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ABSTRACT Aim: to review the literature reporting grammar-based interventions designed to improve morphosyntactic skills among children with specific language impairment (SLI). Methods: several studies reporting grammar-based interventions were analyzed. The criteria for selecting the articles were determined as follows: a) publication date within the last ten years; b) studies that reported a grammar-based intervention; c) groups of study constituted by children with SLI, aged 3.0 to 12.0 years; d) design including Pre and Post measures; e) articles reporting quantitative/qualitative data analyses. The databases selected for this review were: Lilacs, PubMed, Embase, Scopus, ISI-Web of Science, and EBSCOhost. Results: most studies reported interventions focused on expressive grammar, providing no particular details about the specific grammar contents considered. Interventions usually consisted of implicit approaches implemented as individual therapy. Studies reported children with SLI as generally improving on intervened skills. Conclusion: all of the grammar-based intervention programs described in the selected studies, seemed to be equally adequate when working with children with SLI.

Purpose: To estimate the reliability of scripts designed for undergraduate Speech-Language Therapy students., Methods: A descriptive cross-sectional study was carried out. Qualitative variables were summarized by frequency or proportion and quantitative through means (CI 95%). Reliability was estimated through Cronbach's α coefficient, and inter-rater agreement was determined using Fleiss's Kappa index. The analytical tests considered a significance level of p<0.05., Results: 80 scripts organized in four areas of speech-language therapy were validated by 41 speech-language pathologists. The average experience of the professionals was 17.1 years. The reliability of the corpus was α: 0.67 (min= 0.34; max: 0.84), and the inter-rater agreement κ: 0.29 (min: 0.07; max: 0.45)., Conclusion: The corpus's reliability scores were similar to those reported by previous studies in different health professions. Having validated strategies aimed at developing proficiency and supporting classic training actions in undergraduate courses will contribute to increasing the quality of future health professionals.

TEMA: na atualidade, a gagueira pode apresentar definições distintas de acordo com a abordagem defendida pelos autores para fundamentar tal distúrbio. O trabalho tem como objetivo discutir tais abordagens na terapia do caso em questão, aplicando suas técnicas terapêuticas e adequando-as conforme o contexto em questão e a aceitação do indivíduo para com as atividades, promovendo o desenvolvimento dos objetivos, procedimentos e técnicas utilizados na terapêutica para a gagueira. PROCEDIMENTOS: estudo longitudinal de um paciente de 14 anos, atendido em dois momentos: entre 2005/2006, ano em que recebeu alta com indicação de monitoramento, e 2008/2009 época em que retorna ao atendimento devido à recidiva. No estudo, são consideradas as diferentes abordagens: psicolinguística da fluência, neurolinguística e motora da gagueira, vertente contextualizada e abordagem fenomenológica da gagueira. RESULTADOS: na evolução, observou-se a diminuição considerável da gagueira e dos movimentos compensatórios, bem como, comportamento e postura adequados e uma melhor socialização. CONCLUSÃO: o estudo das abordagens consideradas na terapia propiciou a realização do atendimento que atingiu os objetivos propostos. Além disso, o paciente contribuiu no direcionamento da terapia conforme sua aceitação e aplicação em sua vida, revelando, dessa forma, quais condutas foram mais efetivas e puderam contribuir de forma mais direta com a sua qualidade de vida e sua evolução.BACKGROUND: stuttering may currently have different definitions according to the approach advocated by the authors to substantiate such a disorder. The paper aims to discuss such approaches in the therapy of the case, applying its therapeutic techniques and adapting them according to the context at issue and take the individual to activities, promoting the development of goals, procedures and techniques used in the stuttering therapy. PROCEDURES: a longitudinal study of a patient being 14 year old, met on two occasions: in 2005-2006, the year he was discharged with an indication for monitoring, and 2008/2009 season in returning to treatment due to relapse. In the study, the different approaches considered were: psycholinguistics fluency, stuttering and motor neurolinguistics, contextual and phenomenological aspects of stuttering. RESULTS: in the evolution, there was a considerable decrease in stuttering and compensatory movements, as well as appropriate behavior and attitude and improved socialization. CONCLUSION: the study on the approaches considered in the therapy enabled the performance of the service that hit the targets. In addition, the patient contributed for directing the therapy as per the acceptance and application in his life, revealed by the results of more effective behaviors, contributing to the quality of life and evolution.

