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Protocolo de avaliação para apraxia de fala adquirida
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Costa, Beatriz Maurer

; Brescancini, Cláudia Regina

; Ortiz, Karin Zazo

CoDAS

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2024, Volume 36 N. 1 elocation e20220251

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo Elaborar um protocolo de avaliação do planejamento motor da fala com estímulos fonologicamente balanceados para o português brasileiro e que contemple todas as variáveis necessárias para este diagnóstico. Método Foram realizadas três etapas: Na primeira, construíram-se listas de palavras cujo critério principal foram os padrões silábicos e acentuais. Do levantamento realizado na Etapa 1, procedeu-se à seleção dos vocábulos que compuseram a primeira versão do protocolo na Etapa 2, reunidas em duas tarefas: de repetição e de Leitura em Voz Alta (LVA). Em seguida, investigou-se a ocorrência das palavras usando a base de dados do Corpus Brasileiro (PUC-SP) - Linguateca. Na etapa 3 realizou-se a análise estatística para verificar se as listas de repetição e de LVA estavam equilibradas quanto à ocorrência das palavras. Assim, as listas foram distribuídas em quartis e foram analisadas de forma descritiva e bivariada. O nível de significância utilizado foi de 5%. Resultados Após a realização de todas as etapas, foi possível obter as palavras que compuseram as listas das tarefas de repetição e de LVA. Finalmente, foram então acrescidas ao protocolo as demais tarefas consideradas essenciais para a avaliação da apraxia como as taxas diadococinéticas e a prancha para a emissão oral espontânea. Conclusão O protocolo desenvolvido contém as tarefas consideradas padrão para a avaliação da apraxia de fala pela literatura internacional, o que torna esse instrumento importante para o diagnóstico desse distúrbio em falantes do português brasileiro. etapas construíramse construíram acentuais 1 procedeuse procedeu 2 . (LVA) seguida investigouse investigou PUCSP PUC SP (PUC-SP Linguateca realizouse realizou Assim bivariada 5 5% Finalmente espontânea internacional (LVA

ABSTRACT Purpose To develop an assessment protocol for speech motor planning with phonologically balanced stimuli for Brazilian Portuguese, including all necessary variables for this diagnosis. Methods Three stages were carried out: In the first, word lists were built with the main criterion being syllabic and accentual patterns. From the survey conducted in Stage 1, the words that composed the first version of the protocol lists in Stage 2 were selected, and grouped into two fundamental tasks for diagnosing acquired apraxia of speech (AOS): repetition and Reading Aloud (RA). In Stage 3, the occurrence of words was investigated using the Brazilian Corpus (PUC-SP) - Linguateca database, and a statistical analysis was performed to verify if the repetition and RA lists were balanced in terms of the occurrences. Thus, the lists were distributed in quartiles and submitted to both descriptive and bivariate analyses. A significance level of 5% (p<0.05) was adopted. Results After completion of all stages, the words that composed the lists of the repetition and RA tasks were obtained. Finally, other tasks considered essential for the assessment of AOS, such as diadochokinetic rates and the board for spontaneous oral emission, were then added to the protocol. Conclusion The developed protocol contains the tasks considered standard for the assessment of AOS according to the international literature, which makes this instrument important for diagnosing this disorder in speakers of Brazilian Portuguese. Portuguese diagnosis out patterns 1 selected (AOS) RA. . (RA) 3 PUCSP PUC SP (PUC-SP database occurrences Thus analyses 5 p<0.05 p005 p 0 05 (p<0.05 adopted obtained Finally emission literature (AOS (RA p<0.0 p00 (p<0.0 p<0. p0 (p<0. p<0 (p<0 p< (p< (p

https://doi.org/10.1590/2317-1782/20232022251pt

Language impairments in Alzheimer’s disease: What changes can be found between mild and moderate stages of the disease? Alzheimers Alzheimer s disease
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Ortiz, Karin Zazo

; Lira, Juliana Onofre De

; Minett, Thais Soares Ciariancullo

; Bertolucci, Paulo Henrique Ferreira

Clinics

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2024, Volume 79 elocation 100412

