HAYDEE FISZBEIN WERTZNER
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
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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.
- 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.
- Auditory and Visual Sustained Attention in Children with Speech Sound Disorder(2014) MURPHY, Cristina F. B.; PAGAN-NEVES, Luciana O.; WERTZNER, Haydee F.; SCHOCHAT, ElianeAlthough research has demonstrated that children with specific language impairment (SLI) and reading disorder (RD) exhibit sustained attention deficits, no study has investigated sustained attention in children with speech sound disorder (SSD). Given the overlap of symptoms, such as phonological memory deficits, between these different language disorders (i.e., SLI, SSD and RD) and the relationships between working memory, attention and language processing, it is worthwhile to investigate whether deficits in sustained attention also occur in children with SSD. A total of 55 children (18 diagnosed with SSD (8.11 +/- 1.231) and 37 typically developing children (8.76 +/- 1.461)) were invited to participate in this study. Auditory and visual sustained-attention tasks were applied. Children with SSD performed worse on these tasks; they committed a greater number of auditory false alarms and exhibited a significant decline in performance over the course of the auditory detection task. The extent to which performance is related to auditory perceptual difficulties and probable working memory deficits is discussed. Further studies are needed to better understand the specific nature of these deficits and their clinical implications.