Portal de Programas de Pós-Graduação (UFRN)

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PPgFono PROGRAMA DE PÓS-GRADUAÇÃO EM FONOAUDIOLOGIA ADMINISTRAÇÃO DO CENTRO DE CIÊNCIAS DA SAÚDE Phone: (84) 9922-40085 E-mail: erika.mantello@ufrn.br https://posgraduacao.ufrn.br/ppgfon

Dissertations/Thesis

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2025

	Dissertations
1	RAMON CIPRIANO PACHECO DE ARAÚJO Effectiveness of a therapeutic program based on CTAR exercises compared to the chindown maneuver in dysphagic patients with Parkinson's disease Advisor : HIPOLITO VIRGILIO MAGALHAES JUNIOR COMMITTEE MEMBERS : HIPOLITO VIRGILIO MAGALHAES JUNIOR MARINA MARTINS PEREIRA PADOVANI LUCIA FIGUEIREDO MOURÃO Data: Jan 30, 2025 Show Abstract Dysphagia is a condition frequently associated with Parkinson's disease (PD) and can cause not only a decline in quality of life, malnutrition, dehydration, and fear of eating but also increase the risk of aspiration pneumonia, the main cause of death in these patients. Although there is drug treatment for motor symptoms, increasing doses does not guarantee improvement in swallowing disorders. Interventions for oropharyngeal dysphagia include those based on the chin-down postural maneuver, which has shown positive effects on the efficiency and safety of swallowing in PD patients. However, other interventions are being developed, such as the Chin Tuck Against Resistance (CTAR) technique, a promising therapeutic proposal for rehabilitating swallowing function. However,h there is still no published data on its effectiveness in the Parkinson's population. Therefore, this study aims to investigate the efficacy of an intervention program based on CTAR exercises, compared to the chin-down postural maneuver, in dysphagic patients with PD. Ethical principles were complied with and the project was approved by the Research Ethics Committee. The first study was a randomized clinical trial. It included 26 individuals with PD who were randomly allocated to two intervention groups for 4 weeks. Group A performed the CTAR exercises and functional swallowing training, while Group B performed the chin-down maneuver with functional swallowing training with different food consistencies. The outcomes evaluated included clinical assessment of swallowing, maximum isometric tongue pressure, quality of life, and peak cough flow, measured before and after the intervention period. The CTAR group showed a significant improvement in clinical assessment of swallowing, maximum isometric tongue pressure, and quality of life compared to the chin-down group. However, there was no significant difference in peak cough flow between the two groups. The second study, longitudinal in nature, compared the maximum isometric progression of the tongue over the 4 weeks of intervention. The analysis between the groups revealed a significant difference in the increase in tongue pressure in the CTAR group compared to the chin-down group in all the weeks of intervention. The highest peak measurement occurred in the third week and the effect size was considered large. The exploratory studies suggest the efficacy of CTAR exercises in the rehabilitation of dysphagia in PD patients, highlighting them as a promising and efficient approach.
2	MARIA GABRIELA PAZ DA SILVA Age-Related Cochlear Synaptopathy in Rats: The Use of Short-Latency Auditory Evoked Potentials Advisor : ELIENE SILVA ARAUJO COMMITTEE MEMBERS : ELIENE SILVA ARAUJO KELLY CRISTINA LIRA DE ANDRADE KÁTIA DE FREITAS ALVARENGA Data: Mar 6, 2025 Show Abstract Introduction: In the natural aging process, a decrease in synapses occurs between inner hair cells and spiral ganglion neurons of the auditory nerve, a phenomenon known as cochlear synaptopathy (CS). Studies suggest that short-latency auditory evoked potentials (AEP) can identify CS, but there are still gaps in the protocols and parameters used for this identification in clinical practice.Objective: To evaluate the applicability of short-latency AEPs in identifying aging-related CS in rodents. Method: Two studies were conducted. The first was a systematic literature review, registered in PROSPERO (CRD42025615318), aiming to synthesize data on the sensitivity of short-latency AEPs in identifying CS in aging rodents. The review followed the recommendations of the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA), with searches conducted in the PUBMED/MEDLINE, Cochrane Library, Scopus, Embase, Web of Science, Scielo, and LILACS databases, as well as gray literature. Article selection was performed independently and blindly by two reviewers, with the assistance of Rayyan and EndNote tools. The second study was a cross-sectional observational study, approved by the Animal Use Ethics Committee (protocol No. 2024-02-ISD). Ten healthy Wistar rats of both sexes, with no prior noise exposure, were used and divided into age groups: G1 (3–4 months), G2 (10 months), G3 (14–15 months), and G4 (24 months). The animals underwent auditory brainstem response (ABR) recording using the Eclipse equipment (EP25 model) under sedation. Electrodes were positioned at Fz (active), M1 and M2 (references), and the right paw (ground), with impedance below 5 kΩ. Click stimuli with alternating polarity at 90, 85, and 80 dBnHL were presented to each ear through 3A insert earphones at stimulation rates of 33.1, 15.1, and 7.1 clicks/s. The amplitudes of waves I and IV were analyzed blindly by two specialists. Data underwent descriptive and inferential statistical analysis in SPSS, adopting p<0.05. Results: In Study 1, 2,684 articles were identified, of which 15 were included. The most used model was the mouse (n=13), followed by Fisher 344 rats (n=1) and Wistar rats (n=1), with ages ranging from 3 to 33 months. All studies used ABR to identify CS, with wave I amplitude being the most frequent biomarker, and all confirmed CS through neurobiological analysis. In Study 2, examiner agreement was excellent (>90%). The mean amplitude was 1.33±0.69 μV for wave I and 0.75±0.62 μV for wave IV. Age did not influence the results, but a sex effect was observed. Wave I showed greater amplitude at 7.1 clicks/s compared to 33.1 clicks/s. Conclusion: Short-latency AEP demonstrated applicability in identifying CS in rodents, with wave I amplitude as a relevant biomarker and a significant effect of stimulation rate. The findings reinforce the use of ABR in CS investigation and provide insights for future studies.
3	ANA CLARA LOPES MARIZ Knowledge and attitude about children's hearing health in pregnant and postpartum women: an intervention guided by an educational video Advisor : ELIENE SILVA ARAUJO COMMITTEE MEMBERS : ELIENE SILVA ARAUJO HANNALICE GOTTSCHALCK CAVALCANTI MONIQUE RAMOS PASCHOAL DUTRA Data: Mar 7, 2025 Show Abstract Introduction: Parents' knowledge about neonatal hearing screening (NHS), risk indicators for hearing impairment, and attitudes towards hearing loss directly influences child care. Educational videos have been effective in promoting hearing health. Objective: To validate an educational video on child hearing health and assess its impact on the knowledge and attitudes of pregnant women and puerperal woman. Method: The dissertation is structured into two articles. The first is a descriptive study aimed at validating a video as a tool for education in child hearing health. Initially, the video validation was conducted with five specialists, and in the second stage, 50 mothers evaluated their satisfaction with the video using a standardized questionnaire and the Net Promoter Score (NPS). The second study consists of a triple-blind randomized clinical trial, seeking to compare the impact of the educational intervention on child hearing health on the level of knowledge and information retention during pregnancy and the postpartum period. The study involved 60 pregnant women and 80 puerperal woman, with each population divided into two randomized groups: 30 pregnant women and 40 puerperal woman in the intervention group (IG) and the same number from each population in the comparison group (CG). Participants were subjected to a questionnaire on knowledge and attitudes regarding child hearing health, both before and immediately after exposure to the educational video (targeted for IG or about breastfeeding for CG). To assess medium-term information retention, puerperal woman in the IG were re-evaluated with the questionnaire three months after the intervention. Results: In the first study, it was observed that the video was well evaluated from both the specialists' and the target population's perspectives, showing a tendency towards satisfaction with the educational tool used. Specific suggestions for video improvement were noted by the specialists, and 84.0% of the mothers would give positive feedback (promoters), while 14.0% were indifferent. In the second study, an increase in knowledge was observed for both pregnant women (p<0.001) and puerperal woman (p<0.001) when comparing pre- and post-intervention moments in the IG. The comparison between IG and CG post-intervention demonstrated greater knowledge for the groups subjected to the intervention in both populations (p<0.001). On the other hand, when comparing the amount of information assimilated between pregnant women and puerperal woman, no difference was found (p=0.686), indicating that mothers were able to assimilate the knowledge conveyed at both moments of motherhood. Furthermore, for the IG of puerperal woman, there was no difference between knowledge immediately post-intervention and three months after the intervention (p=0.090). Conclusion: The educational video "Hearing Pills" was validated as an effective tool for education in child hearing health. In the first study, specialists and the target population positively evaluated the material, highlighting its appropriateness and relevance. In the second study, it was found that the video significantly increased knowledge on the topic among pregnant women and puerperal woman, with medium-term information retention. The findings indicate that both moments are opportune for educational intervention, enabling mothers to take an active role in their children's hearing health.
4	JOAO VICTOR SILVA DE BARROS LIMA Assessment Instruments for Word and Pseudoword Reading: Review and Applicability Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : ANA LUIZA GOMES PINTO NAVAS CINTIA ALVES SALGADO AZONI LUCIANA MENDONÇA ALVES RENATA MOUSINHO Data: Mar 10, 2025 Show Abstract Objective: To map the literature for validated and non-validated instruments used to assess oral reading of words and pseudowords in schoolchildren aged 6 to 14 (Study 1) and to study the psycholinguistic variables of a stimulus bank to be used as an assessment tool for oral reading of words and pseudowords (Study 2). Method: For Study 1, a scoping review was conducted following PRISMA-ScR guidelines. The research question was developed using the "PCC" strategy (Population, Concept, and Context). Relevant studies were searched in the National Library of Medicine (PubMed), Scopus, Latin American and Caribbean Health Sciences Literature (LILACS), EMBASE, Education Resources Information Center (ERIC), and LiVIVO databases, using terms in Portuguese, Spanish, and English, depending on the database. Studies that used assessment and/or monitoring tools for oral reading of words and pseudowords in schoolchildren aged 6 to 14 years and 11 months, in clinical or educational settings, were included. For Study 2, the Fluency IDB Portuguese app was used to evaluate word and pseudoword decoding in 1st, 2nd, and 3rd-grade elementary school students. Results: In Study 1, the analysis of 16 included studies revealed 11 assessment tools, with stimuli varying in syllabic complexity, regularity, frequency, and length, including high- and low-frequency regular and irregular words, short and long words, and pseudowords following the language rules of the test. However, there was limited description of the validation of the instruments used in the studies. In Study 2, a progressive improvement in performance was observed across school years, with a reduction in errors and an increase in correct responses in the 2nd and 3rd grades. Additionally, factors such as the number and syllabic complexity of the stimuli significantly influenced student performance during schooling. Conclusion: In Study 1, 11 tools for assessing oral reading of words and pseudowords in schoolchildren were analyzed, highlighting the diversity of methods and the frequent lack of validation information, which may compromise the accuracy of the results. Emphasis was placed on speed, accuracy, and features such as syllabic complexity, essential for evaluating lexical and sublexical processing. The findings reinforce the need to develop and validate more reliable tools, contributing to more effective educational policies and interventions. In Study 2, the results indicated that reading performance improves with school progression, influenced by syllabic complexity and lexical familiarity. Younger children struggle more with complex words, while older children perform better, suggesting that reading fluency depends on the development of phonological and orthographic skills. Pseudowords are harder to read than real words, emphasizing the importance of lexical familiarity. The results underscore the need to consider syllabic complexity and school grade in assessments, interventions, and teaching materials, promoting an appropriate progression in reading instruction.
5	JADSON STHEFERSON DUTRA ALVES Obtaining Validity Evidence for the 'Degluto': A Bedside Swallowing Assessment Instrument Advisor : HIPOLITO VIRGILIO MAGALHAES JUNIOR COMMITTEE MEMBERS : ANNA ALICE FIGUEIRÊDO DE ALMEIDA HIPOLITO VIRGILIO MAGALHAES JUNIOR LICA ARAKAWA SUGUENO Data: Mar 10, 2025 Show Abstract Oropharyngeal dysphagia is a prevalent condition in various clinical populations and can lead to complications such as malnutrition, dehydration, and aspiration pneumonia. Structured clinical assessment is essential for the proper management of dysphagia, requiring reliable and validated instruments. Given the need for a protocol adapted to the Brazilian reality, the DEGLUTO: Swallowing Assessment Instrument at the Bedside was developed, and its validation process is the focus of this dissertation. This is a methodological study divided into two phases. The first phase involved obtaining evidence of validity based on content, conducted through the Delphi method, with the participation of 13 dysphagia expert judges. The instrument's items were analyzed for relevance, clarity, and alignment with the evaluated construct. Seven items were removed, and one was reformulated, resulting in a preliminary version with 21 items. The second phase consisted of obtaining evidence of validity based on response processes through the application of the instrument by eight speech-language pathologists in hospital and outpatient settings. The professionals assessed the clarity and applicability of the items, as well as patients' understanding during the evaluation. Statistical analysis included the Content Validity Index (CVI), the Content Validity Coefficient (CVC), and the Kappa coefficient to assess agreement among raters. The results demonstrated high agreement for most items, except for one, which was removed, leading to the preliminary final version of DEGLUTO with 20 items. The study provided evidence that the instrument has clarity, relevance, and clinical applicability, contributing to the qualification of oropharyngeal dysphagia assessment. The findings support the continuation of the validation process, focusing on the analysis of the instrument’s internal structure and psychometric properties.
6	MIRELLY DANGLES DE OLIVEIRA FERREIRA FAMILY LITERACY PRACTICES FOR PRESCHOOLERS Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI Julia Beatriz Lopes Silva VANESSA DE OLIVEIRA MARTINS REIS Data: Mar 28, 2025 Show Abstract Introduction: Family literacy is a construct of practices that includes all the resources, experiences and supports related to skills that promote children's development at home, including the ways in which they engage in literacy activities with other family members. When thinking about the importance for learning, family literacy practices can shape learning development, including in the areas of vocabulary, letter knowledge and reading comprehension. Objective: To analyze family literacy practices in preschool children and their impact on children with developmental risks. Methods: This is a two-part study: (1) a scoping review reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR); (2) a longitudinal, prospective and qualitative study that will be carried out between August 2024 and January 2025. The study population consisted of 8 children of both genders, aged between 15 months and 2 years and 6 months. Results: (1) 29 studies were included in the final synthesis of the scoping review, which revealed a predominance of informal practices. Among the activities carried out, the most cited was reading books, followed by shared reading. (2) When it came to analyzing the effectiveness of family literacy practices, the results showed that in communication skills, the children performed below expectations in the pre-intervention assessment and post-intervention progress. Conclusion: Based on the findings, it was observed that the literacy practices of the Conta pra Mim Program were beneficial for the oral language development of children at risk of development.
7	BEATRIZ DE SOUZA DOS REIS FRANCA Early identification of difficulties in learning to read Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI KARINNA VERISSIMO MEIRA TAVEIRA PATRICIA ABREU PINHEIRO CRENITTE Data: Apr 2, 2025 Show Abstract Objective: To map and analyze screening instruments to identify risks of reading difficulties and disorders in preschool and school-aged children in clinical and educational contexts (article 1) and to investigate initial evidence of validity of the Brazilian version of the SPRouT instrument for screening phonological processing in preschool and school-aged children. Method: Scoping review conducted according to the PRISMA-ScR guidelines. The search was carried out in the SciELO, PubMed, LILACS, ERIC, Google Scholar and Web of Science databases, including studies on the construction, validation and practical application of the instruments (article 1). The second study included a pilot validation, descriptive and analytical stage, carried out in a private school in Brazil with children between 4 and 8 years old, including participants with and without oral and written language complaints (article 2). Results: The analysis of 40 studies identified 32 screening instruments. The review pointed out gaps in the psychometric validation and accessibility of the instruments, which limits their application (article 1). Article 2, in turn, revealed significant negative correlations between the SPRouT and other instruments for assessing phonological processing. Conclusion: Although there are a variety of instruments for screening for reading difficulties, significant challenges, such as accessibility and psychometric validity, restrict their application in different contexts (article 1). The SPRouT, in turn, proved to be particularly effective in predicting performance in tasks associated with phonological processing, providing preliminary evidence of validity and highlighting its potential as a promising tool for the early identification of risk for reading difficulties (article 2).
8	RHADIMYLLA NÁGILA PEREIRA ANALYSIS OF THE APPLICABILITY OF A LANGUAGE EVALUATION PROTOCOL VIA TELECONSULTATION FOR CHILDREN AT RISK AND DIAGNOSED WITH HEARING IMPAIRMENT Advisor : JOSELI SOARES BRAZOROTTO COMMITTEE MEMBERS : ADRIANE LIMA MORTARI MORET ANA MANHANI CACERES ASSENCO JOSELI SOARES BRAZOROTTO Data: Apr 15, 2025 Show Abstract : Introduction: The unequal distribution of specialized professionals has spurred research in digital health to address the needs of oral language care in childhood, given that language delays are common complaints during this period. In this sense, this dissertation, composed of two research articles presented below, aimed to contribute to the field. Article 1: A scoping review investigated: “Which instruments are applicable for screening and assessing oral language in early childhood using digital health?” Studies were included if they utilized screening and assessment tests for oral language via teleconsultation, applications, and web-based tools, without restrictions on time, language, or ethnicity, in clinical, educational, and non-clinical settings. The databases consulted were PubMed, Web of Science, LILACS, Embase, and Scopus, in addition to gray literature via Google Scholar and ProQuest Dissertations and Theses. Out of 2,435 studies identified, 20 comprised the final sample. Eleven studies evaluated language skills screening and nine investigated digital language assessment. Fourteen studies adapted previously validated in-person tests to an online format; four developed specific teleconsultation tools, and two conducted synchronous or asynchronous observations without defined protocols. Most research was conducted in clinical settings with speech-language pathologists, although community health workers also participated in some studies. Videoconferencing was the most frequently used digital modality. The findings of this review reinforce the feasibility of telehealth for screening and assessing oral language, highlighting the need for further research to consolidate evidence-based practice in teleaudiology Article 2: This prospective clinical study, approved by an Institutional Ethics Committee (protocol no. 6.754.773), involved 12 children of both sexes, aged between 21 and 74 months. Of these, seven had bilateral sensorineural hearing loss ranging from moderate to profound, and five exhibited language alterations without confirmed hearing loss. All were evaluated using the Behavioral Observation Protocol (PROC), administered both remotely and in person by trained, blinded researchers. Agreement between scores obtained in each session was assessed using the intraclass correlation coefficient (ICC) and the Kappa index, comparing in-person and remote evaluations. Results: In the hearing-impaired group, the ICC for the overall score was 0.964 (p ≤ 0.05), and in the at-risk group, it was 0.888 (p ≤ 0.05), with a Kappa of 1.0 (p ≤ 0.05) for both groups. In the at-risk group, variable ICCs were observed when analyzing the individual sections of the PROC separately. Conclusion: Language assessment via synchronous teleconsultation using the PROC demonstrated clinical applicability in the studied population.