Tema: atendimento fonoaudiológico em grupo na área da Fonoaudiologia. Para sua realização, visitou-se os textos publicados em revistas científicas da área, nos últimos 15 anos, e os capítulos de livros e dissertações que se detiveram em tematizar o atendimento fonoaudiológico em grupo. Objetivo: identificar, entender e discutir: 1) os princípios teóricos que justificam a indicação do atendimento em grupo, que o estruturam e o sustentam de maneira a explicitar como a dinâmica do grupo age sobre os sintomas ; 2) os critérios para a composição e formação dos grupos e, principalmente, 3) a intervenção do fonoaudiólogo e a possibilidade de eficácia de sua terapêutica. Conclusão: o levantamento bibliográfico identificou diferentes práticas fonoaudiológicas em grupo, atreladas a diversas perspectivas teóricas. No que diz respeito aos critérios de formação, à função do fonoaudiólogo no grupo, à prevalência do atendimento em grupo em relação ao individual, houve divergências de opiniões, dado que os textos visitados, não (cor)responderam com a consistência teórica esperada. Tal resultado se deve ao fato de haver uma certa adoção irrefletida de conceitos de outras áreas, sem argumentação e sem a reestruturação que sua transposição para a clínica fonoaudiológica, exigiria. Sugere-se que estas incoerências ocorrem porque não se evidencia a preocupação em articular os estudos teóricos aos elementos que configuram a clínica fonoaudiológica, a saber: a semiologia, a etiologia, a diagnóstica e a terapêutica.Background: the theme of this literature review is the group therapy in the Speech Therapy area. To perform it, we studied the texts published in scientific journals of the field, in the last 15 years, in the form of articles, book chapters and dissertations, which were focused on the group therapy. Purpose: the goal is to identify, understand and discuss, the following themes: 1) the theoretical principles that justify the indication of group therapy, structuring and maintaining it in order to explain how the dynamics of the group may act on the symptoms; 2) the criteria for the composition and formation of groups and especially, 3) the intervention of speech therapists and the possibility of their therapeutic effectiveness. Conclusion: it was concluded that the literature review on group therapy in the area of Speech Therapy identified different practices, linked to different theoretical perspectives. Regarding the criteria for group formation, the function of the speech therapist in the group, the prevalence of the group intervention in relation to the individual intervention, and there were differences of opinion since the review of the literature did not correspond to the expected theoretical consistency. This happened because there is a certain reflected adoption of concepts from other areas, without argumentation and without a restructuring demanded by the transposition to the speech therapy clinic. This is because there is no evident concern to articulate the theoretical studies to the elements that make up the speech therapy clinic, namely: the semiology, the etiology, the diagnosis and the therapeutics.

OBJETIVO: escutar a percepção materna sobre a introdução e uso da prancha de comunicação ampliada e alternativa na clínica de linguagem da paralisia cerebral. MÉTODOS: foram realizadas entrevistas com um roteiro semi-dirigido e através da coletânea de narrativas foram criadas categorias de análise a partir de três pontos norteadores: a) a constituição da função materna e seu exercício junto ao sujeito com paralisia cerebral; b) a interação dialogal sob a ótica bakhtiniana; e c) os efeitos da clínica de linguagem na função materna e no diálogo das mães com seus filhos. RESULTADOS: os resultados indicam diferentes tipos de uso do recurso na díade mãe-filho, tendo relação com a qualidade do exercício da função materna e a forma de apresentação do recurso ao usuário e a sua família. Quando a concepção de linguagem com a qual é implementado o recurso não inclui a família, nem considera o exercício da função materna, os resultados na sua generalização e manutenção são precários. Nos casos em que houve o debate sobre o uso familiar da prancha, o processo de intersubjetividade do sujeito sem oralidade foi favorecido o uso e a generalização foram ampliados. CONCLUSÃO: conclui-se que a concepção de linguagem dialógica de Bakhtin, atravessada pela psicanálise, permite uma abordagem mais eficaz do recurso comunicativo investigado.PURPOSE: to analyze the maternal perception on the introduction and use of alternative and augmentative communication boards in cerebral palsy language clinic. METHODS: semi-structured interviews were conducted and used to created analysis categories based on three guiding aspects: a) the constitution of maternal function and its execution with individuals with cerebral palsy; b) dialogic interaction under Bakhtinian perspective; and c) the effects of language clinic on the maternal role and on the dialogue between mothers and their children. RESULTS: the results indicate different types of resource usage in the mother-child dyad, which are related to the quality of the maternal role and to the form of presenting the resource to users and their family. When the conception of language with which the resource is implemented does not include the family or consider the exercise of maternal role, the results in its generalization and maintenance are precarious. In cases where there was a debate on family use of the communication board, favoring the process of intersubjectivity between subjects without orality and their family, use and generalization were increased. CONCLUSIONS: it may be concluded that Bakhtin conception on dialogic language crossed by psychoanalysis allows for a more efficacious approach as for the probed communicative device.

