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- ItemSomente MetadadadosAcurácia do teste de linguagem expressiva para identificar alterações morfossintáticas em crianças pré-escolares(Universidade Federal de São Paulo (UNIFESP), 2021) Kayanoki, Fabiana Yumi Sato [UNIFESP]; Puglisi, Marina Leite [UNIFESP]; Universidade Federal de São PauloIntroduction: The evaluation of preschool children's grammatical aspects is essential to identify the areas of major language impairments, in addition to often directing the speech rehabilitation of these children. Thus, it is necessary to develop simple, specific protocols and with reference standards. In Brazil, however, there are few instruments used to assess preschool children using statistical and psychometric analyses, especially with regard to validation in protocols in speech therapy practice. Objective: To validate, compare forms of analysis of the grammatical modality and verify the diagnostic accuracy of the Expressive Language Test (ELT) to identify children with low language performance. Methods: The ELT is an instrument created to assess the grammatical skills of preschoolers and was applied in 618 children aged 3 years and 6 months to 6 years and 1 month enrolled in Years I or II of Municipal Schools of Early Childhood Education in São Caetano do Sul. Children were individually evaluated and encouraged to describe the content of 12 scenes, based on guide questions (picture-elicited language samples). Three objective forms of grammatical analysis of responses were proposed, in which only the sentences pertinent to the content of the test figures were analyzed, pondering the obligatory context of the scenes: 1) Mean Length Utterances – words (MLU-w): mean number of words produced in a sentence; 2) Length Utterances (LU): sum of number of words produced in a sentence e 3) Percentage Grammatical Utterances (PGU): ratio of the number of grammatically correct sentences to the total number of sentences produced in the test. Then, the MLU-w_II and LU_II were computed again, but considering the entire production of the child (both the pertinent sentences and those that extrapolated the content of the figures) for all utterances produced in each item in order to verify whether these measures would also assess the child's complete response. All forms were computed and tested for construct validity by Confirmatory Factor Analysis and only those with the most fitting indicators were considered to test the accuracy. To investigate whether the TLE is sensitive to identify children with Language Disorder (LD), the vocabulary, receptive grammar and phonological working memory tests were considered as the gold standard. And the accuracy of the ELT was assessed using the ROC Curve and the sensitivity and specificity values. Results: The LU, MLU-w and PEG analyzes were considered valid to assess the grammatical skills of children. However, EME-p_II and EE_II did not show indexes of adequacy as robust as the previous ones and therefore were not validated for the ELT. In addition, the test showed 66% Positive Predictive Value (probability of a child presenting a positive result and LD) and 67% Negative Predictive Value (probability of a child presenting a negative result and not LD) for the diagnosis of LD in preschoolers. Conclusions: LU and PEG are the two recommended measures for grammatical analysis for ELT. The cutoff point of the ROC curve -0.429 showed the best prognostic accuracy for the test with a sensitivity of 70.4% and specificity of 66.6%.
- ItemAcesso aberto (Open Access)Avaliação da linguagem oral e escrita em sujeitos com Síndrome de Asperger(CEFAC Saúde e Educação, 2009-01-01) Dias, Karin Ziliotto [UNIFESP]; Silva, Renata Cristina Dias Da [UNIFESP]; Pereira, Liliane Desgualdo [UNIFESP]; Perissinoto, Jacy [UNIFESP]; Bergamini, Carla De Queiroz; Universidade Federal de São Paulo (UNIFESP); Núcleo de Estudos FonoaudiológicosPURPOSE: to evaluate and characterize the oral and written language of subjects with Asperger Syndrome and compare them with a group of subjects with typical development. METHODS: a total of 44 subjects were assessed and divided in two groups. The Asperger group was composed by 22 subjects diagnosed with Asperger Syndrome by an expert clinical team following the DSM-IV criteria. The comparison group, referred to as low risk for developmental disorders was also composed by 22 subjects matched with the subjects in Asperger group by chronological age. All the assessed subjects were right-handed males, with chronological ages between 10 and 30 years and intelligence quotients above 68 according to Wechsler Scale. They completed the following assessment tools: phonological conscience proof, image Peabody vocabulary test, words and pseudo words reading proof, reading comprehension proof, writing proof of dictated words and pseudo words, and the semi-directed text writing proof. RESULTS: the statistical analysis revealed significant statistical differences between the medians obtained for the phonological conscience proof and the means of the image Peabody vocabulary test and the reading comprehension proof in both studied groups (p<0.05). CONCLUSION: for the oral and written language assessments the Asperger Syndrome group was characterized by a worse performance then the one displayed by the group of subjects with a typical development in the phonological conscience proof, Peabody vocabulary test and the reading comprehension proof, indicating handicaps in the phonological, semantic and pragmatic language levels.
- ItemAcesso aberto (Open Access)Linguagem expressiva de crianças nascidas pré-termo e termo aos dois anos de idade(Pró-Fono Produtos Especializados para Fonoaudiologia Ltda., 2009-06-01) Isotani, Selma Mie; Azevedo, Marisa Frasson de [UNIFESP]; Chiari, Brasilia Maria [UNIFESP]; Perissinoto, Jacy [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: expressive language of pre-term children. AIM: to compare the expressive vocabulary of two year-old children born prematurely, to that of those born at term. METHODS: the study sample was composed by 118 speech-language assessment protocols, divided in two groups: the pre-term group (PTG) composed by 58 underweight premature children followed by a multi-professional team at the Casa do Prematuro (House of Premature Children) at UNIFESP, and the full-term group (FTG) composed by 60 full-term born children. In order to evaluate the expressive language of these children, the Lave - Lista de Avaliação do Vocabulário Expressivo (Assessment List of the Expressive Vocabulary) was used. The Lave is an adaptation of the LDS - Language Development Survey - for the Brazilian Portuguese Language. The Lave investigates the expressive language and detects delays in oral language. RESULTS: children born underweight and prematurely present a greater occurrence of expressive language delay, 27.6%. These pre-term children present significantly lower expressive vocabulary and phrasal extension than children of the same age born at full-term in all semantic categories. Family income proved to be positively associated to phrasal extension, as well as to gestational age and weight at birth; thus indicating the effect of these adverse conditions still during the third year of age. The audiological status was associated to word utterances in the PTG. CONCLUSION: children born prematurely and underweight are at risk in terms of vocabulary development; this determines the need for speech-therapy intervention programs.