Revista Chilena de Fonoaudiología

Portada Volumen 23(1), 2024

2025-01-10T19:21:35+00:00

Título	Autores
Discurso Narrativo y Vocabulario en población con Trastornos del Espectro Alcohólico Fetal (TEAF). Estudio de Casos	Yuri E. Vega-Rodríguez, Elena Garayzabal-Heinze y Esther Moraleda-Sepúlveda
Experiencia de fonoaudiólogos sobre la atención por telepráctica a personas adultas y mayores durante la pandemia por COVID-19 en Chile	Jenan Mohammad-Jiménez, Paulina Matus Rosas y Camilo Quezada
Descripción de la participación y acciones ejercidas por fonoaudiólogas/os en el trabajo colaborativo y la co-enseñanza en Chile	Yhara Gutiérrez Solorza, Marilyn San Martín Cofré, Fernanda Cea Rodríguez, Nicolette Cisterna Campos, Tamara Contreras Letelier, José Soto Morales, Bárbara Villalobos Paredes y Sofia Yáñez Labra
Trastorno Cognitivo Comunicativo: propuesta de una clasificación clínica	Manuel Matías Ambiado-Lillo, Ivette Dyana García
Intervenciones fonoaudiológicas en apraxia del habla infantil orientadas al desarrollo de la comunicación funcional: una revisión de alcance	Carolina Herrán Landeros, Nicole Schnitzler Sommerfeld, Camila Díaz Páez, Laura Lagrutta Díaz y Catalina Pérez Maulén
Condiciones laborales de profesionales asistentes de la educación que se desempeñan en Programas de Integración Escolar en Chile: Un estudio de métodos mixtos	Katherine Andrea Dinamarca-Aravena,
Aproximación cualitativa a la diversidad conceptual de la comunicación: Desafíos disciplinares para la Fonoaudiología	Marcelo Sandoval-Ramírez, Antonieta Herrera-Lillo, Carla Leal-Kaymalyz y Katherine Dinamarca-Aravena
Intervención temprana en el habla de alumnado con Trastorno del Desarrollo del Lenguaje (TDL)	María Ángeles Axpe-Caballero, Atteneri Delgado-Cruz y Víctor Acosta-Rodríguez
Percepción de estudiantes de pregrado de Fonoaudiología sobre su educación en cuidados paliativos	Sara Tapia-Saavedra, Natalia Irazábal-Gálvez, Camila Mora-Bolbarán, Renata Aravena-Vásquez, Paula Rivero-Palominos e Isidora Estay
Evaluación ecográfica del porcentaje de aproximación tirohioidea como apoyo a la evaluación clínica de la deglución en la decanulación de una persona con traqueostomía: Un reporte de caso	Matías Lecaros-Moreno, David Morales-Zepeda y Rodrigo Tobar-Fredes
Conciencia Fonológica y Fluidez Lectora en Escolares con y sin Trastorno del Desarrollo del Lenguaje de Segundo, Tercero y Cuarto año de enseñanza básica	Francisca Carreño-Sepúlveda, Beatriz Arancibia-Gutiérrez
Brechas de género en la autoría de publicaciones científicas: Un análisis en base a la Revista Chilena de Fonoaudiología	Lilian Toledo-Rodríguez, Felipe Torres-Morales, Carlos Alvarez Escobar, Cristina Jara, Gloria Jimenez-Moya y Eduardo Fuentes-López
Pruebas de conciencia sintáctica: explorando su validez discriminante en escolares de educación primaria	Sandra Mariángel Q., Pamela Ramírez-Peña
Tasa de diadococinesia en adultos jóvenes típicos entre 18 y 25 años hablantes de español de Chile	Ilich Cancino-Barros, Luis Martinez, Reynaldo Zambra-Vidal, Felisa Quitral-Quezada, Fanny Becerra-Becerra y Ramón D. Castillo
Percepción sobre el diagnóstico y el tratamiento del trastorno del lenguaje en profesionales de la educación chilena	Carla Vergara, Mabel Urrutia y Alberto Domínguez
Desarrollo de habilidades de entrevista usando simulación clínica en fonoaudiología	Victoria del Pilar Aguilar-Fuentealba, Cristhian Pérez-Villalobos
Diseño y validación de contenido de un protocolo de evaluación de la deglución mediante ultrasonido	Roberto Rojas-Segovia, Jorge Sepúlveda-Contreras

