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Attempts to personalize aphasia treatment to the extent where it is possible to reliably predict individual response to a particular treatment have yielded inconclusive results. The current study aimed to (i) compare the effects of phonologically versus semantically focussed naming treatment and (ii) examine biographical and neuropsychological baseline factors predictive of response to each treatment. One hundred and four individuals with chronic post-stroke aphasia underwent 3 weeks of phonologically focussed treatment and 3 weeks of semantically focussed treatment in an unblinded cross-over design. A linear mixed-effects model was used to compare the effects of treatment type on proportional change in correct naming across groups. Correlational analysis and stepwise regression models were used to examine biographical and neuropsychological predictors of response to phonological and semantic treatment across all participants. Last, chi-square tests were used to explore the association between treatment response and phonological and semantic deficit profiles. Semantically focussed treatment was found to be more effective at the group-level, independently of treatment order (P = 0.041). Overall, milder speech and language impairment predicted good response to semantic treatment (r range: 0.256–0.373) across neuropsychological tasks. The Western Aphasia Battery-Revised Spontaneous Speech score emerged as the strongest predictor of semantic treatment response (R2 = 0.188). Severity of stroke symptoms emerged as the strongest predictor of phonological treatment response (R2 = 0.103). Participants who showed a good response to semantic treatment were more likely to present with fluent speech compared to poor responders (P = 0.005), whereas participants who showed a good response to phonological treatment were more likely to present with apraxia of speech (P = 0.020). These results suggest that semantic treatment may be more beneficial to the improvement of naming performance in aphasia than phonological treatment, at the group-level. In terms of personalized predictors, participants with relatively mild impairments and fluent speech responded better to semantic treatment, while phonological treatment benefitted participants with more severe impairments and apraxia of speech., Kristinsson et al. found superior effects of semantic versus phonological therapy in a group of 104 participants with chronic aphasia. Personalized predictors of semantic therapy response included mild language impairment and fluent speech, whereas more severe language impairment and presence of apraxia of speech predicted response to phonological therapy., Graphical Abstract Graphical Abstract

RESUMO As pseudopalavras são um recurso pouco utilizado na prática clínica, mas podem representar uma excelente opção para a terapia fonológica. O objetivo deste estudo foi verificar o progresso terapêutico de crianças com desvio fonológico tratadas a partir de uma nova abordagem terapêutica, considerando o ambiente linguístico favorecedor em pseudopalavras e palavras com significado. A amostra foi composta por 3 crianças, com idades entre 4 e 8 anos, submetidas a uma nova abordagem terapêutica com base fonológica. As crianças foram tratadas com diferentes alvos envolvendo pseudopalavras e palavras reais, em ambiente linguístico favorecedor e neutro. Nos resultados, pode-se observar que a terapia envolvendo ambiente linguístico favorecedor apresentou melhores resultados quando comparada com a realizada em ambiente neutro. Em relação às palavras-alvo, os sujeitos tratados simultaneamente com pseudopalavras e palavras reais apresentaram resultados satisfatórios, indicando que os alvos foram adequados à terapia. A nova abordagem terapêutica envolvendo pseudopalavras e palavras reais em ambientes favorecedores mostrou-se eficaz para o tratamento dos desvios fonológicos.

Based on findings for overlapping representations of bilingual people's first (L1) and second (L2) languages, unilingual therapies of bilingual aphasia have been proposed to benefit the untrained language. However, the generalisation patterns of intra- and cross-language and phonological therapy and their neural bases remain unclear. We tested whether the effects of an intensive lexical-phonological training (LPT) in L2 transferred to L1 word production in a Persian-French bilingual stroke patient with Broca's aphasia. Language performance was assessed using the Bilingual Aphasia Test, a 144-item picture naming (PN) task and a word–picture verification (WPV) task. Electroencephalography (EEG) was recorded during PN and WPV in both languages before and after an LPT in French on a wordlist from the PN task. After the therapy, naming improved only for the treated L2 items. The naming performance improved neither in the untrained L2 items nor in the corresponding items in L1. EEG analyses revealed a Language x Session topographic interaction at 540 ms post-stimulus, driven by a modification of the electrophysiological response to the treated L2 but not L1 items. These results indicate that LPT modified the brain networks engaged in the phonological-phonetic processing during naming only in the trained language for the trained items.