TEMA: intervenção fonológica em crianças com Distúrbio Específico de Linguagem, com base em um Modelo Psicolinguístico. PROCEDIMENTOS: participaram do processo de intervenção 4 pré-escolares, de ambos os gêneros, com idade entre 48 e 83 meses. O desempenho psicolinguístico dos sujeitos foi obtido em duas etapas (pré e pós-intervenção), mediante a utilização de instrumentos que avaliam diferentes níveis do processamento da informação: reconhecimento auditivo-fonético, consciência fonológica, codificação/ produção fonológica, memória de trabalho e acesso lexical. O Programa de intervenção teve duração de 4 meses. RESULTADOS: os pré-escolares apresentaram comprometimento em todos os níveis do processamento da informação avaliados (pré-intervenção), revelando que as dificuldades de organização fonológica estavam relacionadas a problemas no processamento receptivo e expressivo. Ao fim do Programa, todos apresentaram melhora no desempenho fonológico. CONCLUSÃO: o uso de procedimentos de avaliação que abordam os diferentes níveis de processamento possibilita a compreensão da natureza dos distúrbios de linguagem e permitem a programação de estratégias mais efetivas para as dificuldades de linguagem.BACKGROUND: phonologic intervention for children with Specific Language Impairment, within a Psycholinguistic Model. PROCEDURES: this study involved four pre-school children, aging between 48 to 83 months, that had not been previously submitted to intervention. The psycholinguistic assessment was carried pre and post-intervention, through several instruments that evaluate diverse levels of information processing: auditory-phonetic recognition, lexical access, phonological working memory, phonological awareness, articulation, phonological production. The intervention took 4 months. RESULTS: preschool children showed difficulties in diverse evaluated processing information levels(pre-intervention), showing that the difficulties on phonological organization were related to problems in the receptive and expressive processing. To the end of the Program, all had presented improvement in the phonological performance. CONCLUSION: the use of evaluation instruments being suitable to diverse phonological processing levels propitiates the understanding on the nature of language impairments and the programming of more effective intervention strategies.

