LUCIANA DE OLIVEIRA PAGAN NEVES
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- Children with speech sound disorder: comparing a non-linguistic auditory approach with a phonological intervention approach to improve phonological skills(2015) MURPHY, Cristina F. B.; PAGAN-NEVES, Luciana O.; WERTZNER, Haydee F.; SCHOCHAT, ElianeThis study aim ed to compare the effects of a non-linguistic auditory intervention approach with a phonological intervention approach on the phonological skills of children with speech sound disorder (SSD). A total of 17 children, aged 7-12 years, with SSD were randomly allocated to either the non-linguistic auditory temporal intervention group (n = 10, average age 77 +/- 1.2) or phonological intervention group (n = 7, average age 8.6 +/- 1.2). The intervention outcomes included auditory-sensory measures (auditory temporal processing skills) and cognitive measures (attention, short-term memory, speech production, and phonological awareness skills). The auditory approach focused on non-linguistic auditory training (e.g., backward masking and frequency discrimination), whereas the phonological approach focused on speech sound training (e.g., phonological organization and awareness). Both interventions consisted of 12 45-min sessions delivered twice per week, for a total of 9 h. Intra-group analysis demonstrated that the auditory intervention group showed significant gains in both auditory and cognitive measures, whereas no significant gain was observed in the phonological intervention group. No significant improvement on phonological skills was observed in any of the groups. Inter-group analysis demonstrated significant differences between the improvement following training for both groups, with a more pronounced gain for the non-linguistic auditory temporal intervention in one of the visual attention measures and both auditory measures. Therefore, both analyses suggest that although the non-linguistic auditory intervention approach appeared to be the most effective intervention approach, it was not sufficient to promote the enhancement of phonological skills.
- A efetividade dos testes complementares no acompanhamento da intervenção terapêutica no transtorno fonológico(2012) WERTZNER, Haydée Fiszbein; PAGAN-NEVES, Luciana de OliveiraTherapeutic planning and evolution of children with speech sound disorders are related to both the initial assessment and to the complementary tests selected to be applied. Monitoring the case by regular evaluations adds important information to the diagnosis, which allows strengthening the initial findings with regards to the underlying deficits identified in the initial evaluation. The aim of this case report was to verify the effectiveness and the efficiency in using the Percentage of Consonants Correct - Revised (PCC-R) index as well as complementary tests of speech inconsistency, stimulability and phonological awareness skills in monitoring therapeutic intervention in children with speech sound disorders. The study included three male children. At the time of initial evaluation, Case 1 was 6 years and 9 months old, Case 2, 8 years and 10 months old, and Case 3, 9 years and 7 months old. In addition to the specific assessment of phonology, complementary tests were used to help in verifying the underlying deficits for each specific case. Subjects were also evaluated on phonological awareness abilities, speech inconsistency and speech stimulability. Data analysis confirmed that the complementary tests selected for this case study were effective and efficient to complement initial diagnostic as well as to demonstrate modifications that occurred in the three subjects with speech sound disorders.
- Habilidades metafonológicas em crianças com transtorno fonológico: a interferência da idade e da gravidade(2014) WERTZNER, Haydée Fiszbein; PULGA, Marina Jorge; PAGAN-NEVES, Luciana de OliveiraPurpose The objective of the present study is to assess the metaphonological skill levels of children with speech sound disorders as a function of age and disorder severity as assessed by the Lindamood Auditory Conceptualization Test (LAC-3 adapted to the Brazilian Portuguese language). Methods Fifty children with speech sound disorder between the ages of five years and seven years and 11 months were given three versions (I-A, I-B and II) of the Lindamood Auditory Conceptualization Test and then divided by age and speech sound disorder severity assessed by Percentage Consonants Correct-Revised (PCC-R) scores. Results The skills testing results indicate that younger children with 85% PCC-R or less experience greater difficulty than the other children with auditory perception and exhibit more disorganized phonological systems, as shown in their execution of simple metaphonological skills throughout testing, which involve discriminating between isolated phonemic units. The complex task results do not provide sufficient information to determine which cognitive-linguistic knowledge features among children with speech sound disorder are most heavily affected. Conclusion The skills testing results indicate that children with more severe speech sound disorder, who thus present higher degrees of phonological system disorganization, experience greater difficulty in the area of auditory perception. The results further indicate that regardless of the degree of disorder severity, children with phonological disorders struggle with more complex metaphonological skills, and those with greater degrees of disorder severity also struggle to master simpler metaphonological tasks.
