1±4.8 versus 8.8±4.4 dBNA; p=0.001; 95% CI=0.56–1.70) in those with hearing loss (32.3±17.4 versus 27.2±17.6 dBNA; p<0.001; 95% CI=0.54–1.41). In the CG, this difference was observed only among participants with hearing loss (41.6±23.8 versus 34.1±22.3 dBNA; p<0.001; 95% CI=0.82–2.94). Age did not influence the THI and VAS scores, but there was a strong correlation between the two measures of self-perceived tinnitus (p<0.001; r=0.796). Conclusion NBN yielded lower hearing thresholds at most frequencies in individuals with tinnitus and sensorineural hearing loss. However, the sample size limits the generalization of the results, and further studies are needed.
RESUMO A carta discute a importância da elaboração consciente de recursos terapêuticos na Fonoaudiologia na área da infância, destacando-os como mediadores do processo clínico e não como fins em si mesmos. Reflete-se sobre a necessidade de individualização dos recursos, considerando as singularidades da criança e os objetivos terapêuticos. Alerta-se para os riscos do uso acrítico de materiais padronizados e comercializados, que podem deslocar o foco da intervenção. Por fim, enfatiza-se a importância do rigor técnico-científico e da formação acadêmica crítica na criação e utilização desses recursos.
RESUMO Objetivo Comparar os limiares auditivos obtidos com ruído de banda estreita (RBE) e na audiometria de tom puro em indivíduos com e sem queixa de zumbido, considerando a presença ou ausência de perda auditiva. Métodos Pesquisa descritiva e transversal com 35 participantes, selecionados por conveniência, com idades entre 19 e 82 anos (média 47,5±18,4). O grupo de estudo (GE) foi composto por 25 indivíduos com zumbido, sendo 15 com perda auditiva sensorioneural e dez sem perda auditiva, e o grupo-controle (GC) por dez indivíduos sem zumbido, sendo cinco com perda auditiva sensorioneural e cinco com limiares auditivos normais. Realizou-se audiometria de tom puro e RBE, aplicação do Tinnitus Handicap Inventory (THI) e da Escala Visual Analógica (EVA) para zumbido. A ordem dos testes foi randomizada e os dados foram analisados com o programa Jamovi, adotando-se p<0,05. Resultados No GE, os limiares auditivos foram menores com o RBE em relação à audiometria de tom puro, tanto em indivíduos sem perda auditiva (12,1±4,8 versus 8,8±4,4 dBNA; p=0,001; IC95%=0,56–1,70), quanto com perda (32,3±17,4 versus 27,2±17,6 dBNA; p<0,001; IC95%=0,54–1,41). No GC, tal diferença foi observada apenas entre os participantes com perda auditiva (41,6±23,8 versus 34,1±22,3 dBNA; p<0,001; IC95%=0,82–2,94). A idade não influenciou os escores do THI e EVA, mas houve forte correlação entre as duas medidas de autopercepção do zumbido (p<0,001; r=0,796). Conclusão Os testes realizados com ruído de banda estreita (RBE) resultaram em limiares auditivos menores na maioria das frequências em indivíduos com zumbido e perda auditiva sensorioneural. Contudo, o tamanho amostral limita a generalização dos resultados, sendo necessários estudos adicionais.
ABSTRACT Purpose To evaluate the factors associated with the burden of caregivers of children and adolescents with autism spectrum disorder (ASD), identifying which variables have the greatest impact on their daily lives. Methods The study evaluated 19 caregivers of children with ASD, aged 2 to 12 years; 18 were boys (94.7%). The diagnosis was made by a multidisciplinary team, and the participants were under the care of a pediatric neurologist. The variables collected included the child's age and sex, comorbidities (intellectual disability, attention-deficit/hyperactivity disorder, and so forth), current complaints, type of ongoing intervention, score on the Childhood Autism Rating Scale (CARS), caregiver age, number of children, and family income. Caregiver burden was assessed using the Zarit Burden Interview. Statistical analysis used linear regression with a stepwise selection method to identify the factors significantly associated with burden. Results only the CARS score was significantly associated with caregiver burden (p = 0.0077), indicating that higher levels of impairment in ASD are related to greater burden. The patients’ age and sex, comorbidities, current complaints, intervention at the time of assessment, and socioeconomic level were not significant. Conclusion The severity of ASD symptoms, reflected by the CARS score, was the main factor associated with caregiver burden. Other aspects, such as age, comorbidities, and socioeconomic level, may also exert influence, as described in the literature, but were not statistically significantly associated in this study.