The effectiveness of two treatment approaches (phonological therapy and articulation therapy) for treatment of 14 children, aged 4;0-6;7 years, with phonologically based speech-sound disorder (SSD) has been previously analysed with severity outcome measures (percentage of consonants correct score, percentage occurrence of phonological processes and phonetic inventory). Considering that the ultimate goal of intervention for children with phonologically based SSD is to improve intelligibility, it is curious that intervention studies focusing on children's phonology do not routinely use intelligibility as an outcome measure. It is therefore important that the impact of interventions on speech intelligibility is explored.

The studies of phonological therapy for patients with both phonemic planning and articulatory implementation deficits report the related dichotomy of anterior and posterior syndrome with psycholinguistic model. However, there must be some investigation on segmental errors as input of rehabilitation within phonological framework. This study investigates whether the errors-based rehabilitation model can encourage two Balinese individuals with Broca's aphasia (KW and NS) to reduce the phonological errors. The results showed that KW and NS performed different segmental errors and types of the phonological process even though they suffered from identical non-fluent symptom. KW, in pre-intervention tended to present phonemes substitution, omission and insertion errors which mostly occurred in the initial position of words and he transposed the onset of the second syllable to the onset of the first syllable. Meanwhile, NS in some cases, tended to transpose the phonemes randomly, inserted other segments – especially [nasal] and [lateral] between two vowels (hiatuses) and altered the high complex segments with less complex ones. The phonological error-based rehabilitation was effective to reduce the errors and the phonetic relaxation helped them exhibit minor errors. This indicated that phonetic based training can stimulate the articulatory processing deficit as anterior syndrome.

PURPOSE: To verify the changes in the deviant phonological system regarding phonemes acquisition and in the severity level of phonological disorders in subjects submitted to phonological therapy using the contrastive approach, in comparison to a group of subjects not submitted to intervention. METHODS: Participants were 18 subjects aged between 4 years and 10 months and 7 years and 4 months, of both genders, with diagnosis of phonological disorder. Nine subjects treated by contrastive approach constituted the Experimental Group, and the other nine subjects, the Control Group (on the waiting list for phonological therapy). All subjects were assessed before and after the period of contrastive therapy applied only to the Experimental Group. Subjects in both groups were matched by age, severity level of the phonological disorder, number of absent sounds in the first phonological assessment, and period of time between the first and the second phonological assessment. In both assessments, the number of acquired sounds in the general phonological system was verified and the Percentage of Consonants Correct - Revised was calculated to determine the severity level of the phonological disorder. Data were statistically analyzed. RESULTS: The Experimental Group acquired more sounds, which determined changes in the severity level of the phonological disorder. The differences found between groups were significant. CONCLUSION: The phonological therapy using the contrastive approach promotes changes in the phonological system that significantly influence the acquisition of sounds and the change of the severity level.

This study aimed to analyze the phonological awareness skills and progress (phonetic and phonological inventory and generalizations) in phonological therapy. The research group consisted of five children presenting speech disorders, aged 5:0 and 6:11, subjected to phonological therapy. The results of the phonological awareness assessment were analyzed before the treatment in order to verify the performance of children and their phonological knowledge. The evaluation was performed before and after the treatment. It was possible to obtain the phonetic and phonological inventories of the subjects and, after that, the generalizations obtained with phonological therapy were analyzed (considering lexical items that were not used during treatment, other positions in word, within one sound class or another class of sounds). The results showed that there is no relation between the performance in phonological awareness tasks and the evolution of the phonological therapy. On the other hand, the results agree with the research findings from the literature, reinforcing the idea that, children with phonological disorder can be able to react properly to metalinguistic tasks such as phonological awareness without being able to correct their speech problems. Finally, it can be conclude that this research subject should be investigated deeper and another analysis should be carried out involving a higher number of subjects, including the phonological awareness evaluation before and after therapy. By doing this, it will be possible to obtain other important data to improve the treatment of phonological disorder.