2024

	Dissertations
1	LARISSA FERNANDES GOMES Brain hemodynamic response to auditory stimuli and its relationship with auditory and language performance in children using cochlear implants. Advisor : JOSELI SOARES BRAZOROTTO COMMITTEE MEMBERS : EDGARD MORYA JOSELI SOARES BRAZOROTTO LUCIANA MACEDO DE RESENDE SHEILA ANDREOLI BALEN Data: Feb 23, 2024 Show Abstract Introduction: Functional Near-Infrared Spectroscopy (fNIRS) records cerebral hemodynamics to speech stimuli in Cochlear Implant (CI) users. The characterization of fNIRS and the establishment of its association with auditory-linguistic development can contribute to prognosis and monitoring in this population. Purposes: To define the fNIRS acquisition parameters in CI users, through a systematic review and characterize the cortical responses obtained by fNIRS, associating such responses with auditory and language performance in a child using a Hearing Aids (HA) and CI. Method: Two studies were carried out. Study 1 is a systematic review of fNIRS acquisition parameters in CI users (Prospero, number CRD42022358346). The search took place in the following databases: PubMed, EMBASE, LILACS, Web of Science, Science Direct, Scopus, PsycINFO, CENTRAL, IEEE Xplore and in gray literature: Google Scholar web search; Proquest (theses and dissertations), with the acronym PECOS. Studies with CI users in any age group, submitted to fNIRS with speech stimuli, were included. Study 2, approved by the Institutional Ethics Committee under opinion number 5,989,435, is a clinical case of a girl, with a chronological age of eight years and an auditory age of five years and two months, user of CI in the left ear and hearing aids in the right ear undergoing auditory rehabilitation for five years. Clinical protocols were applied to characterize auditory-linguistic performance and fNIRS (NIRXSport1) with speech stimuli /ba/ and /da/ was presented in a free field, with electronic devices turned on, in a habituation and dishabituation paradigm to identify auditory detection and discrimination. Eight emitters and eight detectors were used, positioned in the temporal lobe of both cerebral hemispheres, totaling 20 channels. Results: In study 1,671 articles were found in the database and 216 in the search for additional literature. After removing duplicates, analyzing titles and abstracts in phase 1 and the complete work in phase 2, 18 studies from the database and one from additional literature were included, totaling 19. Of these, 13 presented a low risk of bias. The selected studies showed uniformity in the following fNIRS acquisition parameters in CI users: wakefulness (awake); use of auditory stimulation of words and phrases presented in a free field; display of visual stimuli; recording of the temporal region bilaterally and three centimeters between the optodes. In study 2, the child showed auditory and language development within the developmental milestones and cortical responses to speech stimuli, with no significant difference between the cerebral hemispheres. Final considerations: Although some of the fNIRS acquisition parameters in CI users are common, there are still divergences in their acquisition in this population due to the variability of the objectives of each research. Given the feasibility of this tool for visualizing brain physiological responses to speech stimuli, as observed in both studies carried out, it is important that multicenter studies are carried out to strengthen the applicability of fNIRS in prognosis and monitoring in auditory rehabilitation.
2	MARÍLIA CARDOSO PRUDÊNCIO EVALUATION OF THE HEARING AIDS USE RECORD BY HARD OF HEARING CHILDREN AND ADOLESCENTS Advisor : JOSELI SOARES BRAZOROTTO COMMITTEE MEMBERS : ERIKA BARIONI MANTELLO JOSELI SOARES BRAZOROTTO REGINA TANGERINO DE SOUZA JACOB Data: Feb 29, 2024 Show Abstract To evaluate the record of Hearing Aids use in a group of hard of hearing children rehabilitated in a SUSservice. Method: approved by institutional CEP under number 5,924,421. This is a mixed method, methodological, retrospective and cross-sectional research. The sample consisted of 32 children with mild to profound sensorineural hearing loss and their respective guardians. In study 1, with a methodological design, the cross-cultural adaptation of the Parent Hearing Aid Management Inventory into Brazilian Portuguese is presented as Article 1. Two stages and eight steps were carried out to achieve the adaptation: obtaining permission from the authors; formation of a committee of experts who worked on some of the steps to validate the translation, translation by 2 proficient translators, synthesis of translations and evaluation of equivalences, reverse translation and synthesis of the same, pilot study with 10 families to verify applicability of the instrument and synthesis of the final version of the instrument. In study 2, the trajectory of the time of hearing aids use was characterized, by collecting data from medical records, in the years 2019, 2022 and collecting current datalogging. Using an Excel® spreadsheet, data from 86 medical records was tabulated. Of these 86, it was found that there was complete information in 32 medical records. Statistical tests were applied to evaluate the normality of the data and repeated measures ANOVA to verify the variation in the time of use in the evaluated period. Results: the adaptation of the inventory, in Brazilian Portuguese, called Hearing Aid Management Inventory for the Family was presented (Article 1). Regarding the use record of the devices, there was no statistically significant variation in the time of use of hearing aids in the measurements carried out in the years 2019, 2022 and 2023, observing that the year 2019 was the period in which children used the devices less than 10h/day, below ideal for the acquisition and development of listening and language skills. Some individuals are alert to their use, since in the 3 periods evaluated they remained using the devices insufficiently. Children who use less than recommended are at risk for their hearing and language development. Conclusion: the adaptation of the PHAMI inventory to Brazilian Portuguese and the analysis of the use record of hearing aids in children brings contributions to auditory rehabilitation in childhood in our country. Monitoring the use of hearing devices is essential and should be part of the routine in auditory rehabilitation services, as a way of ensuring assertive therapeutic planning and effective results for this population. Follow-up and multicenter studies are relevant to enhance the use of hearing devices in the hearing-impaired child population.
3	ANA BEATRIZ SANTOS DEVELOPMENT OF NEURAL DECODING FOR SPEECH IN TYPICAL INFANTS, CHILDREN AND ADULTS AND CHILDREN WITH CONGENITAL SYPHILIS Advisor : SHEILA ANDREOLI BALEN COMMITTEE MEMBERS : ELIARA PINTO VIEIRA BIAGGIO KELLY CRISTINA LIRA DE ANDRADE SHEILA ANDREOLI BALEN Data: Mar 14, 2024 Show Abstract Introduction: Child development includes several stages and can be influenced by some infections, including congenital syphilis, which is considered a risk indicator for hearing impairment. Frequency Following Response (FFR) is an auditory evoked potential that non-invasively evaluates the neural decoding of speech and can be used in the early stages of child development. Objectives: Study 1: study FFR responses with speech stimuli in the frequency and time domains in typical infants, children and adults depending on age and ear evaluated. Study 2: analyze the development of the auditory pathway using Frequency Following Response with speech stimulation in babies with congenital syphilis treated during the first two years of life. Method: Cross-sectional study, approved by the Research Ethics Committee no 5,685,328. FFR performed with the speech stimulus /da/ synthesized with a fundamental frequency of 100 Hz, duration of 170 ms, speed of 3.70/s. The first 10 ms of onset, 47 ms of the consonant-vowel transition and 113 ms of vowel sustain. Four measurements of 1,000 sweeps were presented, analysis window from -40 to 270.27 ms at 80dBnHL on the SmartEP platform. Artifacts below 10% and online bandpass filter of 30-3000 Hz. Descriptive and inferential analysis was applied in both studies according to the distribution of data and variables, adopting a significance level of 5%. Results: Study 1: 63 subjects, 12 infants, 10 children and 41 adults. RMS pre-neural activity showed better results for adults in both ears, whereas the spectral amplitude of the fundamental frequency was greater in the right ear in babies up to 60 days old. The spectral amplitude of the harmonics of the consonant and vowel portion is influenced by increasing age, whereas neural lag is suggestive of reaching maturity first in the left ear than in the right ear in all groups. Study 2: sample consisting of 84 babies with congenital syphilis and 58 controls. In babies up to 60 days old, the spectral amplitude of the harmonics of only the consonant portion was greater in the GSC than the CG. In the SC group, an increase in Fo spectral amplitude was evident with increasing age. The neuro lag in the GSC showed a decrease in time with increasing age, with a significant difference between all age groups. Conclusions: Study 1: Speech decoding is influenced by age, which differs between ears over time in the time and frequency domains. Study 2: Sound processing tends to show better responses with increasing age in both control children and children with adequately treated congenital syphilis.
4	FERNANDA VANESSA DA COSTA VARELA Literacy Practices in children and adolescents with myelomeningocele. Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI ISABELLE CAHINO DELGADO DIONÍSIA APARECIDA CUSIN LAMÔNICA Data: Mar 27, 2024 Show Abstract Introduction: Myelomeningocele is a type of open spina bifida, resulting from inadequate closure ofthe neural tube during the development period, which can cause motor, neurological and cognitivechanges. In Brazil, the prevalence of this condition is approximately 1.6 per 1000 live births. Due tothe various complications of the condition, the repercussions of the malformation can lead toimpairments in oral and written language and, consequently, intervention practices related to literacyin this population can be better explored. Objective: To characterize written language skills inchildren and adolescents with Myelomeningocele and investigate the effects of literacy practices inthis population. Method: Research structured in two studies: (1) cross-sectional to characterize writtenlanguage skills (phonological processing, reading, and writing) in 09 children and adolescents withMyelomeningocele between 7 and 15 years of age who attend a Specialized Rehabilitation Centerand; (2) longitudinal to investigate literacy practices in the target population. Results: In study 1, 6participants presented deficits in the skills of phonological awareness, rapid automatic naming,phonological working memory, reading, and writing; in study 2, there was a benefit after literacypractices in terms of the skills assessed, with better performance in phonological awareness, rapidcolor naming, repetition of non-words, reading and writing. Conclusion: Changes in written languagein the studied group can harm the educational development of these children and adolescents,however, literacy practices can serve as a protective factor that helps promote the development ofreading and writing.
5	HELLEN FRANÇA ALCANTARA Reading and writing in low-income children: follow-up study after the pandemic Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI ISABELLE CAHINO DELGADO ANA LUIZA GOMES PINTO NAVAS Data: Apr 23, 2024 Show Abstract Introduction: The beginning of the new coronavirus pandemic prompted reflections on the effects of school closures and the influence on student learning. Such effects may be more pronounced in low- income children. Objective: To verify whether there were changes in the written language performance of low-income students who were subjected to an intervention process prior to the emergence of the Covid-19 pandemic and to evaluate the reading and writing of this group in the 5th year of elementary school. Methodology: This dissertation has two studies, in which study 1 is longitudinal, qualitative and quantitative and study 2 is cross-sectional, both approved by the research ethics committee number 4,704,128. In study 01 and 02, 21 and 27 children with education between the 2nd and 5th year of elementary school participated, respectively. Study 01 was based on assessment data before and after the pandemic, from children who participated in sessions to stimulate phonological awareness and vocabulary skills before the pandemic. Letter recognition skills, phonological awareness, phonological working memory, access to the mental lexicon and reading decoding were assessed. In study 02, performance after the pandemic of reading skills, speed, comprehension and reading and writing fluency were analyzed. Results: In study 1 we observed improvements in phonological awareness, syllabic subtest and total score; phonological working memory, pseudowords and digits subtest in direct order; access to the mental lexicon, number, letter and object subtests; and reader decoding. Despite the improvement in performance, these values still did not reach the expected level for the age and education of the participants. In article 02, fluency, comprehension, reading and writing are below what is expected for the children's age and education. Conclusion: The losses in written language skills highlight the relevance in understanding the educational reality of low-income children in Brazil, as well as in formulating future actions aimed at minimizing possible delays in students' literacy.
6	LARESSA CARDOSO BARBOSA Quality of life in dysphagia and functional performance of cancer patients. Advisor : HIPOLITO VIRGILIO MAGALHAES JUNIOR COMMITTEE MEMBERS : LICA ARAKAWA SUGUENO HIPOLITO VIRGILIO MAGALHAES JUNIOR RENATA LIGIA VIEIRA GUEDES Data: Apr 29, 2024 Show Abstract Objective: To correlate functional performance and the impact of dysphagia on the quality of life of cancer patients. Method: Article 1) Cross-sectional and analytical study that aimed to correlate the functional performance and impact of dysphagia on the quality of life of cancer patients in palliative care. Article 2) A cross-sectional, analytical study that aimed to compare the impact of dysphagia on the quality of life and functional performance of cancer patients with different tumor sites. Descriptive methods were used to analyze the data from the two articles for categorical variables, while measures of central tendency, mean and standard deviation were calculated for quantitative variables. Pearson's test was used to correlate the scores of the test instruments in the first article, where the variables were normal, while Spearman's correlation was used in the second article due to the non-normality of the variables, and Mann- Whitney was used to compare the means of the groups, with a significance level of 5%. Results of the first article: 39 patients took part, 29 from the outpatient clinic and 10 from the ward. A positive and moderate correlation was identified between the results of the M. D. Anderson Dysphagia Questionnaire (MDADI) and the level of functionality according to the Palliative Performance Scale (PPS) in outpatients. It was concluded that cancer patients at the palliative care outpatient clinic showed a correlation between functional performance and the impact of dysphagia on quality of life. Results of the second article: four patients with head and neck cancer (HNC) and eight with non-localized head and neck cancer (NSCLC) participated. A statistically significant difference was found between the two groups for the MDADI and the global and physical domains, while no difference was found between the groups for the PPS scale. It is concluded that there was a different perception of dysphagia in each group and that in this study, the determining factor for the severity of the perception of dysphagia was the location of the tumor, rather than functionality.
7	STEFANE MARIA DE LIMA CAMPOS Investigation of oropharyngeal dysphagia in Parkinson's disease. Advisor : HIPOLITO VIRGILIO MAGALHAES JUNIOR COMMITTEE MEMBERS : CAROLINE CUNHA DO ESPIRITO SANTO HIPOLITO VIRGILIO MAGALHAES JUNIOR LEANDRO DE ARAUJO PERNAMBUCO Data: Apr 30, 2024 Show Abstract Introduction: Oropharyngeal dysphagia (OD) is a common clinical condition in Parkinson's disease (PD)and can be present in people with late PD, early-onset Parkinson's disease (PPD) and at any stage ofevolution. The signs and symptoms of this disorder may reflect changes in the efficiency and safety of swallowing to take food from the mouth to the esophagus, as well as being influenced by the decreased function of the tongue during the swallowing process, which can cause risks of penetration and aspiration. Objective: Article 1 aimed to measure the maximum isometric pressure (MIP) of the tongue in different PD stages and whether there was any interference from the decrease in (MIP) of the tongue with changes in the efficiency and safety of swallowing. For article 2, the objective was to identify whether there are changes in swallowing efficiency and safety that signal the presence of oropharyngeal dysphagia in PPD. Method: Article 1 is an analytical, cross-sectional study and article 2 is a case series. To obtain the data, sample characterization protocols, self-assessment of swallowing changes, tongue MIP assessment using a tongue peak pressure transducer and swallowing volume/viscosity test were applied. An exploratory analysis of the data was carried out by calculating simple frequency and percentage with results expressed as mean and standard deviation and subjected to analysis of variance (ANOVA). Normal distribution was assessed using the Shapiro-Wilks test and comparisons between tongue MIP levels, final assessment of the swallowing test, PD stage and interaction between final assessment and stage were performed using the Tukey test. Results of article 1: 50 individuals participated in the study, 22 in the initial stage, 20 in the moderate stage and 8 in the advanced stage. The average PIMax of the tongue was 33.82 kPa (±17.08), which identified the interference of the PD projects in the PIMax of the tongue, but without any influence on changes in swallowing efficiency and safety. Results of article 2: 12 individuals participated in the study, six in the initial stage and six in the moderate stage and among these, only two did not show any sign of change in the efficiency and safety of swallowing. In relation to safety, the change in vocal quality was the most frequent in the volume of 5mL in IDDSI level 0, 2 and 4 consistencies and in efficiency they were: suspected pharyngeal residue and multiple swallowing in IDDSI level 2 and 4 consistencies. Conclusion: Individuals with PD have a decrease in tongue MIP and as the disease progresses, the pressure oftongue tends to decrease, despite this, the efficiency and safety of swallowing were not related to the decrease in tongue MIP. It was also identified that people with PPD in less aggressive stages of the disease showed signs of changes in swallowing, due to the presence of pharyngeal residues.
