RESUMO Objetivo: caracterizar as ações de promoção de saúde vocal e/ou prevenção de distúrbios vocais aplicadas em profissionais da voz. Métodos: foi conduzida uma revisão de escopo seguindo as diretrizes do PRISMA-ScR nas bases de dados SciELO e PubMed. Foram incluídos artigos que tivessem como participantes profissionais da voz sem tratamento vocal concomitante, que descrevessem propostas de promoção da saúde ou prevenção de distúrbios vocais, publicados entre 2010 e 2023. Os artigos foram agrupados em categorias e os dados apresentados de forma descritiva. Revisão da Literatura: foram incluídos 18 artigos com profissionais da voz artística e não-artística, em sua maioria professores. A maior parte dos estudos tinha como foco vozes saudáveis, visando a prevenção primária. Muitos artigos apresentaram orientações sobre higiene e saúde vocal e utilizaram recursos como aprimoramento vocal, oficina de voz, amplificadores de voz e aplicativos. Todos os artigos mencionam resultados benéficos, principalmente no que se refere à autopercepção em relação a voz, qualidade vocal e de vida, conscientização de práticas positivas e prejudiciais à voz. Conclusão: as propostas contemplaram diferentes níveis de prevenção, mas a maioria tinha como foco a prevenção primária, incluindo participantes vocalmente saudáveis; todos os artigos indicaram resultados favoráveis na autopercepção em relação à voz, qualidade vocal e de vida e conscientização de práticas benéficas e prejudiciais à voz. Objetivo eou Métodos PRISMAScR PRISMA ScR PubMed concomitante 201 2023 descritiva Literatura 1 nãoartística, nãoartística não artística, não-artística professores saudáveis primária aplicativos benéficos Conclusão 20 202 2

ABSTRACT Purpose: to characterize the actions of vocal health promotion and/or prevention of vocal disorders applied to voice professionals. Methods: a scoping review following the PRISMA-ScR guidelines in SciELO and PubMed databases was conducted. Articles that had as participants voice professionals without concomitant vocal treatment, that described proposals for health promotion or vocal disorders prevention, published between 2010 and 2023, were included. They were grouped into categories and data were presented descriptively. Literature Review: eighteen articles with artistic and non-artistic voice professionals, mostly teachers, were included. Most of the studies focused on healthy voices, aiming at primary prevention. Many articles presented guidance on vocal hygiene and health and used resources such as vocal enhancement, voice workshop, voice amplifiers and apps. All the articles positively mentioned their results, especially with regard to self-perception in relation to voice, vocal quality and quality of life, awareness of positive and harmful practices to the voice. Conclusion: the proposals contemplated different levels of prevention, but most focused on primary prevention, including vocally healthy participants; all articles indicated positive results in voice self-perception, voice quality and quality of life, and awareness of positive and harmful voice practices. Purpose andor Methods PRISMAScR PRISMA ScR conducted treatment 201 2023 included descriptively Review nonartistic non teachers voices enhancement workshop apps selfperception self perception life Conclusion selfperception, perception, 20 202 2

RESUMO O Transtorno do Espectro Autista (TEA) é classificado pelo Manual de Diagnóstico e Estatístico de Transtornos Mentais (DSM-5) como um Transtorno do Neurodesenvolvimento, sendo caracterizado, principalmente, por alterações na comunicação social e pela presença de um repertório restrito de atividades e interesses. Na literatura, há muitos estudos sobre autismo, fala e linguagem, mas poucos correlacionando fala e autismo. Este estudo teve como finalidade realizar um estudo de caso que abordou autismo, fala e PROMPT (Pontos para a Reestruturação de Objetivos Fonéticos e Oro-Musculares) e mensurou a melhora da fala no participante com autismo, utilizando o método. Foram definidas palavras-alvo para toda a intervenção, conforme o Sistema de Observação e Análise (SOA) e Hierarquia Motora de Fala (HMF), que fazem parte da avaliação de PROMPT. Após a avaliação, o participante foi atendido por 16 sessões, uma vez semanalmente. Após análise dos dados, observou-se melhora em todos os aspectos que foram delineados de acordo com a avaliação no pré-tratamento, como controle fonatório, controle mandibular, controle lábio-facial e controle lingual, como também no movimento sequenciado, apesar deste não ser o objetivo traçado na avaliação. Também foi possível mensurar melhora no número de vocábulos adequados, número de fonemas adequados, porcentagens de consoantes corretas – revisado (PCC-R) e inteligibilidade. TEA (TEA DSM5 DSM 5 (DSM-5 Neurodesenvolvimento caracterizado principalmente interesses literatura autismo linguagem Pontos OroMusculares Oro Musculares Oro-Musculares método palavrasalvo palavras alvo intervenção SOA (SOA HMF, HMF , (HMF) 1 sessões semanalmente dados observouse observou se prétratamento, prétratamento pré tratamento, tratamento pré-tratamento fonatório mandibular lábiofacial lábio facial lingual sequenciado adequados PCCR PCC R (PCC-R inteligibilidade (DSM- (HMF (DSM