Narrative Discourse and Vocabulary in the Population with Fetal Alcohol Spectrum Disorder (FASD): A Case Study

2023-10-27T23:06:11+00:00

Narrative discourse is a complex task that involves linguistic, cognitive, social, and affective skills. The level of development and performance found when evaluating this task are good predictors of oral language proficiency and reading comprehension. Moreover, narrative discourse significantly influences communicative interactions and social dynamics Conversely, children diagnosed with Fetal Alcohol Spectrum Disorder (FASD) often exhibit compromised narrative discourse due to associated linguistic and cognitive challenges. However, evidence is still scarce on this matter. The objective of this study was to describe the narrative discourse and vocabulary in individuals with FASD. To this end, narrative discourse was evaluated in 19 people between the ages of 6.6 and 17.7 years diagnosed with FASD, using the story "Frog, Where Are You". Additionally, micro- and macro-structural analyses of narrative discourse were conducted employing the Monitoring Indicators of Scholarly Language (MISL) index, and vocabulary was assessed using the Peabody test. At the macro-structural level, the discourse of the population with FASD was characterized by the presence of a singular protagonist, the use of non-specific names, generic temporal and spatial references, little or no connection between described events, low complexity, an absence of emotion, and the use of action verbs. At the micro-structural level, they exhibited grammatical errors, as well as minimal use of subordinating conjunctions, adverbs, metacognitive and metalinguistic verbs, and nominal phrases. Vocabulary was well below chronological age expectations. In conclusion, an impairment in narrative discourse and vocabulary is evident in the population with FASD, significantly impacting their communication and social performance. Consequently, narrative discourse performance may serve as a diagnostic indicator for FASD. These difficulties require early, interdisciplinary intervention that encourages educational and social inclusion.

The Experience of Speech-Language Therapists with Telepractice for Adults and Older Adults During the COVID-19 Pandemic in Chile

2023-09-05T20:48:45+00:00

Telepractice, as a strategy for remote care, has a long history in the field of speech-language therapy in developed countries, and gained sudden prominence in Chile due to the COVID-19 pandemic. This study aims to characterize the teletherapy provided to adults and older adults by speech-language therapists during the healthcare crisis. A survey was administered to 38 speech-language therapists. Subsequently, the responses were analyzed by topic, after which descriptive statistics were used in the form of Fischer's exact tests. Most patients were between 60 and 79 years old and enrolled in Fondo Nacional de Salud (National Health Fund). Significant barriers were identified, related to digital literacy, access to a device, and the environment of the patient. However, facilitators were also highlighted, including ongoing access to therapy, reduced travel times, and the ability to work with co-therapists. When comparing public and private sector care, significant differences were found in the quality of the environment (p=0.03) and digital literacy (p=0.008). In conclusion, participants noted more barriers than facilitators in implementing telepractice during the pandemic. Nevertheless, they consider it an effective tool that can complement in-person care. It is crucial to develop best practices for telepractice, considering barriers related to material resources that may limit access. Additionally, this modality should be included in the training of speech-language therapists.