8	TÁSSYA KAMILA FERNANDES CALDAS DE LIMA Tinnitus symptom rehabilitation through Transcranial Direct Current Stimulation Advisor : ERIKA BARIONI MANTELLO COMMITTEE MEMBERS : ERIKA BARIONI MANTELLO MARINE RAQUEL DINIZ DA ROSA RODRIGO PEGADO DE ABREU FREITAS EDGARD MORYA Data: Apr 30, 2024 Show Abstract Tinnitus is the perception of sound in the absence of an external sound source, its impact on quality of life can range from slight to catastrophic. Currently, there are several possibilities for tinnitus management, among them is neuromodulation. Transcranial Direct Current Stimulation (tDCS) is a painless and non-invasive neuromodulation technique that uses a low-intensity electrical current to stimulate or inhibit the central nervous system in order to normalize neuronal activity and alleviate tinnitus. Purpose: (1) to verify if there is a change in the annoyance and impact of tinnitus after tDCS in patients with chronic tinnitus. (2) to investigate the applicability and effectiveness of Transcranial Direct Current Stimulation as a therapeutic resource in individuals with chronic tinnitus complaints. Method: (1) pilot study designed as an uncontrolled clinical trial. (2) study designed as a randomized controlled clinical trial. Approved by the Research Ethics Committee of the Hospital Universitário Onofre Lopes (HUOL), opinion nº 5.622.441 and by ReBEC, nº RBR-109xh8d6. The sample consisted of adult patients referred from the Tinnitus clinic at HUOL, of both genders, with a current complaint of chronic tinnitus, after basic audiological evaluation. Patients who fit the contraindications to the use of neuromodulation were excluded. Anamnesis, high-frequency audiometry and, to characterize the outcome measures, acuphenometry, the Visual Analog Scale (VAS) and the Tinnitus Handicap Inventory (THI) questionnaire were performed. The intervention protocol consisted of applying a current of 2mA, for 20 minutes, with an anodic electrode in the left temporoparietal cortex and a cathodic electrode in the right dorsolateral prefrontal cortex, in five consecutive sessions (1), and during ten alternating sessions (2). The results were analyzed descriptively (1) and the preliminary data (2) submitted to inferential statistical analysis. Results: (1) Three female and two male patients were evaluated; average age of 45 years, hearing within normal ranges and decreased hearing sensitivity at high frequencies. After the five neuromodulation sessions, the mean total score on the THI ranged from 36.8 to 33.2 points and, on the VAS, it ranged from 5.16 to 4.4 points. (2) So far, the sample consisted of 17 patients (ten in the experimental group (EG) and seven in the control group (CG)), with a mean age of 49 years. The total average on the VAS reduced from 4.8 to 4.3 points (p= 0.17). There was a reduction in the scores of all THI subscales after neuromodulation, with a significant difference (p= 0.001) for the total score (38 to 28 points). There was also a significant difference (p= 0.0005) in the total THI score, in the comparison between the EG and GC after neuromodulation. Final considerations: (1) There was a decrease in the perception of tinnitus annoyance and damage after the neuromodulation sessions. (2) So far, there was a significant decrease in the perception of the impact of tinnitus on quality of life after the intervention through tDCS, in the experimental group and in the comparison between groups.
9	ANNA IRENNE DE LIMA AZEVEDO USE OF TECHNOLOGIES IN COGNITIVE-LINGUISTIC SKILLS IN SCHOOL PEOPLE WITH ADHD Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI CLARA REGINA BRANDÃO DE AVILA TAÍS DE LIMA FERREIRA MATTAR Data: Jul 30, 2024 Show Abstract Introduction: With the advancement of technology, interest in non-pharmacological approaches for the treatment of various disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), has been growing. Studies suggest that techniques like Electroencephalogram (EEG) and Neurofeedback (NFB) can aid in diagnosis and intervention, respectively, improving cognitive-linguistic skills and academic performance. This dissertation is divided into two studies with the following objectives: Study 1: Analyze the characteristics of phonological processing in schoolchildren with ADHD and verify if these skills show relationships with brain functioning through electrophysiological measures. Study 2: Verify the impact of NFB training on the development of cognitive-linguistic skills in children diagnosed with ADHD. Method: Study 1: A qualitative field research, approved by the ethics committee with protocol number 6.483.440. Ten children aged 7 to 14 years with a prior diagnosis of ADHD participated. They underwent a phonological processing assessment—phonological awareness, phonological working memory, and phonological access to the mental lexicon—and brain electrophysiological measures (theta/beta ratio and alpha peak). Study 2: An integrative literature review in the Medline, Lilacs, Scielo, and ERIC databases; and grey literature, constructed from the research question, "What are the effects of NFB on the cognitive-linguistic skills of children with ADHD?" Results: Study 1: The schoolchildren performed below expectations on the phonological processing subtests and electrophysiological measures, showing a qualitative relationship between performance in phonological and electrophysiological processing skills. Study 2: Following the eligibility criteria, the review included 18 articles from international journals, which observed that although there are discussions about the use of NFB as a therapeutic approach, it is evident that it can contribute to improvements in cognitive-linguistic skills in individuals with ADHD. Conclusion: The use of technologies can be presented as an aid in the diagnosis and intervention of ADHD. However, studies need to advance regarding implementation in clinical practice, as it is not yet a consensus in the scientific community.
10	BÁRBARA LOUISE COSTA MESSIAS CHARACTERIZATION OF WRITTEN LANGUAGE IN CHILDREN AND ADOLESCENTS WITH AUTISM SPECTRUM DISORDER Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI ANA CRISTINA DE ALBUQUERQUE MONTENEGRO ANA LUIZA GOMES PINTO NAVAS Data: Aug 26, 2024 Show Abstract Introduction: Extrinsic and intrinsic conditions of the individual can directly impact writtenreading. Therefore, understanding these mechanisms contributes to identifying and managing the child'sspecific needs. In cases of Autism Spectrum Disorder (ASD), with the complexity of language development,these subjects may present difficulties in academic and social areas. Although there are advances inintervention strategies, it is observed that more precise information about them is still limited. Thisdissertation was divided into two studies, with the following objectives: Study 1: investigate writtenlanguage performance in children and adolescents with ASD. Study 2: verify the development of predictivereading and written language skills of children and adolescents with ASD, pre and post intervention. Studymethod 1: This is a cross-sectional and quantitative study. The sample consisted of 17 children andadolescents with ASD. Phonological processing skills, intelligence and level of support for ASD wereassessed. Study method 2: this is a non-randomized clinical trial consisting of 8 individuals, who weredivided into 2 groups of 4 participants - control group (CG) and intervention group (IG). The IG received 13phonological remediation sessions, lasting 45 minutes each. Results of study 1: it was observed that allphonological processing skills are below what was expected for the age and education of the sample.Furthermore, it was not possible to find significant correlations between phonological processing,intelligence quotient (IQ) and level of ASD support, with the exception of phonological working memory -digits in reverse order. Results of study 2: phonological processing skills evolved in the post-interventionperiod. However, in the inferential analysis between groups, there were no significant differences.Conclusion: It was observed that the written language skills of children and adolescents with ASD areimpaired. Therefore, the use of phonological remediation can present positive results for this population.However, due to the limitations of this research, it is suggested that new studies be carried out, considering alarger sample and an analysis of the long-term impacts of the intervention.
11	ALBA MIRANDA BESERRA GURGEL SENA Reliability, convergent validity and performance of TRILHAR: instrument validation process. Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI APARECIDO JOSÉ COUTO SOARES DÉBORA MARIA BEFI-LOPES Data: Aug 27, 2024 Show Abstract Children with restricted vocabulary are at risk for language disorders, and may present delays at morpho-syntactic level, difficulties in decoding and reading comprehension. Identifying this signs contribute to early intervention and, therefore, a better prognosis. TRILHAR is an instrument developed by brazilian researchers and aims screening the receptive and expressive vocabulary of children between 3 and 7 years old. This study aims to contribute to the TRILHAR validation process by verifying the performance difference in students from different regions and by verifying the reliability and convergent validity of the instrument. For the first analysis, there are 255 children between 3 to 7 divided intro two groups: G1 – 122 children from the state of São Paulo and G2 – 133 children from the state of Rio Grande do Norte. All students, from G1 and G2, studies in brazilian public schools. Children in G1 had an average of 9.90 (SD = 0.350) points in receptive vocabulary, while those in G2 had 9.83 (SD = 0.412) points. As for expressive vocabulary, children in G1 had an average of 8.82 (SD = 1.305) and those in G2 8.53 (SD = 1.253) points. To compare performances, the t-test was used, demonstrating a p-value of 0.16 for receptive vocabulary and 0.07 for expressive vocabulary. This result demonstrates that there was no significant difference in performance between the two groups. The semantic aspect can be influenced by the family and school environment, age, parent’s education and sociocultural diversity. Therefore, when developing Brazilian vocabulary measurement and tracking tools, the sociolinguistic reality must be observed. The target words must consider the diversity of vocabulary in a geographically extensive country like Brazil. It is concluded that TRILHAR is suitable for application in these two different sociocultural contexts. Furthermore, it was possible to observe the average score obtained by both populations. This analysis may contribute to the process of establishing expected reference values for each age group. The second analysis aims to verify the convergent validity and reliability of TRILHAR. In addition, it aims to compare the expressive and receptive vocabulary performance of four different clinical groups - children with Speech Sound Disorders (G-SSD), Development Language Disorder (G-DLD), Autism Spectrum Disorder (G-ASD) and children at risk for dyslexia (G-DD) - and to analyze the performance of other vocabulary tests and TRILHAR. The sample consisted of 35 children between 5 and 7 years old (mean of 6.17 ± 0.82). To verify reliability, Cronbach's Alpha was verified by applying TRILHAR twice with an interval of 7 days. It presented very good reliability (α = 0.927). For convergent validity and comparison of vocabulary between the groups, the TVfUSP and ABFW vocabulary were applied. Kendall's Correlation was used for this analysis. The expressive vocabulary screening of TRILHAR showed a moderate correlation with ABFW (r = 0.425; p = 0.002), while the receptive vocabulary screening did not show a significant p (p = 0.063) and demonstrated weak correlation strength (r = 0.291). In the comparison between groups, G-SSD and G-DD had a higher average of correct answers in TRILHAR - 19.54 ± 0.82 and 19.2 ± 1.30 respectively - ABFW - 100 ± 8.49 and 102.33 ± 11.90 - and TVfUSP - 100.63 ± 13.93 and 102.88 ± 13.37. The G-DLD presented the lowest score in TRILHAR and ABFW, 16.9 ± 3.14 for TRILHAR and 73.62 ± 22.69 for ABFW. The G-ASD presented the lowest performance for TVfUSP – 82.25 ± 24.18, but presented a higher score than the G-DLD in ABFW – 93.2 ± 19.99. This performance is consistent with the results found in the literature, since the DLD presents significant implications in the acquisition and development of language, resulting in specific difficulties in phonological and lexical processing - in receptive and expressive vocabulary. In conclusion, TRILHAR presents very good reliability and moderate correlation with the ABFW, a validated instrument and widely used in expressive vocabulary research in Brazil. For the next steps, it is necessary to continue the validation process of the instrument, so that it can be made available for screening the vocabulary of Brazilian children.
12	ALLYA FRANCISCA MARQUES BORGES Stomatognathic Functions and Orthognathic Surgery: A Scoping Review and Scientometric Analysis Advisor : KARINNA VERISSIMO MEIRA TAVEIRA COMMITTEE MEMBERS : CAMILA DE CASTRO CORRÊA KARINNA VERISSIMO MEIRA TAVEIRA LUCIANA VITALIANO VOI TRAWITZKI RENATA VEIGA ANDERSEN CAVALCANTI Data: Dec 13, 2024 Show Abstract The combination of dental and skeletal malocclusion characterises dento-skeletal deformities. The condition is manifested by disharmony between the bone and tooth bases, and its arrangement influences the adjacent soft tissues and can have a significant impact on quality of life and the stomatognathic system. The combination of orthognathic surgery and orthodontic treatment enables effective correction of facial asymmetries, promoting the establishment of a harmonious balance between the facial pattern and adjacent structures. Despite orofacial skeletal balance and the establishment of favourable conditions for the execution of orofacial functions, altered functional patterns persist which can have a negative impact on orofacial myofunctional equilibrium. From this perspective, this dissertation was based on a scoping review and a scientometric review, the objectives of which will be addressed respectively. In order to compose the dissertation, the studies aimed to map the orofacial and cervical myofunctional intervention programmes developed for adults undergoing orthognathic surgery, and to analyse the scientific mapping of orthognathic surgery research patterns and trends related to the functions of the stomatognathic system. To develop the scoping review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist was used, searching the Cochrane, EMBASE, LILACS, LIVIVO, PubMed/Medline, Scopus and Web of Science databases, as well as grey literature. The scientific review was carried out using the PubMed, Scopus and Web of Science databases, with no date or language restrictions, and analyses were carried out using the Bibliometrix package and VosViewer software. In order to compose the scoping review, studies were included that addressed therapeutic programmes, myofunctional exercises and their influence on the stomatognathic system of adults undergoing orthognathic surgery, without delimiting time or language, excluding secondary studies, populations under the age of 18 and comorbidities associated with dentofacial deformities. The scientometric analysis selected studies that assessed orofacial functions, excluding systematic reviews, books, book chapters, abstracts and grey literature. In total, five studies were eligible for the scoping review and 223 studies were included in the scientometric review. The five eligible studies were published between 2006 and 2019, with participants with an average age between 19 and 31 years, a predominance of females and the use of post-surgical guidelines and the practice of isometric, isotonic, postural and functional exercises, as well as tactile-kinesthetic and thermal stimulation, with a positive emphasis on the functional improvement of the stomatognathic system. The 223 studies included were analysed from 1981 to 2024, with an average annual growth rate of 2.96%, an average of 18.4 citations, 389 keywords, an average of 4.99 co-authors per document and 2.69% of international co-authorships, highlighting the gradual increase in productions, as well as the global and collaborative nature of scientific research. Thus, after detailed data extraction and analysis according to the methodology of each study, it can be concluded that despite the substantial gap identified in the scoping review, its mapping highlights a significant improvement in the performance of orofacial functions, suggesting an optimization of the functionality of the stomatognathic system, a better perception of oral health and improvements in the tone and mobility of orofacial structures in individuals who underwent orofacial and cervical myofunctional intervention after orthognathic surgery. The scientific analysis reveals a significant increase in the number of publications on orthognathic surgery and stomatognathic functions, emphasizing the relationship and importance between orthognathic surgery and the stomatognathic system.