TEMA: percursos de aquisição fonológica de crianças tratadas com ambientes favoráveis em oposição aos ambientes pouco favoráveis e neutros para a produção de /z/, /∫/e /ℑ/na terapia fonológica. PROCEDIMENTOS: foram selecionadas seis crianças com desvio fonológico e idades entre 4:7 e 7:8 para participarem do estudo. As mesmas estavam devidamente autorizadas por seus responsáveis. Foram realizadas avaliações fonoaudiológicas e complementares para diagnóstico do desvio fonológico. Os sujeitos foram pareados de acordo com a gravidade do desvio fonológico, sexo, faixa etária e aspectos do sistema fonológico em relação aos fonemas alterados. Metade das crianças foi tratada com palavras em que os fonemas /z/, /∫/e /ℑ/encontravam-se em ambientes favoráveis e a outra metade com ambientes pouco favoráveis e neutros. Foram realizadas oito sessões e, após estas, novas avaliações foram realizadas para descrever e comparar qualitativamente os percursos de aquisição fonológica dos sujeitos por meio do Modelo Implicacional de Complexidade de Traços. RESULTADOS: os resultados indicaram discreta vantagem na evolução terapêutica de dois sujeitos tratados com ambientes favoráveis, em relação a seus pares. Porém, uma criança tratada com ambientes pouco-favoráveis e neutros, obteve resultados mais positivos do que seu par. CONCUSÃO: os ambientes favoráveis à produção das fricativas /z/, /∫/e /ℑ/ não determinaram o sucesso terapêutico, porém influenciaram positivamente a evolução fonológica dos sujeitos do estudo. BACKGROUND: routes of phonological acquisition in children treated with favorable environments in contrast with unfavorable and neutral environments for production of /z/, /∫/and /ℑ/in phonological therapy. PROCEDURES: six children with phonological disorder aged between 4:7 and 7:8 were selected to take part in the study. They were properly authorized by their parents. There were speech-language and complementary evaluations in order to diagnose the phonological disorder. The subjects were matched according to the severity of the phonological disorder, gender, age and aspects of the phonological system in relation to the altered phonemes. Half of the children were treated with words in which the phonemes /z/, /∫/and /ℑ/ were in favorable environments and the other half with unfavorable and neutral environments. There were eight sessions and, after that, new evaluations were made in order to describe and qualitatively compare the routes of phonological acquisition in the said subjects through the Implicational Model of Features Complexity. RESULTS: the results indicated a small advantage in the therapeutic evolution of two subjects treated with favorable environments, in relation to their matches. However, children treated with unfavorable and neutral environments obtained more positive results than their matches. CONCLUSION: the favorable environments for production of fricatives /z/, /∫/and /ℑ/ did not determine the therapeutic success, but positively influenced the phonological evolution in the subjects in the study.

This study had the aim to analyze both the phonological changes and the generalization obtained in the treatment with rothics in two models of phonological treatment. The sample consisted of four subjects diagnosed with phonological disorder, with ages between four and six years. All of them were assessed before and after the phonological therapy. Two groups were established for the treatment with rothics. One group was treated with ABAB - Withdrawal and Multiple Probes Model, and the other group with the Maximal Opposition Model. The phonological system and the occurrence of generalizations before and after the treatment were analyzed. It was found that none of the subjects acquired the rothics that were practiced in the treatment, however, the occurrence of generalization to untreated items was observed only in the subjects treated by the ABAB - Withdrawal and Multiple Probes model. The other types of generalization occurred in both models. The Maximal Opposition Model provided greatest changes in the phonological system of the subjects, which can have been favored by the other target-sound of the pair