OBJETIVO: identificar e caracterizar as habilidades e o desenvolvimento da Atenção Compartilhada de crianças autistas, não-verbais, pela observação de comportamentos comunicativos. MÉTODOS: a pesquisa envolveu cinco meninos, entre 5a,9m e 8a,6m, com diagnóstico de Transtorno Autista (DSM-IV, 2002), filmados em dois momentos, com intervalo de 4 meses. Neste período, as crianças foram submetidas à intervenção fonoaudiológica baseada na estimulação da Atenção Compartilhada. Cada gravação era de 15 minutos e envolvia uma criança ou um grupo de 2-3 crianças com a terapeuta, em situações de interação não-dirigida e semi-dirigida, na escola onde estudavam. Foram observados e registrados comportamentos referentes às habilidades de Atenção Compartilhada. O material utilizado envolveu instrumentos musicais de percussão. Os dados foram analisados considerando-se o tempo, a interação e o(s) interlocutor(es). RESULTADOS: o comportamento olhar apresentou maior crescimento em cada um dos sujeitos. A análise dos dados revelou que os sujeitos apresentaram tendências qualitativas de evolução da habilidade de compartilhar a atenção, revelando um significado clínico importante, apesar da não ocorrência de significância estatística. Cada sujeito apresentou características e evolução dos Comportamentos Comunicativos relativos à Atenção Compartilhada de maneira individualizada. Após o período de intervenção fonoaudiológica, verificou-se aumento quantitativo dos comportamentos observados nos cinco sujeitos, principalmente na interação criança-terapeuta. CONCLUSÕES: o olhar é um importante patamar para o desenvolvimento dos outros comportamentos em direção à Atenção Compartilhada. A interação adulto-criança favorece o surgimento de comportamentos comunicativos e o compartilhar. A terapia fonoaudiológica focada nas habilidades de Atenção Compartilhada parece contribuir positivamente para o desenvolvimento da comunicação das crianças autistas.PURPOSE: to identify and characterize abilities of Joint Attention of non-verbal autistic children through the observation of communicative behaviors. METHODS: the research involved 5 boys, between 5,9 and 8,6-year old, diagnosed as Autistic Disorder (DSM IV, 2002), recorded in two instances with a four months interval. Meanwhile, the children were submitted to a language therapy mediation based on Joint Attention stimulation. Each recording was 15 minutes long and involved one child or group of 2-3 children with the therapist within non-directed and semi-directed interaction situations, at school where they studied. We observed and registered behaviors regarding Joint Attention abilities. The used material involved percussion instruments. Data were analyzed in relation to time, interaction and interlocutor. RESULTS: the gaze behavior showed the greatest growth in each subject. Data analysis revealed that the subjects showed qualitative trends for evolution of the Joint Attention ability revealing important clinical meaning although there was lack of statistical significance. Each subject showed characteristics and evolution of the communicative behaviors regarding Joint Attention in an individualized manner. After the period of language therapy intervention, we observed a quantitative behavioral growth in the 5 subjects, specifically under child-therapist interaction. CONCLUSIONS: the gaze behavior is an important step for the development of others behaviors toward Joint Attention. The adult-child interaction situation facilitates the appearance of communication behaviors and sharing. Language therapy with focus on the Joint Attention abilities seems to contribute positively for communication development of autistic children.

OBJETIVO: proveer evidencia sobre la contribución de estimular los guiones para el desarrollo narrativo en un grupo de niños con Trastorno Específico de Lenguaje y déficit narrativo. MÉTODOS: seis niños con Trastorno Específico del Lenguaje constituyeron el grupo experimental al que se le aplicó el programa y seis niños con Trastorno Específico del lenguaje conformaron el grupo control. Todos presentaban déficit narrativo y tenían un promedio de edad de 4 años, 5 meses. El programa se aplicó individualmente durante 18 sesiones. Se comparó el desempeño narrativo antes y después de la intervención en ambos grupos de niños. RESULTADOS: todos los niños del grupo experimental incrementaron significativamente su desarrollo narrativo. Incluso, el 50% de ellos logró niveles narrativos correspondientes a su edad cronológica. En el grupo control no se observó un aumento significativo. CONCLUSIONES: el programa basado en los guiones es una estrategia eficaz para estimular las habilidades narrativas tempranas en niños con Trastorno Específico del Lenguaje y déficit narrativo.PURPOSE: providing evidence about the possible contribution of scripts to the narrative development of a group of children with Specific Language Impairment and narrative deficit. METHODS: a program for script-based narrative development intervention is submitted. Twelve preschool children with Specific Language Impairment participated in the current study. They were divided at random in two groups. The intervention was developed in one of these groups and, the other was the control group (mean age of 4;5 for both groups). RESULTS: all children in the experimental group significantly increased their narrative development. Including 50% of them that achieved a narrative level corresponding to their chronological age. No significant increase was noted in the control group. CONCLUSION: the present study shows that using scripts in children with Specific Language Impairment and narrative deficit may be successful in helping them to overcome their difficulties in narrative performance.