ABSTRACT Autism Spectrum Disorder (ASD) is classified by Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a neurodevelopmental disorder, whose characteristics are mainly deficits in social communication and a restricted range of interests. There are several studies about autism, speech, and language in the literature, but few correlate speech and autism. This study aims to carry out a case study that will address autism, speech, and PROMPT (Restructuring Oral Muscular Phonetic Targets) and also to describe the speech improvement in the participant with autism using the method. The target words were defined for the entire intervention according to the System Analysis Observation (SAO) and Motor Speech Hierarchy (MSH), which are parts of the PROMPT evaluation. After the evaluation, the participant was attended for 16 sessions, once weekly, with the objective of improving their speech. After analyzing the data, it was possible to observe improvement in all aspects outlined according to the pre-treatment evaluation of the method such as phonatory control, mandibular control, lip-facial control and lingual control as well as in the sequenced movement although this was not the aim outlined in the evaluation. It was also possible to measure the improvement of an adequate number of words, an adequate number of phonemes, percentages of correct consonants – revised (PCC-R), and intelligibility. ASD (ASD DSM5 DSM 5 (DSM-5 disorder interests literature Restructuring Targets SAO (SAO MSH, MSH , (MSH) 1 sessions weekly data pretreatment pre treatment lipfacial lip facial phonemes PCCR, PCCR PCC R (PCC-R) intelligibility (DSM- (MSH (PCC-R (DSM

RESUMO Objetivo Descrever o conhecimento de cantores amadores que se apresentam em cultos religiosos sobre saúde e higiene vocal e comparar esses achados em dois momentos distintos. Métodos Pesquisa descritiva, longitudinal, com 100 participantes que praticavam canto amador em cultos religiosos; idades entre 18 e 82 anos (média 33,72 anos), 54 mulheres e 46 homens. Os participantes responderam ao Questionário Inicial, que inclui dados pessoais e autoavaliação vocal, e ao Questionário de Saúde e Higiene Vocal, este em dois momentos, com intervalo de 20 dias e com as questões aleatorizadas. Foi dada devolutiva desse questionário após cada aplicação, por meio da apresentação das respostas corretas de cada um de seus itens. Os dados foram analisados de forma descritiva e inferencial. Resultados A maior parte dos cantores referiu algum grau de alteração vocal e relatou ao menos um sintoma vocal (principalmente pigarro e falha na voz). A pontuação foi maior na segunda aplicação do questionário e não houve correlação entre a autoavaliação vocal e a pontuação obtida. Conclusão Cantores amadores de ambos os gêneros que se apresentam em cultos religiosos demonstraram conhecimento sobre saúde e higiene vocal correspondente ao de indivíduos vocalmente saudáveis, acima do ponto de corte em ambas as aplicações do Questionário de Saúde e Higiene Vocal. Contudo, a maioria referiu alterações e sintomas vocais. Verificou-se aumento do conhecimento sobre saúde e higiene vocal na segunda aplicação, ainda que discreto. O nível de conhecimento sobre saúde e higiene vocal não se correlacionou com o grau de alteração vocal. distintos longitudinal 10 1 8 média 3372 33 72 33,7 anos, , anos) 5 4 homens Inicial Vocal 2 aleatorizadas itens inferencial principalmente voz. voz . voz) obtida saudáveis Contudo vocais Verificouse Verificou discreto 337 3 7 33,

ABSTRACT Purpose To describe the knowledge of amateur singers who perform in religious services, about vocal health and hygiene, and compare these findings at two different moments. Methods Descriptive, longitudinal research with 100 participants who practice amateur singing in religious services; ages between 18 and 82 years (average 33.72 years), 54 women and 46 men. Participants answered the Initial Questionnaire (Q1), which includes personal data and vocal self-assessment, and the Vocal Health and Hygiene Questionnaire (QSHV), on two occasions with an interval of 20 days and with the questions randomized. The participants were given a feed-back of the QSHV after each application i.e. the correct answers to each item. The data were analyzed descriptively and inferentially. Results Most singers reported some degree of self-assessed vocal alteration and reported at least one vocal symptom (mainly throat clearing and voice failure). The score was higher in the second application of the QSHV and there was no correlation between the vocal self-assessment and the score obtained in the QSHV. Conclusion Amateur singers of both sexes who perform in religious services demonstrated knowledge about vocal health and hygiene corresponding to that of vocally healthy individuals, above the cutoff point in both applications; however, the majority reported vocal changes and symptoms. There was an increase in knowledge about vocal health and hygiene in the second application, however discreet. The level of knowledge about vocal health and hygiene did not correlate with the degree of vocal alteration. moments Descriptive 10 1 8 average 3372 33 72 33.7 years, , years) 5 4 men Q1, Q1 Q (Q1) selfassessment, selfassessment self assessment, assessment QSHV, (QSHV) 2 randomized feedback feed back ie i e i.e item inferentially selfassessed assessed mainly failure. failure . failure) individuals applications symptoms discreet 337 3 7 33. (Q1 (QSHV (Q

