Avaliação vocal de crianças disfônicas pré e pós intervenção fonoaudiológica em grupo: estudo de caso

Abstract

Este estudo tem como objetivo caracterizar a dinâmica vocal de crianças disfônicas pré e pós-terapia fonoaudiológica em grupo por meio de avaliação perceptivo-auditiva e acústica da voz. Participaram seis crianças, dois meninos e quatro meninas, com idades entre sete e dez anos, com diagnóstico de disfonia funcional ou organofuncional. As crianças foram submetidas à anamnese, análise perceptivo-auditiva e acústica da voz, antes e após processo terapêutico grupal semanal, num total de doze sessões de quarenta minutos cada. Como estratégias terapêuticas foram propostas atividades de dramatizações, desenhos, brincadeiras, elaboração de painéis e realizados exercícios vocais (de forma coletiva e lúdica). Buscou-se a troca de experiências entre os membros do grupo, a construção conjunta de conhecimentos sobre a produção da voz e saúde vocal, e, a atuação direta por meio de técnicas e exercícios. Os dados foram analisados usando um nível de significância de 0,10. Quanto aos parâmetros de rugosidade e grau global da disfonia da avaliação perceptivo-auditiva, houve diferença entre as avaliações realizadas antes e depois do processo terapêutico grupal (p=0,024 e p=0,074, respectivamente). Em relação à análise acústica da voz pré e pós-terapia, não houve diferença para frequência fundamental e intensidade vocal média (p=0,288 e p=0,906, respectivamente). Já para as medidas de ruído, jitter e shimmer, houve diferença entre as avaliações iniciais e finais (p=0,079 e p=0,046, respectivamente). A terapia fonoaudiológica em grupo promove modificações na dinâmica vocal de crianças disfônicas, no que se refere aos parâmetros perceptivo-auditivos e acústicos.

Análise da qualidade de vida relacionada à voz na população infantil

“…This may lead to delays in the demand for intervention, which in turn will result in chronic voice disorder with potential to limit the school life and the social and future professional opportunities of these children (2) . Therefore, early diagnosis and treatment of pediatric vocal disorders are extremely important so that they do not interfere with social activities and, consequently, with adulthood (3) . Prevalence of pediatric dysphonia in schools varies from 6 to 23.4%, reaching its peak in children aged five to 10 years (4) .…”

Sintomas vocais auditivos e proprioceptivos pré e pós-terapia de grupo de pacientes com disfonia

“…However, this motivation is being overtaken and substituted by a broader view in which group therapy aims to provide individuals with an exchange of experiences, selfperception, self-knowledge, inclusion, and the creation of ties with other participants, in order to encourage more motivation in these individuals to regularly participate in the group, thus favoring therapy efficiency 14 .…”

Proposta de acolhimento a pais de crianças disfônicas: relato de caso

“…In this context, the speech therapy group stands out for acting with the joint construction of knowledge, and the exchange of experiences and desires, that individual, become collective, allowing the (re) signification of the pathologic processes [2][3][4] . This therapeutic practice differs from individualized treatment based on curative medical perspective, where the conditions are seen as the absence of health and the priority are the quantitative results 3,4 .…”

“…In this context, the speech therapy group stands out for acting with the joint construction of knowledge, and the exchange of experiences and desires, that individual, become collective, allowing the (re) signification of the pathologic processes [2][3][4] . This therapeutic practice differs from individualized treatment based on curative medical perspective, where the conditions are seen as the absence of health and the priority are the quantitative results 3,4 . In contrast to this practice is engaged in orientation and therapy through exercise, therapeutic group with children seeks a contextualization, making the practice closest to the reality of the subject, and seeks the (re) signification of insight into the pathology, facilitating positive results 3,4 .…”

“…This therapeutic practice differs from individualized treatment based on curative medical perspective, where the conditions are seen as the absence of health and the priority are the quantitative results 3,4 . In contrast to this practice is engaged in orientation and therapy through exercise, therapeutic group with children seeks a contextualization, making the practice closest to the reality of the subject, and seeks the (re) signification of insight into the pathology, facilitating positive results 3,4 . Therapeutic groups have been conducted not only with children but also with caregivers, parents and family because it is realized that even by approaching the subject, closest people desires remain 1,3,5 .In acting with parents under the Speech Therapy, the group has been offering the possibility of inter-subjective exchanges on experiences of family routine and the(re) signification of desires to face the speech-language pathology ofchildren 3,4,[6][7][8][9] .…”