PURPOSE: To examine the occurrence of complex onset pre- and post-treatment in children treated with three different models of phonological therapy. METHODS: Twenty-one subjects with phonological disorder participated in the study, 16 boys and five girls, with ages varying between four years and seven years and eleven months. The children were divided into three groups of seven subjects, according to the therapy models used: Modified Cycles Model, Maximum Opposition Model and ABAB-Withdrawal and Multiple Probes Model. Data from initial and final evaluations of the phonological system were analyzed, regarding the total production of complex onsets and of production of complex onsets with /l/ and /r/. These were classified as: not acquired, from 0 to 39%; partially acquired, from 40 to 69%; and acquired, from 70 to 100%. Statistical analyses were carried out. RESULTS: Regarding the total number of occurences of complex onsets, there was a difference between pre- and post-therapy means of not acquired and acquired complex onsets in the Modified Cycles Model and in the Maximum Opposition Model; in the ABAB-Withdrawal and Multiple Probes Model, this difference was found only for acquired complex onsets. The same was veryfied for complex onsets with /r/. With regards to complex onsets with /l/, differences were found only in the Modified Cycles Model, between not acquired and acquired complex onsets. A different classification of not acquired and acquired complex onsets was observed, in all models, between pre- and post-treatment. CONCLUSION: The three models of phonological therapy were effective for the treatment of complex syllabic onset structure.

PURPOSE: to describe the phonological systems of monozygotic twins both having phonological disorders and to analyze the gradual development of the speech therapy after applying Modified Maximal Opposition Model in order to investigate the influence of genetic and environmental factors on the outset and continuity (maintenance) of phonological disorders. METHODS: the initial phonological assessments were compared as well as the target-sounds used in therapeutic plan, and the final phonological assessments at the end of each year of treatment for both monozygotic male twins who were six years and five months of age at the beginning of the research, and diagnosed as having phonological disorders. The boys were treated from August 2002 to December 2004 according to the Modified Maximal Opposition Model. All the material was obtained from the database of a project developed in the speech/language clinic of the Federal University of Santa Maria. RESULTS: great similarities were found in the phonological systems of both subjects in the beginning, during the therapeutic evolution and at the end of the phonological therapy, even though the target sounds were not necessarily the same throughout therapy. The boys acquired the absent and partially acquired sounds, presenting generalization in the various possible situations, confirming the efficiency of the therapeutic model employed. CONCLUSION: the genetic influence induces the onset and continuity of phonological disorders; nevertheless environmental factors cannot be disregarded.

Although the naming disorders given much attention in clinical practice, the researchers still search for effective approaches to the treatment and understanding nature of word-finding deficits in the aphasics. This paper presents the results of the phonological and semantic strategies on the capabilities of the naming in patients with Broca's and in patients Wernicke's aphasia. The results showed that phonological strategy contributes to the increasing capabilities in patients with Broca's aphasia, while in the patients with Wernicke's aphasia, the semantic strategy have a greater effect than phonological strategy. . Iako se poremećaju imenovanja poklanja dosta pažnje u kliničkoj praksi, još uvek se traga za efikasnim pristupima u tretmanu. U ovom radu su prikazani rezultati efekta fonološke i semantičke podrške na sposobnost imenovanja kod pacijenata sa Brokinom i Vernikeovom afazijom. Rezultati su pokazali da fonološka podrška doprinosi povećanju sposobnosti imenovanja kod Brokine afazije, dok je kod Vernikeove afazije utvrđen veći efekat semantičke nego fonološke podrške. .

OBJETIVO: Verificar e comparar a ocorrência de estratégias de reparo empregadas nas consoantes fricativas do Português Brasileiro, além de analisar as estratégias aplicadas para cada fricativa em relação à gravidade do desvio fonológico. MÉTODOS: Participaram do estudo 87 sujeitos de ambos os gêneros, com idades entre 4 anos e 8 anos e 11 meses. Todos apresentavam estratégias de reparo envolvendo pelo menos uma das consoantes fricativas (/f/, /v/, /s/, /z/, , ), com ocorrência mínima de 40%. Os dados são provenientes de avaliações fonológicas pré-terapia, com a gravidade do desvio fonológico determinada pelo cálculo do Percentual de Consoantes Corretas - Revisado. Os dados foram analisados estatisticamente. RESULTADOS: Houve progressão no emprego de estratégias de reparo conforme a complexidade de produção do fonema. As estratégias de reparo foram encontradas em todas as gravidades do desvio fonológico, estando as que mais comprometem a inteligibilidade de fala nos graus mais acentuados. CONCLUSÃO: Quanto mais complexa a fricativa, mais estratégias de reparo são empregadas e, quanto maior o grau do desvio fonológico, mais vezes estes recursos são utilizados. PURPOSE: To verify and compare the occurrence of repair strategies used in the fricative consonants of Brazilian Portuguese, and to analyze the strategies applied for each fricative according to the severity of phonological disorders. METHODS: Participants were 87 subjects of both genders, with ages between 4 years and 8 years and 11 months. All children used repair strategies involving at least one of the fricative consonants (/f/, /v/, /s/, /z/, , ), with minimal occurrence of 40%. Data are from the phonological assessments conducted before phonological therapy, and the severity of phonological disorders was determined by the Percentage of Consonants Correct - Revised. Data were statistically analyzed. RESULTS: There was progression in the use of repair strategies according to the production complexity of the phoneme. Repair strategies were found in all severities of phonological disorders, and the strategies that most affect speech intelligibility were found in more severe degrees. CONCLUSION: The more complex the fricative, the more repair strategies are used, and the more severe the phonological disorder, the more occurrences these strategies have.