TEMA: na atualidade, a gagueira pode apresentar definições distintas de acordo com a abordagem defendida pelos autores para fundamentar tal distúrbio. O trabalho tem como objetivo discutir tais abordagens na terapia do caso em questão, aplicando suas técnicas terapêuticas e adequando-as conforme o contexto em questão e a aceitação do indivíduo para com as atividades, promovendo o desenvolvimento dos objetivos, procedimentos e técnicas utilizados na terapêutica para a gagueira. PROCEDIMENTOS: estudo longitudinal de um paciente de 14 anos, atendido em dois momentos: entre 2005/2006, ano em que recebeu alta com indicação de monitoramento, e 2008/2009 época em que retorna ao atendimento devido à recidiva. No estudo, são consideradas as diferentes abordagens: psicolinguística da fluência, neurolinguística e motora da gagueira, vertente contextualizada e abordagem fenomenológica da gagueira. RESULTADOS: na evolução, observou-se a diminuição considerável da gagueira e dos movimentos compensatórios, bem como, comportamento e postura adequados e uma melhor socialização. CONCLUSÃO: o estudo das abordagens consideradas na terapia propiciou a realização do atendimento que atingiu os objetivos propostos. Além disso, o paciente contribuiu no direcionamento da terapia conforme sua aceitação e aplicação em sua vida, revelando, dessa forma, quais condutas foram mais efetivas e puderam contribuir de forma mais direta com a sua qualidade de vida e sua evolução.BACKGROUND: stuttering may currently have different definitions according to the approach advocated by the authors to substantiate such a disorder. The paper aims to discuss such approaches in the therapy of the case, applying its therapeutic techniques and adapting them according to the context at issue and take the individual to activities, promoting the development of goals, procedures and techniques used in the stuttering therapy. PROCEDURES: a longitudinal study of a patient being 14 year old, met on two occasions: in 2005-2006, the year he was discharged with an indication for monitoring, and 2008/2009 season in returning to treatment due to relapse. In the study, the different approaches considered were: psycholinguistics fluency, stuttering and motor neurolinguistics, contextual and phenomenological aspects of stuttering. RESULTS: in the evolution, there was a considerable decrease in stuttering and compensatory movements, as well as appropriate behavior and attitude and improved socialization. CONCLUSION: the study on the approaches considered in the therapy enabled the performance of the service that hit the targets. In addition, the patient contributed for directing the therapy as per the acceptance and application in his life, revealed by the results of more effective behaviors, contributing to the quality of life and evolution.

Este artigo tem por finalidade discutir criticamente os aspectos fisiológicos e psicológicos da disfonia funcional psicogênica por puberfonia do tipo muda vocal incompleta, esclarecendo os objetivos da terapia fonoaudiológica e os fatores que podem interferir no prognóstico. O estudo foi realizado a partir de uma consulta sistemática a fontes clássicas e atuais da literatura científica nacional e internacional. Com base nos aspectos abordados, foi possível concluir que a conduta fonoaudiológica fundamenta-se em técnicas que visam à diminuição da frequência fundamental a partir do abaixamento da laringe. No entanto, faz-se necessário um trabalho interdisciplinar, visto que as causas deste quadro são predominantemente emocionais.

ABSTRACT Purpose: to investigate which intelligence, described in the Theory of Multiple Intelligences, favors the development of language (linguistic intelligence) of the patients, in relation to the studied variables: development phase (children and adolescents), sex and preferential intelligences. Methods: the quantitative-qualitative approach was used, with the identification by content analysis of the preferred intelligences of the 107 patients participating in the investigation and the intelligences contemplated in each therapy. After the coding of these data in numbers, the results obtained in the 1,802 therapies analyzed were compared with the development phase, sex and preferential intelligences, using a statistical test. Results: in the analysis of the data, it was evidenced that the results obtained in the therapy differ between children and adolescents, according to the intelligences contemplated, which is also observed when considering females and males, but to a lesser extent. Conclusion: it is important to observe the characteristics of age, sex and preferential intelligences, in relation to the contemplation of the different intelligences in the activities developed in the therapy, with a view to the qualification of the results.

ABSTRACT Drug use during pregnancy is a well-known risk factor for the manifestation of speech-language disabilities. However, the necessity of studies directed towards drug use and its influence on interventional speech process in cases of alterations of child language and fluency is observed. In this study, clinical history data are presented as well as pre and post-assessment tests (Speech and Language) and the description of an interventional process of a six-year child. The main communication complaint about the child was stuttering. In addition to the child’s clinical history, there was also knowledge of alcohol and legal and illegal drug use by the mother from before the moment of conception until this intervention process was reported. The protocols Stuttering Severity Instrument (SSI), Child Language Test (ABFW): phonology, vocabulary, and fluency tests, along with the Checklist of Verbal Communication Skills were applied. Based on these assessments, the child was diagnosed with mild to moderate stuttering, phonological simplifications, vocabulary inferior to that expected for his age, difficulty maintaining communicative turns, simplified narrative skills, alterations in psycholinguistic processes, and complaints from the school about his learning. The child underwent speech therapy in the areas of fluency and Child Language (phonological approach), showing evolution in the post-intervention assessment. Thus, in the present case, it became clear that the concomitant use of alcohol with exposure to cigarettes and marijuana may trigger changes in the acquisition and development of language, fluency and, consequently, learning.