Abstract: En | Text: En | PDF: En

Abstract Objective: To investigate how language deteriorates over the Alzheimer’s Disease course. Methods: A cross-sectional, observational study was carried out. 35 patients diagnosed with dementia due to AD using the NINCDS-ARDRA criteria and undergoing treatment for AD with a therapeutic dose of acetylcholinesterase inhibitors were assessed by the Boston Diagnostic Aphasia Examination (BDAE). The sample comprised 15 patients with mild AD (MMSE > 23, CDR = 0 or 0.5‒1.0) and 20 patients with moderate AD (MMSE = 13‒23, CDR = 2). The results for the 2 groups on all language tasks were compared. Results: A statistically significant difference was found between the mild and moderate AD groups for total score on the BDAE (95% CI 47.10‒114.08, t = 5.0, DF = 21, p = 0.000*), as well as on several tasks involving oral and writing comprehension, language oral expression and writing. Conclusion: The study results showed major changes in the moderate stage. Also, the decline in language performance correlated with the worsening of dementia syndrome, independently of sociodemographic variables. Objective Alzheimers Alzheimer s course Methods crosssectional, crosssectional cross sectional, sectional cross-sectional out 3 NINCDSARDRA NINCDS ARDRA BDAE. . (BDAE) 1 MMSE 23 0.5‒1.0 0510 5 1323 13 13‒23 2. 2) compared Results 95% 95 (95 471011408 47 10 114 08 47.10‒114.08 50 5.0 21 0.000*, 0000 0.000* , 000 0.000*) comprehension Conclusion stage Also syndrome variables (BDAE 0.5‒1. 051 132 13‒2 9 (9 47101140 4 11 47.10‒114.0 5. 0.000 00 0.5‒1 05 13‒ ( 4710114 47.10‒114. 0.00 0.5‒ 471011 47.10‒114 0.0 0.5 47101 47.10‒11 0. 4710 47.10‒1 471 47.10‒ 47.10 47.1 47.

https://doi.org/10.1016/j.clinsp.2024.100412

Brazilian practice guidelines for stroke rehabilitation: part II rehabilitation
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Minelli, Cesar

; Luvizutto, Gustavo José

; Cacho, Roberta de Oliveira

; Neves, Luciana de Oliveira

; Magalhães, Sheila Cristina Sayuri Abe

; Pedatella, Marco Túlio Araújo

; Mendonça, Lucia Iracema Zanotto de

; Ortiz, Karin Zazo

; Lange, Marcos Christiano

; Ribeiro, Priscila Watson

; Souza, Luciane Aparecida Pascucci Sande de

; Milani, Cristiano

; Cruz, Daniel Marinho Cezar da

; Costa, Rafael Dalle Molle da

; Conforto, Adriana Bastos

; Carvalho, Fernanda Martins Maia

; Ciarlini, Bruna Silva

; Frota, Norberto Anizio Ferreira

; Almeida, Kelson James

; Schochat, Eliane

; Oliveira, Tatiana de Paula

; Miranda, Camila

; Piemonte, Maria Elisa Pimentel

; Lopes, Laura Cardia Gomes

; Lopes, Camila Galvão

; Tosin, Michelle Hyczy de Siqueira

; Oliveira, Bianca Campos

; Oliveira, Beatriz Guitton Renaud Baptista de

; Castro, Shamyr Sulyvan de

; Andrade, João Brainier Clares de

; Silva, Gisele Sampaio

; Pontes-Neto, Octávio Marques

; Carvalho, João José Freitas de

; Martins, Sheila C. Ouriques

; Bazan, Rodrigo

Arquivos de Neuro-Psiquiatria

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jul 2022, Volume 80 N. 7 Pages 741 - 758

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderênciaao usode medicamentos, cuidados paliativos,ofuturodareabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC. (AVC incapacidades I randomizados sistemáticas tema comunicação disfagia equilíbrio ataxias espasticidade superior marcha cognição unilateral sensoriais domiciliar medicamentos paliativosofuturodareabilitação paliativos ofuturodareabilitação cuidadores pósAVC. pósAVC pós AVC. pós-AVC

Abstract The Brazilian Practice Guidelines for Stroke Rehabilitation – Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke. Academia Neurologia Portuguese, Portuguese , Portuguese) I trials reviews metaanalyses, metaanalyses meta analyses, analyses meta-analyses guidelines communication dysphagia balance ataxias spasticity gait cognition neglect impairments adherence SARSCoV2 SARSCoV SARS CoV (SARS-CoV-2 infection caregivers (SARS-CoV- (SARS-CoV

https://doi.org/10.1055/s-0042-1757692

Formal language assessment in low-educated persons with aphasia: can the lesion effect be distinguished from the education effect?
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MEDEIROS, Natalia Malagueta de

; ORTIZ, Karin Zazo

Arquivos de Neuro-Psiquiatria

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feb 2022, Volume 80 N. 2 Pages 125 - 128

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Antecedentes: Os testes de linguagem são importantes para a avaliação e o acompanhamento de pacientes afásicos. Apesar disso, a avaliação de linguagem em indivíduos com baixa escolaridade ainda é um desafio. Objetivo: Investigar se a avaliação formal da afasia é capaz de diferenciar o efeito da lesão neurológica versus o efeito da baixa escolaridade em pacientes afásicos, acometidos por acidente vascular cerebral (AVC). Métodos: A amostra foi composta de um grupo de 30 sujeitos afásicos (AG) e um grupo controle (CG) de 36 indivíduos, todos com um a quatro anos de escolaridade. A Bateria Montreal-Toulouse de Avaliação da Linguagem foi administrada a todos os participantes. Resultados: Das 20 tarefas analisadas, 19 apresentaram diferenças significativas entre os grupos. Conclusões: Os resultados sugerem que procedimentos formais de avaliação são capazes de identificar as alterações linguísticas ocasionadas por um AVC, também em pacientes com baixa escolaridade.

