DEBORA MARIA BEFI LOPES
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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- Aspectos da fluência da fala em crianças com distúrbio específico de linguagem(2014) ANDRADE, Cláudia Regina Furquim de; BEFI-LOPES, Debora Maria; JUSTE, Fabíola Staróbole; CÁCERES-ASSENÇO, Ana Manhani; FORTUNATO-TAVARES, Talita MariaPurpose The present study aimed to assess specific aspects of speech fluency in children with specific language impairment (SLI). This included examining the typology of speech disruption and rate (in words and syllables per minute), across different age groups. Methods A total of 50 children, aged 3 to 7 years old, presenting with nonverbal IQ and hearing thresholds within normal limits (without the presence of stuttering) participated in the study. Children were divided into two groups: G1 (SLI) included 25 children (7 girls and 18 boys) and G2 (typical development) included 25 children matched on age and gender with G1. Each child was shown a figure and asked to discuss what s/he liked about the figure. Each speech sample included 200 fluent syllables or 100 fluent words. Results Between-group analyses demonstrated that children aged 3 to 4 years old in G1 had lower speech rate than their age-matched peers from G2. Within-group analyses revealed no differences in disruption typologies between age groups in G1 participants. In contrast, hesitation was the most frequent typology for 4- to 5-year-old G2 children, whereas hesitation and word repetition typologies were observed in 6- to 7-year-old G2 children. Conclusion Children with suspected SLI between the ages of 3 to 4 years old showed a reduction in word and syllable production. Hesitation-type speech disruptions were prominently used by typically developing children, regardless of age, and were not observed in SLI children.
- How Word/Non-Word Length Influence Reading Acquisition in a Transparent Language: Implications for Children's Literacy and Development(2023) SOARES, Aparecido J. C.; SASSI, Fernanda C.; FORTUNATO-TAVARES, Talita; ANDRADE, Claudia R. F.; BEFI-LOPES, Debora M.Decoding skills are crucial for literacy development and they tend to be acquired early in transparent languages, such as Brazilian Portuguese. It is essential to better understand which variables may affect the decoding process. In this study, we investigated the processes of decoding as a function of age of children who are exposed to a transparent language. To this end, we examined the effects of grade, stimulus type and stimulus extension on the decoding accuracy of children between the ages of six and 10 years who are monolingual speakers of Brazilian Portuguese. The study included 250 children, enrolled from the first to the fifth grade. A list of words and pseudowords of variable length was created, based on Brazilian Portuguese structure. Children assessment was conducted using the computer program E-prime((R)) which was used to present the stimuli. The stimuli were programmed to appear on the screen in a random order and children were instructed to read them. The results indicate two important moments for decoding: the acquisition and the mastery of decoding skills. Additionally, the results highlight an important effect of the extent and type of stimuli and how it interacts with the school progress. Moreover, data indicate the multifactorial nature of decoding acquisition and the different interactions between variables that can influence this process. We discuss medium- and long-term implications of it, and possible individual and collective actions which can improve this process.
- Syntactic Structural Assignment in Brazilian Portuguese-Speaking Children With Specific Language Impairment(2012) FORTUNATO-TAVARES, Talita; ANDRADE, Claudia R. F. de; BEFI-LOPES, Debora M.; HESTVIK, Arild; EPSTEIN, Baila; TORNYOVA, Lidiya; SCHWARTZ, Richard G.Purpose: In this study, the authors examined the comprehension of sentences with predicates and reflexives that are linked to a nonadjacent noun as a test of the hierarchical ordering deficit (HOD) hypothesis. That hypothesis and more modern versions posit that children with specific language impairment (SLI) have difficulty in establishing nonadjacent (hierarchical) relations among elements of a sentence. The authors also tested whether additional working memory demands in constructions containing reflexives affected the extent to which children with SLI incorrectly structure sentences as indicated by their picture-pointing comprehension responses. Method: Sixteen Brazilian Portuguese-speaking children (8;4-10;6 [years; months]) with SLI and 16 children with typical language development (TLD) matched for age (+/- 3 months), gender, and socioeconomic status participated in 2 experiments (predicate and reflexive interpretation). In the reflexive experiment, the authors also manipulated working memory demands. Each experiment involved a 4-choice picture selection sentence comprehension task. Results: Children with SLI were significantly less accurate on all conditions. Both groups made more hierarchical syntactic construction errors in the long working memory condition than in the short working memory condition. Conclusion: The HOD hypothesis was not confirmed. For both groups, syntactic factors (structural assignment) were more vulnerable than lexical factors (prepositions) to working memory effects in sentence miscomprehension.
bookPart Desenvolvimento da audição, da linguagem, da atividade motora oral e da alimentação e seus principais distúrbios(2018) ANDRADE, Cláudia Regina Furquim de; MOLINI-AVEJONAS, Daniela Regina; CARVALHO, Ana Claudia Martinho de; BEFI-LOPES, Débora Maria- Children with cochlear implants: communication skills and quality of Life(2012) FORTUNATO-TAVARES, Talita; BEFI-LOPES, Debora; BENTO, Ricardo Ferreira; ANDRADE, Claudia Regina Furquim deGiven the multidimensional scope of cochlear implants, there is a growing need to assess clinical measures related communicative abilities and more general aspects involved in the effectiveness of treatment, such as quality of life. Aim: To translate and adapt an international questionnaire of quality of life to Brazilian Portuguese; to apply the questionnaire in parents of children with cochlear implant to assess quality of life of children after cochlear implantation; to analyze correlations among factors related to quality of life; to analyze correlations between quality of life and clinical measures of outcome. Method: prospective study in which parents of children with cochlear implants responded to validated instruments on quality of life and communication abilities. Results: The translation and adaptation of the questionnaire was satisfactorily completed. According to the data, cochlear implants had a positive effect on quality of life of the implanted children and their families. Observed correlations for the variable communication demonstrate a direct relationship between oral communication and other variables of quality of life. Conclusions: This study makes this questionnaire available in Brazilian Portuguese. For parents of Brazilian children with cochlear implants, lexical development(acquisition and use of words) is the variable that relates most to the quality of life of their children.