Introduction and Objectives: Speech perception that takes place in the cochlea is involved in the process of language. The objective was to describe the findings in transient otoacoustic emissions in children with language problems before and after 6 months of speech therapy., Methods: There were 17 children with language problems between 3 and 6 years of age diagnosed with anarthric language delay (expressive and mixed language disorder). They underwent medical history, otoscopy, intelligence level testing, initial language test, tympanometry of 226Hz, audiometry and transient otoacoustic emission test., Results: We evaluated the 17 patients again after 6 months of attending speech therapy. The percentage of overall reproducibility of transient otoacoustic emissions in both ears was adequate to perform frequency analysis. We found a statistically significant difference (P≤0.01) in the frequency of 1kHz reproducibility when comparing results before and after therapy in the right ear. There was a significant difference (P≤0.05) when comparing the results of audiometry at frequencies of 0.5, 1.5, 2, 4 and 8kHz in the right ear and a highly significant difference (P=0.001) in the frequency of 3kHz in the left ear., Conclusions: The analysis of sound through the cochlea is involved in the process of language acquisition. A poor processing of speech sounds in the peripheral system could result in poor processing at the central level. Consequently, it is important to consider our results when making a diagnosis and carrying out rehabilitation treatment in children with language disorders., (Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.)

Introduction: The latest research findings show the importance of early intervention in children with autism spectrum disorder (ASD) in all areas of development, including language. The use of augmentative and alternative communication systems (AACS) favors linguistic and communicative development., Aim: To show the effectiveness of AACS to develop oral language in non-verbal toddlers diagnosed with ASD., Patients and Methods: Thirty children (25 males and 5 females) diagnosed with ASD when they were between 18 and 30 months of age, through the instruments ADOS and ADIR. None of them displayed oral language development at the time of assessment. An intervention program in the area of language was designed based on the use of total communication by the therapist and training the child in the Picture Exchange Communication System (PECS). One year later, the formal aspects of language were assessed with the PLON-R because oral language had been developed., Results: All the children had developed oral language to some extent over a one-year period., Conclusions: Early intervention and the use of AACS with visual props favor the development of oral language in children with ASD in the first years of life.

Aims: The study reviews language disorders in children. Taking their normal development as the starting point, the work puts forward a differential diagnosis based on the symptoms presented in the moment the patient visited the physician. It also suggests an approach for children with language disorders from the neuropaediatric point of view while also updating the management of some of its forms., Development: The acquisition of language is one of the key milestones in the development of children. A child's social and intellectual development is affected by delayed acquisition of language and this can give rise to a ongoing effect involving isolation and regression, which tends towards poor academic achievement and, eventually, leads to the development of learning and social problems. There are studies that evidence a close relationship in children between the development of spoken language and written language, as well as the importance of acquiring language as the basis for writing skills. These problems cause a great deal of anxiety in parents., Conclusions: Knowledge of the problem allows the specialist to detect these children early on in the preschool stage and to ensure they receive the right attention. If treated in time, language learning can be modified to a significant degree, thereby avoiding the complications that affect its development. The specialist working with children must recognise these problems and channel them towards the most suitable therapy.

There have been several proposals for the classification of language disorders in children; some of them are based on the desire to differentiate in terms of its possible cause, while others are based on the criteria for symptoms grouping ('syndromes'), in order to facilitate the diagnostic process and orientate some intervention programs. In the first part, there is an analysis of the advantages and limitations of the most popular classifications, pointing to the inaccuracy on description basis and to the inability to distinguish between several subgroups. In the second part, it is analysed the clinical purpose of using these nomenclatures. Finally, the idea of using a clinical tool is proposed, in order to include the severity criteria of symptoms in the differential diagnosis.