Abstract Introduction The acoustic analysis of speech (measurements of the fundamental frequency and formant frequencies) of different vowels produced by speakers with the Angle class II, division 1, malocclusion can provide information about the relationship between articulatory and phonatory mechanisms in this type of maxillomandibular disproportion. Objectives To investigate acoustic measurements related to the fundamental frequency (F0) and formant frequencies (F1 and F2) of the oral vowels of Brazilian Portuguese (BP) produced by male speakers with Angle class II, division 1, malocclusion (study group) and compare with men with Angle class I malocclusion (control group). Methods In total, 60 men (20 with class II, 40 with class I) aged between 18 and 40 years were included in the study. Measurements of F0, F1 and F2 of the seven oral vowels of BP were estimated from the audio samples containing repetitions of carrier sentences. The statistical analysis was performed using the Student t-test and the effect size was calculated. Results Significant differences (p-values) were detected for F0 values in five vowels ([e], [i], [o], [o] and [u]), and for F1 in vowels [a] and [ɔ], with high levels for class II, division 1. Conclusion Statistical differences were found in the F0 measurements with higher values in five of the seven vowels analysed in subjects with Angle class II, division 1. The formant frequencies showed differences only in F1 in two vowels with higher values in the study group. The data suggest that data on voice and speech production must be included in the protocol’s assessment of patients with malocclusion. II 1 disproportion F (F0 (F (BP group control . total 6 20 (2 4 sentences ttest t test calculated pvalues p (p-values e, e , ([e] i, i [i] o, o [o u, u [u]) a [a ɔ, ɔ [ɔ] protocols protocol s 2 ( ([e [i [u] [ɔ [u

RESUMO Objetivo: caracterizar a população com Transtorno do Espectro Autista e a Rede de Atenção Psicossocial de Taboão da Serra-SP. Métodos: estudo realizado com usuários da rede de saúde de Taboão da Serra com Transtorno do Espectro Autista com até 18 anos. Os dados dos participantes foram coletados dos prontuários do Centro de Atenção Psicossocial Infantil de Taboão da Serra com autorização da Secretaria Municipal de Saúde e as informações coletadas foram analisadas por vertente quantitativa. Resultados: o total de usuários com Transtorno do Espectro Autista na referida rede de saúde em abril de 2019 foi de 237. Destes, 188 realizavam atendimento no Centro de Atenção Psicossocial infantil, 110 em atendimento semanal. Verificou-se predominância do sexo masculino (73,63%), faixa etária de 3 a 10 anos com maior porcentagem em 5 anos (17,27%), e tempo médio de atendimento de 32 meses. a menor idade encontrada foi 2 anos de idade. Metade da amostra (50%) concentra-se em atendimento semanal e abordagem medicamentosa da homeopatia. Foram encaminhados 24 usuários (21,81%) pelo fonoaudiólogo e 19 (17,27%) pela escola. Considerações Finais: apesar da referência do território ser o Centro de Atenção Psicossocial infantil sabe-se que este equipamento por si só não atende a todas as necessidades dos indivíduos com Transtorno do Espectro Autista. Utilizar uma rede de serviços articulada segundo a demanda individual do paciente e a realidade do território garantiria os direitos almejados, diminuição de gastos públicos e permitiria a ocupação destes usuários não mais em um único lugar, mas sim “lugares”. Objetivo SerraSP. SerraSP SP. SP Serra-SP Métodos 1 quantitativa Resultados 201 237 Destes 11 Verificouse Verificou se 73,63%, 7363 73,63% , 73 63 (73,63%) 17,27%, 1727 17,27% 17 27 meses 50% 50 (50% concentrase concentra homeopatia 21,81% 2181 21 81 (21,81% (17,27% escola Finais sabese sabe almejados lugar lugares. lugares . “lugares” 20 23 736 73,63 7 6 (73,63% 172 17,27 (50 21,81 218 8 (21,81 (17,27 “lugares 73,6 (73,63 17,2 (5 21,8 (21,8 (17,2 73, (73,6 17, ( 21, (21, (17, (73, (21 (17 (73 (2 (1 (7