OBJETIVO: investigar a relação dos tipos de estratégias de reparo utilizadas nas consoantes líquidas do Português Brasileiro de acordo com a faixa etária e a gravidade do desvio fonológico. MÉTODOS: participaram do estudo 120 crianças, sendo 41 do sexo feminino e 79 do masculino, com idades entre quatro e oito anos e onze meses. Todas as crianças empregavam pelo menos uma das estratégias envolvendo alguma das consoantes líquidas (/l/, //, /r/, /R/) - substituição, semivocalização e/ou omissão - com emprego de 40% ou mais da estratégia no sistema fonológico. Os dados foram extraídos das avaliações fonológicas de crianças que não haviam recebido terapia fonológica, e a gravidade do desvio fonológico foi determinada por meio do Cálculo do Percentual de Consoantes Corretas - Revisado. Os dados foram submetidos à análise estatística por meio do Teste Exato de Fisher, com p/, /r/, /R/) - replacement, semi-vocalization and / or omissions - using 40% or more of the strategy in the phonological system. Data were extracted from the phonological assessments of children who had not received phonological therapy, and the severity of phonological disorders was determined by the Percentage of Consonants Correct-Revised (PCC-R). Data were statistically analyzed by using Fisher's Exact Test, with p

OBJETIVO:verificar a abordagem terapêutica mais eficaz às crianças com desvio fonológico que realizam a estratégia de alongamento compensatório (EAC) nos casos de C¹C²V → C¹V. MÉTODOS: foram selecionados quatro sujeitos que empregavam a EAC na simplificação do OC e possuíam em seu inventário fonético os segmentos [] e [l]. Do total de sujeitos, dois foram submetidos à terapia fonológica (TF), baseada no modelo de Pares Mínimos, e dois à terapia fonética/articulatória (TA), enfatizando-se a co-articulação do som, o uso de pistas visuais, táteis/cinestésicas e auditivas, bem como o treino articulatório. As crianças receberam dois atendimentos semanais até a aquisição de CCV (80% de acertos da estrutura na fala espontânea). Para a verificação da diferença no tempo de terapia fonética e fonológica, aplicou-se o Teste t para amostras independentes com nível de significância de 5%. Os progressos terapêuticos dos sujeitos foram analisados de forma qualitativa. RESULTADOS: na comparação dos resultados entre a média de sessões obtida com cada modelo terapêutico, percebe-se que as crianças que receberam TA precisaram de metade do tempo do que os sujeitos submetidos à TF, apesar desse resultado não ser estatisticamente significante (p=0,40). é relevante frisar, na prática clínica, a diferença no tempo de tratamento. CONCLUSÃO: as crianças que empregam a EAC apresentaram melhores resultados quando submetidas à terapia que promoveu implementação fonética e não a organização fonológica, visto que os pacientes expostos à TA obtiveram progressos mais rápidos quando comparados ao modelo fonológico. PURPOSE: to verify the more effective therapeutic approach for children with phonological disorder who carry out the compensatory lengthening (SCL) strategy in cases of C¹C²V → C¹V. METHODS: we selected four subjects employing the simplification of SCL in CC, and had in its inventory phonetic segments [] and [l]. In the total of people, two were submitted to phonological therapy (PT), based on the model of the minimum pair and two therapy phonetic-articulatory (TA) emphasizing the co-articulation of the sound, the use of visual clues, tactile/kinesthetic and auditory, and articulatory training. Children received two weekly visits for the acquisition of CCV (80% of correct structure in spontaneous speech). To check the difference in time of phonetic and phonological therapy was applied the T Test for independent samples of 5% significance level. The therapeutic advances of the subjects were analyzed in a qualitative. RESULTS: in the comparison of the results in the sessions between the average obtained with each therapeutic model, we found that children receiving TA needed half of the time of the subjects that underwent PT, although not statistically significant (p = 0.40). It is relevant to highlight the difference in time of treatment in clinical practice,. CONCLUSION: children using SCL, benefit when submitted to therapy in order to promote an phonetic implementation and not the phonological organization, since that the patients who were exposed to TA obtained faster progresses when compared to the phonological model.