2023

	Dissertations
1	THAIS LENHARO SATERS Hearing and language monitoring in childhood: analysis of an application for families Advisor : ELIENE SILVA ARAUJO COMMITTEE MEMBERS : ANA MANHANI CACERES ASSENCO DORIS RUTHY LEWIS ELIENE SILVA ARAUJO KÁTIA DE FREITAS ALVARENGA Data: Mar 28, 2023 Show Abstract Introduction: The family has an extremely important role in identifying hearing disorders, especially in the first years of the child's life, and the use of technological resources such as Smartphone applications can favor this process. Objective: To analyze family adherence and the usability of an application as a technological solution for auditory and language follow-up in childhood. Methods: This is an observational, descriptive, and cross-sectional study. Families residing in three municipalities in the state of São Paulo and one in Rio Grande do Norte participated, between July and December 2022. Phase 1 consisted of applying a knowledge questionnaire on child hearing health, with 200 families, in order to analyze whether there is influence of prior knowledge on adherence to technology-mediated follow-up. In phase 2, using the System Usability Scale (SUS) and the Net Promoter Score (NPS), the usability and satisfaction of the application “Ei- Escuta Infantil” was analyzed by 10 judges and 18 users. Descriptive and inferential statistical analysis was performed using the Software Statistical Package for the Social Sciences (SPSS), with a significance of 5%. Results: The results were organized into two manuscripts. The level of prior knowledge of families about child hearing health was classified as “little knowledge” for 103 participants (51.5%) and attitudes towards child audiology services were predominantly positive (n= 193; 96.5%). There was no influence of the family income, education level and research participant (mother or father) variables on the level of knowledge in hearing health. Furthermore, 23.5% of the participants installed the app, and there was no association between adherence and the level of prior knowledge or with the mode of delivery of public/private or hospital/outpatient neonatal hearing screening. About usability, all judges evaluated the app with a score higher than the 50th percentile of the SUS, an average total score of 74 points, which demonstrates that the tool did not present major usability problems. In the family members' perception, the SUS median was equivalent to 92.5 points and, following the NPS criteria, 88.8% (n=16) of them would give positive publicity to the product. Conclusion: Families' knowledge about children's hearing health is predominantly restricted, but it does not interfere with adherence to the application. “Ei – Escuta Infantil” showed good usability and can be an auxiliary technological solution to improve parents' knowledge on the subject and maximize auditory and language monitoring in childhood.
2	HELLEN TATYANNE DA SILVA BARBOSA Hearing and language in early childhood: analysis of the effectiveness of a course for early childhood education professionals Advisor : ELIENE SILVA ARAUJO COMMITTEE MEMBERS : ELIENE SILVA ARAUJO ANA MANHANI CACERES ASSENCO ISABELLE CAHINO DELGADO MARINA LEITE PUGLISI Data: Apr 27, 2023 Show Abstract The school environment expands the child's social life, allowing the development of communicative skills in early childhood. The educator is a fundamental agent for the full development of children. Its performance has the potential both to favor communicative skills and to identify possible changes in their development. However, despite the origin of Speech Therapy being associated with Education, there is still little collaboration between these areas in early childhood education. Seeking to fill this gap, this dissertation aimed to analyze the effectiveness of a course on the development of communication in early childhood for training professionals in early childhood education. The longitudinal study was linked to a university extension course aimed at early childhood education professionals. Data collection was based on the application of virtual questionnaires that evaluated the teachers' knowledge about the development of communication in early childhood, decision-making, faced with simulated situations about the development of communication and the opinion about the course. The data collection period extended from September 2021 to December 2022 and consisted of three moments: (1) pre-course; (2) post-immediate - immediately after completion of the course; and (3) post-late - six months after completion of the course. In total, the responses of 92 professionals who participated in the three moments were considered. The casuistry was composed mostly of women, aged up to 39 years, and with specialization as the maximum level of schooling. The results obtained were divided into two articles. The first compared teachers' knowledge about the development of communication in early childhood in the three moments of the study. The comparison of the total number of correct items between the moments revealed that in the post-late period, the participants had more correct answers. In turn, the second article compared the decision-making of professionals in the face of simulated situations in the three moments. This comparison indicated significant differences between performance before and after the course. Thus, it was possible to conclude that the training of early childhood education professionals through a distance course is effective as a tool for expanding knowledge about the development of communication in early childhood.
3	RAYANE MEDEIROS PEREIRA Association of audiological and psychoacoustic measures of tinnitus with anxiety symptoms Advisor : ERIKA BARIONI MANTELLO COMMITTEE MEMBERS : ERIKA BARIONI MANTELLO FATIMA CRISTINA ALVES BRANCO BARREIRO MARINE RAQUEL DINIZ DA ROSA Data: May 29, 2023 Show Abstract Introduction: Tinnitus is the perception of a sound generated in the auditory pathways in the absence of an external sound source and can cause different emotional reactions. Objective: (1) To verify whether there is a relationship between the presence of chronic tinnitus and risk factors and comorbidities reported by participants in this research. (2) To verify the relationship and compare the psychoacoustic characteristics, the impact and level of discomfort of tinnitus with symptoms associated with anxiety, in patients with and without hearing loss. Method: Study approved by the Research Ethics Committee, nº 4,880,618. Dissertation structured in two articles. (1) Observational, analytical case-control study, with a sample of 100 participants divided into the Research Group (RG) with chronic tinnitus and the Control Group (CG) without tinnitus. (2) Cross-sectional and analytical study, with a sample of 50 participants divided into two groups, group 1 (G1) without hearing loss and group 2 (G2) with hearing loss. The responses obtained by the visual analogue scale (VAS), Tinnitus Handicap Inventory (THI), acuphenometry and State-Trait Anxiety Inventory (STAI) were analysed. Results: (1) There was influence of diabetes mellitus and hearing loss associated with tinnitus. (2) A significant difference was observed for the variables pitch in the right ear (RE) and total VAS score between the groups. There was a correlation between VAS and loudness and THI with VAS and IDATE-T, in G1. Conclusion: (1) There was an association between the comorbidities diabetes mellitus and hearing loss as risk factors for the presence of tinnitus. (2) There was no difference in the impact of tinnitus on quality of life, the feeling of symptom intensity and signs of anxiety between patients with and without hearing loss. However, there was a difference in the sensation of the frequency of tinnitus in the right ear and the level of discomfort of the symptom, which was greater among patients with hearing loss. It was also identified a relationship between the level of annoyance and the greater sensation of tinnitus intensity, in both ears, in the normal hearing group.
4	ANA PAULA SABINO DE MEDEIROS NEVES Behavioral organization status and breastfeeding performance of late preterm newborns with hyperbilirubinemia undergoing phototherapy Advisor : HIPOLITO VIRGILIO MAGALHAES JUNIOR COMMITTEE MEMBERS : HIPOLITO VIRGILIO MAGALHAES JUNIOR ANDREA MONTEIRO CORREIA MEDEIROS GEOVANA DE PAULA BOLZAN Data: Sep 21, 2023 Show Abstract Introduction: Prematurity is a risk factor for the occurrence of eating disorders. However, the late preterm newborn, in general, is accompanied in rooming-in without differentiated management. Jaundice is the clinical manifestation of hyperbilirubinemia and is common in the neonatal period. Late preterm infants are at high risk of developing significant hyperbilirubinemia. Bilirubin in high amounts is potentially neurotoxic and phototherapy, a commonly used treatment, can cause adverse events, such as water loss and changes in the circadian cycle. Feeding difficulty is a risk factor for increased serum bilirubin levels. Thus, it is necessary to investigate possible difficulties in breastfeeding, to evaluate the state of behavioral organization and its relationship with latching and sucking responses, in order to provide data that allow adequate management in the face of possible difficulties and guarantee the preterm submitted to phototherapy an effective feeding and adequate intake. Such measures may reduce the risks of increased bilirubin and, as a consequence, the possibility of reducing the duration of phototherapy treatment. Objective: 1) To evaluate the breastfeeding performance of preterm newborns with hyperbilirubinemia undergoing phototherapy. 2) To investigate the responses of the state of behavioral organization of late preterm newborns with hyperbilirubinemia submitted to phototherapy and its association with the latch responses, nutritive and non-nutritive sucking. Method: Controlled cross-sectional study. It was carried out in a public teaching maternity hospital whose sample consisted of 60 mother/newborn dyads, divided into two groups. A group composed of 30 newborns who presented significant hyperbilirubinemia, therefore, in need of phototherapy (case group), and another group with 30 newborns without the need for phototherapy (control group). The characterization data of the sample were obtained through anamnesis and collection from medical records. Performance assessment in breastfeeding was carried out using the Breastfeeding Observation Form protocol proposed by UNICEF, the assessment of the state of behavioral organization and non-nutritive sucking using the Preterm Oral Feeding Readiness Scale instrument. Indirect bilirubin levels were checked on the day of the assessment by the pediatrician. For statistical analysis, the Mann-Whitney U test was used in order to analyze the differences between the groups in sample characterization, breastfeeding performance, behavioral organization and aspects of non-nutritive sucking, Kendall's Tau-B test was used. used to verify the association between the variables state of behavioral organization, attachment, nutritive and non-nutritive sucking. A significance level of 5% was adopted for all analyses. Results: In the assessment of breastfeeding performance, there was a significant difference in the general observation of the newborn, position of the newborn, latching and sucking sections. There was a significant difference in the state of behavioral organization and non-nutritive sucking. It was also verified, the association between the state of behavioral organization and the handling responses, nutritive and non-nutritive sucking. Conclusion: Newborns undergoing phototherapy have more breastfeeding difficulties, lower scores in the state of behavioral organization and in non-nutritive sucking. The speech-language evaluation can contribute to identify feeding difficulties and enable assertive behaviors in the care of these newborns.
5	BIANCA STEPHANY BARBOSA VITAL REMOTE MICROPHONE SYSTEMS IN CHILDREN AND ADOLESCENTS WITH AUTISMO SPECTRUM DISORDER Advisor : SHEILA ANDREOLI BALEN COMMITTEE MEMBERS : ARYELLY DAYANE DA SILVA NUNES ARAÚJO JOSELI SOARES BRAZOROTTO REGINA TANGERINO DE SOUZA JACOB SHEILA ANDREOLI BALEN Data: Sep 28, 2023 Show Abstract Introduction: Autism Spectrum Disorder (ASD) has a prevalence of 1/36 diagnosedchildren and may present social, behavioral and language difficulties.Sensory andperceptual changes, including auditory changes, can also be observed. The RemoteMicrophone (MR) is an assistive technology that allows for a better signal-to-noiseratio and can promote improvements in auditory perception, attention and reducedlistening effort. Objective: Map studies on the use of remote microphone in childrenand adolescents with ASD. Methodology: This is a Scope Review study that followsthe methodological guidelines of the Joanna Briggs Institute (JBI) andrecommendations from the PRISMA-ScR checklist. A search was carried out in thefollowing databases: Embase, Scopus, Web of Science, Lilacs and Google Scholarand ProQuest gray literature, in addition to reference lists of included studies andconsultation with experts. The search strategy was adapted to each database usingspecific units. Intervention studies were included, with children and adolescents withASD who used MR, without restrictions on gender, language, age, time ofpublication, ethnicity or geographic location. Results: 709 studies were identified inthe databases and gray literature. Of these, seven articles were included forinclusion and data analysis. Of the publications identified in the list of references andindicated by experts, only one was included in the exclusion and data analysis. The08 studies were heterogeneous regarding the model of the MR system (individual orin the field), the tests applied, the intervention period and the location of theintervention. In seven studies, it was possible to verify an improvement inparticipants' speech perception after the MR intervention period. As well as,improvements in verbal response time, social interaction, classroom behavior,auditory attention, auditory memory, noise tolerance and stress reduction andchanges in neural activity with electrophysiological assessment after a period werealso observed among the studies. of intervention. Conclusion: Children andadolescents who used MR showed benefits in speech perception, social interactionand behavior. This assistive technology shows promise for this population, howevermore field studies are needed to define more specific protocols and parameters ofuse describing the variables that exist depending on the different conditions andlevels of ASD.
6	CLAYDIANNE DOS SANTOS FREITAS Professional development of literacy teachers in the context of reading science Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI ANGELA MARIA CHUVAS NASCHOLD RENAN DE ALMEIDA SARGIANI Data: Sep 29, 2023 Show Abstract Studies show that teacher training based on scientific evidence impacts the theoretical and practical understanding of these professionals. The moments of professional improvement in initial or continuing education enrich the teaching practice by providing contributions that support an effective and structured pedagogical intervention focused on the educational needs of students. Current scientific evidence on literacy, the result of highly methodologically rigorous research in the field of Cognitive Sciences of reading, has helped teachers in the practice of teaching children with persistent difficulties in the development of reading through approaches that consider the effectiveness of explicit and systematized teaching of reading and writing. However, there are few intervention studies with teacher training that address content about the neurobiological process of reading and persistent difficulties in the development of written language, which motivated the application of this study, which aims to identify the knowledge of Brazilian professionals who work in the public education network of municipalities in Rio Grande do Norte on literacy and verify the impact of the Professional Development Program for Literacy Teachers in the Context of the Science of Reading. The study is descriptive of an exploratory nature with data analysis based on the Bardin model. For its design, literature reviews, Likert evaluation questionnaires and intervention with professional training were used. With this, it was possible to identify that the participants did not have confidence in relation to knowledge about evidence-based literacy and about teaching students with persistent difficulties in the development of reading. The research findings support future professional training in evidence-based literacy that supports the strengthening of educational actions aimed at inclusive teaching of reading and writing that meets the educational needs of students who have greater difficulties in the learning process.
7	INGRID RAFAELLA DANTAS DOS SANTOS TELEINTERVENTION GUIDED BY VIDEOFEEDBACK FOR FAMILIES OF HARD OF HEARING CHILDREN Advisor : JOSELI SOARES BRAZOROTTO COMMITTEE MEMBERS : JOSELI SOARES BRAZOROTTO SHEILA ANDREOLI BALEN LUCIANA PIMENTEL FERNANDES DE MELO Data: Sep 29, 2023 Show Abstract Therapeutic protocols that optimize development results in the hearing-impaired child population still lack evidence. Videofeedback is a low-cost, easily accessible technology procedure that can improve communication between family and child, with impacts on their development. Its use through telepractice can transform the provision of specialized therapies for this population. Therefore, the present study aimed to analyze the effectiveness of a remote intervention program with videofeedback to improve interaction between families and hard of hearing children. This is, therefore, a quasi-experimental intervention study, with a convenience sample based on the availability of families to participate in teleconsultation sessions, consisting of 12 families using a hearing health service, divided into control and experimental groups, evaluated pre- and post-intervention by researchers blind to the study. Families and children were characterized using secondary data from medical records and questionnaires and clinical assessments. The variables analyzed in the pre and post moments were those referring to the evaluation of the interaction between the family and their child, recorded on video. The intervention program through telepractice consisted of 10 intensive, sequential sessions. Prior to the main study, a single-case pilot study was carried out to calibrate the research procedures, presented as Article 1.In the pilot study (Article 1), reliable change and clinical significance were observed for the mother's behaviors and reliable change for the child's receptive and expressive language behaviors, indicating the potential of the proposed model. In the intervention study (Article 2), a statistically significant difference was found between the control and experimental groups in the pre- and post-intervention moments (p <0.01). Among the variables highlighted in family-child interaction (general assessment of the caregiver's communicative competence, tuned interaction, intrusiveness, solution of breaks in communication and syntactic expansion) it was observed that both in the EG and in the CG some families behaved as outliers, however, reliable clinical change was found in the families in the experimental group in relation to the control group and clinical significance for some of the families in the EG. It is concluded that the intervention guided by videofeedback mediated by telepractice is effective, highlighting the improvement of interactions between families and their hard of hearing children and the potential of this tool for optimizing results in clinical pediatric auditory rehabilitation programs.
8	ISABELLE COSTA DE VASCONCELOS Functional near-infrared spectroscopy (fNIRS) in infants with congenital syphilis. Advisor : SHEILA ANDREOLI BALEN COMMITTEE MEMBERS : GABRIELA CINTRA JANUÁRIO PEDRO DE LEMOS MENEZES SHEILA ANDREOLI BALEN Data: Sep 29, 2023 Show Abstract Introduction: Neurosyphilis is an infection of the central nervous system caused by Treponema pallidum and can be symptomatic or asymptomatic in children with congenital syphilis. Syphilis infection can cause different alterations, including hearing loss as a possible late manifestation of congenital syphilis, and is a globally recognized risk indicator for hearing loss. However, there is little information on the consequences for cerebral hemodynamics. Research combining near-infrared spectroscopy (fNIRS) and auditory stimuli in infants plays a significant and multifaceted role in science and society. One of the main contributions of this research is to provide information on how babies' brains develop in response to auditory stimuli. Objective: To identify the acquisition parameters of functional near-infrared spectroscopy (fNIRS) with speech stimulation in infants up to two years of age, through a systematic review. To describe the cortical activation pattern of a four-month-old infant with neurosyphilis using fNIRS with speech stimulation. Method: Two studies were carried out. Study 1 was a systematic review of fNIRS parameters (Prospero n. CRD42022311267). The search was carried out in PubMed, Embase, Scopus, Web of Science, LILACS, PsycINFO, Livivo, Google Scholar and ProQuest. We included cross-sectional studies of normal-hearing infants aged 0-24 months using fNIRS with monosyllabic speech stimuli. Study 2 is a clinical case study (CEP/HUOL n. 5.323.957). The clinical case is of a four-month-old infant referred by an infectious disease specialist for audiological assessment. The audiological assessment included the following procedures: Tympanometry, Evoked Otoacoustic Emissions, Brainstem Evoked Response Audiometry with click stimulus and fNIRS with speech stimulus. Results: A total of 932 articles were identified in the database (DB) and 770 in the gray literature (LC). After removing duplicates, 409 remained in the DB and 499 in the LC. The titles and abstracts were then read in phase 1, when 64 articles in the DB and 25 articles in the LC were selected for full reading, of which four remained for final analysis and data extraction. From the articles included, the conformity of only three parameters involved in the experimental designs was evidenced: the presentation of stimuli bilaterally as well as the bilateral capture of response in the temporal lobes and the use of natural sleep. In study 2, a similar tetha was observed between the conditions and channels evaluated in both cerebral hemispheres, with greater oxyhemoglobin (HbO) amplitude being observed in the frontal position when compared to the posterior region. Final Considerations: In study 1, there was a lack of uniformity in the parameters adopted by the various studies, which shows the absence of a standardized procedure. Study 2 showed development within the expected range for hearing, with cortical responses to speech stimuli.
9	THAYSA FLORÊNCIO BARBOSA FELIPE TELEPRACTICE IN WRITTEN LANGUAGE: PARENT GUIDANCE PROGRAM OF CHILDREN AND ADOLESCENTS WITH DYSLEXIA. Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI ISABELLE CAHINO DELGADO IVONALDO LEIDSON BARBOSA LIMA PATRICIA ABREU PINHEIRO CRENITTE Data: Sep 29, 2023 Show Abstract INTRODUCTION: The family is the child's first interactive subject with the world, which plays a fundamental role in child development, and can contribute to the acquisition of written language from the first years of life, so those responsible need information and tools to assist in this participation. of learning. OBJECTIVE: To analyze the impact of a parental guidance program for children and adolescents with dyslexia, using telephonoaudiology. METHOD: the study was divided into two articles: 1) Integrative review study and; 2) Quantitative and qualitative, longitudinal, prospective study, in which a parental guidance program was applied to children and adolescents with dyslexia via telephonoaudiology, in order to provide information on how the family can contribute to the development of reading and writing. The sample consisted of 12 mothers, who answered 2 Google forms questionnaires, pre and post application of the program, and participated in 8 remote meetings. EXPECTED RESULTS: 1) Integrative review study: important findings pointed out how beneficial the participation and help of the family in the acquisition of reading and writing is, but the number of international research on this topic overlaps with national research, requiring more national studies that encourage and present the population about the importance of parental involvement in written language. 2) Study 2: Brought contributions in the acquisition of knowledge to families of children with dyslexia, on how they can contribute to such development and also expanding research and actions in the field of Telephonoaudiology.
10	VANESSA BARBOSA DA SILVA SOUSA VALIDATION OF EDUCATIONAL GAMES FOR PARENTAL COACHING OF HARD OF HEARING CHILDREN FAMILIES Advisor : JOSELI SOARES BRAZOROTTO COMMITTEE MEMBERS : JOSELI SOARES BRAZOROTTO LUCIANA FIGUEIREDO DE OLIVEIRA LUCIANA PIMENTEL FERNANDES DE MELO Data: Sep 29, 2023 Show Abstract The daily activities of the family of children with hearing impairment are a strong factor in their development, as they are the most effective agents in continuously supporting the child's development. There is, however, a lack of evidence on specific intervention models for parental training for families, especially those aimed at validating specific intervention materials. Therefore, the objective of this study was to develop and validate games for parental training for families of children with hearing impairment. This is a mixed method, documentary, methodological study (through the development of educational games and their validation). For the development of the games, an integrative review was carried out to systematize the evidence on parental training programs for families of children with disabilities, which is presented as Article 1. After studying the programs and research in the area, a set of of games and a guide consisting of multipurpose cards, a route game and a guide for families on aspects related to the development of children with hearing impairment and the role of the family with facilitating strategies. Such games were evaluated by 6 experienced judges in auditory rehabilitation, as well as by 2 families of children with hearing impairment who have already been discharged from rehabilitation, using the Health Educational Content Validation Instruments (HECVI) and Educational Games Validation, adapted for the purpose of this research. After the content and appearance validation stage of the materials by the judges, with 95% agreement on the adequacy of the material, it was used in a short-term pilot intervention, consisting of 5 sessions, 1 in a group setting and 4 individual sessions, pre- and post-intervention design, for 4 families of hearing-impaired children from a hearing health service, in which pre- and post-interaction and their satisfaction with the intervention were evaluated, presented as Article 2. The results showed that the games were validated and comprise a kit with manual and rules for the 2 games, 21 multipurpose cards and a route game with 25 situational cards to reflect on how to optimize communication with children with hearing impairment. Although no reliable change or clinical significance was found in the inferential analysis of the interactions, in the qualitative analysis an improvement was observed for 3 of the four families, in particular, in the variables: responds to the child's communication, enthusiasm in the interaction, tuned interaction and first uses the voice to attract the child's attention. All families participating in the intervention using the games were satisfied. It was concluded that the game package was developed and validated, called: “Game of Tuning”, which proved to be a promising auxiliary tool for parental coaching in pediatric auditory rehabilitation services.