ABSTRACT Purpose: to characterize the population with autism spectrum disorder and the Psychosocial Care Network. Methods: a study conducted with patients presented with autism spectrum disorder up to 18 years old treated at the health network in Taboão da Serra, Brazil. Participants’ data were collected from medical records of the Psychosocial Care Network for Children of that city, authorized by the Municipal Department of Health, and quantitatively analyzed. Results: altogether, there were 237 patients with autism spectrum disorder in the said health network by April 2019. Of these, 188 were treated at the Psychosocial Care Network for Children, 110 of them with weekly therapy. There was a predominance of males (73.63%), age range from 3 to 10 years, with a higher percentage of 5-year old (17.27%) patients, and a mean treatment time of 32 months. The youngest age was 2 years old. Half the sample (50%) had weekly therapy and received homeopathic medication; 24 users (21.81%) were referred by speech-language-hearing therapists and 19 (17.27%), by the school they attended. Final Considerations: although the Psychosocial Care Network for Children is the reference in the region, it is known that this facility alone cannot meet all needs of individuals with autism spectrum disorder. A service network coordinated according to patient’s individual needs and the region's reality would ensure their expected rights, decrease public spending, and enable these users to occupy not only one but many places in society. Purpose Methods 1 Serra Brazil Participants city Health analyzed Results altogether 23 2019 11 73.63%, 7363 73.63% , 73 63 (73.63%) 5year year 5 17.27% 1727 17 27 (17.27% months 50% 50 (50% medication 21.81% 2181 21 81 (21.81% speechlanguagehearing speech language hearing 17.27%, attended Considerations region patient s regions rights spending society 201 736 73.63 7 6 (73.63% 17.27 172 (17.27 (50 21.81 218 8 (21.81 20 73.6 (73.63 17.2 (17.2 (5 21.8 (21.8 73. (73.6 17. (17. ( 21. (21. (73. (17 (21 (73 (1 (2 (7

RESUMO Objetivo Analisar a relação entre o risco de disfonia e a qualidade vocal em estudantes de graduação em Artes Cênicas. Método Estudo transversal observacional com 38 estudantes de graduação em Artes Cênicas. Foram aplicados protocolos de rastreio de risco de disfonia geral e específico para atores, e realizadas gravações da emissão sustentada da vogal /a/, fala espontânea e leitura de texto, usadas para análise perceptivo-auditiva, efetuada por três avaliadores, com o uso da escala GRBASI. Após testes de confiabilidade intra e interavaliadores chegou-se à classificação final do grau geral do desvio vocal para cada participante. Foram feitas comparações entre grupos que tinham ou não outra profissão/atividade com o uso da voz e os grupos formados a partir do grau geral. Resultados A maioria dos estudantes apresentou alto risco para disfonia. Todos apresentaram alteração vocal, com predominância de grau leve. Os estudantes que tinham outra profissão/atividade com uso da voz obtiveram maior pontuação no protocolo específico para atores, bem como na soma desse protocolo com o de rastreio geral. Não houve relação entre o grau de alteração vocal e o risco de disfonia. Os estudantes que ainda não atuavam profissionalmente apresentaram mais alterações vocais de grau moderado ou severo, e os que atuavam profissionalmente apresentaram com maior frequência alteração vocal de grau leve. Conclusão A maior parte dos estudantes apresentou alto risco para disfonia. Todos apresentaram alteração vocal, com predomínio de grau leve. Não houve relação entre o risco de disfonia e o grau de alteração vocal. Cênicas 3 atores /a/ texto perceptivoauditiva, perceptivoauditiva perceptivo auditiva, auditiva perceptivo-auditiva avaliadores GRBASI chegouse chegou se participante profissãoatividade profissão atividade leve severo /a

ABSTRACT Purpose To analyse the relationship between the risk of dysphonia and vocal quality in undergraduate performing arts students. Methods Observational cross-sectional study with 38 undergraduate students in Performing Arts. We applied screening protocols for general and specific risk of dysphonia for actors and made recordings of sustained emission of the vowel /a/, spontaneous speech and reading a text, used for perceptual analysis performed by three evaluators using the GRBASI scale. After intra and inter-rater reliability tests it was obtained final classification of the general degree of vocal deviation parameter for each participant. Comparisons were made considering groups that had or did not have other profession/activity with the use of voice, and the groups were formed from the general grade. Results Most students were at high risk for dysphonia. All had vocal alteration, with a predominance of mild degree. Students who had another profession/activity with voice use scored higher in the specific protocol for actors, and in the sum of this protocol with the general screening protocol. There was no relationship between the degree of vocal alteration and the risk of dysphonia. Students who did not yet work professionally had more moderate or severe vocal alterations, and those who did work professionally had a higher frequency of mild vocal alterations. Conclusion Most students were at high risk for dysphonia. All had vocal alteration, with a predominance of mild alteration. There was no relationship between the risk of dysphonia and the degree of vocal alteration. crosssectional cross sectional 3 Arts /a/ text scale interrater inter rater participant professionactivity profession activity grade alterations /a