- Medidas aerodinâmicas, eletroglotográficas e acústicas na produção da fricativa pós-alveolar vozeada(2018) HASHIMOTO, Patrícia Tiemi; PAGAN-NEVES, Luciana de Oliveira; JESUS, Luis Miguel Teixeira de; WERTZNER, Haydée FiszbeinABSTRACT Purpose Describe and correlate phonological and complementary measures regarding aerodynamics, electroglottography, acoustics, and perceptual judgment of production of the voiced fricative sound /ʒ/ comparing the performance of Brazilian Portuguese-speaking children with and without speech sound disorders. Methods Study participants were 30 children aged 5 years to 7 years and 11 months divided into a group of children with typical development - Control Group (CG) and a group of children with speech sound disorders - Research Group (RG). Phonology (PCC, PCC-R, and occurrence of phonological processes) and the aerodynamic (amplitude of the oral airflow and f0), eletroglottographic (open quotient) and acoustic (classification of voicing) measures were evaluated. Results Numerically, children with speech sound disorders presented higher relative oral airflow amplitude, lower relative f0, and open quotient indicative of less efficient voicing production compared with those of children with typical development. The weak voicing values showed that 66.1% of the children with speech sound disorders presented weaker voicing of the fricative sound /ʒ/ compared with that of the posterior vowel sound, and between-groups comparison demonstrated that these children presented greater difficulty in voicing. The acoustic analysis of speech used to classify the weak/strong voicing showed variations, especially regarding the classification partially devoiced. Conclusion Results suggest that the strategies for voicing production and voicing maintenance of the fricative sound /ʒ/ are still variable in children aged 5 years to 7 years and 11 months; however, children with speech sound disorders seem to have more difficulties in using them effectively. In addition, the study shows the importance of applying complementary tests to obtain a more detailed diagnosis.
- Sensibilidade e especificidade da Porcentagem de Consoantes Corretas Revisada na identificação do transtorno fonológico(2017) BARROZO, Tatiane Faria; PAGAN-NEVES, Luciana de Oliveira; PINHEIRO DA SILVA, Joyce; WERTZNER, Haydée FiszbeinABSTRACT Purpose The purpose of the study was to determine the sensitivity and specificity, and to establish cutoff points for the severity index Percentage of Consonants Correct - Revised (PCC-R) in Brazilian Portuguese-speaking children with and without speech sound disorders. Methods 72 children between 5:00 and 7:11 years old - 36 children without speech and language complaints and 36 children with speech sound disorders. The PCC-R was applied to the figure naming and word imitation tasks that are part of the ABFW Child Language Test. Results were statistically analyzed. The ROC curve was performed and sensitivity and specificity values of the index were verified. Results The group of children without speech sound disorders presented greater PCC-R values in both tasks, regardless of the gender of the participants. The cutoff value observed for the picture naming task was 93.4%, with a sensitivity value of 0.89 and specificity of 0.94 (age independent). For the word imitation task, results were age-dependent: for age group ≤6:5 years old, the cutoff value was 91.0% (sensitivity of 0.77 and specificity of 0.94) and for age group >6:5 years-old, the cutoff value was 93.9% (sensitivity of 0.93 and specificity of 0.94). Conclusion Given the high sensitivity and specificity of PCC-R, we can conclude that the index was effective in discriminating and identifying children with and without speech sound disorders.