2022

	Dissertations
1	TALITA TRIGUEIRO DOMINGOS PUBLIC AWARENESS OF DEVELOPMENTAL LANGUAGE DISORDER IN BRAZIL Advisor : ANA MANHANI CACERES ASSENCO COMMITTEE MEMBERS : ANA MANHANI CACERES ASSENCO DÉBORA MARIA BEFI-LOPES JULIANA PERINA GÂNDARA Data: Jan 12, 2022 Show Abstract Language Development Disorder (DLD) is not a new or rare condition, but internationally its public awareness is inferior to other conditions with lower incidence. In Brazil there is no documented study in the literature on the subject. To fill this gap, this dissertation aimed to investigate public awareness of Developmental Language Disorder in Brazil. For this, an observational, descriptive and cross-sectional study was developed, carried out through a questionnaire provided by the virtual platform Google Forms. This questionnaire corresponds to the translated version into Brazilian Portuguese of an instrument used internationally. Questions are divided into six sections, including demographic and social characteristics; awareness about conditions that compromise language development; the nature of DLD; speech-language therapy services; role of the family; and strategies to raise awareness about DLD, respectively. Data collection took place between July and November 2021, after approval by the Research Ethics Committee (opinion 4,801,877). A total of 320 valid responses were obtained, the results of which were divided into two studies. The first considered all the answers to describe a profile of this awareness in Brazil, while the second compared the topic between health (n=99) and educational (n=95) professionals. Based on their results, it was possible to verify that less than 40% of respondents had already heard of DLD. Even among health (38.4%) and educational (45.3%) professionals this index is low, pointing to the need for specific actions to expand the dissemination of the DLD in Brazil.
2	ANA BEATRIZ LEITE DOS ANJOS EFFECTS OF AN INTERVENTION RESPONSE PROGRAM ON READING DECODING OF SCHOOL CHILDREN IN SOCIAL VULNERABILITY Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI ISABELLE CAHINO DELGADO LUCIANA MENDONÇA ALVES Data: Feb 18, 2022 Show Abstract Introduction: Reading is an important skill that enables communication, knowledge and integration of information with the language, both in the academic and social spheres. Social vulnerability is a severely present reality in developing countries like Brazil. Despite being a political-social issue, continuous and extreme cases of vulnerability are still present, generating developmental and biological biological consequences in children who grow up in such environments. Consequences in neurodevelopment, such as behavioral difficulties, memory, executive functions and the like, can be observed in these children, as well as academic difficulties, with changes in language development, such as delays in predictive reading and writing skills that considerably hinder the learning process. literacy and other stages of an individual's student life. Objective: To identify the effects of an intervention response program on the reading decoding of socially vulnerable schoolchildren in the period prior to the COVID-19 pandemic. Method: Longitudinal, interventional, prospective, descriptive and correlational. The study sample is 39 students from a public school, in the second year of elementary school. The sample was divided into two groups: experimental group (EG) and control group (CG). The EG underwent a program of response to the intervention, in the classroom, in 12 meetings, three times a week of 60 minutes each, for 5 weeks, in addition to the school activities in the classroom. The CG remained in formal literacy and received intervention activities after the end of the research. In this program, phonological awareness skills and expressive vocabulary were stimulated. Before and after the intervention, expressive vocabulary skills, phonological awareness, letter recognition and reading of words and pseudowords were evaluated. Results found: The two study groups obtained improvements in all assessed skills, such as increased expressive vocabulary and improvements in average performance in phonological awareness (GE: p=0.038; CG: p=0.082), reading words and pseudowords ( GE: p=0.002; GC: p=0.009) and letter recognition (GE: p=0.001; GC: p=0.030), in addition to showing an increasing trend in the GE results. There was a strong correlation between the results of phonological awareness and improvement in reading ability. Conclusion: the results infer the effectiveness of the program to respond to the intervention in the school environment of children in social vulnerability
3	ALICE ANDRADE LOPES AMORIM CHILDREN'S AUDIOLOGICAL AND LANGUAGE FOLLOW-UP: PROPOSAL OF AN APPLICATION AS A TECHNOLOGICAL SOLUTION IN PRIMARY CARE Advisor : ELIENE SILVA ARAUJO COMMITTEE MEMBERS : ELIENE SILVA ARAUJO PEDRO DE LEMOS MENEZES KÁTIA DE FREITAS ALVARENGA Data: Feb 25, 2022 Show Abstract Objective: To characterize the use of an application as a technological solution in the Children's Hearing Health Program articulated with Primary Care (PC) in different locations of Rio Grande do Norte (RN). Method: A pilot study, with a prospective descriptive design, subdivided into two phases: (I) Usability assessment of the ‘Agente Escuta’ application; (II) Child hearing health by mHealth: challenges and perspectives in PC. In the first stage, the System Usability Scale (SUS) and the Net Promoter Score (NPS) were used with 10 judges and 35 Community Health Workers (CHW) from six cities in RN. In the second phase, it was characterizing the implementation of the app on hearing and language monitoring of children from RN, through two questionnaires. All data were subjected to inferential and descriptive statistical analysis. Results: The app prototype had “good” usability (Score=78.21) in the SUS and +48.58% in the NPS. There were no significant differences in the mean results of the SUS and the NPS regarding the participating cities (p-value > 0.05). Of the 35 CHW, only three (8.57%) used the app in their work routine. Of the 14 participating Basic Units, only five (35.71%) had tablets and nine (64.28%) had internet for their CHW, to use during work. Aspects such as “the high demand for activities” and “lack of time” were identified as the obstacles in the effective use of the app by the participants. Conclusion: Although the ‘Agente Escuta’ shows good usability, for its effective implementation, structural aspects need to be considered previously.
4	DEUZIMAR PIRES DE ARAÚJO AUDIOLOGY TEACHING MEDIATED BY TECHNOLOGY AND THE IMPACT ON PRACTICAL PERFORMANCE Advisor : ELIENE SILVA ARAUJO COMMITTEE MEMBERS : ELIENE SILVA ARAUJO LÍLIAN CÁSSIA BORNIA JACOB CORTELETTI SHEILA ANDREOLI BALEN Data: Apr 29, 2022 Show Abstract Introduction: The use of technologies integrated into teaching can make classes more dynamic and interesting and help the teaching-learning process. Objective: To develop and validate technologymediated tools for teaching audiology. Method: A prospective descriptive study, structured in two manuscripts: (I) Virtual patients: impact of computer simulation on practical performance in audiology and, (II) Virtual Audiometer: online tool for teaching and learning. In the first study, two professors and 35 students from two Speech-Language Pathology and Audiology courses answered a satisfaction questionnaire and a self-assessment scale of the impact on practical performance, both on a Likert scale. In the second manuscript, the online version of the virtual audiometer was used by 481 people from 17 states and the Federal District (DF). Of these, 98 students, 24 professors and nine audiologists registered their assessment in a Likert scale questionnaire, in addition to citing positive and negative points. Results: The audiometric simulator and the online version of the virtual audiometer were positively evaluated as auxiliary tools in teaching, with intra- and inter-category user agreement. In addition, there was a positive perception of the impact on audiological practice. In the content analysis, the predominant negative point was the “installation difficulty” for the simulator and the “lack of an instruction manual” for the virtual audiometer. Conclusion: The two tools developed were positively evaluated and can bring benefits to the audiology teaching. The similarity with the physical audiometer, the low cost and the ease of installation are fundamental aspects for the efficiency of these solutions.
5	CAMILA NASCIMENTO DO RÊGO Reporting profile of workers' hearing problems in Brazil, between 2018 and 2021 Advisor : SHEILA ANDREOLI BALEN COMMITTEE MEMBERS : ANA CLAUDIA FIORINI ELIANA COSTA GUERRA MARIA ANGELA FERNANDES FERREIRA SHEILA ANDREOLI BALEN Data: May 20, 2022 Show Abstract Introduction: Hearing loss in workers may be related to their occupation, especially when exposed to continuous high levels of sound pressure or other risk factors. These hearing problems related to the work process are common injuries among the Notifications of Work Accidents (CAT) registered at the National Institute of Social Security (INSS) and at the Information System of Notification Diseases (SINAN). Objective: To know the main workrelated hearing problems, their causes, occupations, economic sectors, demographic profile of affected workers and place of occurrence, between 2018 and 2021. Method: Cross-sectional, retrospective study in a secondary database. Collection was carried out in INSS and SINAN public databases, from 2018 to 2021. For INSS data, information from notifications regarding occupational accidents related to the affected body part described as “Ear (External, Middle, Internal)” was collected. In SINAN records, the exclusive information of notification of “NoiseInduced Hearing Loss (NIHL)” was selected. Data for categorical variables were presented as absolute numbers and percentages, and data for quantitative variables as means and standard deviation. Descriptive statistics were performed. Results: In the years 2018 to 2021, a total of 2631 notifications of work accidents were observed in INSS, while in SINAN there was a total of 1965 notifications. The most recurrent problems were those described as “Alteration of the inner ear and/or auditory nerve / sensorineural hearing loss / labyrinthitis / dizziness”, with a total of 49.98% of notifications to INSS and 79.50% to SINAN. As for age, they ranged between 16 and 90 years, with a mean age of 41.48 years (SD=11.63) for INSS and 51.93 years (SD=11.9) for SINAN. A higher frequency of occupational hearing loss was observed in males (86.7%). The states that most notified were those in the North and Northeast regions for the INSS, while for the SINAN they were those belonging to the Southeast, South and Center-West regions of the country. When analyzing the occupation with the highest prevalence among workers with hearing loss, Machine Operator/Miners was the predominant one, with 35.61% cases in INSS and 33.49% in SINAN. And when analyzing the activity of companies, those that most reported workers with hearing loss were Industry and Oil companies, with 33.22% cases in INSS and 10.89% in SINAN. Still to INSS data, it was observed that the main agent causing accidents was noise (55.44%), with greater development of occupational disease (49.33%) and injuries related mainly to loss or impairment of hearing (62,37%). Conclusion: The results presented show a greater occurrence of hearing loss caused by changes in the inner ear related to the effects of noise, trauma and injuries in Brazilian workers notified, with a greater number of cases in male workers, who operate machinery and who work in the industry.
6	MARCELLE STELLA DE LIMA SOUZA Evidence-based practice in Speech Language intervention with Developmental Language Disorder Advisor : ANA MANHANI CACERES ASSENCO COMMITTEE MEMBERS : ANA MANHANI CACERES ASSENCO DÉBORA MARIA BEFI-LOPES JULIANA PERINA GÂNDARA Data: Aug 26, 2022 Show Abstract Introduction: Scientific production regarding speech language intervention in the area of child language is still scarce. This intervention proves to be effective as long as the speech language therapist acts in accordance with the principles of evidence-based practice (EBP), using valid therapeutic approaches. However, there is a limited scientific evidence base available related to EBP and language intervention in Brazil, especially when it comes to Developmental Language Disorder (DLD). Objective: To investigate the use of EBP principles by speech language therapists in DLD intervention in Brazil, and also describe the main therapeutic approaches applied. Method: Primary, cross-sectional and descriptive study. Initially, a data collection protocol was developed, consisting of five blocks of questions (sociodemographic, work field, knowledge about DLD, aspects of EBP and intervention principles). This protocol was based on a European questionnaire on intervention in DLD and on the adaptation to speech language therapy practice of a Brazilian questionnaire about EBP. Data collection began in August 2021 and consists of the protocol application in a virtual format by the Google Forms platform. The target audience of the study comprises speech language therapists who work clinically in the area of child language in Brazil. Expected results: It is expected to obtain an overview of the knowledge of EBP principles by Brazilian speech language therapists who work with DLD, as well as describe the main approaches used by these professionals. With such results, it is intended to contribute with proposals aimed at improving the clinical practice of speech language therapy.
7	LARISSA MARIANE MORAES DE ANDRADE MACÊDO Neuropsychological Functions of Schoolchildren with Developmental Language Disorder and Developmental Dyslexia Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI RAUNI JANDÉ ROAMA ALVES SIMONE ROCHA DE VASCONCELLOS HAGE Data: Aug 30, 2022 Show Abstract Introduction: In view of the growing number of cases referring to schoolchildren with developmental dyslexia or developmental language disorder in neuropsychological evaluations and the need to expand scientific evidence in the Brazilian scenario, we propose a study in which the main context points to the several areas in which the evaluation may be a competent instrument to favor a cognitive profile of these schoolchildren that will facilitate the differential diagnosis. Objective: to verify the cognitive functions in schoolchildren with developmental dyslexia and schoolchildren with developmental language disorder. Method: the study was divided into two articles: article 1- integrative review study and; study 2: case study, transversal, observational and quantitative, composed of elementary school students, aged between 06 and 12 years old. Initially, 16 children were evaluated, 8 with a diagnostic hypothesis of developmental dyslexia and 8 with a hypothesis of developmental language disorder. But, when they were evaluated, only 6 confirmed the diagnoses. Children with diagnoses of other neurodevelopmental disorders, genetic syndromes, hearing impairment, and school difficulties resulting from educational failures were excluded from this study. The abilities evaluated were: Neuropsychological tests and batteries standardized for the Brazilian population, in addition to interview with the family. Expected results: it is expected that the neuropsychological profile of these students will help in the interdisciplinary differential diagnosis between developmental language disorder and developmental dyslexia
8	MARIA CAROLAINE FERREIRA AGUIAR Evaluation and monitoring of vestibular function using the video head impulse test in patients with vestibular dysfunction Advisor : ERIKA BARIONI MANTELLO COMMITTEE MEMBERS : ALINE CABRAL DE OLIVEIRA BARRETO ERIKA BARIONI MANTELLO LIDIANE MARIA DE BRITO MACEDO FERREIRA Data: Aug 30, 2022 Show Abstract Introduction: The video head impulse test (vHIT) objective assessment of the vestibulo-ocular reflex (VOR) at high frequency. Objective: (1) To characterize the effect of vestibular rehabilitation (VR) on VOR gain, saccades, body balance and quality of life in three patients with peripheral vestibular hypofunction. (2) To compare the values of VOR gain, asymmetry between the semicircular canals (SCCs) and saccadic parameters in patients with Méniere's Disease (DM) and Vestibular Migraine (VM). Method: Study approved by the Research Ethics Committee, opinion nº 4,462,519. Dissertation structured in two articles. (1) Report of three cases submitted to VR and monitored by vHIT. (2) A cross-sectional and retrospective study, medical records of individuals diagnosed with DM and VM who underwent vHIT were selected. Results: (1) An increase in VOR gain was observed, consistent with normality standards and, extinction or reduction of saccades, in the three cases. (2) The sample consisted of 33 individuals, 18 from group 1 (G1), with VM, and 15, from group 2 (G2), with DM. In vHIT, in both groups, there was a predominance of normality in RVO gain. There was no difference between the average gain, per CSC, nor between the right and left CSCs, between G1 and G2. There was a difference in asymmetry between the posterior CSCs (p=0.042). Conclusion: In this study, vHIT was considered a useful instrument in the monitoring of vestibular function, post VR (1), but it was a limited test in the functional differential diagnosis between DM and VM (2).
9	BRENDA KARLA SILVA DA CUNHA CHARACTERIZATION OF OTOACOUSTIC EMISSIONS EVOKED IN ADULTS WITH HIV AND/OR ACQUIRED SYPHILIS AND ASSOCIATED FACTORS Advisor : SHEILA ANDREOLI BALEN COMMITTEE MEMBERS : SHEILA ANDREOLI BALEN ELIENE SILVA ARAUJO ALESSANDRA SPADA DURANTE Data: Sep 6, 2022 Show Abstract Introduction: The auditory system is a complex structure composed of sensory organs that make up its peripheral and central portions. There are external factors that can act as harmful agents and cause damage to the inner ear, such as some diseases. Syphilis and HIV are a known cause of sensorineural hearing loss, but there is a scarcity of studies that evaluate these damages. Objective: To characterize the findings of transient stimulus-evoked otoacoustic emissions (TEOAE) and distortion product (DPOAE) in individuals with HIV and/or syphilis. Methodology: Prospective observational study of the sectional type carried out in Public Services of Natal, approved by the Research Ethics Committee of the Institution (n. 4,627,820). Eighty-seven adults of both genders, aged 18 to 59 years and 11 months, were recruited. One was excluded for presenting other risk indicators, so the others were allocated into four groups: G1: nine adults with acquired syphilis; G2: 34 adults with HIV; G3: 10 adults with HIV and syphilis (coinfection) and G4: 33 adults without a diagnosis of acquired syphilis and/or HIV or other pathologies that indicate risk for hearing loss. The research protocol consisted of anamnesis, analysis of medical records, application of the Brazilian Association of Research Companies (ABEP) scale, tympanometry with a 226Hz probe, TEOAE and DPOAE. The S/N ratio and amplitude were analyzed at all frequencies per ear and intra- and inter-group statistical tests were applied. Therefore, the data were analyzed using descriptive and inferential statistics. The significance level adopted was 5%. Results: Of the 86 subjects, three were excluded because they presented alterations in the meatoscopy and one in the tympanometry. Therefore, of the 82 subjects included (average of 34.52 years), 66.2% were men, cisgender, and one transgender woman, belonging to G1. There was no association between the presence and absence of TEOAE and DPOAE and the groups studied. However, the G1 presented 33% of failure in the TEOAE and 67% of the DPOAE were present with altered amplitudes in the RE. Still, it was possible to observe in the TEOAE of the EO that the S/N ratio was higher in G3 and G4 when compared to G1. There were no statistically significant differences in the DPOAE S/N ratio in both ears. Furthermore, in general, greater amplitudes were observed in the lower frequencies in both OAEs. Conclusion: The audiological findings did not show an association between the presence or absence of TEOAE and DPOAE responses and the diagnosis of HIV and/or syphilis.