Objectives: (I) To serve as a model for ENT services in the process of creating a voice unit and (II) to show the results obtained in our Voice Unit over the past 12 months., Methods: Sections on Voice Unit Functions, Organisation and Procedures are presented, as well as the study of 122 patients: an assessment of patient self-perception using the Voice Handicap Index, diagnostic category, Voice Unit diagnosis, previous treatments and treatments proposed by the Unit., Results: The results highlight that Voice Handicap Index scores tend towards mild and moderate evaluations; that the most frequent pathological group are exudative lesions affecting Reinke's space; that there are diagnostic discrepancies of more than 50% between the general ENT consultations and the Voice Unit; and that the most common treatment is speech and language therapy (45%), followed by phonosurgery (28%)., Conclusions: The main aim of the Voice Unit is to achieve maximum effectiveness and quality in its various functions. Correct diagnosis and treatment increases effectiveness and allows better use of resources; achieving this requires a minimal, essential setup: laryngostroboscope, a multidimensional protocol and interdisciplinary work., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

Aims: In this paper we analyse the educational and therapeutic needs of children who present pragmatic disorders in language and communication., Development: Pragmatic disorders in language and communication stand apart from the other disorders affecting the remaining aspects of language development. Their less specific nature goes beyond the purely linguistic domain and involves wide areas of the patient's affective and social development., Conclusions: Not only is it necessary to adapt the general model of speech therapy intervention, but also to include it within a set of pedagogical (based on the framework of school itself) and psychological measures (in early care and family guidance services).

Introduction: Language is almost always affected in fragile X syndrome (FXS) and a delay in language acquisition is one of the first characteristics. They articulate poorly and have a repetitive language, using the last word or sentence they have said or have been told. They have a tendency to change subjects as they talk and to repeat what they have heard. Even if comprehension is correct, they are unable to answer questions. Sometimes this is due to the fact that they don't expect the question or because they are not paying attention. They react better to short and concise commands. Their speech is fast with a poor control of the rhythm and inappropriate pausing in words, making it difficult to understand them. Some children with severe language dysfunction will require a complementary communication system to aid them., Development: In speech therapy we will improve their communicative skills, both in comprehension as in expression, minimising or eliminating negative patterns, with exercises, techniques and strategies. Work is needed on the use of alternative language if necessary and finally work on feeding problems caused by the low muscular tone and on sensorial problems such as tactile hyper/hypo stimulation or difficulties to plan their movements. In conclusion, we must bear in mind that each child is different and so are their specific needs., Conclusion: We must know the individualities to provide for opportunities of development or of their control, and focus our objectives in a more real and effective manner.

Introduction: Preventive activities in communication disorders treated by speech-hearing therapists of the Universidad del Valle in Cali Colombia, between January and April, 1995, are described., Methodology: Forty-five professionals to whom a self administered questionnaire with 13 questions was applied, were included in the study., Results: For 67% the program of graduation is basic as source of their preventive knowledge. 47% used only one of nine strategic options and 29% report the use of only two of these preventive interventions. For all communication areas, on average nearly 60% of speech-hearing therapists never use preventive actions., Conclusion: The alumni of the Universidad del Valle do not exercise the practice of prevention in a systematic way it has been claimed by the curriculum of the school. Some determinants of social context and demand of professional services are suspected to induce a great reduction in the proportion and frequency of preventive practice in the professional role.

Unfortunately, in spite of the advances in foetal and perinatal medicine in the last twenty years, the incidence of cerebral palsy has remained unchanged (1.5-2.5 per 1000 live births). It has even possibly risen slightly in premature babies of low birth weight, in parallel with the increased survival of these babies. In spite of modern techniques of rehabilitation, 25% of these patients cannot walk and 35% are mentally retarded. This costs society 5,000 million dollars annually, not counting the loss of opportunity and the emotional and economic burden imposed on these families. The development of new preventive measures such as the use of antagonists of the cortical excitatory amino acids (which when in excess may cause irreversible cerebral damage in cases of hypoxic-ischaemic encephalopathy of the new born). Intramuscular botulinum toxin and continuous intrathecal baclofen seem to promise a reduction in the incidence and functional incapacity of cerebral palsy.