ABSTRACT Purpose To develop computational codes for the automated modification of large quantities of sentence recordings, capable of performing format modifications, filtering, simulating sound signal processing in cochlear implants, and adjusting root mean square amplitude to equalize perceived volume between sentences. Methods Python codes were developed for the intended processes, using the Spyder interface and packages such as pydub, soundfile, os, and numpy. The codes were tested on two sets of previously recorded audio files in Brazilian Portuguese, in .MP3 and .WAV formats. Results Codes were implemented for 1) file format modification, 2) fade-in and fade-out adjustment, 3) high-pass filtering, 4) optional vocoderization, and 5) adjustment of root mean square amplitude. Testing the developed codes on two sets of sentence recordings available in .WAV and .MP3 formats in Portuguese showed consistent results as expected. Conclusion Python codes were developed for the automated modification of audio files, available on the GitHub website for further adaptations and improvements by third parties.
RESUMO Objetivo desenvolver códigos computacionais para modificação automatizada de grandes quantidades de sentenças gravadas, que realizem modificações de formato, filtragens, simulem o processamento dos sinais sonoros em implantes cocleares e ajustem as médias quadráticas de amplitude, a fim de equalizar o volume sonoro percebido entre sentenças. Métodos para os diferentes processamentos pretendidos, foram desenvolvidos códigos em Python, usando as interfaces Spyder e pacotes tais como o pydub, soundfile, os e numpy. Os códigos foram testados em dois conjuntos de arquivos de áudio gravados previamente em português brasileiro, nos formatos .MP3 e .WAV. Resultados foram implementados códigos para modificação do formato dos arquivos, ajuste de fade-in e fade-out, filtragem de passa-alta, vocoderização opcional e ajuste das médias quadráticas das amplitudes. Os testes dos códigos desenvolvidos em dois conjuntos de sentenças disponíveis em .WAV e .MP3 na língua portuguesa demonstraram resultados consistentes com o esperado. Conclusão desenvolveram-se códigos na linguagem Python para modificação de maneira automatizada de arquivos de áudio, disponíveis no site GitHub para adaptações e aprimoramentos por terceiros.
RESUMO Objetivo Avaliar os fatores associados à sobrecarga de cuidadores de crianças e adolescentes com transtorno do espectro autista (TEA), identificando quais variáveis apresentam maior impacto na vida diária desses cuidadores. Métodos Foram avaliados 19 cuidadores de crianças com TEA, com idades entre 2 e 12 anos, sendo 18 meninos (94,7%). O diagnóstico foi realizado por equipe multiprofissional e os participantes estavam em acompanhamento com neurologista infantil. As variáveis coletadas incluíram idade e sexo da criança, presença de comorbidades (deficiência intelectual, transtorno do déficit de atenção e hiperatividade, entre outras), queixas atuais, tipo de intervenção em andamento, pontuação na escala Childhood Autism Rating Scale (CARS), idade do cuidador, número de filhos e renda familiar. A sobrecarga do cuidador foi avaliada por meio da escala Zarit Burden Interview. Para a análise estatística, utilizou-se regressão linear com método de seleção stepwise, a fim de identificar os fatores significativamente associados à sobrecarga. Resultados Apenas a pontuação na escala CARS apresentou associação significativa com a sobrecarga do cuidador (p = 0,0077), indicando que níveis mais altos de comprometimento no TEA estão relacionados à maior sobrecarga. As variáveis idade e sexo do paciente, comorbidades, queixa atual, presença de intervenção no momento da avaliação e nível socioeconômico não foram significativas. Conclusão A gravidade dos sintomas do TEA, refletida pela pontuação na escala CARS, foi o principal fator associado à sobrecarga dos cuidadores. Outros aspectos, como idade, comorbidades e nível socioeconômico, podem também exercer influência, conforme descrito pela literatura, mas não demonstraram associação estatisticamente significativa no presente estudo.