2021

	Dissertations
1	DANIELA DANTAS GALVÃO PHONOAUDIOLOGICAL ACTION WITH HOSPITALIZED DYSPHAGIC PATIENTS IN REFERENCE EMERGENCY HOSPITAL Advisor : GIORVAN ANDERSON DOS SANTOS ALVES COMMITTEE MEMBERS : ANA CAROLINA ROCHA GOMES FERREIRA EDNA PEREIRA GOMES DE MORAIS GIORVAN ANDERSON DOS SANTOS ALVES SILVIA DAMASCENO BENEVIDES Data: Feb 25, 2021 Show Abstract Introduction: As phonoaudiology gains ground inside the hospital, the necessity for specific knowledge also grows. In this scenario, the phonoaudiologist is a professional capable of assessing, diagnosing, and treating dysphagic patients early in emergency rooms. The presence of a phonoaudiologist is of great importance as early intervention allows for a better prognostic, reduces hospitalization time, and consequently reduces hospital costs with medications, enteral nutrition, human resources, besides improving quality of life. Objectives: Study 1: 1) it aims to characterize phonoaudiological care for hospitalized dysphagic patients, 2) correlate swallowing characteristics with basic pathologies. Study 2: it aims to analyze scientific production on the phonoaudiological action inside the hospital with adult patients with oropharyngeal dysphagia. Methods: study 1 was retrospective study, organizational, transversal, with 36 patients with a dysphagia diagnosis who were hospitalized at the wards and Intensive Care Units of Hospital Monsenhor Walfredo Gurgel in the city of Natal. Demographic and clinical data from de assessment and phonoaudiological therapy were collected and correlated to the characteristics of swallowing to verify if there was a difference between basic pathologies, using the form for Phonoaudiological Assessment and Evolution Ward and ICU from the rehabilitation sector. Study 2 was an integrative revision. Searches were done on databases for the following descriptors: “Speech-Language and Hearing Sciences”; “Swallowing”; “Swallowing disorders”; “Adult”; “Bed Capacity Hospital” and “Hospital”; in a ten-years’ time frame (2010-2020). Results: Study 1 found that the majority of patients was in average 60,78 years old, male, diagnosed with EVA, in regular clinical state, was making use of nasoenteral feeding tubes, in ambient air, adequate laryngeal elevation, they had no drooling, were on a thick liquified diet, with adequate capitation and preparation, functional swallowing and they received passive therapy, half of the patients were phonoaudiological discharged. Study 2 found 137 articles and selected 24. They approached several kinds of patients, assessment descriptions, dysphagia risk indicators and indicators for quality of dysphagia management. Also, emphasizing specific therapeutical resources on the rehabilitation of a dysphagic patient. Conclusion: In study 1, phonoaudiological treatment involved clinical assessment of the swallowing and the aspects of phonoaudiological therapy. It was also shown that half the patients under phonoaudiological intervention had their swallowing function rehabilitated and had had a diagnosis of stroke. There were significative correlations between some swallowing characteristics, however, there was no significative difference between groups of pathologies and the swallowing characteristics. In study 2, there was a heterogeneity among studies. Thus, a lack of studies was perceived regarding the whole therapeutical process, from the assessment to the complete rehabilitation of swallowing function.
2	KRISIA THAYANA LIMA DA COSTA ANALYSIS OF AUDIOLOGICAL EVALUATION AND HYPERSENSITIVITY IN CHILDREN AT RISK FOR AUTISTIC SPECTRUM DISORDER Advisor : ELIENE SILVA ARAUJO COMMITTEE MEMBERS : ELIENE SILVA ARAUJO JOSILENE LUCIENE DUARTE VANESSA GIACCHINI Data: Mar 26, 2021 Show Abstract Introduction: Autistic Spectrum Disorder (ASD) is considered a neurodevelopmental disorder with high worldwide prevalence and is characterized mainly by deficits in social skills, social interaction and the possibility of sensory-perceptual changes. Studies have shown the possibility of hearing hypersensitivity in these individuals, as well as behaviors that resemble hearing loss. Thus, hearing assessment is an essential part of the process of diagnosing cases with suspected ASD. Objective: To analyze the results of the behavioral, electroacoustic and electrophysiological auditory assessment of children with clinical signs of ASD risk, as well as the parents' perception about the occurrence of hypersensitivity. Method: this is an observational and cross-sectional study, structured in two studies: (1) audiological behavioral, electro-acoustic and electrophysiological evaluation of children with clinical signs of ASD risk: a series of cases and (2) parents' perception of hypersensitivity hearing loss in children with clinical signs of ASD risk: a preliminary study. Results: Nine children were evaluated in the first study and all were able to perform behavioral assessment. Despite the absence of hearing loss, there was a change in electroacoustic and electrophysiological tests, with absent acoustic reflexes and absolute latencies of waves III and V and increased interpeak intervals. The complaint of hypersensitivity was found in 66.6% of the children, with behaviors related to misophonia being reported. Conclusion: the children with clinical signs of ASD did not present peripheral hearing loss, however, there was an alteration in the auditory pathway from the cochlear nuclei and a high occurrence of hearing hypersensitivity complaint in this population.
3	MARIA EDUARDA BRAGA DE ARAÚJO Peripheral and central auditory findings in children with communication disorders Advisor : ELIENE SILVA ARAUJO COMMITTEE MEMBERS : ANA MANHANI CACERES ASSENCO ELIENE SILVA ARAUJO JOSILENE LUCIENE DUARTE Data: Mar 30, 2021 Show Abstract Introduction: Communication disorders include impairments in language, speech and communication. Knowing the close relationship between hearing and language and speech development, hearing tests can be used in an attempt to assist in the early identification and therapeutic process of children with these disorders. Objective: To investigate the acoustic stapedial reflex (ASR) responses in children with developmental language disorder (DLD) or phonological disorder (PD), as well as to verify the characteristics of the cortical auditory evoked potential (CAEP) in childhood apraxia of speech (CAS). Method: Dissertation structured in two manuscripts: (1) cross-sectional study in which the sample was composed of subjects with DLD, PD, with language complaints or without language complaints. The participants underwent a complete audiological evaluation and, subsequently, those responsible answered a questionnaire about the development of their respective children; (2) case report of a male child, with a previous diagnosis of CAS and referred for audiological diagnosis. Complete audiological evaluation and CAEP with speech stimulus were performed. Results: The highest number of absent or increased ASR was found in children with DLD or PD compared to subjects without language complaints. In addition, asymmetry was observed between the ears in the latency values of the CAEP in a clinical case with CAS. Conclusion: Changes in the ASR proved to be prevalent in children with language disorders and, together with the CAEP, they can be objective indicators for the early identification of communication disorders.
4	FLAVIA FERREIRA LEMOS INTERVENTION IN PHONOLOGICAL CONSCIOUSNESS AND VOCABULARY IN LOW-INCOME CHILDREN IN LITERACY PHASE. Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI ISABELLE CAHINO DELGADO ANA LUIZA GOMES PINTO NAVAS Data: Mar 31, 2021 Show Abstract Introduction: children from low socioeconomic levels are more likely to present difficulties in reading and response to intervention programs (RTI) may contribute positively to the development of this skill. Objective: to verify the effectiveness of an intervention in phonological awareness and expressive vocabulary in low-income children at the beginning of literacy. Method: an interventional, longitudinal, retrospective and documental study, carried out by collecting a database of children in the 1st year of elementary school. Participants were 127 children of both sexes, aged 6 and 7 years old, distributed into two groups: intervention group (GI): 40 children that underwent intervention in phonological awareness and vocabulary; and control group (GC): 87 children that were not exposed to intervention. The comparative pre- and post-intervention evaluations analyzed phonological awareness, rapid automatic naming, phonological operational memory, letter identification and expressive vocabulary. The Mann-Whitney test was used for intragroup comparison, and the Wilcoxon test for intragroup comparison. Results: Intragroup analysis showed statistically significant performance after the intervention; there were improvements in phonological awareness (syllabic, phonemic and total), digit and letter RAN, phonological operational memory in direct and reverse digit order, and letter identification. In the GC, there was improvement in all phonological processing skills and expressive vocabulary in the semantic categories clothing, food, animals, transportation, places, and toys. Comparing the groups pre-intervention there was a statistically significant difference in syllabic awareness, and post-intervention there was no difference between groups, showing improvement in phonological awareness in the GI. Conclusion: the intervention was effective in developing phonological processing skills in GI.
5	ALANNA STEFANY DE LIMA EVANGELISTA Vestibular manifestations in individuals with diseases of the central nervous system Advisor : ERIKA BARIONI MANTELLO COMMITTEE MEMBERS : CARLOS KAZUO TAGUCHI ERIKA BARIONI MANTELLO VALDETE ALVES VALENTINS DOS SANTOS FILHA Data: Apr 30, 2021 Show Abstract Introduction: Diseases of the central nervous system (CNS) affect the brain and spinal cord. CNS damage associated with vestibular symptoms occurs due to lesions in the central vestibular pathways. Objective: (1) To review the scientific literature on the applicability and results of vHIT in diseases of the CNS. (2) To characterize the neurological and vestibular findings of clinical cases diagnosed with Multiple Sclerosis (MS). Method: Dissertation structured in two articles. The first (1) is an integrative review of 18 scientific publications on the use of vHIT in individuals with CNS disease. The second (2) is the description of three clinical cases with MS. Results: (1) As for vHIT, the RVO gain was reduced in most studies, with the occurrence of compensatory withdrawals and described changes in oculomotor tests, such as the presence of spontaneous and semispontaneous nystagmus, in the RVO with and without visual optimization, in the test saccadic chase and tilt deviation. (2) Vestibular symptoms and alterations were observed in at least one of the clinical tests of body balance and cerebellar function. In vHIT, changes in oculomotor tests, such as the presence of semi-spontaneous nystagmus and in some parameter of saccadic chase, in addition to the reduction in gain in one or more vertical channels. The association of these findings suggests the presence of vestibular dysfunction of the mixed type, compatible with the central lesions detected in imaging exams. Conclusion: The findings of both studies provided evidence of changes in vestibular function and body balance in different neurological conditions.
6	PRISCILA SILVA MARTINS FUNCTIONAL AND POSTURAL BALANCE ANALYSIS OF ELDERLY PEOPLE WITH PROBABLE ALZHEIMER'S DISEASE IN ADVANCED STAGE: A SERIES OF CASES Advisor : JULIANA MARIA GAZZOLA COMMITTEE MEMBERS : LUCIANA ESCANOELA ZANATO ALMEIDA JULIANA MARIA GAZZOLA JULIANA VENITES Data: Apr 30, 2021 Show Abstract Alzheimer's disease (AD) is a fast-rising dementia syndrome that most affects the world population. The AD it is a progressive and irreversible neurodegenerative disease that causes the deterioration of intellectual, functional and motor faculties, such as postural balance. Objective: analyze clinical-cognitive, functional and postural balance data in the elderly in the severe phase of AD. Method: This is an observational, cross-sectional and descriptive study carried out at the Centro de Referência Estadual de Atenção à Saúde do Idoso (CREASI) in Natal / RN, evaluating seven elderly people aged 60 years or over and staging at CDR3. The instruments used were: Mini Mental Health State Examination (MMSE); Clock design test (TDR); Verbal Fluency Test (TFV); Timed-Up-and-Go Test (TUGt); Clinical Test of Sensory Interaction and Balance (CTSIB) and the Functional Activities Questionnaire. The data were interpreted through a simple descriptive analysis. Results: There was a functional impairment for IADLs (24.2); for mobility in simple TUG (time 28.1 and steps 24), cognitive TUGt (time 30.1 and steps 27.8) and motor TUG (time 27.8 and steps 26.7). In addition, there was cognitive impairment by MMSE (4.1), TDR (1.1) and TFV (1.4), as well as in postural balance, with averages in the conditions: OASF (30), OFSI (27,1), OASI (9.6) and OFSI (11.1). Conclusion: The results shows that elderly people with AD in the severe phase have important functional dependence, mobility, and importante changes in cognitive functions, such as language, executive functions, memory and attention
7	LEILA JULIANE PINHEIRO DO NASCIMENTO SANTOS CONTRALATERAL SUPPRESSION OF OTOACOUSTIC EMISSIONS BY TRANSIENTS IN BABIES WITH CONGENITAL SYPHILIS Advisor : SHEILA ANDREOLI BALEN COMMITTEE MEMBERS : ALESSANDRA SPADA DURANTE RENATA MOTA MAMEDE CARVALLO SHEILA ANDREOLI BALEN Data: Jun 8, 2021 Show Abstract Introduction: Syphilis is a global public health problem with complex challenges. In pregnant women, treponema paliidum can be transmitted to the fetus, leading to congenital syphilis, being a risk indicator for hearing loss, as there is evidence of the presence of sensorineural late hearing loss related to vertical transmission to the baby. Based on this premise, the efferent auditory pathway, in particular, the medial olivocochlear region and the outer hair cells, can be assessed by suppressing the otoacoustic supplied by transients, contributing to the identification of the maturation of important physiological processes of this pathway with congenital syphilis. Objective: Study 1 - To characterize the suppression of otoacoustic emissions by transients in children without risk indicators for hearing loss in the first year of life. Study 2 - Analyze the inhibitory effect of contralateral noise on otoacoustic emissions by transients in babies with congenital syphilis. Methodology: Study 1 - Systematic review registered in PROSPERO (nº CRD42020187035). The search took place in the EMBASE, LILACS, LIVIVO, PubMed, Scopus and Web of Science databases. The gray literature included Google Scholar, Open Gray and ProQuest, manual search of references of included studies and consultation with experts. Study 2 - Cross-sectional and prospective study approved by the Research Ethics Committee (nº 3,360,991). The total sample consisted of 35 babies divided into two groups (control -14 babies and study - 21 babies), all of which presented I-III-V waves in the BAEP at 80 dB nNA and wave V at 30 dB nNA and the presence of non-linear TEOAE bilaterally. The suppression analysis was performed using linear TEOAE without noise at 60 dB SPL with white noise contralateral to 60 dB SPL. The mean of inhibition was obtained by subtracting the TEOAE without noise from the TEOAE with noise. Results: Study 1 - 3796 articles were found, after the selection steps 14 studies met the eligibility criteria. All studies showed efferent inhibition in neonates without risk indicators for hearing loss. Suppression was greater in studies that applied non-linear and unfiltered click with averages greater than 1 dB in neonates in the first weeks of life. Study 2 - The study group (SG) showed greater inhibition in RE for the frequency bands from 1.5 to 4KHz. The general amplitudes in both test conditions were higher in the control group (CG), in relation to gender, but they did not present statistical significance. The SG presented 27.8% inhibition ≥ 1 dB and 25% for the CG in the right ear, on the left there was 33.3% ≥ 1 dB in the SG 46.2% in the CG. Conclusion: Study 1 - TEOAE suppression occurs in babies without risk indicators for hearing loss in protocols with different uptake characteristics, generating mean responses that do not allow a normative clinical value so far. Study 2 - The inhibitory effect of contralateral noise on TOAEs of babies with congenital syphilis does not differ from those without risk indicators for hearing loss.
8	ALESSANDRA PINHEIRO DA SILVA TELEMONITORING OF PRESCHOOL CHILDREN WITH CLINICAL RISK INDICATORS FOR AUTISM SPECTRUM DISORDER IN A PANDEMIC CONTEXT Advisor : ANA MANHANI CACERES ASSENCO COMMITTEE MEMBERS : ANA MANHANI CACERES ASSENCO JULIANA IZIDRO BALESTRO SAMANTHA SANTOS DE ALBUQUERQUE MARANHÃO Data: Aug 19, 2021 Show Abstract Introduction: Autistic Spectrum Disorder is a neurodevelopmental disorder whose diagnosis can be made from the third year of life, but the clinical manifestations,although difficult to discern, can be observed from the 6th month of life onwards. In this sense, even without a diagnosis of autism, identifying, monitoring signs of risk and providing communicative support to parents, expanding and optimizing children's communicative intentions in social situations in a plastic period of development are fundamental, especially in a historical pandemic scenario. Objective: To propose a speech therapy protocol for telemonitoring for early stimulation of pragmatic language in preschoolers with clinical risk indicators for child development. Method: This is a case series, observational, prospective, cross-sectional and analytical study with a sample found by children aged between 18 and 44 months, with clinical indicators of risk for autism, evaluated parents consented to telemonitoring for a period of three months at the Specialized Center in Rehabilitation III, Instituto Santos Dumont. The study was divided into three stages: (1) structured interview with parents, assessment of pragmatic skills and the use of children's actions and gestures, (2) preparation of parent guidance telephone calls based on the results obtained in the assessment, and ( 3) reassessment. A statistical analysis was conducted by descriptive and inferential tests that compared pre- and post-intervention performance. Results: Seven children remained in weekly telemonitoring via an open digital platform. A profile of children with gestural and verbal communication deficits was observed. Conclusion: The results show that ASD is a neurodevelopmental disorder prevalent in children and is closely associated with quality in social communication and communicative intention, which demands attention from reference services, professionals in the field and parents. Investing in early intervention for symptoms optimizes the prognosis and empowers the family, reducing future costs.
9	VICTOR VASCONCELOS BARROS DIGITS IN NOISE IN BRAZILIAN PORTUGUESE: analysis of the influence of demographic and socioeconomic factors and the accuracy according to the type of stimuli. Advisor : SHEILA ANDREOLI BALEN COMMITTEE MEMBERS : ANA PAULA CORONA LEANDRO DE ARAUJO PERNAMBUCO SHEILA ANDREOLI BALEN Data: Aug 26, 2021 Show Abstract Aim: To verify the accuracy of the diotic and antiphasic digits-in-noise (DRT) test in Brazilian Portuguese in four criteria for analyzing the golden pattern test and the influence of demographic and socioeconomic variables. Method: Two studies were designed: Accuracy Study 1 with normal-hearing and hearing impaired subjects applying TDR with diotic and antiphasic stimuli, by smartphone with in-ear headphones. ROC curves were established to define the cutoff point, measures of sensitivity, specificity, positive and negative predictive values for diotic and antiphasic TDR considering four criteria for analysis of pure tone audiometry (best and worst ear ≤ 25 and 40 dB). Study 2 was cross-sectional and prospective with normal hearing subjects. The diotic TDR was applied and the influences of sex, age, socioeconomic level, and education were analyzed. Results: In study 1 there were 102 subjects (18 to 90 years), 15.68% normal hearing, 69.60% with sensorineural hearing loss and 14.70% mixed. The highest sensitivity measure (96.51%) was found in the antiphasic stimulus for the worst ear mean criterion (≤ 25dB) with a cutoff of -11.90 dB in the TDR. There was a positive correlation between diotic and antiphasic TDR and degree of hearing loss. In study 2, 151 normal hearing subjects demonstrated the influence of age, education and socioeconomic level on the TDR, with no influence of gender. Conclusion: The sensitivity and specificity values in the diotic and antiphasic conditions were above 75% among the analyzed criteria. Age, schooling and socioeconomic level influence the response to diotic TDR.
10	LIDIA SILVA DE SOUZA Perception of mothers of children at risk for Autism Spectrum Disorder regarding their children's communicative profile in a pandemic context Advisor : ANA MANHANI CACERES ASSENCO COMMITTEE MEMBERS : LILIANE PERROUD MIILHER ANA MANHANI CACERES ASSENCO JULIANA IZIDRO BALESTRO Data: Aug 27, 2021 Show Abstract Introduction: Introduction: The identification of clinical signs of risk for Autism Spectrum Disorder (ASD) by the family itself is essential in the search for professional help, either for the diagnosis process or for intervention. With the context of social distancing imposed by the COVID-19 pandemic, families began to spend more time with their children, which led to an increase in the perception of difficulties related to communication. Objective: To characterize the perception of caregivers of children at risk for ASD regarding their children's communicative difficulties, in addition to investigating whether this perception is compatible with the speech-language assessment. Method: This research was carried out through an observational study, whose sample consisted of eight mothers whose children had clinical indicators of risk for ASD and who were followed up in a brief telemonitoring project. The results were divided into two manuscripts, the first using the Questionnaire on Communicative Difficulties (QDC); and in the second, the Functional Communication Profile (PFC) and the pragmatics protocol of the ABFW child test were used. Results: From the results obtained, it was possible to characterize the main difficulties perceived by the mothers and verify that the participation in the telemonitoring program did not cause substantial changes in this perception. In addition, the communicative profile of these children was characterized and compared with the perception of their mothers. Conclusion: The instruments used demonstrated the ability to characterize the perception of mothers regarding their children's communication difficulties, contributing to the diagnosis and intervention process.