Cognitive Communication Disorder: A Proposal for Clinical Classification

2023-12-13T16:57:26+00:00

Cognitive Communication Disorders (CCD) represent an area of speech-language therapy that consistently poses challenges to the discipline. This is partly due to the heterogeneous nature of the clinical picture of CCD, but also to how relatively recent the approach to this disorder is. Due to this, there is a need for subclassifications that account for the distinctive characteristics of the different profiles of this disorder. The aim of this study was to determine the feasibility of establishing a clinical characterization that enables the sub-classification of CCD. To achieve this, a systematic review was carried out, analyzing articles that address the topic. The search was performed using the PubMed and Web of Science (WoS) databases, including the terms Cognitive-Communication Disorder OR Cognitive-Communication Impairment. The cognitive-communicative characteristics identified in each of the articles were analyzed by category, enabling potential groupings that are based on the degree of convergence between the findings and macro-categories to which they can be subsumed. The results show that there are three profiles associated with this disorder: one linked to difficulties in basic cognitive skills, another that presents difficulties in pragmatic communicative skills, and a third that exhibits difficulties in both areas. It is concluded that the subclassification of CCD is viable given the evident convergence of difficulties, and it can be sub-categorized into Executive CCD (ECCD), Pragmatic CCD (PCCD), and Executive-Pragmatic CCD (EPCCD).

Speech-Language Therapy Interventions in Childhood Apraxia of Speech Aimed at Developing Functional Communication: a Scoping Review

2023-09-22T23:39:14+00:00

The treatment of Childhood Apraxia of Speech (CAS) has traditionally focused on enhancing expressive skills such as articulation and intelligibility. Although most of the available strategies promote improvements in speech production, those that improve functional communication have yet to be explored in depth. The objective of this scoping review was to compare the speech-language therapy interventions for CAS that have the most substantial literature support in terms of their focus on promoting functional communication. This review adhered to the PRISMA-ScR guidelines for scoping reviews and considered five interventions frequently mentioned in the literature: The Nuffield Dyspraxia Programme (NDP-3); Physically Restructuring Oral Muscular Phonetic Targets (PROMPT); Dynamic Temporal and Tactile Cueing (DTTC); The Kaufman Speech to Language Protocol (K-SLP); and Integrated Phonological Awareness (IPA). Furthermore, articles published between January 2015 and December 2021 were included from PubMed, WoS, LILACS, Cochrane Library, and Scopus databases. The most relevant findings indicate a lack of generalizability due to small sample sizes, hindering the extrapolation of results related to the intervention of functional communication. This represents a problem in the field of research and could be detrimental to Evidence-Based Practice. In conclusion, an eclectic and holistic approach may be more effective in the treatment of CAS; therefore, we propose a checklist aimed at assessing interventions based on their indicators of functionality.

Working Conditions of Support Services Professionals in School Integration Programs in Chile: A Mixed Methods Study

2023-12-14T20:16:44+00:00

In the context of educational inclusion, Chile stands out as one of the first countries to formalize the work of speech therapists, psychologists, physical therapists, and occupational therapists within school settings, known as Support Services Professionals. This research analyzes the perceptions of these professionals regarding their working conditions in School Integration Programs (PIE) in Chile. A sequential, exploratory, and mixed-methods approach was used. Interviews were carried out (N=52) and a questionnaire was administered (N=474) using the Respondent Driven Sampling (RDS) method. The interviews were analyzed using a thematic approach, while descriptive statistics were used to analyze quantitative results. The results reveal that formalizing the working conditions of Support Services Professionals contributes to their retention in schools. However, the lack of adequate working spaces, the restriction and standardization of time allocated for intervention, and insufficient resources negatively impact educational practice and contribute to burnout. The tensions highlighted by the professionals underscore the urgency of investigating the management of resources allocated to the development of PIEs. This research is pioneering in its subject matter and provides, for the first time in the country, a detailed description of the working conditions of Support Services Professionals. It also demonstrates the implementation of a non-conventional sampling method, which could be of interest to researchers addressing hard-to-reach populations or those without an established sampling frame. The findings invite policymakers, researchers, and civil society to reflect on the working conditions in schools and to assess the efficiency with which resources are utilized in the country's PIEs.