- Implicações da diadococinesia oral no transtorno fonológico(2013) WERTZNER, Haydée Fiszbein; PAGAN-NEVES, Luciana de Oliveira; ALVES, Renata Ramos; BARROZO, Tatiane FariaPURPOSE: To verify the performance of children with and without speech sound disorder in oral motor skills measured by oral diadochokinesia according to age and gender and to compare the results by two different methods of analysis. METHODS: Participants were 72 subjects aged from 5 years to 7 years and 11 months divided into four subgroups according to the presence of speech sound disorder (Study Group and Control Group) and age (<6 years and 5 months and >6 years and 5 months). Diadochokinesia skills were assessed by the repetition of the sequences 'pa', 'ta', 'ka' and 'pataka' measured both manually and by the software Motor Speech Profile®. RESULTS: Gender was statistically different for both groups but it did not influence on the number of sequences per second produced. Correlation between the number of sequences per second and age was observed for all sequences (except for 'ka') only for the control group children. Comparison between groups did not indicate differences between the number of sequences per second and age. Results presented strong agreement between the values of oral diadochokinesia measured manually and by MSP. CONCLUSION: This research demonstrated the importance of using different methods of analysis on the functional evaluation of oro-motor processing aspects of children with speech sound disorder and evidenced the oro-motor difficulties on children aged under than eight years old.
- Aplicação de medidas de gravidade e de inconsistência de fala em crianças com transtorno fonológico(2013) WERTZNER, Haydée Fiszbein; PEREIRA, Karina; SILVA, Thaís Zemlickas; PAGAN-NEVES, Luciana de OliveiraPURPOSE: To describe the severity indexes PCC-R, IRS, IRO, IRD, PDI and SII in children with speech sound disorder with and without the phonological process of devoicing and verify its efficiency in identifying differences among children. METHODS: This is retrospective and cross-sectional study involving 20 children with speech sound disorder between 5 and 8 years-old. Two subgroups were created according to the presence of the phonological process of stops and fricatives devoicing. Phonology test from the infantile language test (ABFW) was used to calculate productivity of phonological processes, the number of different types of phonological processes and the indexes PDI, PCC-R, IRS, IRO and IRD. Speech inconsistency test was applied to calculate the speech inconsistency index. Data were statistically analyzed. RESULTS: The study demonstrated that children with speech sound disorder and the presence of fricative and/or stops devoicing were more severe and presented higher values of the speech inconsistency index, PDI, IRS, IRO and IRD. The articulatory error most observed for both groups was the substitution while distortion occurred more in the group of children without the phonological process of devoicing. CONCLUSION: The severity indexes used were efficient to differentiate children with from children without the presence of the phonological processes of devoicing. There is evidence that children who have the phonological process of devoicing have difficulty with the phonological representation of the sound.
- The influence of (central) auditory processing disorder on the severity of speech-sound disorders in children(2016) VILELA, Nadia; BARROZO, Tatiane Faria; PAGAN-NEVES, Luciana de Oliveira; SANCHES, Seisse Gabriela Gandolfi; WERTZNER, Haydee Fiszbein; CARVALLO, Renata Mota MamedeOBJECTIVE: To identify a cutoff value based on the Percentage of Consonants Correct-Revised index that could indicate the likelihood of a child with a speech-sound disorder also having a (central) auditory processing disorder. METHODS: Language, audiological and (central) auditory processing evaluations were administered. The participants were 27 subjects with speech-sound disorders aged 7 to 10 years and 11 months who were divided into two different groups according to their (central) auditory processing evaluation results. RESULTS: When a (central) auditory processing disorder was present in association with a speech disorder, the children tended to have lower scores on phonological assessments. A greater severity of speech disorder was related to a greater probability of the child having a (central) auditory processing disorder. The use of a cutoff value for the Percentage of Consonants Correct-Revised index successfully distinguished between children with and without a (central) auditory processing disorder. CONCLUSIONS : The severity of speech-sound disorder in children was influenced by the presence of (central) auditory processing disorder. The attempt to identify a cutoff value based on a severity index was successful.