2020

	Dissertations
1	MARIA TAIANY DUARTE DE OLIVEIRA Analysis of implementation and evaluation of a child hearing health program in primary care Advisor : ELIENE SILVA ARAUJO COMMITTEE MEMBERS : ELIENE SILVA ARAUJO KÁTIA DE FREITAS ALVARENGA MARCUS VALERIUS DA SILVA PEIXOTO Data: Feb 21, 2020 Show Abstract Introduction: The World Health Organization and the Ministry of Health have recommended the articulation of Child Hearing Health Programs with primary health care, with the Community Health Agent (CHA) playing an extremely important role in this proposal, due to the scope of the Family Health Strategy and the close relationship of this professional with the families. Objective: To implement and evaluate a child hearing health program in primary care. Method: Prospective longitudinal observational study, structured in two stages: (1) Analysis of the effectiveness of an online course for the training of CHA in the area of child hearing health; (2) Analysis of a Child Hearing Health Program in Primary Care. 2859 enrolled participants in this online course, and of these, 23 formed a specific group of CHA from two basic health units, with face-to-face monitoring. Results: 1842 participants (63.34%) finished the course, with representation from all Brazilian states and also from abroad and from various specialties, predominantly in the medical field. The course was well evaluated and reflected in improved post-training knowledge. 102 children aged zero to two years were followed up by the CHA during the period of one year, proceeding with the referral of 15 of them. A case of conductive hearing loss was found. Conclusion: The self- instructional online course proved to be effective for distance education of CHAs in the area of child hearing health. The Child Hearing Health Program linked to primary care is feasible and promising, however, strategies are necessary to minimize the existing problems.
2	RODRIGO OLIVEIRA DA FONSÊCA ANALYSIS OF THE CONCESSION OF HEARING AIDS BY UNIFIED HEALTH SYSTEM (2005-2018) Advisor : MARIA ANGELA FERNANDES FERREIRA COMMITTEE MEMBERS : HANNALICE GOTTSCHALCK CAVALCANTI MARIA ANGELA FERNANDES FERREIRA STELA MARIS AGUIAR LEMOS Data: Mar 13, 2020 Show Abstract Introduction: The hearing aids (HA) has emerged as an alternative to minimize the consequences of hearing loss. In Brazil, this device provided by the Unified Health System (SUS). With the epidemiological dimensions of the country, the concession of HA can pose a challenge over time. Objective: Know the ambulatory production of aspects related to the concession of HA by the SUS from 2005 to 2018. Methodology: This is an ecological study carried out in the SUS Outpatient Information System. The trend of annual concession fees analyzed with the Joinpoint program. A descriptive analysis of the technological categories, replacement, monitoring and financing of the HA was performed. Results: The lowest concession rate was observed in the Northern region (3.20/10,000 habitants), while the highest concession rate was found in the Southern region (9.96/10,000 habitants). For Brazil, the trend is for a significant increase between 2005 and 2011 (APC1 = 7.8; 95% CI 4.0 to 11.8). The dispensing of HA according to the technological categories revealed a percentage of 39.26% of type A, 36.93% of type B and 23.81% of type C. Replacement and follow-up procedures were greater in the Southeast and lower in the region North. As for the financing, the resource approved in the country was R$ 1.706.221.375,00 reaching higher and lower amount approved in the years 2005 and 2009, respectively. Conclusions: The analysis of the concession of hearing aids by SUS revealed discrepancies between the geographic regions of Brazil, as well as mismatches related to technological categories, replacement, monitoring and financing.
3	GIZELE FRANCISCO FERREIRA DO NASCIMENTO Vestibular evaluation through Video Head Impulse Test in patients with Heart Failure Advisor : ERIKA BARIONI MANTELLO COMMITTEE MEMBERS : ERIKA BARIONI MANTELLO MIGUEL ANGELO HYPPOLITO STHELLA ZANCHETTA Data: Jun 10, 2020 Show Abstract Introduction: Heart Failure (HF) presents high prevalence, several etiologies and high mortality rates. Vestibular symptoms, secondary to HF, are not commonly studied, but it is known that, besides generating physical symptoms, they can lead to losses in the performance of social activities of these patients. Objective: To verify the association between the findings of the clinical evaluation of postural balance, the gain of vestibulo-ocular reflex (VOR), the self-perception of cardiological and vestibular symptoms with the advancement of age in patients with HF. Method: Cross-sectional, analytical-descriptive, observational, prospective study, structured in two stages: (1) Report of three cases on high-frequency vestibular evaluation in patients with Chagas cardiomyopathy. (2) Clinical and objective assessment of vestibular function in patients with HF, divided by age group. Participated 34 subjects submitted to clinical assessment of postural balance, quality of life questionnaires and vestibular evaluation through the Video Head Impulse Test (vHIT). Results: The prevalence of reduced VOR gain in the vertical semicircular channels (SCC) was found, as well as some loss of postural balance in patients with HF, whether of Chagas origin (study 1), multifactorial or ischemic cardiomyopathies (study 2). In study 2, there was no significant association between the gain of VOR, self-perception of cardiological and vestibular symptoms with advancing age. However, there was a statistical association of the results of the Unterberger-Fukuda test with parameters evaluated by vHIT, among the age groups. Conclusion: In both studies, the prevalence of peripheral vestibular hypofunction was observed in patients with HF, regardless of age and etiology.
4	ANTONIO MARCOS OLIVEIRA DE LIMA ASSESSMENT OF COGNITIVE AND LANGUAGE DEVELOPMENT IN PRE-SCHOOL CHILDREN BORN PRETERM Advisor : ANA MANHANI CACERES ASSENCO COMMITTEE MEMBERS : ANA MANHANI CACERES ASSENCO CINTIA ALVES SALGADO AZONI DIONÍSIA APARECIDA CUSIN LAMÔNICA Data: Jul 13, 2020 Show Abstract The early identification of language development impairments in children born prematurely favors intervention in the ideal period and minimizes the impacts of a language disorder on the child's life. However, such identification requires instruments capable of assessing the child's communicative skills, including the correction of age in the case of premature births. In Brazil, communication and language assessment instruments are still scarce, especially in the early years of early childhood. In this dissertation, two studies were conducted, both approved by the research ethics committee (CAAE: 97759718.4.0000.5292). The first study aimed to adapt cross-culturally for Brazilian Portuguese a specific instrument for premature births, which is based on the report of parents, Parent Report of Children’s Abilities-Revised (PARCA-R). This instrument went through the entire process of translation and back-translation, and was applied in two stages with parents or guardians of children in the second year of life. The second study aimed to compare the performance at two years of life of children born premature and at term in the receptive and expressive subscales of language of Bayley III, considered the gold standard for assessing child development and recently translated and commercialized in Brazil. Based on its results, this dissertation contributes to fill the gap related to language assessment in the first years of life.
5	LAISE CAROBA DA SILVA Frequency of hearing loss related to congenital infections: a retrospective study Advisor : SHEILA ANDREOLI BALEN COMMITTEE MEMBERS : HANNALICE GOTTSCHALCK CAVALCANTI MARIA ANGELINA NARDI DE SOUZA MARTINEZ SHEILA ANDREOLI BALEN Data: Aug 14, 2020 Show Abstract The impact of hearing loss is widely known for its effects on child development. Hearing impairment can be caused by genetic, congenital or acquired factors. Among the congenital factors are the presence of infections that can occur during pregnancy, such as: toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis, HIV and Zika virus. The high fetal and neonatal morbidity and mortality and the presence of important sequelae of affected patients make congenital infections a public health problem and their prevention, diagnosis, monitoring and treatment are necessary before, during and after pregnancy. Objective: To verify the frequency of hearing loss in children attended at the SUVAG Center of RN with risk indicators for congenital infections. Methods: This is a retrospective, observational and descriptive study. The study population consisted of 4806 children aged 0 to 3 years attended at the SUVAG Center of RN in the period from 2011 to 2019. Of this total, 692 children had a history of congenital infections alone or in combination with other risk indicators from the recorded data in the institution's database. 134 were excluded because they did not complete the audiological evaluation. Thus, the sample of this study was composed of 558 children. Descriptive analysis was carried out to establish the frequency of hearing loss in relation to each congenital infection isolated or associated with other risk indicators. Results: The frequency of hearing loss was 1.25% in children with reports and / or confirmation of congenital infections, with the presence of sensorineural hearing loss in six children (85.71%) and conductive hearing loss (14 , 29%), of which six were bilateral (85.71%) and one unilateral (14.29%). Conclusion: The present study allowed us to verify that there was a reduced frequency of hearing loss related to the report of congenital infections.
6	ANA CAROLINA DANTAS DE MEDEIROS PERFORMANCE IN PHONOLOGICAL AND SYNTHETIC SKILLS OF BILINGUAL AND MONOLINGUAL CHILDREN IN LITERACY Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI PATRICIA ABREU PINHEIRO CRENITTE TAÍS DE LIMA FERREIRA MATTAR Data: Sep 30, 2020 Show Abstract Introduction: Language acquisition occurs through the child's interaction with family members and society. This study is composed of three scientific articles: the first is an integrative literature review and the others, original studies through the assessment of linguistic and metalinguistic skills in bilingual children. Objective: Objective: to verify the performance in phonological processing, syntactic awareness, vocabulary and reading of bilingual children in literacy phase. Method: Cross-sectional, descriptive and quantitative study, conducted with students from the 1st to the 5th of elementary school. Study 1: 10 children for the bilingual group and 5 for monolingual children from the 1st year of elementary school. Study 2: 32 children, subdivided into: G1: five children from the 1st year; G2: five children from the 2nd year; G3: eight children from the 3rd year; G4: five children from the 4th year; G5: nine children from the 5th year. Children were assessed in Portuguese for phonological awareness, syntactic awareness, phonological working memory, rapid automatic naming, and reading skills. Results: In study 1, significant differences were found in phonological awareness (phonemic and total), rapid automatic naming (objects), and reading of pseudowords. In study 2, it was noted that children with higher education had better performance in all skills assessed. Conclusion: exposure to a second language in a sequential way makes children more susceptible to the sounds of the language, presenting benefits in certain phonological processing skills, having a positive impact on reading performance.
7	FABIANA APARECIDA LEMOS Analysis of frequency following response in babies with congenital syphilis Advisor : SHEILA ANDREOLI BALEN COMMITTEE MEMBERS : ELIARA PINTO VIEIRA BIAGGIO HANNALICE GOTTSCHALCK CAVALCANTI SHEILA ANDREOLI BALEN Data: Oct 1, 2020 Show Abstract Congenital syphilis is considered a risk indicator for hearing loss in children, but the real impacts caused by syphilis on these children over their general development, including hearing, are still unknown. Objectives: Study1: Verify the parameters used to acquire the frequency following response (FFR) response in children up to 24 months of age through systematic review; Study 2: Analyze the results of the frequency following response in babies with congenital syphilis. Method: In study 1: The protocol was registered in PROSPERO, following the recommendations of PRISMA. The research was carried out by two independent reviewers in six databases (LILACS, Livivo, psycINFO, PubMed, Scopus, Web of Science); gray literature (Google Scholar, Open Gray, Proquest) and manual searches on bibliographic references. In study 2, the sample consists of 9 children with congenital syphilis (EG) and 5 children without syphilis (CG), aged between 12 and 24 months. All participants present responses in the Brainstem Auditory Evoked Potential at 80 dB nNA and transient evoked otoacoustic emissions present. They performed the FTA-ABS laboratory test from 18 months and the FFR with stimulus / da /, lasting 170 ms, speed of 3.70 / s, at an intensity of 80dBnNA in both ears. Results: In study 1: 459 studies were identified. After reading the full text, 15 studies were included. The acquisition parameters vary according to the studies. The most common among the studies were: Vertical assembly of the electrodes, alternating polarity, sampling rate of 20,000 Hz, / da / synthesized. In study 2: There was no difference between the groups studied in the analysis of parameters of the time and frequency domain in the FFR response. Conclusion: Study 1: There is a consensus on the use of some parameters of acquisition of the FFR with speech stimulus, such as alternating polarity, the sampling rate of 20,000 Hz, the syllable / da / synthesized stimulus and a 40 ms duration stimulus. Although these parameters have a consensus, the results show the lack of a single protocol established for the acquisition of data for the collection of the frequency following response with speech stimulus in children in the investigated age group. Study 2: Children aged 12 to 24 months with notification of congenital syphilis at birth have the same pattern of central auditory neural response assessed by the FFR as children without congenital syphilis.
8	ÉRIKA SUÊNYA GOMES CORDEIRO POSTURAL BALANCE IN CHILDREN WITH AUTISTIC SPECTRUM DISORDER Advisor : JULIANA MARIA GAZZOLA COMMITTEE MEMBERS : JULIANA MARIA GAZZOLA CAROLINA DANIEL DE LIMA ALVAREZ ANA CRISTINA DE ALBUQUERQUE MONTENEGRO Data: Nov 6, 2020 Show Abstract Introduction: Postural balance is ensured by the interaction between three sensory systems: visual, proprioceptive, and vestibular. Changes in sensory demands are cited since the first descriptions of Autistic Spectrum Disorder (ASD), with difficulties in processing, modulation, and sensory integration. The literature shows that there is a performance decrease of children with ASD when compared to children of typical development. Objective: 1). Identify state of the art of scientific production on postural balance in children with ASD; 2). Search for relationship between characteristics associated with ASD and postural balance difficulties of these children. Method: In study 1, a literature review, a search was carried out in databases and in the references of selected articles, with the descriptors "postural balance", "vestibular diseases", "postural equilibrium" and "autism". Study 2 is a cross-sectional analytical descriptive study, with a convenience sample, consisting of 12 children with ASD, assessed by the Pediatric Balance Scale and the Sensory Organization Test. These children's medical records were also analyzed to verify existence of characteristics of behavior, interaction and language associated with ASD. Results: In study 1, 62 articles were found based on the eligibility criteria. The peak of publications related to the topic occurred during years 2015 and 2016, and the first publication found occurred in 1974. Additionally, most studies were published in the USA, in English, with a quantitative approach, and cross-section design. As for study 2, the children presented similar responses among themselves and within the expected for their age groups. Conclusions: In study 1, it was observed that body balance and postural control in children with ASD are on the rise in scientific publications. Regarding study 2, no relationship was found between children who had characteristics associated with ASD and performance on the Pediatric Balance Scale.
9	MARIA HELENA DA SILVA RELATIONSHIP OF THE PHONOLOGICAL SYSTEM AND PHONOLOGICAL AWARENESS IN LOW INCOME PRE-SCHOOL CHILDREN Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI HAYDÉE FISZBEIN WERTZNER ISABELLE CAHINO DELGADO Data: Dec 4, 2020 Show Abstract Introduction: The written language is an extension of the oral language and its development occurs under the influence of several factors, among which we can highlight in the oral language, the phonological level and among the phonological processing skills, the phonological awareness. The phonological level is related to the system of sounds present in a given language and it has demonstrated a possible relationship with the development of reading and writing. Phonological awareness is one of the phonological processing skills of greatest influence for the acquisition of written language. Objective: To evaluate the phonological system and phonological awareness in low-income preschool children and correlate the skills with each other. Method: Observational, cross-sectional, retrospective and documentary study. Sample made up of 93 children from level IV of early childhood education, students from Municipal Centers of Early Childhood Education (CMEI) from 3 regions of the city of Natal / RN (West, South and East), aged between 5 and 6 years and 11 months, of both sexes. The results of the phonology evaluations of the Child Language Test - ABFW and the phonological awareness of the CONFIAS instrument were analyzed. For the analysis of the phonological level, it was considered the Percentage of Consonants Correct (PCC), Percentage of Consonants Correct - Revised (PCC-R), Index of Occurrence of Processes (PDI) and the productivity of phonological processes and, for phonological awareness , the correctness of syllabic and phonemic skills and the total score were considered. Results: In study 1, adequacy of the PCC and PCC-R values was observed in most participants (PCC: 82 children - 88,2%; PCC R: 84 children - 90,4%), productivity of the processes of liquid simplification (SL), simplification of consonant clusters (SEC), simplification of final consonant (SCF) and frontalization palatal (FP) and very strong negative correlation between the variables PCC x PDI and PCC-R x PDI. In study 2, on the other hand, the sample presented a performance below the expected in all CONFIAS scores, showing weaknesses in the phonological awareness skills. The correlation between PCC and phonological awareness and PCC R and phonological awareness and PDI and phonological awareness was weak.