BACKGROUND: phonological therapy in subjects with phonological disorders. AIM: to compare the efficacy of three contrastive approach models in three different severities of phonological disorder. METHOD: participants of the study were nine subjects with phonological disorders, with ages ranging between 4:2 and 6:6 years. All subjects were evaluated prior to and after phonological therapy. Three groups, with three subjects each, were determined for treatment. Each group presented one individual with severe, one with moderate-severe and one with mild-moderate phonological disorder. Each group was treated using a different therapy model - Minimal Opposition, Maximal Oppositions/Empty Set and Multiple Opposition. Results were analyzed according to the Friedman Test, considering p < 0.05; a descriptive analysis was also performed among the models. RESULTS: there was no statistical difference among the models considering the severity of phonological disorder. The Minimal and Maximal Oppositions/Empty Set approaches favored a greater number of sound acquisitions in the phonetic inventory of subjects with severe and moderate-severe disorder. On the other hand, the Multiple Oppositions approach favored a better performance of sound acquisition in the phonological system and a decrease in the impaired distinctive features in severe and moderate-severe disorder. CONCLUSION: the models of therapy were effective in the treatment of different severities of phonological disorders observing the best performance in children with severe and moderate-severe disorder.

TEMA: terapia fonológica em irmãos com desvio fonológico. PROCEDIMENTOS: participaram da pesquisa dois irmãos, S1 e S2, do sexo masculino e feminino, respectivamente. O S1, 6:6 de idade, apresentava desvio fonológico de grau severo e foi tratado pelo modelo de Oposições Mínimas e o S2, 4:8 de idade, com desvio fonológico de grau moderado-severo foi tratado pelo Modelo de Oposições Máximas. Ambos os sujeitos realizaram 25 sessões de fonoterapia. RESULTADOS: o S2 obteve uma melhor evolução terapêutica comparado ao S1. O S1 apresentou generalização a itens não utilizados no tratamento e o S2 apresentou generalização dentro de uma classe de sons. CONCLUSÃO: os modelos utilizados são eficazes, pois proporcionaram a ocorrência de generalizações e a melhora do sistema fonológico de ambos os sujeitos. No entanto os fatores ambientais podem ter limitado a evolução do tratamento, uma vez que as crianças apresentavam substituições semelhantes na fala o que favorecia a manutenção da alteração.

TEMA: terapia fonológica. OBJETIVO: avaliar a eficácia do tratamento em três diferentes modelos de terapia quanto às mudanças no sistema fonológico de sujeitos com diferentes gravidades do Desvio Fonológico (DF). MÉTODO: a amostra constituiu-se de 66 sujeitos, com idades entre 4:4 e 8:2, sendo 43 do sexo masculino e 23 do feminino, integrantes do banco de dados de uma clínica escola. Todos foram avaliados, antes e após um período de 15 a 25 sessões de terapia fonológica, utilizando-se a Avaliação Fonológica da Criança, a partir da qual foi determinada a gravidade do DF conforme o Percentual de Consoantes Corretas - PCC, o número de Segmentos Não Adquiridos - SNA , e o percentual de Segmentos Adquiridos (SA) após o período de tratamento. Os sujeitos foram tratados pelos modelos ABAB-Retirada e Provas Múltiplas, Oposições Máximas Modificado e Ciclos Modificado. Posteriormente, realizou-se análise estatística dos dados, utilizando o Teste T para amostras iguais, considerando-se p < 0,05. RESULTADOS: verificou-se um aumento do PCC e do percentual de SA, bem como redução do número de SNA em todos os grupos tratados pelos diferentes modelos de terapia. Estes resultados foram estatisticamente significativos para a maioria dos grupos. CONCLUSÃO: os resultados permitem afirmar que os três modelos de terapia aplicados foram eficazes no tratamento de crianças com DF, para as diferentes gravidades do desvio. Além disso, as maiores mudanças no sistema fonológico ocorreram para os grupos com DF de grau mais acentuado.