A Qualitative Approach to the Conceptual Diversity of Communication: Disciplinary Challenges for Speech Therapy

2023-08-15T01:53:13+00:00

Communication is a dynamic and complex process influenced by social and contextual factors, extending beyond the mere transmission of information. The field of Speech Therapy studies how these elements impact verbal and non-verbal interaction, as well as the disorders that may arise within this process, aiming to enhance both the quality of individuals’ communication and their overall quality of life. The objective of this research was to analyze the meanings that speech therapists attribute to communication and dialogue. A qualitative approach was employed through semi-structured interviews conducted with speech therapists (n=14). The results indicate that the subjects have varying perceptions of what is understood by communication, revealing the need to unify disciplinary criteria regarding this matter. This research highlights the necessity to update concepts around communication in the field of Speech Therapy. In conclusion, it is essential to establish greater reflective foundations for the concept of communication, the core subject of the discipline, considering that the concept itself has evolved in recent times in light of constant social changes. It is crucial to update and broaden this concept in order to strengthen the professional identity of speech therapists.

Early Speech Intervention in Students with Developmental Language Disorder (DLD)

2024-03-06T21:40:39+00:00

Some children with Developmental Language Disorder (DLD) may experience disruptions in their phonological system, leading to difficulties in speech production. These difficulties appear as substitution errors, syllable structure issues, and distortions, resulting in a higher number of phonological processes (PP) than expected for their age. The main bjective of this study was to design and implement an intervention program based on the principles of stimulability and psycholinguistic approaches to improve speech production in children with DLD. An intervention program was carried out with 24 five-year- old students diagnosed with DLD using the Clinical Evaluation of Language Fundamentals, Spanish Fourth Edition (CELF- 4). Phonological productions were assessed through Registro Fonológico Inducido (RFI). The intervention was structured under a Multi-Tiered System of Supports (MTSS), comprising a total of 30 intervention sessions, each lasting 15 minutes. The activities were designed according to the criteria of gestural support for phonemes and metaphonology. The results reveal a significant reduction in phonological processes following the intervention, particularly in those affecting words and syllables. Based on these findings, we conclude that an intervention combining these approaches effectively reduces PPs. Future research should explore the impact of increasing the length of each session and the number of trials for each goal, as suggested by the literature.

Undergraduate Speech Therapy Students' Perceptions of Their Education in Palliative Care

2023-10-09T23:22:47+00:00

This study examines the perceptions of Speech-Language Therapy students at Universidad de Chile regarding the training they receive in palliative care (PC). This is contextualized within the growing global demand for PC and the implementation of Ley de cuidados universales (Universal Care law) in Chile. A qualitative methodology was employed, including group interviews and content analysis. The findings indicate that students perceive a limited emphasis on these topics within the curriculum. The identified limitations include a lack of systematic focus in both theoretical and practical education, as well as insufficient opportunities to develop specific competencies required for working with individuals in end-of-life stages. Notably, students perceive a gap between the theoretical knowledge provided in courses and the practical preparation needed to address real-life situations. Additionally, they recognize the importance of being trained in transversal competencies, particularly those related to emotional and communication skills. This study highlights the need for comprehensive training that integrates both theory and practice, with specific strategies for supporting populations requiring PC.

Ultrasonic Evaluation of the Thyrohyoid Approximation Percentage as Support for Clinical Swallowing Assessment in Decannulation of a Tracheostomized Patient: A Case Report

2023-12-13T16:56:57+00:00

Decannulation is crucial in the rehabilitation of tracheostomized patients, and its success depends on an interdisciplinary and rigorous assessment of airway patency, respiratory parameters, and secretion swallowing safety. However, clinical evaluation of swallowing, while essential, remains a subjective procedure that is highly dependent on the clinician’s experience. This case report explores the usefulness of ultrasound as a complementary tool that can enhance the objectivity of clinical evaluation. We present the case of a man with a tracheostomy and prolonged mechanical ventilation. After meeting the respiratory criteria for decannulation, the clinical evaluation of swallowing suggested a possible restriction in hyolaryngeal mobility. To objectively quantify this disturbance, ultrasound was employed, and the findings were later confirmed through an endoscopic swallowing evaluation. The results revealed that ultrasound enabled the objective measurement of hyolaryngeal excursion, identifying an impairment in its movement. This was quantified by calculating the percentage of change in the approximation between the thyroid cartilage and the hyoid bone compared to their resting positions. In conclusion, ultrasound appears to be a promising tool to complement the clinical evaluation of swallowing in individuals with a tracheostomy, allowing for objective measurement of hyolaryngeal function, particularly when conventional instrumental evaluations (videofluoroscopy or endoscopy) are not feasible. Clinicians are encouraged to share their experiences with the use of ultrasound to enhance knowledge in this and other clinical contexts.