RESUMO Objetivo avaliar o risco de disfonia e a presença de alteração vocal em profissionais de diferentes categorias que atuam em ambiente universitário. Métodos pesquisa transversal com uso do Protocolo de Rastreio de Risco de Disfonia para análise das variáveis gênero, idade, hidratação, tabagismo, categoria profissional e demanda vocal e para cálculo do escore final. A gravação da voz ocorreu no ambiente de trabalho, com uso do protocolo Consenso da Avaliação Perceptivo-Auditiva da Voz - CAPE-V. A análise perceptivo-auditiva foi feita por juízes. Os dados foram comparados entre os grupos alto/baixo risco de disfonia e presença/ausência de alteração vocal. Resultados participaram 80 indivíduos, média de idade de 47,7 anos, 84% do gênero feminino. Observou-se alto risco de disfonia em 70% deles e alteração vocal em 34%. Hidratação insuficiente e tabagismo foram frequentes. No grupo com risco elevado de disfonia e presença de alteração vocal destacaram-se os funcionários da área administrativa e, no grupo com menor risco e sem alteração, os funcionários da saúde. Idade mais avançada foi associada à presença de alteração vocal, independentemente dos grupos. Conclusão a identificação do alto risco de disfonia e a relevante presença de alterações vocais em indivíduos de diferentes categorias profissionais que fazem parte do ambiente universitário sugerem a necessidade de propostas de ações preventivas e de promoção de saúde do trabalhador.

ABSTRACT Purpose To assess the risk of dysphonia and presence of voice change in professionals from different categories working in a university environment. Methods Cross-sectional research using the Dysphonia Risk Screening Protocol to analyze the variables sex, age, hydration, smoking, professional category and vocal demand and to calculate the final score. Voice recording took place in the work environment using the CAPE-V protocol. Judges performed the auditory-perceptual analysis. Data were compared between the groups with high/low risk of dysphonia and presence/absence of voice disorders. Results 80 individuals participated, with an average age of 47.7 years, 84% female. There was a high risk of dysphonia in 70%, and voice change in 34%. Insufficient hydration and smoking were frequent. In the group with a high risk of dysphonia and who had voice disorders, the presence of employees from the administrative area stood out, and, in the group with lower risk and no changes, health employees were outstanding. Older age was associated with voice disorders, regardless of groups. Conclusion Identification of high risk of dysphonia and the relevant presence of voice changes in individuals from different professional categories who are part of the university environment suggest the need to propose preventive actions and promote workers' health.

RESUMO Objetivo Verificar se existem diferenças em aspectos vocais entre idosos com presbifonia, divididos em três faixas etárias. Método Participaram 60 idosos de ambos os sexos com idades entre 60 e 90 anos (média=72,3), com diagnóstico de presbifonia estabelecido em avaliação otorrinolaringológica. A partir da gravação das vozes foi realizada análise perceptivo-auditiva e acústica e os dados foram comparados por meio dos testes estatísticos com os participantes divididos nos grupos etários 60-70 anos, 71-80 anos e 81-90 anos. Resultados Ainda que os idosos dos três grupos tenham apresentado alterações em aspectos vocais variados, como instabilidade e ruído em frequências graves, aqueles com mais de 80 anos apresentaram maior grau de disfonia, rugosidade, soprosidade e pitch. Também foram observados neste grupo maiores desvios em jitter, shimmer e irregularidade e a medida GNE no limite da normalidade. Todas as diferenças foram estatisticamente significativas. A maioria dos idosos dessa faixa etária apresentou ainda alteração no diagrama de desvio fonatório e quebra de frequência. Conclusão Diversos aspectos perceptivo-auditivos e acústicos se apresentaram mais desviados nos idosos mais velhos, o que reforça a necessidade de serem consideradas essas especificidades tanto na avaliação dos efeitos do envelhecimento na voz quanto no desenvolvimento de ações para minimizar o declínio vocal.

ABSTRACT Purpose To verify if there are differences in the vocal aspects of older people from three different age groups with presbyphonia diagnosis. Methods Sixty older adults joined this study. They were both female and male, with an age range from 60 to 90 years old (average: 72.3) and with presbyphonia diagnosis established after otolaryngology evaluation. From their voice recordings, it was possible to make the acoustic and auditory-perceptual analysis. The data collected was compared through statistical tests considering the division of the participants into the following groups: 60-70 years old, 71-80 years old, and 81-90 years old. Results Even though the older people from all of the three groups have presented deviation in multiple vocal aspects such as instability and vocal noise in low frequencies, those with more than 80 years old have presented a higher deviation of the general grade of dysphonia, roughness, breathiness, and pitch. In this group, it was also observed higher deviations in jitter, shimmer, vocal breaks, and the GNE measure on the edge of normality. All the differences were statistically significant. The majority of the older participants from that group presented even a deviation in the phonatory deviation diagram and frequency break. Conclusion Various acoustic and auditory-perceptual aspects had a higher deviation in the older adults over 80 years old, which reinforces the need to consider those specificities in the evaluation of the vocal aging impacts and also in the development of actions to minimize vocal declination.