OBJETIVO: comparar a generalização dentro de uma classe e para outras classes de sons no tratamento de sujeitos com diferentes gravidades do desvio fonológico submetidos aos Modelos de Ciclos Modificado, ABAB-Retirada e Provas Múltiplas e Oposições Máximas Modificado. MÉTODOS: 21 crianças com desvio fonológico, 11 do sexo masculino e 10 do feminino, com média de idade de 5:7 anos tiveram seus dados de fala foram analisados por meio da avaliação fonológica. Após a realização da análise contrastiva, foi calculado o Percentual de Consoantes Correta (Shriberg e Kwiatkowski, 1982) e os sujeitos foram classificados em diferentes gravidades do desvio fonológico: grave, moderado-grave, leve-moderado, leve. Seis sujeitos foram submetidos ao Modelo de Ciclos Modificado, oito ao ABAB-Retirada e Provas Múltiplas, e sete ao de Oposições Máximas Modificado. Fez-se uma comparação da generalização dentro de uma classe e para outras classes de sons entre os três modelos em cada grau de gravidade do desvio fonológico. RESULTADOS: a generalização dentro de uma classe de sons ocorreu em todos os modelos pesquisados. O Modelo ABAB-Retirada e Provas Múltiplas foi efetivo para todos os graus de gravidade e o de Oposições Máximas Modificado foi mais efetivo nos graus grave e moderado-grave. Em relação à generalização para outras classes de sons os sujeitos submetidos ao Modelo ABAB-Retirada e Provas Múltiplas foram os que apresentaram um maior número de produções corretas nas diferentes gravidades do desvio fonológico. CONCLUSÃO: todos os sujeitos apresentaram evoluções quanto às generalizações pesquisadas nos três modelos. PURPOSE: to compare the generalization inside of a sound class and for other sound classes in the treatment of subjects with different severity levels of phonological disorders submitted to the Modified Cycles Model, ABAB-Withdrawal and Multiple Probes and Maximum Opposition Model. METHODS: 21 children with phonological disorder, 11 males and 10 females, with average age 5:7, were their speech data analyzed through the phonological assessment. From the contrastive analysis we calculated the Percentage of Correct Consonants (Shriberg & Kwiatkowski, 1982) and the subjects were classified in the different severity levels of phonological disorders: severe, moderate-severe, mild-moderate and mild. Six subjects were submitted to the treatment with Modified Cycles Model, eight to the ABAB-Withdrawal and Multiple Probes Model, and seven to the Modified Maximum Opposition Model. After this was compared the generalization inside of a sound class and for other sound classes among three therapy models for each severity level of phonological disorder. RESULTS: the generalization inside a sound class occurred in all studied models. ABAB-Withdrawal and Multiple Probes Model were effective for all severity groups and the Modified Maximum Opposition were more effective for the severe and moderate-severe groups. In the generalization for other sound classes, the subjects treated with ABAB-Withdrawal and Multiple Probes Model showed a major generalization in different severity levels of phonological disorder. CONCLUSION: all the subjects showed evolution in all kinds of generalization studied in three different therapeutic models.