bookPart Distúrbios da linguagem(2012) ANDRADE, Claudia Regina Furquim de; LOPES, Debora Maria Befi- Syntactic comprehension and working memory in children with specific language impairment, autism or Down syndrome(2015) FORTUNATO-TAVARES, Talita; ANDRADE, Claudia R. F.; BEFI-LOPES, Debora; LIMONGI, Suelly O.; FERNANDES, Fernanda D. M.; SCHWARTZ, Richard G.This study examined syntactic assignment for predicates and reflexives as well as working memory effects in the sentence comprehension of children with Specific Language Impairment (SLI), Down syndrome (DS), high functioning Autism (HFA) and Typical Language Development (TLD). Fifty-seven children (35 boys and 22 girls) performed a computerised picture-selection sentence comprehension task. Predicate attachment and reflexive antecedent assignment (with working memory manipulations) were investigated. The results showed that SLI, HFA and DS children exhibited poorer overall performance than TLD children. Children with SLI exhibited similar performance to the DS and HFA children only when working memory demands were higher. We conclude that children with SLI, HFA and DS differ from children with TLD in their comprehension of predicate and reflexive structures where the knowledge of syntactic assignment is required. Working memory manipulation had different effects on syntactic comprehension depending on language disorder. Intelligence was not an explanatory factor for the differences observed in performance.
bookPart Atuação fonoaudiológica em cuidados paliativos - enfoque na comunicação(2018) COSTA, Tharsila Moreira Gomes da; NASCIMENTO, Liz Teixeira; MEDEIROS, Gisele Chagas de; MANSUR, Leticia Lessa; ANDRADE, Claudia Regina Furquim de; BEFI-LOPES, Débora Maria- Avaliação da deglutição e indicadores clínicos associados em crianças após correção cirúrgica de doença cardíaca congênita(2021) FERNANDES, Heloisa Regina; SASSI, Fernanda Chiarion; ANDRADE, Claudia Regina Furquim de; LOPES, Debora Maria BefiABSTRACT Purpose To identify clinical markers that are associated to swallowing alterations in infants after surgical repair of congenital heart disease (CHD) and to correlate these markers to the categories on the Risk Adjustment for Congenital Heart Disease 1 (RACHS-1) scale. Methods Using the Pediatric Center Database System we conducted a retrospective, observational cohort study on children admitted to the pediatric hospital unit due to CDH. We collected data on specific parameters of a clinical swallowing assessment (SA) and dysphagia was classified according to the Dysphagia Management Staging Scale. We also included demographic and clinical markers and patient´s risk of mortality was determined by using the RACHS-1. Results The final study sample consisted of 108 patients. Important findings were: the more severe signs of dysphagia are associated to an increased length of hospital stay (p=0.005); an increased number and duration of orotracheal intubation (p=0.022 and 0.005 respectively); an increased time between hospital admission and SA (p=0.003); an increased time between the surgical procedure and swallowing assessment (0.043); and an increased number of SLP sessions to remove alternate feeding methods and warrant safe oral feeding (p<0.001). No correlations were observed between the infant’s risk of mortality and the altered sings on the clinical swallowing assessment. Conclusion The data from this study contributes to the current knowledge that children with heart condition requiring heart surgery in the first month of life have high risk of presenting feeding difficulties and will require prolonged hospital care. No correlation was observed between the categories on RACHS-1 and the altered signs on the clinical swallowing assessment.
- Dysphagia and associated clinical markers in neurologically intact children with respiratory disease(2018) SASSI, Fernanda C.; BUHLER, Karina C. B.; JUSTE, Fabiola S.; ALMEIDA, Fabiola C. F.; BEFI-LOPES, Debora M.; ANDRADE, Claudia R. F. deObjectiveThe identification of oropharyngeal aspiration is paramount since it can have negative consequences on a compromised respiratory status. Our hypothesis was that dysphagia in neurologically intact children with respiratory disease is associated to specific clinical markers. Study DesignUsing the medical files we conducted a retrospective, observational cohort study on children admitted to the pediatric hospital unit due to respiratory disease. We collected data on specific parameters of a clinical swallowing assessment and dysphagia was classified according to the Dysphagia Management Staging Scale. We also included the following clinical markers: age, days of hospitalization, need for orotracheal intubation (OTI), duration of orotracheal intubation (in hours), number of previous hospital admissions due to respiratory disease, number of previous hospital admissions due to other causes, and previous orotracheal intubations. ResultsThe final study sample consisted of 102 patients (mean age of 5.88 months). For the purposes of statistical analysis, the patients were grouped according to the classification of dysphagia (ie, no dysphagia, mild dysphagia, and moderate-severe dysphagia). Data analysis indicated that the clinical markers of orotracheal intubation (P=0.042), duration of orotracheal intubation (P=0.025), and days of hospitalization (P=0.037) were significant in children with moderate-severe dysphagia. ConclusionsOur data indicate that neurologically intact children with respiratory disease who were submitted to prolonged OTI (ie, over 48h) should be prioritized for receiving a detailed swallowing assessment.