Resumo Objetivo Realizar um mapeamento exploratório das evidências científicas disponíveis sobre os efeitos diretos e indiretos do uso de dispositivos eletrônicos para fumar na voz. Estratégia de pesquisa Revisão de escopo conduzida segundo as diretrizes do manual do Joanna Briggs Institute e as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Extension for Scoping Reviews, com protocolo registrado na Open Science Framework. Foram utilizadas as bases de dados Embase, MEDLINE, Scopus, Web of Science, CINAHL e LILACS. Critérios de seleção Foram incluídos estudos publicados em português, inglês ou espanhol, sem limitação temporal. Foram excluídos estudos com restrição de acesso ou não disponíveis na íntegra, mesmo após contato com os autores, bem como documentos provenientes da literatura cinzenta, além de cartas ao editor, artigos de opinião e resenhas. Resultados Dos 279 estudos identificados, 6 atenderam aos critérios de elegibilidade. Achados diretos incluíram disfonia, alterações em parâmetros acústicos e impactos na qualidade de vida vocal. Achados indiretos incluíram epiglotite, inflamação supraglótica, lesões químicas e citotoxicidade das pregas vocais, que podem influenciar a função vocal ao longo do tempo. Conclusão O mapeamento exploratório sugere que o uso de dispositivos eletrônicos para fumar pode afetar a voz por meio de efeitos diretos e indiretos. Apesar desses achados, as evidências disponíveis permanecem limitadas, destacando a necessidade de estudos longitudinais e experimentais para compreender com mais precisão os impactos do cigarro eletrônico sobre a função vocal e a saúde laríngea.
Abstract Purpose To conduct an exploratory mapping of the available scientific evidence on the direct and indirect effects of Electronic Nicotine Delivery Systems (ENDS) use on the voice. Research strategy A scoping review conducted according to the Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Extension for Scoping Reviews (PRISMA-ScR), with the protocol registered on the Open Science Framework. The databases searched included Embase, MEDLINE, SCOPUS, Web of Science, CINAHL, and LILACS. Selection criteria Studies published in Portuguese, English, or Spanish were included, without time restrictions. Studies with restricted access or not available in full text, even after contacting the authors, as well as grey literature, letters to the editor, opinion articles, and reviews, were excluded. Results Of the 279 studies identified, 6 met the eligibility criteria. Direct findings included dysphonia, changes in acoustic parameters, and impacts on voice-related quality of life. Indirect findings included epiglottitis, supraglottic inflammation, chemical lesions, and cytotoxicity of the vocal folds, which may influence vocal function over time. Conclusion The exploratory mapping suggests that the use of ENDS may affect the voice due to both direct and indirect effects. Despite these findings, the available evidence remains limited, highlighting the need for longitudinal and experimental studies to better understand the impacts of electronic cigarettes on vocal function and laryngeal health.
ABSTRACT Purspose To investigate the association between misophonia, auditory complaints, and symptoms of anxiety and depression. Methods A quantitative, observational, descriptive, and analytical cross-sectional study was conducted with students, faculty, and staff from a Brazilian public university. Data collection was carried out virtually using a form created on the Google Forms platform, which was made available to participants via email from June to December 2022. The form included questions related to misophonia (using the Misophonia Screening List), auditory complaints, comorbidity, and anxiety and depression (using the Hospital Anxiety and Depression Scale). Results Misophonia was associated with the complaint of hearing loss (p=0.020), tinnitus (p=0.004), discomfort with loud sounds (p=0.010), and anxiety (p=0.011). Conclusion Misophonia is associated with hearing loss, tinnitus, discomfort with loud sounds, and anxiety.
ABSTRACT Purpose To verify the association between the self-reported degree of stuttering severity, the stuttering severity index, and the percentage of speech discontinuity in adults who stutter. Methods Cross-sectional, analytical, observational study that analyzed fluency and stuttering severity in 56 adults who self-reported stuttering. Participants completed a sample characterization questionnaire and underwent spontaneous speech recording via Zoom. Fluency was analyzed using the Fluency Profile Assessment Protocol, considering 200 fluent syllables. Severity was assessed using the Stuttering Severity Instrument, examining frequency, duration of disfluencies, and physical concomitants. Data were analyzed using SPSS software, with the chi-square and Kruskal-Wallis tests, considering p ≤ 0.05. Results There were significant associations between the self-reported degree of stuttering severity and the percentage of speech discontinuity (p = 0.020), and between the severity index and the percentage of speech discontinuity (p = 0.001). Conclusion The study highlights the relevance of aligning self-perception with the assessment of stuttering severity, demonstrating the need to understand the individuals in their entirety, from a broad biopsychosocial perspective.