ABSTRACT Background: Language tests are important in the assessment and follow up of people with aphasia (PWA). However, language assessment in the low literacy population is still a challenge. Objective: To investigate whether a formal evaluation of aphasia is able to distinguish the neurological effect from the effect of low educational level in people with post-stroke aphasia. Methods: The sample consisted of a group of 30 aphasic subjects (AG) and a control group (CG) of 36 individuals, both with an educational level of 1-4 years. The Brazilian Montreal-Toulouse Language Assessment battery was applied to all subjects. Results: There were statistically significant differences between the groups in 19 out of the 20 tasks analyzed. Conclusions: These results suggest that formal evaluation procedures are able to detect language disorders resulting from stroke, even in subjects with low educational level.

https://doi.org/10.1590/0004-282x-anp-2020-0475

Language skills differences between adults without formal education and low formal education
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Pereira, Ariane

; Ortiz, Karin Zazo

Psicologia: Reflexão e Crítica

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2022, Volume 35 elocation 4

Abstract: En | Text: En | PDF: En

Abstract Background: The influence of education on cognition has been extensively researched, particularly in countries with high levels of illiteracy. However, the impact of low education in all cognitive functions appears to differ. Regarding to language, the effects of education on many linguistic tasks—supported by different processing— remain unclear. The primary objective of this study was to determine whether oral language task performance differs among individuals with no formal and low-educated subjects, as measured by the Brazilian Montreal-Toulouse Language Assessment Battery (MTL-BR). This is the only language battery available for use in Brazil, but lacks normative data for illiterate individuals. The secondary objective was to gather data for use as clinical parameters in assessing persons with aphasia (PWA) not exposed to a formal education. Methods: A total of 30 healthy illiterate individuals aged 34–60 years were assessed. All participants underwent the MTL-BR Battery, excluding its written communication tasks. The data obtained in the present study were compared against results of a previous investigation of individuals with 1–4 years of education evaluated using the same MTL-BR instrument. Results: Statistically significant differences in performance were found between non-formal education and the low-educated (2–4 years) groups on the tasks Auditory Comprehension, Repetition, Orthographic/Phonological Fluency, Number dictation, Reading of numbers and also on simple numerical calculations. Conclusion: The study results showed that individuals with no formal education/illiterate had worse performance than low-education individuals on some of the language tasks of the MTL-Br Battery, suggesting that each year of education impacts cognitive-language performance. Also, data were obtained which can serve as a guide for PWA not exposed to a formal education.

https://doi.org/10.1186/s41155-021-00205-9

Language impairment in the moderate stage of dementia due to Alzheimer's disease
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ORTIZ, Karin Zazo

; DE LIRA, Juliana Onofre

; MINETT, Thais Soares Ciariancullo

; BERTOLUCCI, Paulo Henrique Ferreira

Arquivos de Neuro-Psiquiatria

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apr 2021, Volume 79 N. 4 Pages 283 - 289

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: Durante o estágio moderado da demência na doença de Alzheimer (DA), o distúrbio de linguagem se intensifica, afetando a comunicação. A identificação minuciosa das habilidades linguísticas mais comprometidas nessa fase da doença pode auxiliar no uso de estratégias facilitadoras para a comunicação. Este estudo visou identificar as alterações de linguagem em pacientes com DA na fase moderada. Métodos: 20 pacientes com o diagnóstico de DA provável com base nos critérios do NINCDS-ARDRA, MMSE entre 13 e 23 pontos, CDR=2 e em tratamento medicamentoso para DA foram submetidos à avaliação da global da linguagem por meio do teste de Boston para diagnóstico de Afasia. Os resultados obtidos foram comparados aos da população normal. Resultados: Os pacientes apresentaram escores normais nas tarefas de compreensão oral e escrita de palavras, repetição, mecânica da escrita, ditado do primeiro nível e soletração para o ditado, mas também apresentaram comprometimento em todos os níveis do processamento linguístico, tanto na compreensão quanto nas emissões oral e escrita. Em geral, como esperado, as tarefas envolvendo o acesso lexical foram mais afetadas, porém os pacientes obtiveram desempenho adequado para a nomeação responsiva em que a pista semântica é o eliciador para a resposta. Além disso, os pacientes tiveram melhor desempenho em tarefas de compreensão escrita do que oral. Conclusão: A gravidade da alteração linguística não foi homogênea com algumas habilidades linguísticas mais alteradas do que outras. As habilidades identificadas como preservadas podem contribuir para o uso de estratégias facilitadoras da comunicação nessa fase da DA.