2019

	Dissertations
1	ELIZA MIKAELE TAVARES DA SILVA Complaint of Dizziness and sociodemographic, clinical-functional and psycho-cognitive relations in the elderly with Diabetes Mellitus type 2 Advisor : JULIANA MARIA GAZZOLA COMMITTEE MEMBERS : FATIMA CRISTINA ALVES BRANCO BARREIRO JULIANA MARIA GAZZOLA LEONARDO WANDERLEY LOPES Data: Feb 20, 2019 Show Abstract Introduction: Elderly people with Type 2 Diabetes Mellitus (DM2) commonly develop changes over time in the sensory systems responsible for postural balance, which may make the dizziness complaints more common in this population. Purpose: To verify the association of the complaint of dizziness with sociodemographic, clinical-functional and psycho-cognitive data in the elderly with DM2. Method: This is a cross-sectional, descriptive study of an analytical character performed in a university hospital of average and high complexity. Elderly patients aged 60 years and older diagnosed with DM2 have participated. The elderly were evaluated through a multidimensional survey containing sociodemographic, clinical-functional and psycho-cognitive data. In addition, the following instruments were used: Mini-Mental State Exam (MMSE), Geriatric Depression Scale (GDS) and Timed Up and Go Test (TUGT) for screening for cognitive deficit and depressive symptoms and mobility analysis, respectively. Results: The sample consisted of 157 elderly people, of whom 45.22% presented dizziness. The complaint of dizziness presented association with the variables gender, marital status, education, self-perception of general health and vision, complaint of pain in lower limbs, fear of falls, tendency to falls and psycho-cognitive symptoms. Conclusion: The association between the complaint of dizziness and the negative self-perception of general health and vision and marital status without marital life is highlighted.
2	ALEXANDRE LUCAS DE ARAÚJO BARBOSA Evidences based on content validity of a vocabulary screening tool Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : ANA MANHANI CACERES ASSENCO CINTIA ALVES SALGADO AZONI PATRICIA ABREU PINHEIRO CRENITTE Data: Mar 28, 2019 Show Abstract AIM: to verify the evidences based on content validity of a vocabulary screening instrument for children aged from 3 to 7 years old. METHODS: This study was divided into three steps: 1º) Integrative literature review on nacional and international database Scielo, Lilacs, Eric and Pubmed, to verify the vocabulary screening instruments used recently (Article 1); 2º) Content analysis: the instrument was sent to fifteen judges, who analyzed the content validity based on the criterias of Theory, Screening Principles and Materials, considering the Content Validity Index (CVI) and Content Validity Index Item (Article 2); 3º) Aplicability of the instrument: screening of 133 children from 3 to 7 years old, students of four public schools (Article 3). RESULTS: from the theorical review, it was possible to construct the receptive and expressive vocabulary screening instrument, named TRILHAR. On the content validity analysis, the CVI has proven itself adequate. However, the CVI-I for the subcriterias of graphic aspects and description of the application sheet was inadequate, indicading the necessity of revision for those items. On the pilot study, there was differences on the performance between the groups and correlation between these variables, showing that the result on the screening improves according to the advencement of age. Besides that, there was a positive correlation between receptive and expressive vocabulary. CONCLUSION: the results of this research showed that TRILHAR is an adequate instrument for infant vocabulary screening. However, more validity studies are necessary to verify it's capability to identify children with vocabulary delays.
3	MARIA HELIMARA DE MEDEIROS Vocal tract discomfort and voice parameters after vocal cool-down in a group of popular singers Advisor : LOURDES BERNADETE ROCHA DE SOUZA COMMITTEE MEMBERS : LEONARDO WANDERLEY LOPES LOURDES BERNADETE ROCHA DE SOUZA Patricia Maria Mendes Balata Data: Mar 29, 2019 Show Abstract Introduction: Popular singers have a high demand for work and, due to a lack of knowledge about vocal health care, end up making vocal cord trauma more often. It is known that vocal cool-down can contribute to the reduction of muscle fatigue after work, however, there are still few studies on this practice in these professionals. Purpose: to verify the influence of vocal cool-down time on the symptoms of vocal tract discomfort and on vocal parameters in a group of popular singers. Methods: it is a transversal interventional study. The sample consisted of a group of popular singers randomly allocated in two groups according to the time of execution of vocal cool-down exercises: G5 (5 minutes) and G10 (10 minutes). Acoustic, perceptive-auditory, aerodynamic evaluation were made and self-assessment were performed through the Vocal Tract Discomfort Scale (VTDS) in the moments after the show and after the cool-down exercises. This research was approved by CEP HUOL under opinion nº 2,315,036. Parcial results: There was improvement of the symptoms and vocal parameters after the cool-down exercises, however, only the acoustic parameter jitter and the irritated throat symptom presented a statistically significant value in G10, and the value of the s / z ratio in G5.
4	JÉSSIKA SANTIAGO DA ROCHA Predictors of reading skills in first grade schoolers Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI MARIA ANGELA FERNANDES FERREIRA TAÍS DE LIMA FERREIRA MATTAR Data: Apr 5, 2019 Show Abstract ABSTRACT: There are a large range of predictors of the reading development in the literature. Regarding the language aspects, the phonological awareness, rapid automatized naming, phonological working memory and letter identification have been widely described as relevant for this process. Aim: to characterize the predictors of reading skills in first grade students of public schools in Natal-RN and correlate theses habilities with each other. Method: 138 children between 6- and 7-years-old participated, from three public schools of Natal/RN. The assessment was made based on phonological awareness – Phonological Awareness Test – Sequencial assessment instrument CONFIAS; phonological access of the lexicon – Rapid automatized naming test; Phonological working memory – Working memory task – pseudowords and digits; Letter identification – letter identification subtest – PROLEC; expressive vocabulary – vocabulary subtest – Infant language test ABFW. Results: the children had worst performance than expected on expressive vocabulary, especially on the categories of clothing, food, places, shapes and colors; phonological processing, except on RAN ‘objects’, and letter identification; the habilities showed a weak correlation with each other. Conclusion: the children from this study performed worst than expected according to their schooling on phonological processing tasks, vocabulary and letter identification, which can influence the literacy process, highlighting the need of further studies as to intervention practice, in order to minimize the impact of these difficulties over the school life.
5	LUANA GABRIELE GARCIA DE SOUZA LINGUISTIC PREDICTORS OF LITERACY IN LOW-INCOME PRESCHOOL CHILDREN Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : ANA LUIZA GOMES PINTO NAVAS CINTIA ALVES SALGADO AZONI ISABELLE CAHINO DELGADO Data: Apr 8, 2019 Show Abstract Introduction: Brazil has one of the worst levels of reading, as assessed by the Programme for International Student Assessment. The development of reading has been the subject of studies with preschoolers, but still scarce in the country. Purpose: To characterize the performance of linguistic predictors of literacy in low income preschool children and to relate socioeconomic factors, vocabulary and phonological awareness. Method: The research presents two studies: in the first, the sample was composed of 96 children of the last year of the kindergarten evaluated regarding phonological discrimination, phonology, vocabulary, phonological awareness, rapid automatic naming, phonological work memory and letters identification; in the second, 34 children were evaluated for vocabulary, phonological awareness and a socioeconomic and cultural questionnaire was applied with the child’s parents. Results: the study 1 showed poor performance in vocabulary, phonological awareness, working memory, rapid automatic naming and letters identification; there was a significant correlation between phonological awareness and working memory, phonological awareness and letter identification, rapid automatic naming, and letter identification. In study 2, a significant correlation was found only between the percentage of correct answers in the professions field of vocabulary and the frequency of excursions performed by the child in the last 12 months in the questionnaire. Conclusion: Low income preschool children presented lower performance in terms of linguistic predictors of literacy; these present developmental correlation with each other. The findings of the study reaffirm the importance of periodic monitoring from early childhood education to avoid problems related to literacy in later years of the school life of these children.
6	INARA MARIA MONTEIRO MELO ACCURACY OF SCREENING HEARING TESTS VIA SMARTPHONES FOR THE IDENTIFICATION OF HEARING LOSS. Advisor : SHEILA ANDREOLI BALEN COMMITTEE MEMBERS : DEBORAH VIVIANE FERRARI DYEGO LEANDRO BEZERRA DE SOUZA HANNALICE GOTTSCHALCK CAVALCANTI SHEILA ANDREOLI BALEN Data: May 29, 2019 Show Abstract Introduction: Hearing screening through smartphones is an attractive strategy because it is self-manageable, affordable and affordable. The use of speech materials, such as digits, in the presence of background noise, makes hearing screening more sensitive to identify hearing loss, since they simulate everyday situations. Objective: 1) To identify the effectiveness of cellular applications for the detection of hearing loss through a systematic review and 2) to verify the accuracy of the software-based noise test in Brazilian Portuguese. Method: The research presents two studies: a systematic review and a study of accuracy, in the first, the sample was composed by 12 diagnostic articles that used smartphone applications for hearing screening; In the second one, 186 subjects were evaluated by means of the audiological tests considered gold standard in the diagnosis of hearing loss and the Software-Based Noise Test in the Portuguese version. Results: In the one study it was observed that all 11 applications studied showed values of sensitivity and specificity favorable to diagnostic tests (AUC> 60%). In the second study, the Noise Digit Test presented a final cut-off point of -6.9dB for the pass / fail criterion, 92.7% sensitivity and 67.1% specificity. Conclusion: The systematic review provided significant information to show which applications may be considered the most effective in identifying hearing loss and the accuracy study inserts TDR in Portuguese as a new effective method of hearing screening
7	LUANA CELLY SILVA APRÍGIO SUMMER LEARNING LOSS EFFECT IN CHILDREN FROM LOW SOCIO ECONOMIC STATUS IN INICIAL FASE OF LITERACY Advisor : CINTIA ALVES SALGADO AZONI COMMITTEE MEMBERS : CINTIA ALVES SALGADO AZONI LEONARDO WANDERLEY LOPES PATRICIA ABREU PINHEIRO CRENITTE Data: Jun 14, 2019 Show Abstract Introduction: The Summer Learning Loss effect is characterized as risk of impairment or stagnation of learning processes, especially for children in situations of social vulnerability. The effect is not enough explored in Southern Hemisphere of the world. Objective: In view of the scenario, two objectives were presented. The first is to review in the literature the occurrence and characterize this effect. The second is to verify the occurrence of this effect in low-income students of public schools in the city of Natal-RN context. Method: The first study is an integrative review of the literature on the "Summer Learning Loss" effect, with search in the databases Scielo, Pubmed, Eric, Medline, Lilacs, Periodico Capes. The second is a quantitative, longitudinal, observational study in which predictive reading skills were assessed in low-income children of three municipal schools in the city of Natal. The evaluation happened in two school periods, before and after the vacation. Results: In the study 1, 149 articles were found and 8 were selected for review, according to the criteria adopted. The occurrence of the "Summer Learning Loss" effect independent of the culture is described. There is a focus on the study of the occurrence of the effect in children from the last year of Infant Education until the last year of Primary Education, mainly related do basic reading and math skills. In study 2, the statistical analysis of the data showed a predominant stagnation in the comparison of the means of the linguistic-cognitive abilities evaluated before and after the vacations of 10 weeks. Conclusions: There is a consensus in the literature about the occurrence of the "Summer Learning Loss" effect in low-income populations, which generates cumulative losses. The second study reiterated the information brought by the review, in which low-income children tend to decline or stabilize the learning process during school break.
8	THALINNY DA COSTA SILVA SMARTPHONE-BASED DIGITS-IN-NOISE HEARING TEST FOR BRAZILIAN PORTUGUESE TO SCREENING AUDITORY PROCESSING DISORDER Advisor : SHEILA ANDREOLI BALEN COMMITTEE MEMBERS : DEBORAH VIVIANE FERRARI JOSELI SOARES BRAZOROTTO SHEILA ANDREOLI BALEN Data: Sep 27, 2019 Show Abstract Objectives: 1) To review the literature regarding the effectiveness of screening instruments for Auditory Processing Disorder (APD); 2) Compare the final Digits in Noise Test (DNT) signal-to-noise ratio (SNR) in children with APD versus typical children and analyze the accuracy of the instruments DNT, SCAN, and QFISHER. Methods: In study 1, the search went over six databases and gray literature. Risk of bias of the included articles through QUADAS 2 was analyzed. In study 2, the convenience sample consisted of 30 children, 23 with APD (G2) and seven without the disorder (G1), aged 8 to 12 years that performed audiological evaluation; tympanometry; visual numerical recognition; DNT; auditory processing screening; and behavioral assessment of auditory processing to diagnose APD. The analysis used DNT final SNR comparing G1 and G2. The accuracy of the three instruments was calculated with significance level of 5%. Results: From study 1, 1.114 articles were identified. In the analysis of title and abstract, 24 articles went to full-article analysis, remaining five after this. Three articles had a high risk of bias in at least one domain. For study 2, the mean SNR was -7.25 dB in G2 subjects and -8.34 dB in G1. Conclusions: In study 1, all instruments have good specificity, however, only the STAP and seven German battery tests are sensitive in identifying APD. Regarding study 2, the performance in DNT of children with APD was similar to children without disorder.