Phonological Awareness and Reading Fluency in Children with and without Developmental Language Disorder in Second, Third, and Fourth Grade of Primary School

2024-01-14T16:11:37+00:00

Reading fluency requires metaphonological skills for efficient word reading. These skills are often diminished in children with Developmental Language Disorder (DLD). Despite this, insufficient attention has been given to their fluency, which is why this study examines the relationship between reading fluency and phonological awareness in 15 students with DLD and 15 with Typical Language Development (TLD) in second, third, and fourth grades of primary school. Using mixed repeated-measures ANOVAs and considering age as a covariate, the study examines group differences and whether phonological awareness influences variations in reading fluency. The test Instrumento de Diagnóstico para los Trastornos Específicos de Lenguaje en Edad Escolar (IDTEL) was employed to measure syllable addition, syllable inversion, and phoneme blending. Reading fluency (speed, accuracy, volume, intonation, pauses, segmentation, overall quality, and total fluency) was assessed using the Reading Fluency Scale in Spanish (Escala de Fluidez Lectora). Correlations were observed between phoneme blending and the accuracy, segmentation, and overall quality of reading. In children with TLD, correlations were found between syllable inversion, phoneme blending, and fluency. The main results of the mixed ANOVAs indicate a significant effect of diagnosis on both phonological awareness and reading fluency in children with DLD, and for both groups, an effect of phoneme blending ability on reading fluency.

Gender Gap in the Authorship of Scientific Publications: An Analysis Based on Revista Chilena de Fonoaudiología

2024-04-29T15:04:36+00:00

Gender inequality is present in various social contexts, including academia and scientific practices, as reflected in the authorship of publications. The aim of this study is to determine whether differences exist between men and women regarding first authorship, the thematic areas investigated, and the effect of the first author's gender on team composition in articles published in Revista Chilena de Fonoaudiología between 1999 and 2020. An analytical and retrospective study was conducted using univariate Generalized Linear Models (GLM) with a log link, Poisson family, and robust estimation. The results showed that 53.4% of the articles had a woman as the first author, which dropped to 43.8% between 2016 and 2020. Men predominated in areas such as swallowing and voice, while women were more prominent in child communication and language (61.9%). Additionally, the probability of women being co-authors decreases when men are the first authors. These results indicate that, despite the relevant role of female scientists, the gender inequality in publications persists.

Syntactic Awareness Tests: Exploring their Discriminant Validity in Primary School Students

2024-05-20T13:23:30+00:00

This article reports the results of a pilot study aimed at determining the discriminant power of seven tasks to assess syntactic awareness in first and second-cycle elementary school students. The participants were 39 students from 2nd to 8th grade at a private-subsidized school. The outcomes show that four of the seven tests can detect statistically significant variations in students' performance in syntactic awareness tasks, which makes it possible to describe a specific developmental pattern of metasyntactic skills at the analyzed school levels. These results provide relevant information on the usefulness of some tests over others to adequately evaluate syntactic awareness in schoolchildren. At the same time, they reveal methodological aspects that should be considered when assessing syntactic awareness. Finally, the methodological and educational implications that derive from this study are discussed.

Diadochokinetic Rate in Typically Developing Young Adults Aged 18 to 25 Years Who Are Spanish Speakers from Chile

2024-04-26T15:38:17+00:00

Diadochokinesia is the ability to perform repeated and alternating movements quickly. In speech evaluation, the diadochokinetic (DDK) rate is used to assess the dexterity and integrity of motor control. Although studies on DDK rate exist for Chilean Spanish speakers, data on young adults remain limited. This study aimed to describe and establish preliminary normative data for DDK rate among Chilean Spanish-speaking young adults, with a sample of 250 typically developing individuals aged 18 to 25 years. Participants were instructed to repeat the syllable [pa] into a microphone as quickly as possible for 8 seconds. Speech was recorded using Motor Speech Profile software, and five parameters were analyzed: DDKavp, DDKavr, DDKcvp, DDKjit, and DDKcvi. The distribution of scores for these parameters in the sample did not fit a normal distribution; therefore, norms were established based on quartiles. Additionally, Spearman correlation analysis indicated that the parameters DDKcvp and DDKjit tended to decrease with age within the 18-25 years range. These findings hold potential for research and clinical applications, as they enable comparisons with populations of different ages and with clinical groups.