- Fatores causais e aplicação de provas complementares relacionadas à gravidade no transtorno fonológico(2012) WERTZNER, Haydée Fiszbein; FRANCISCO, Danira Tavares; PAGAN-NEVES, Luciana de OliveiraPURPOSE: To determine whether the severity index that measures the percentage of consonants correct distinguishes children with speech sound disorders (SSD) according to measures of stimulability and speech inconsistency, as well as to the presence of heritability (familial history) and history of early recurrent otitis media. METHODS: Participants were 15 subjects aged between 5 and 7 years and 11 months, diagnosed as phonologically disordered. The PCC-R index was calculated for both words imitation and picture naming tasks, separately. The need to apply stimulability test was considered according to the criteria proposed in previous research for Brazilian Portuguese-speaking children. Speech inconsistency allowed the classification of subjects as either consistent or inconsistent. Data were statistically analyzed. RESULTS: Comparison between PCC-R calculated for picture naming and words imitation tasks demonstrated difference only for the need for the application of the stimulability test. Such difference was not observed in the speech inconsistency test. No difference was found at PCC-R values considering both familial and otitis media histories. CONCLUSION: The present research indicates that children who were submitted to the stimulability test presented lower values of PCC-R. However, PCC-R values were not determinant for differences among children, regarding the speech inconsistency test and familial and otitis media histories.
- Generalization of Sensory Auditory Learning to Top-Down Skills in a Randomized Controlled Trial(2015) MURPHY, Cristina B.; PERES, Andressa K.; ZACHI, Elaine C.; VENTURA, Dora F.; PAGAN-NEVES, Luciana; WERTZNER, Haydee F.; SCHOCHAT, ElianeBackground: Research has shown that auditory training improves auditory sensory skills; however, it is unclear whether this improvement is transferred to top-down skills, such as memory, attention, and language, and whether it depends on group characteristics in regard to memory and attention skills. Purpose: The primary goal of this research was to investigate the generalization of learning from auditory sensory skills to top-down skills such as memory, attention, and language. We also aimed to compare whether this generalization process occurs in the same way among typically developing children and children with speech sound disorder. Research Design: This study was a randomized controlled trial. Study Sample: Typically developing 7- to 12-yr-old children and children with speech sound disorder were separated into four groups: a trained control group (TDT; n = 10, age 9.6 +/- 2.0 yr), a nontrained control group (TDNT; n = 11, age 8.2 +/- 1.6 yr), a trained study group (SSDT; n = 10, age 7.7 +/- 1.2 yr), and a nontrained study group (SSDNT; n = 8, age 8.6 +/- 1.2 yr). Intervention: Both trained groups underwent a computerized, nonverbal auditory training that focused on frequency discrimination, ordering, and backward-masking tasks. The training consisted of twelve 45 min sessions, once a week, for a total of 9 hr of training, approximately. Data Collection and Analysis: Near-transfer (Gap-In-Noise [GIN] and Frequency Pattern Test) and far-transfer measures (auditory and visual sustained attention tests, phonological working memory and language tests) were applied before and after training. The results were analyzed using a 2 x 2 x 2 mixed-model analysis of variance with the group and training as the between-group variables and the period as the within-group variable. The significance threshold was p 0.05. Results: There was a group x period x training interaction for GIN [F-(1.35) = 7.18, p = 0.011], indicating a significant threshold reduction only for the TDT group (Tukey multiple comparisons). There was a significant group x period interaction [F-(1.35) = 5.52, p = 0.025] and a training x period interaction for visual reaction time [F-(1.35) = 4.20, p = 0.048], indicating improvement in the SSDT group and worsening in both nontrained groups. There was also a significant group x training x period interaction [F-(1.35) = 4.27, p = 0.0461 for the auditory false alarms, with a significant improvement after training only for the SSDT group. Analysis of variance also revealed that all groups exhibited approximately the same level of gains for all measures, except for GIN [F-(3,F-38) = 4.261, p = 0.011] and visual response time [F(3,38) = 4.069, p = 0.014]. Conclusions: After training, the TDT group demonstrated a significant improvement for GIN and the SSDT exhibited the same for sustained attention, indicating learning generalization from an auditory sensory training to a top-down skill. For the other measures, all groups exhibited approximately the same level of gains, indicating the presence of a test-retest effect. Our findings also show that the memory span was not related to the learning generalization process given that the SSDT exhibited a more pronounced gain in attention skills after the sensory training.