ABSTRACT Background: During the moderate stage of dementia due to Alzheimer’s disease (AD), language disorder is more evident and it impacts on communication. An overview of language impairment could be helpful to find compensatory communication strategies for these patients. Objective: To identify all language impairments among patients with moderate-stage of AD. Methods: 20 patients diagnosed with probable AD based on the criteria of the NINCDS-ARDRA, with a MMSE score of 13-23 points and CDR=2, who were undergoing treatment for AD with therapeutic doses of acetyl cholinesterase inhibitors, were assessed using the Boston Diagnostic Aphasia Examination (BDAE), a test that provides a broad assessment of language. The results were compared with the performance of a normal population. Results: The patients assessed in this study presented normal scores for oral and written word recognition, repetition, mechanics of writing, primer-level dictation and spelling to dictation but also had impairment at most levels of linguistic processing, in oral and written comprehension and production. In general, as expected, the tasks relying on access to the mental lexicon were most significantly affected. However, they performed well in the naming task, in which semantic cues were presented. Moreover, the patients assessed in this study had better performance in written comprehension tasks than in oral ones. Conclusion: The severity of the language impairments was not homogenous, with some linguistic abilities more impaired than others. The abilities that were found to be preserved can help to guide strategies for aiding in communication at this stage of AD.

https://doi.org/10.1590/0004-282x-anp-2020-0123 389 downloads

Qualitative and quantitative aspects of the F-A-S fluency test in people with aphasia
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Jansson, Isabella Linnea

; Ortiz, Karin Zazo

; Barreto, Simone dos Santos

Dementia & Neuropsychologia

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dec 2020, Volume 14 N. 4 Pages 412 - 418

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO. Testes de fluência verbal são procedimentos amplamente utilizados na avaliação neuropsicológica. A análise da performance de pessoas com afasia no teste de fluência verbal fonêmica (FVF), do ponto de vista quantitativo e qualitativo, pode contribuir para uma melhor compreensão das mudanças cognitivas que ocorrem nesse grupo de pacientes. Objetivo: Os objetivos deste estudo foram analisar as medidas de estratégias de agrupamento e de mudança de agrupamento na FVF de pessoas com afasia e investigar a correlação entre o uso dessas estratégias, o desempenho quantitativo no teste e o desempenho em funções executivas. Métodos: Foi realizado um estudo transversal com 15 pessoas com afasia, destros, falantes nativos do português brasileiro, com idade entre 19 e 92 anos. Eles foram submetidos ao teste F-A-S e ao Teste do Relógio (TDR). Foram obtidas as seguintes medidas no F-A-S: escore total, número e tamanho médio de agrupamento e número de mudança de agrupamento. Para análise de correlação foi utilizado o teste de Spearman. Resultados: Foi verificada correlação positiva entre todos os escores do teste F-A-S, variando entre p=0,61 (p<0,001) e p=0,91 (p<0,001). Não foram encontradas correlações entre tais medidas e o escore no TDR (p≤0,31; p≥0,260). Conclusões: A análise quantitativa e qualitativa do F-A-S de pessoas com afasia, mesmo com diferentes manifestações linguísticas, mostrou que elas apresentam escores inferiores e o número total de palavras e o número de mudanças de agrupamento possuem forte correlação. Não foi observada correlação entre funções executivas, avaliada pelo TDR, e o desempenho na medida de mudança de agrupamento.

ABSTRACT. Verbal fluency tests are widely used in neuropsychological assessment. The quantitative and qualitative analysis of the performance of aphasic individuals on the phonemic verbal fluency (PVF) test can contribute to a better understanding of cognitive changes in this group of patients. Objective: This study aimed to analyze clustering and switching measures of PVF in people with aphasia and investigate the relationship between the use of these strategies, the quantitative performance on the test, and the performance on executive functions. Methods: This is a cross-sectional study of 15 people with aphasia, right-handed, native speakers of Brazilian Portuguese, aged 19 to 92 years. They were submitted to the F-A-S test and the Clock Drawing Test (CDT). The following measures were obtained in the F-A-S test: total score, number of clusters, mean cluster size, and number of switches. Spearman's test was used to analyze correlation. Results: We found a positive correlation among all F-A-S test scores, ranging from p=0.61 (p<0.001) to p=0.91 (p<0.001). No correlation was identified between these measures and CDT performance (p≤0.31; p≥0.260). Conclusions: The quantitative and qualitative analysis of F-A-S in people with aphasia, even those with different linguistic manifestations, showed that these individuals presented lower scores and that the number of total words and the number of switches were strongly correlated. We found no correlation between executive function, assessed by the CDT, and switching performance on the F-A-S test.