Perception of Chilean Education Professionals on the Diagnosis and Treatment of Developmental Language Disorder

2024-03-10T19:49:10+00:00

Developmental Language Disorder (DLD) is increasingly prevalent in childhood. In this context, the perception of therapists and education professionals is crucial to improving clinical and educational practices related to its treatment. This qualitative phenomenographic study addresses the personal experiences, perceptions, and practices of therapists and education professionals in charge of treating DLD within educational settings in Chile through semi-structured interviews. The sample includes ten professionals with experience working in schools dedicated to language therapy and schools with Programa de Integracion Escolar (School Integration Program) in the south of the country. The content of the interviews was subject to thematic analysis, which yielded three central themes: the heterogeneity of DLD, perceptions of the experience of working with children, and therapeutic and educational interventions' structure. This research highlights the diversity of approaches and challenges professionals face in treating DLD. The results reflect a need for consensus to improve the terminology, classification criteria, and assessments in this area, with limitations that point to future research that expands the sample and includes other Spanish-speaking contexts. This study has significant projections for updating interventions and standardizing assessment instruments for DLD.

Development of Interview Skills Using Clinical Simulation in Speech-Language Therapy

2024-06-04T01:51:00+00:00

Objective structured clinical evaluation (OSCE) is a type of clinical simulation that has significantly changed how clinical interview skills are developed, specifically regarding anamnesis and communication. However, there is little evidence of its use in speech-language therapy. The purpose of this work was to analyze the use of formative OSCE as a pedagogical strategy to teach clinical interview skills in the second year of a Speech-Language Therapy program. This is a quantitative and analytical-relational study with a quasi-experimental, pre-post design. The sample included 17 students from the Speech Therapy program at Universidad Andres Bello. Clinical interview skills were evaluated using an observation scale and a self- efficacy scale, both before and after the formative OSCE. Three observation guidelines were applied during the interview: anamnesis, clinical judgment, and communication. Finally, students completed a survey on their perception of the OSCE methodology. All participants showed improvements in their clinical interview skills and their levels of self-efficacy. The differences in anamnesis and communication were statistically significant (p<0.05). Similarly, they expressed high levels of satisfaction with the methodology. In conclusion, formative OSCE favors the development of anamnesis and communication competencies in speech-language therapy students, in addition to increasing their self-efficacy in these areas. Furthermore, the participants expressed a high degree of satisfaction with the method.

Design and Content Validation of an Ultrasound Swallowing Assessment Protocol

2024-04-12T15:25:19+00:00

Although evidence suggests that ultrasound can be used to evaluate and quantify various dynamic aspects of swallowing, no validated protocol currently exists for exploring the swallowing process specifically. This cross-sectional descriptive study aimed to design a swallowing assessment protocol with diagnostic utility for dysphagia and to validate its content through expert judgment. Seven national and international specialists participated in a survey, where Lawshe’s statistical test was used, requiring a content validity index (CVI) of 0.99. In addition to this, a method for resolving controversies was used. The resulting items included: tongue characteristics, hyoid-thyroid approximation, vocal fold adduction, assessment of the upper esophageal sphincter, and hyoid bone movement. The experts also provided input on the type of transducer to use for the evaluation and the type of examination to perform for each item. The protocol was subsequently applied to three healthy subjects to determine measurement possibilities and establish technical conditions for the examination. The results were validated by a sonographer and an international specialist. Based on the findings of this study, future directions include proceeding to the criterion validity phase by piloting the protocol in a healthy population, as well as conducting studies to establish standard and normative values.