ABSTRACT Purpose To map and describe the findings regarding the performance of individuals who stutter on cortical auditory evoked potentials in the speech-language pathology clinical setting. Research strategy This scoping review was conducted according to the PRISMA-ScR guidelines and registered with the OSF (https://doi.org/10.17605/OSF.IO/KGHXV). The search was conducted in PubMed, LILACS, Embase, Cochrane Library, Web of Science, Science Direct, SpeechBITE, OpenGrey.eu, and DissOnline, with no language or period restrictions. Selection criteria Primary studies comparing cortical auditory evoked potentials between individuals with and without stuttering, with normal peripheral hearing, and without comorbidities were included. Results A total of 1,516 studies were identified. After exclusions and screening, seven articles were included. The total sample consisted of 151 adults (18 to 46 years) and 202 children and adolescents (4 to 18 years). The findings suggest that individuals who stutter, especially those with more severe symptoms, tend to have higher latencies and lower amplitudes in the P1-N1-P2-N2 components, especially in the right ear. More marked changes were observed in children, indicating greater sensitivity of cortical auditory evoked potentials in this age group. Conclusion The data suggest that cortical auditory evoked potentials may reflect alterations in central auditory processing in individuals who stutter, especially in the most severe cases.
ABSTRACT Purpose To analyze the perception and conduct of speech-language pathologists regarding the assessment process in the differential diagnosis of childhood apraxia of speech. Methods This was a cross-sectional observational analytical study with data collection conducted virtually via the Google Forms platform. Initially, 100 speech-language pathologists were recruited through content sharing via WhatsApp and email. Speech-language pathologists from across Brazil who were currently treating or had previously treated children with speech and/or language disorders were included. Undergraduate students were excluded. The questionnaire contained 26 questions regarding the assessment process for suspected cases of apraxia of speech. Data collection took place from September 2023 to July 2024. Results Sixty speech-language pathologists from the South, Southeast, and Northeast regions, most of whom held a specialization degree, responded to the questionnaire. The majority used standardized assessment instruments, the most frequently applied was the ABFW Child Language Test – phonology subtest and checklists for childhood apraxia of speech. They observed that apraxia of speech is accompanied by other comorbidities and that more than five sessions were necessary to confirm the diagnosis. They also observed at least three clinical markers and mentioned referrals to other professionals. There was no significant correlation between the variable number of years of professional experience and the number of sessions required to confirm the diagnosis. Conclusion In the perception of the professionals participating in the study, there is difficulty in performing a differential diagnosis and insecurity regarding the conduct and methods used in the assessment process.
RESUMO Objetivo apresentar reflexões acerca do interesse da população brasileira pelo termo “afasia” nos últimos 21 anos. Métodos foi realizada uma pesquisa no Google Trends com o termo “afasia” e verificado o volume de pesquisa relativa normalizada (VPR), que pode variar de zero a 100. Esta análise foi realizada em junho de 2025 e considerou o VPR de junho de 2004 a junho de 2025. Possíveis tendências na série temporal foram analisadas por meio do teste de tendência de Mann-Kendall, utilizando o software R versão 4.2.3, considerando o nível de significância de 5%. Resultados não foram observadas tendências estatísticas de crescimento no volume de busca ao longo da série temporal estudada (tau = 0,0835, p-valor = 0.06345). O pico de busca ocorreu em 2022, atingindo o VPR de 100. Conclusão Ao longo da série temporal de 21 anos não foi observado um aumento no volume de buscas por afasia que pode sugerir que a população não se informa sobre esta temática no Google por falta de conhecimento desta condição de saúde.
ABSTRACT Purpose To evaluate functional balance and semicircular canal function in individuals with hearing loss, with and without dizziness. Methods Observational, cross-sectional, analytical study with 59 participants (27–79 years old) treated at the Specialized Rehabilitation Center in Contagem, Minas Gerais, Brazil. Among them, 42 had dizziness and 17 did not. The following procedures were performed: medical history survey, application of questionnaires to assess the degree of hearing impairment and dizziness, Berg Balance Scale, and Timed Up and Go Test. The Video Head Impulse Test was performed on 33 participants (25 with dizziness, eight without dizziness) to assess semicircular canal function. Data were analyzed descriptively and compared between groups using Pearson's chi-square test, considering p<0.05. Results Complaints of tinnitus (88.1%) and discomfort with loud sounds (66.1%) were significantly more common among individuals with dizziness (p=0.008 and p=0.049, respectively). The use of antivertigo and central inhibitor medications was also more frequent in this group (p=0.031). Of the 33 individuals evaluated with the video Head Impulse Test, 17 (51.5%) had normal results and 16 (48.5%) had semicircular canal dysfunction, predominantly in the dizziness group, but without significant differences between the groups (p=0.224). Conclusion In individuals with hearing loss, semicircular canal dysfunction can occur independently of dizziness complaints. The study highlights the relevance of vestibular evaluation in this population, even in the absence of balance-related symptoms.