https://doi.org/10.1590/1980-57642020dn14-040012 664 downloads

Speech in the foreign accent syndrome: differential diagnosis between organic and functional cases
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Barreto, Simone dos Santos

; Ortiz, Karin Zazo

Dementia & Neuropsychologia

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sep 2020, Volume 14 N. 3 Pages 329 - 332

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO. A síndrome do sotaque estrangeiro (SSE) é um distúrbio extremamente raro, com 112 casos descritos até 2019. Foram comparados dois casos de SSE em falantes nativos do português brasileiro em sua forma clássica e em sua variante psiquiátrica. Os seguintes casos foram analisados: (1) homem de 69 anos, destro, com história prévia de acidente vascular cerebral, e (2) mulher de 43 anos, destra, com diagnóstico de esquizofrenia. Eles foram avaliados quanto à linguagem e à fala, incluindo a inteligibilidade. Ambos apresentaram alterações de fala, como um sotaque novo adquirido, sem exposição prévia à língua estrangeira. Entretanto, o início do distúrbio foi súbito no caso 1 e insidioso e com eventos transitórios no caso 2, com escores de inteligibilidade da fala de 95,5 e 55,3%, respectivamente. Além do comprometimento neurológico, a apresentação clínica da variante psiquiátrica foi mais grave e diferiu dos casos de SSE, cuja inteligibilidade da fala é preservada.

ABSTRACT. Foreign accent syndrome (FAS) is an extremely rare disorder, with 112 cases described until 2019. We compare two cases of the foreign accent syndrome in native speakers of Brazilian Portuguese in its classic form (FAS) and psychiatric variant (FALS). Two cases were analyzed: (1) a right-handed, 69-year-old man, with a prior history of stroke, and (2) a right-handed, 43-year-old woman, diagnosed with schizophrenia. They were evaluate for language and speech, including the speech intelligibility. Both patients had speech impairments complaints, similar to a new accent, without previous exposure to a foreign language. However, the onset of the speech disorder was sudden in case 1 and insidious and with transient events in case 2, with speech intelligibility scores of 95.5 and 55.3% respectively. Besides neurologic impairment, the clinical presentation of FALS was extremely severe and differed to that expected in FAS cases, in which speech intelligibility is preserved.

https://doi.org/10.1590/1980-57642020dn14-030015 982 downloads

Influence of age and schooling in written discourse of healthy adults
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Zanichelli, Larissa

; Fonseca, Róchele Paz

; Ortiz, Karin Zazo

Psicologia: Reflexão e Crítica

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2020, Volume 33 elocation 10

Abstract: En | Text: En | PDF: En

Abstract Background: Discourse production is a very complex cognitive task that requires the integration of several linguistic cognitive skills. Socio-demographic factors such as schooling can impact on cognitive tasks. This study investigated the impact of age and schooling in some macrolinguistic and microlinguistic aspects in the written discourse of healthy adults. Methods: Individuals with no previous history of language, hearing, neurological, or psychiatric disorders were asked to write a story based on a figure that showed a “bank robbery.” A total of 463 graphic narrative were analyzed. The schooling was stratified into the following three bands: 5 to 8 years, 9 to 11 years and 12 or more, and the age ranged from 19 to 75 years. Results: Individuals with high schooling (12 years or more) produced discourses with more information units, more coherent, and cohesive. The oldest group (60 to 75 years) needed more time to finish the written production. Conclusion: The schooling influences some micro and macrolinguistic aspects in the written discourse production. A higher educational level provided a greater number of words as well as a higher number of information units, and the discourses produced are more coherent and cohesive. The age influenced only the time of discourse production.

https://doi.org/10.1186/s41155-020-00148-7 297 downloads

10.