OBJECTIVES: We aimed to analyze the vocal self-perception of Brazilian teachers and their communication needs, vocal signs and symptoms, and voice-related lifestyles during the coronavirus disease (COVID-19) pandemic and, based on this information, to develop guidance materials intended for dissemination to these teachers and the general community. METHODS: An online questionnaire designed for this survey was distributed via the researchers' networks and was available for completion by any teacher, except those who were not working at the time. There were 1,253 teachers from all over Brazil, of both sexes, covering a wide age range, working at different levels of education, and most with more than ten years of experience. Descriptive and inferential analyses of the data were performed. RESULTS: On comparing the prepandemic period with the current one, participants indicated voice improvements. In contrast, they presented symptoms such as dry throat, effort in addressing remote classes, hoarseness after classes, and difficulties with the use of headphones, among others. They further indicated stress, general fatigue, impact of the pandemic on mental health, and the overlapping of many home tasks with professional tasks. Some smoked, and others hydrated insufficiently. CONCLUSION: Although teachers generally noticed voice improvements during the pandemic, a proportion of them perceived worsening of voices. Many indicated several factors in which speech-language pathologists could guide them with the aim of improving performance and comfort during remote and hybrid classes, an initiative that will positively impact not only their voice and communication but also their quality of life.

RESUMO Objetivo Verificar o efeito imediato da corrente elétrica excitomotora, denominada FES, na qualidade vocal e no tempo máximo de fonação (TMF), e possíveis desconfortos, em mulheres sem alteração vocal, com aplicação em intensidade máxima suportada (IMS) e associada à fonação. Método Estudo experimental com 20 mulheres adultas normofônicas. Elas emitiram a vogal /a/ sustentada e depois foi aplicada a FES durante emissão da mesma vogal. Foram cinco séries com três minutos de emissão cada, intercaladas com descanso passivo; o estímulo elétrico foi na IMS pela participante, ajustado por série. Antes e após as emissões as vozes foram gravadas e coletados os TMF e a intensidade dos estímulos. A qualidade vocal foi classificada por juízes. Foram comparados os dados pré e pós emissão/eletroestimulação em cada fase. A análise qualitativa foi realizada a partir de sintomas autorreferidos. Resultados Não houve diferença na qualidade vocal e nos TMF entre os momentos pré e pós nas duas fases. A diferença entre a IMS e a intensidade de percepção do estímulo foi maior na série 1 em relação à série 2. Houve aumento da IMS na série 5 em relação à série 1. Não foram relatados sintomas negativos imediatos ou em até 48 horas após os procedimentos. Conclusão A corrente FES em IMS, associada à fonação, não gerou mudança imediata na qualidade vocal, nos TMF ou desconfortos autorreferidos pelas mulheres sem alteração vocal, mesmo com aumento gradual do estímulo.

ABSTRACT Purpose To verify the immediate effect of the Excitomotor Electrical Current, called Functional Electrical Stimulation (FES), on vocal quality, Maximum Phonation Time (MPT) and possible discomfort, in women without vocal alteration, with application at Maximum Supported Intensity (MSI) and associated with phonation. Methods Experimental study with 20 normophonic adult women. They emitted the sustained vowel / a / and then it was applied to FES during emission of the same vowel. There were five series with three minutes of emission each, interspersed with passive rest. The electrical stimulus was at the MSI by the participant, adjusted by series. Before and after the emissions the voices were recorded and the MPT and the intensity of the stimuli were collected. The vocal quality was rated by judges. Statistical analysis made it possible to compare pre and post emission / electrostimulation data in each phase. Qualitative analysis was performed based on self-reported symptoms. Results There was no difference in vocal quality and MPT between pre and post moments in both phases. The difference between MSI and stimulus perception intensity was greater in series 1 than in series 2. There was an increase in MSI in series 5 compared to series 1. No significant negative symptoms or within 48h after procedures were reported. Conclusion The FES at MSI, associated with phonation, did not generate an immediate change in vocal quality, in the MPT or self-reported discomforts by women without vocal alteration, even with a gradual increase in the stimulus, series by series.