TEMA: terapia fonológica em crianças com desvios fonológicos. OBJETIVO: comparar as mudanças referentes ao sistema fonológico de crianças com desvio fonológico, com base na comparação do número de fonemas adquiridos, número de sons estabelecidos no inventário fonético e traços distintivos alterados, antes e após a terapia, e verificar se houve diferença em relação a estas mudanças de acordo como o modelo de terapia utilizado - Ciclos Modificado, Oposições Máximas e ABAB - Retirada e Provas Múltiplas. MÉTODO: o grupo pesquisado foi constituído por 21 sujeitos, sendo 15 do sexo masculino e 6 do sexo feminino, com desvios fonológicos que já haviam recebido alta do atendimento fonoaudiológico. Foram comparadas a avaliação fonológica inicial e a avaliação após a terapia em relação ao número de sons estabelecidos nos sistemas fonológicos, o número de sons presentes nos inventários fonéticos e os traços distintivos alterados; também foram comparadas as mudanças fonológicas resultantes da aplicação dos três modelos terapêuticos. RESULTADOS: observou-se diferença estatisticamente significante entre as avaliações iniciais e finais nos três modelos quanto aos fonemas estabelecidos no sistema fonológico e traços distintivos alterados, enquanto que no inventário fonético, houve diferença estatística significante somente entre os modelos ABAB - Retirada e Provas Múltiplas e Oposições Máximas. Não houve diferença estatística entre os modelos terapêuticos. CONCLUSÃO: os modelos de terapia foram efetivos no tratamento das crianças com desvio fonológico, pois estas apresentaram evolução nos seus sistemas fonológicos, inventários fonéticos e traços distintivos alterados, não havendo diferença estatisticamente significante entre os modelos. BACKGROUND: phonological therapy in children with phonological disorders. AIM: to verify changes in the phonological system of children with phonological disorders, based on the comparison of number of acquired phonemes, number of sounds in the phonetic inventory and altered distinctive features, before and after therapy, and to verify differences between therapy models: Modified Cycles, Maximal Oppositions and ABAB - Withdrawal and Multiple Probes. METHOD: the research group was composed of 21 subjects, 15 male and 6 female, with phonological disorders, who had already completed speech-language treatment. The initial and final phonological assessments were compared taking into consideration the number of phonemes in the phonological systems, the number of sounds in the phonetic inventory and the altered distinctive features. Phonological changes that resulted from the application of the three therapeutic models were also compared. RESULTS: statistically significant differences were observed between the initial and final assessments in all of the three therapeutic models considering the number of acquired phonemes and the altered distinctive features, whereas in the phonetic inventory a statistically significant difference was observed only between the ABAB - Withdrawal and Multiple Probes and the Maximal Oppositions model. No statistical difference was observed between the therapy models. CONCLUSION: the three therapy models were effective in the treatment of children with phonological disorders, once all of the children presented improvement of their phonological system, phonetic inventory and altered distinctive features. No significant statistical difference was found between the models.

This study aimed at analyzing and comparing the phonological changes that occur in the different degrees of phonological disorder severity in individuaIs treated with the Modified Maximum Opposition Model (Bagetti,Mota & Keske-Soares, in press) as well as verifYingthe way of approaching the distinctive features in the target sounds (contrast or reinforcement) which lead to major phonological changes. The phonological disorder (PD) diagnosis was carried out by means of phonological and complementary assessments. The subjects' speech data were analyzed through the performance of the Child's Phonological Assessment (CPA) proposed by Yavas, Hemandorena & Lamprecht (1991). After the phonological assessment, the percentage of correct consonants (PCC) proposed by Shriberg & Kwiatkowski (1982) was calculated and the subjects were then classified in the degrees of severity of the phonological disorder: severe (SD), moderate-severe (MSD), mild-moderate (MMD) and mild disorder (MD). The studied group was composed by seven subjects, four males and three females aged from 3:10 to 6:9. For the treatment, the Modified Maximum Opposition Model (Bagetti, Mota & Keske-Soares, in press), which is based on the Maximum Opposition Model (Gierut, 1992), wasused. After 20 therapeutic sessions, the CPA was performed again, the PCC was calculated and the phonological changes referent to the PCC were analyzed, as well as the number of sounds acquired during the therapy and generalizations (to items not used in the treatment, to another position of the word, within a class of sounds and to other classes of sounds). The phonological changes were analyzed before and after the treatment, considering and not considering the way ofpresenting the stimulus (contrast or reinforcement). It was analyzed whether there was a statistically significant difference (Wilcoxon Non-Parametric Test, p