Brief Montreal-Toulouse Language Assessment Battery: adaptation and content validity
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Altmann, Raira Fernanda

; Ortiz, Karin Zazo

; Benfica, Tainá Rossato

; Oliveira, Eduarda Pinheiro de

; Pagliarin, Karina Carlesso

Psicologia: Reflexão e Crítica

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2020, Volume 33 elocation 18

Abstract: En | Text: En | PDF: En

Abstract Background Evaluating patients in the acute phase of brain damage allows for the early detection of cognitive and linguistic impairments and the implementation of more effective interventions. However, few cross-cultural instruments are available for the bedside assessment of language abilities. The aim of this study was to develop a brief assessment instrument and evaluate its content validity. Methods Stimuli for the new assessment instrument were selected from the M1-Alpha and MTL-BR batteries (Stage 1). Sixty-five images were redesigned and analyzed by non-expert judges (Stage 2). This was followed by the analysis of expert judges (Stage 3), where nine speech pathologists with doctoral training and experience in aphasiology and/or linguistics evaluated the images, words, nonwords, and phrases for inclusion in the instrument. Two pilot studies (Stage 4) were then conducted in order to identify any remaining errors in the instrument and scoring instructions. Results Sixty of the 65 figures examined by the judges achieved inter-rater agreement rates of at least 80%. Modifications were suggested to 22 images, which were therefore reanalyzed by the judges, who reached high levels of inter-rater agreement (AC1 = 0.98 [CI = 0.96–1]). New types of stimuli such as nonwords and irregular words were also inserted in the Brief Battery and favorably evaluated by the expert judges. Optional tasks were also developed for specific diagnostic situations. After the correction of errors detected in Stage 4, the final version of the instrument was obtained. Conclusion This study confirmed the content validity of the Brief MTL-BR Battery. The method used in this investigation was effective and can be used in future studies to develop brief instruments based on preexisting assessment batteries.

https://doi.org/10.1186/s41155-020-00157-6 460 downloads

11.

Análise do reconhecimento populacional das figuras do sentence production program for aphasia
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Reis, Bianca Rodrigues Pinto dos

; Silva, Rebeca Sandriny Santa da

; Ortiz, Karin Zazo

CoDAS

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2019, Volume 31 N. 2 elocation e20180193

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo Analisar o reconhecimento das figuras e a familiaridade dos contextos do Sentence Production Program for Aphasia (SPPA), para obter dados sobre a possibilidade de uso para a língua portuguesa e/ou da necessidade de sua adaptação. Método Inicialmente, foi realizada a tradução dos estímulos por falantes do inglês e, em seguida, a retrotradução para ajustes sem a alteração das estruturas sintáticas das frases. O material foi então submetido para a análise de 39 indivíduos adultos de alta escolaridade. Na primeira fase do estudo, os adultos deveriam criar uma frase de acordo com cada figura apresentada. Na fase seguinte do estudo, os participantes foram expostos às frases originais associadas aos seus respectivos contextos. Os participantes receberam uma folha de registro das respostas com numeração segundo as figuras e julgaram a familiaridade dos contextos a partir de uma escala analógica de 0 a 10. Resultados Observou-se que a média geral de concordância dos estímulos com as respostas para as figuras do SPPA foi de 35,5%. Em relação à familiaridade dos contextos com as figuras, essa foi maior para as cenas relativas às frases com estrutura sintática mais usadas em português. Conclusão Pelo fato de os estímulos terem apresentado baixo grau de reconhecimento, adaptações serão necessárias para que o programa possa vir a ser utilizado na população brasileira. O estudo também permitiu identificar quais as figuras que necessitam de adaptação antes de serem usadas para a reabilitação de pacientes agramáticos no Brasil.

ABSTRACT Purpose To analyze the recognition of the pictures and contexts familiarity from the Sentence Production Program for Aphasia (SPPA) to acquire data determining its potential use in Portuguese and/or need for adaption. Methods The stimuli for English speakers were first translated, back-translated and adjusted without changing the syntactic structures of the phrases. The material was then tested in 39 highly literate individuals. In the first stage of the study, the adults had to produce a phrase corresponding to each picture. In the second stage, participants were exposed to the original phrases associated with their respective contexts. Participants were given an answer sheet containing numbered responses for each picture and rated the familiarity of the contexts on an analogic scale ranging from 0 to 10. Results Based on the sentences produced by the participants, the overall mean agreement of stimuli with responses for the pictures from the SPPA was 35.5%. Familiarity of the contexts with pictures was greater in scenes involving sentences with a syntactic structure similar to that of Portuguese. Conclusion Given most stimuli had a low level of recognition, adaptations are required for use of the program in the Brazilian population. The study allowed identification of those pictures which need adapting before use in the rehabilitation of agrammatic patients in Brazil.

https://doi.org/10.1590/2317-1782/20182018193 1361 downloads

12.