RESUMO Objetivo Propor o Protocolo de Rastreio do Risco de Disfonia para Atores do Teatro Musical (PRRD-TM), verificar sua aplicabilidade em associação ao Protocolo de Rastreio do Risco de Disfonia Geral (PRRD-G), correlacionar escores finais de ambos, e desses com o escore total, e comparar o risco de disfonia entre atores com e sem queixa vocal. Método Estudo transversal observacional com 34 atores de teatro musical adultos, ambos os sexos, com e sem queixa vocal, profissionais ou estudantes. Os questionários foram aplicados individualmente. A análise estatística possibilitou verificar a correlação entre os escores de risco de disfonia e para comparação entre os grupos com e sem queixa vocal. Resultados A maioria dos participantes era do gênero masculino, jovens adultos, atores profissionais e sem queixa vocal. Observou-se elevado risco de disfonia, evidenciado pela aplicação do PRRD-G, com escores médios compatíveis com valores encontrados em indivíduos com disfonia, e reforçado pelos índices encontrados com aplicação do PRRD-TM. Observou-se correlação moderada e diretamente proporcional entre os escores dos dois questionários e desses com o escore total. Escores mais elevados do PRRD-G foram encontrados no grupo que apresentou queixa vocal. Conclusão O PRRD-TM mostrou-se viável e de fácil aplicabilidade e apresentou correlação positiva com o escore do PRRD-G e com o escore total. Elevado risco de disfonia foi evidenciado em indivíduos com queixa vocal. Apesar do escore específico do PRRD-TM não diferenciar atores de teatro musical com e sem queixa vocal, tanto o escore do PRRD-G quanto o escore total realizaram tal diferenciação.

ABSTRACT Purpose To propose the Dysphonia Risk Screening Protocol for Musical Theatre Actors (DRSP-MTA), to verify its applicability in association with the General Dysphonia Risk Screening Protocol (G-DRSP), to correlate the final scores of both, and these with the total risk score, and to compare the risk of dysphonia measured in musical theater actors with and without vocal complaint. Methods An observational cross-sectional study with 34 musical theater actors, adults, of both genders, with and without vocal complaints and regardless of whether they are professionals or students. The questionnaires were applied individually. Statistical analysis made it possible to verify the correlation between the dysphonia risk scores and to compare the groups with and without vocal complaint. Results Most of the participants were male, young adults, professional actors and without vocal complaint. There was a high risk of dysphonia, evidenced by the application of G-DRSP, with means scores compatible with values found in individuals with dysphonia, and reinforced by the indices found with DRSP-MTA application. There was a moderate and directly proportional correlation between the two questionnaire scores; and a correlation of both with the total risk score. Higher G-DRSP scores were observed in the vocal complaint group. Conclusion DRSP-MTA was feasible and easy to apply and was positively correlated with the total score and G-DRSP score. A high risk of dysphonia was evidenced in individuals with vocal complaints. Although the specific DRSP-MTA score did not differentiate musical theatre actors with and without vocal complaints, the G-DRSP score and the total risk score performed such differentiation.

OBJECTIVES: The objective of the study was to establish a cut-off point for high dysphonia risk in children using the Child Dysphonia Risk Screening Protocol (DRSP-C). METHODS: Through a preliminary study, voice recordings of 59 children (4-12 years of age) were collected during an auditory-perceptual analysis using the Consensus Auditory-Perceptual Evaluation of Voice protocol. Thirty of the patients had voice disorders (patient group), and 29 did not (control group). A risk score for dysphonia was then calculated, and data were compared between groups. The relationship between overall degrees of deviation and questionnaire scores was analysed. The questionnaire’s validity was verified from the area under the Receiver Operating Characteristic (ROC) curve, and cut-off points were obtained based on diagnostic criteria for screening procedures. RESULTS: The DRSP-C score was found to be higher for the patient group, as was the partial score for vocal behaviour. No correlation was found between overall degrees of dysphonia and questionnaire scores. The area under the ROC curve was measured as 0.678, denoting limited diagnostic capacity. The cut-off point was set at 16.50. Thus, above this value, dysphonia risk is higher. CONCLUSION: A cut-off point for high dysphonia risk was calculated. The DRSP-C proved to be a promising tool for children’s clinical vocal and health promotion and should be used in conjunction with General Dysphonia Risk Screening.

OBJECTIVE: The aim of this study was to correlate several instruments currently used for the assessment of the quality of life of patients who underwent total laryngectomy and speech rehabilitation. METHODS: A cross-sectional, observational study was conducted with 38 patients after total laryngectomy and speech therapy aiming to develop oesophageal speech. The patients were divided into the following two groups (19 participants each): speakers and non-speakers. The quality of life instruments used were as follows: visual analogue scale (VAS); Voice Handicap Index (VHI); Voice-Related Quality of Life (V-RQOL); Functional Assessment of Cancer Therapy - Head & Neck (FACT-H&N); European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck (EORTC QLQ-H&N35); and University of Washington Quality of Life (UW-QOL). RESULTS: The V-RQOL global health domain exhibited a strong correlation with the VHI. The EORTC QLQ-C30 exhibited a moderate to strong correlation with the EORTC QLQ-H&N35 functional domain in both groups. The EORTC QLQ-C30 functional domain exhibited a strong to moderate correlation with all other instruments in both groups. The UW-QOL exhibited a moderate to strong correlation with the VHI and EORTC QLQ-C30 in both groups. CONCLUSION: The EORTC QLQ-C30, EORTC QLQ-H&N35 and UW-QOL were the instruments that most correlated with the remaining instruments, indicating that any of the three can be used to assess the quality of life of the target population regardless of oesophageal voice development.