Formal language assessment in low-educated healthy subjects
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Akashi, Daniela Aiko

; Ortiz, Karin Zazo

Dementia & Neuropsychologia

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sep 2018, Volume 12 N. 3 Pages 284 - 291

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo As funções cognitivas, dentre elas a linguagem, sofrem a interferência da escolaridade. A hipótese deste estudo é que mesmo o uso de parametros obtidos em populações de 5 a 8 anos de escolaridade pode levar a falsos-positivos em populações com escolaridade de 2 a 4 anos de estudo. Objetivo: Verificar a influência da baixa escolaridade nas tarefas linguísticas da bateria MTL-Br e obter dados que possam ser utilizados como parâmetros clínicos nas avaliações de indivíduos cérebro-lesados de baixa grau de escolaridade. Métodos: Trata-se de um estudo prospectivo, em que foram avaliados 30 indivíduos normais de baixa escolaridade, de dois a quatro anos de estudo, com idade entre 19 e 60 anos, de ambos os sexos. Os indivíduos foram submetidos ao Mini-Exame do Estado Mental e Teste do Desenho do Relógio para fins de rastreio cognitivo. Resultados: Todos os indivíduos que obtiveram escores compatíveis com os parâmetros de normalidade nestes dois testes foram submetidos à bateria MTL-Br. A avaliação seguiu estritamente as normas publicadas no instrumento original e o registro foi realizado nas folhas da própria bateria. Conclusão: No presente estudo evidenciamos a influência da escolaridade em tarefas linguísticas. Além disso, foi possível obter dados que poderão ser utilizados como parâmetros clínicos nas avaliações de indivíduos cérebro-lesados de baixa escolaridade.

Abstract Although many studies have shown the influence of education on cognition, the impact of low education on the various cognitive functions appears to differ. The hypothesis of the present study is that, with regards to language, the use of parameters derived from populations with 5-8 years of education leads to false-positive results. Objective: to determine the influence of low education on the language tasks assessed by the MTL-Brazil Battery Methods: 30 healthy adults with 2-4 years of education were submitted to the MTL-Br Battery, comprising 22 subtests. The data were submitted to descriptive statistical analysis for each subtest and Z-scores were then calculated based on the parameters of a population with 5-8 years of education. All participants would be considered impaired if the Battery had been applied according to published normative criteria for a population with 5-8 years of education. Results: Separate analysis revealed that published scores for 17 out of the 22 Battery tasks were inappropriate for a population with 2-4 years of education. Conclusion: Education was found to effect performance for each of the language abilities differently. In addition, the study results can be applied to language assessments of individuals with 1-4 years of education using the MTL-Br battery, since this is the only language test for adults available in Brazil, and for which there are no normative data for low-educated subjects.

https://doi.org/10.1590/1980-57642018dn12-030009 721 downloads

13.

Pneumo-phono-articulatory coordination assessment in dysarthria cases: a cross-sectional study
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Chappaz, Rebeca de Oliveira

; Barreto, Simone dos Santos

; Ortiz, Karin Zazo

Sao Paulo Medical Journal

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may 2018, Volume 136 N. 3 Pages 216 - 221

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Pneumo-phono-articulatory coordination is often impaired in dysarthric patients. Because all speech is produced upon exhalation, adequate respiratory support and coordination are essential for communication. Nevertheless, studies investigating respiratory parameters for speech are scarce. The objectives of the present study were to analyze and compare the numbers of words and syllables (universal measurement) per exhalation among healthy and dysarthric speakers, in different speech tasks. DESIGN AND SETTING: A cross-sectional analytical study with a control group was conducted at the Department of Speech, Language and Hearing Sciences at UNIFESP. METHODS: The study sample consisted of 62 individuals: 31 dysarthric patients and 31 healthy individuals matched for sex, age and education level. All participants performed number counting and text reading tests in which the numbers of words and syllables per exhalation were recorded. All measurements obtained from the two groups were compared. RESULTS: Statistically significant differences between the dysarthric and healthy groups were found in the two tasks (counting of syllables and words per exhalation) (P < 0.001). In contrast, the performance of the dysarthric patients did not vary according to the task: reading and number counting in syllables/exhalation (P = 0.821) or words/exhalation (P = 0.785). CONCLUSIONS: The mean numbers of words and syllables per exhalation among dysarthric subjects did not vary according to the speech task used but they clearly showed differences between dysarthric patients and normal healthy subjects. The study also made it possible to obtain preliminary data on the average numbers of words and syllables per expiration produced by healthy individuals during their speech production.

https://doi.org/10.1590/1516-3180.2017.0320161217 1176 downloads

14.

The influence of education on performance of adults on the Clock Drawing Test
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Noronha, Ísis Franci Cavalcanti de

; Barreto, Simone dos Santos

; Ortiz, Karin Zazo

Dementia & Neuropsychologia

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mar 2018, Volume 12 N. 1 Pages 61 - 67

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O Teste do Desenho do Relógio (TDR) é um instrumento importante para rastrear indivíduos com suspeita de alterações cognitivas. Objetivo: Verificar a influência da variável sociodemográfica escolaridade no desempenho de adultos saudáveis no TDR. Métodos: Foram analisados os desenhos de 121 adultos saudáveis sem queixas e/ou alterações neurológicas, distribuídos em 4 subgrupos, a partir de quatro níveis de escolaridade: 27 adultos analfabetos, 34 adultos com 1-4 anos de estudo formal, 30 adultos com 5-11 anos de estudo formal, 30 adultos com >11 anos de estudo formal. Os desenhos obtidos foram analisados segundo os critérios propostos por Sunderland et all (1989),¹ com uma escala que variou de 1 a 10 pontos. A comparação dos grupos segundo a escolaridade foi feita utilizando-se o teste de Kruskal-Wallis seguido do teste de comparações múltiplas de Tukey para verificar onde as diferenças se deram. Resultados: Apesar dos escores terem aumentado conforme a escolaridade, foram observadas diferenças estatisticamente significantes apenas entre analfabetos e os demais grupos no TDR. Conclusão: O desempenho dos indivíduos melhorou de acordo com a escolaridade, porém o TDR não sofreu forte influência da escolaridade em sua aplicação, exceto para indivíduos analfabetos, que apresentaram escores diminuídos. Deste modo, acredita-se que o teste pode ser utilizado na avaliação da praxia visuo-construtiva em indivíduos independentemente dos anos de escolarização.

ABSTRACT The Clock Drawing Test (CDT) is an important instrument for screening individuals suspected of having cognitive impairment. Objective: To determine the influence of education on the performance of healthy adults on the CDT. Methods: A total of 121 drawings by healthy adults without neurological complaints or impairments were analysed. Participants were stratified by educational level into 4 subgroups: 27 illiterate adults, 34 individuals with 1-4 years of formal education, 30 with 5-11 years, and 30 adults with >11 years' formal education. Scores on the CDT were analyzed based on a scale of 1-10 points according to the criteria of Sunderland et al. (1989).¹ The Kruskal-Wallis test was applied to compare the different education groups. Tukey's multiple comparisons test was used when a significant factor was found. Results: Although scores were higher with greater education, statistically significant differences on the CDT were found only between the illiterate and other educated groups. Conclusion: The CDT proved especially difficult for illiterate individuals, who had lower scores. These results suggest that this screening test is suitable for assessing mainly visuoconstructional praxis and providing an overall impression of cognitive function among individuals, independently of years of education.

https://doi.org/10.1590/1980-57642018dn12-010009 893 downloads

15.

Limb apraxia in aphasic patients
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Ortiz, Karin Zazo

; Mantovani-Nagaoka, Joana

Arquivos de Neuro-Psiquiatria

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nov 2017, Volume 75 N. 11 Pages 767 - 772

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A apraxia de membros está frequentemente associada com lesões do hemisfério esquerdo, com inúmeros casos de pacientes afásicos. O objetivo deste estudo foi verificar a ocorrência da apraxia de membros em pacientes afásicos bem como a natureza desse distúrbio. O estudo foi realizado com 28 indivíduos afásicos e 44 controles pareados segundo a idade e a escolaridade. Todos os participantes foram avaliados com uma extensa bateria de apraxia de membros, consistindo de subtestes que avaliaram a compreensão e a produção dos aspectos léxico-semânticos relacionados aos gestos bem como produção motora propriamente dita. Os pacientes afásicos apresentaram dificuldades em tarefas envolvendo aspectos conceptuais da produção gestual. A dificuldade encontrada na imitação de gestos dinâmicos também indicou déficits no processamento gestual independente do déficit conceptual observado nestes pacientes. Esses resultados reforçam a importância da avaliação da apraxia de membros e apontam para a dificuldade de realização de pantomimas como indicativa de déficits semânticos.

ABSTRACT Limb apraxia is usually associated with left cerebral hemisphere damage, with numerous case studies involving aphasic patients. The aim of this study was to verify the occurrence of limb apraxia in aphasic patients and analyze its nature. This study involved 44 healthy volunteers and 28 aphasic patients matched for age and education. AH participants were assessed using a limb apraxia battery comprising subtests evaluating lexical-semantic aspects related to the comprehension/production of gestures as well as motor movements. Aphasics had worse performances on many tasks related to conceptual components of gestures. The difficulty found on the imitation of dynamic gesture tasks also indicated that there were specific motor difficulties in gesture planning. These results reinforce the importance of conducting limb apraxia assessment in aphasic patients and also highlight pantomime difficulties as a good predictor for semantic disturbances.

https://doi.org/10.1590/0004-282x20170150 2023 downloads

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