RESUMO Objetivo: comparar as medidas de frequência fundamental (F0) e frequência dos dois primeiros formantes (F1 e F2) das sete vogais orais do português brasileiro em duas tarefas de fala em adultos sem distúrbios de voz e fala. Métodos: oitenta participantes entre 18-40 anos pareados por gênero foram selecionados após avaliações orofacial, ortodôntica e perceptivo-auditiva da voz e fala. Os sinais de fala foram obtidos de sentenças-veículo e vogais sustentadas e foram estimados os valores de F0 e frequências de F1 e F2. As diferenças foram verificadas por meio do teste t e foi calculado o Effect Size. Resultados: foram encontradas diferenças nas medidas de f0 entre as duas tarefas de fala em duas vogais no gênero masculino e em cinco vogais no gênero feminino. Nas frequências de F1 foram notadas diferenças em seis vogais nos homens e em duas nas mulheres. Nas frequências de F2 houve diferença em quatro vogais nos homens e em três nas mulheres. Conclusão: a partir das diferenças encontradas, conclui-se que a tarefa de fala para avaliação de frequência fundamental e frequências dos formantes no português brasileiro pode demonstrar resultados distintos tanto em medidas glóticas como supraglóticas na produção das diferentes vogais orais deste idioma. Desta forma, sugere-se que os clínicos e pesquisadores considerem ambas formas de emissão para interpretação mais apurada das implicações destes dados na avaliação da comunicação oral e no direcionamento de condutas terapêuticas.

ABSTRACT Purpose: to compare the measurements of fundamental frequency (F0) and frequency of the first two formants (F1 and F2) of the seven oral vowels of the Brazilian Portuguese in two speech tasks, in adults without voice and speech disorders. Methods: eighty participants in the age range 18 and 40 years, paired by gender, were selected after orofacial, orthodontic and auditory-perceptual assessments of voice and speech. The speech signals were obtained from carrier phrases and sustained vowels and the values of the F0 and frequencies of F1 and F2 were estimated. The differences were verified through the t Test, and the effect size was calculated. Results: differences were found in the F0 measurements between the two speech tasks, in two vowels in males, and in five vowels, in females. In the F1 frequencies, differences were noted in six vowels, in men, and in two, in women. In the F2 frequencies, there was a difference in four vowels, in men, and three, in women. Conclusion: based on the differences found, it is concluded that the speech task for evaluation of fundamental frequency and formants’ frequencies, in the Brazilian Portuguese, can show distinct results in both glottal and supraglottal measures in the production of different oral vowels of this language. Thus, it is suggested that clinicians and researchers consider both forms of emission for a more accurate interpretation of the implications of these data in the evaluation of oral communication and therapeutic conducts.

Abstract Introduction Supracricoid laryngectomy still has selected indications; there are few studies in the literature, and the case series are limited, a fact that stimulates the development of new studies to further elucidate the structural and functional aspects of the procedure. Objective To assess voice and deglutition parameters according to the number of preserved arytenoids. Methods Eleven patients who underwent subtotal laryngectomy with cricohyoidoepiglottopexy were evaluated by laryngeal nasofibroscopy, videofluoroscopy, and auditory-perceptual, acoustic, and voice pleasantness analyses, after resuming oral feeding. Results Functional abnormalities were detected in two out of the three patients who underwent arytenoidectomy, and in six patients from the remainder of the sample. Almost half of the sample presented silent laryngeal penetration and/or vallecular/ hypopharyngeal stasis on the videofluoroscopy. The mean voice analysis scores indicated moderate vocal deviation, roughness and breathiness; severe strain and loudness deviation; shorter maximum phonation time; the presence of noise; and high third and fourth formant values. The voices were rated as unpleasant. There was no difference in the number and functionality of the remaining arytenoids as prognostic factors for deglutition; however, in the qualitative analysis, favorable voice and deglutition outcomes were more common among patients who did not undergo arytenoidectomy and had normal functional conditions. Conclusion The number and functionality of the preserved arytenoidswere not found to be prognostic factors for favorable deglutition efficiency outcomes. However, the qualitative analysis showed that the preservation of both arytenoids and the absence of functional abnormalities were associated with more satisfactory voice and deglutition patterns.