Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Narrative discourse is considered a linguistic unit that is used in a specific communicative context, being an indicator of thinking organization. Previous evidence shows how hearing aid users, have difficulties with different language skills, both expressive and comprehensive, including the ability to narrate. Additionally, there is evidence showing how therapeutic intervention would help to improve their narrative performance. However, the information available about the discursive skill and the effect of stimulation programs on it in hearing impaired children is scarce. Accordingly, the present study aims to explore narrative performance in hearing impaired children users of hearing aids/cochlear implants, before and after a narrative speech stimulation program. Twenty-two children diagnosed with bilateral hearing loss users of hearing aids/cochlear implants with a mean age of 6.5 years were included. An initial assessment of the narrative skills was performed using Narrative Discourse Assessment (EDNA), which provided a narrative Stage and a Total score. A twelve-session stimulation program was developed and individually administered to children once a week. Finally, an assessment was performed after the program ended. In the initial assessment, 45.5% of children did not have a structured narrative speech, a percentage that was reduced to a 9.1% in the final evaluation. Statistically significant differences were observed on the EDNA scores when comparing initial and final assessments. The results obtained in the present investigation show how children who use hearing aids/cochlear implants improved significantly their narrative abilities after participating in a pilot narrative speech stimulation program.

The COVID-19 pandemic caused by the SARS-CoV-2 virus has rapidly spread worldwide. Public health authorities have recommended limiting non-essential healthcare, in search of a balance between the risk of delaying treatment and the potential exposure to the virus. Most services in the audiology and otoneurology areas can easily exceed 45 minutes and it is not possible to keep the recommended physical distancing. Both factors increase the risk of professionals being infected. Therefore, the purpose of this review is to describe the current evidence about recommendations in audiology and otoneurology care in the context of COVID-19. In addition to the search of scientific articles in various databases, recommendations issued by the main associations in the area were consulted. The information was gathered considering four relevant clinical aspects: health care services, procedures, personal protective equipment and the cleaning of equipment and supplies. Scientific evidence and suggestions made by associations are being constantly updated, and therefore there is limited content on some topics. However, the recommendations agree on prioritizing remote health care, increasing the use of personal protective equipment, implementing protocols for hand hygiene and for the cleaning of equipment and supplies. The incorporation communication strategies other than oral language to interact with people with hearing loss to facilitate speech discrimination is also recommended.

COVID-19 pandemic has challenged professional teams regarding the provision of health services in Primary Health Care (PHC). Speech pathologists who work at this level have diversified their work, so it becomes necessary to reflect on their practice in this context. The objective of this narrative review is to update the state of the art regarding the domains of the provision of services in speech therapy and their relevance in PHC, regarding the pandemic. The various areas of speech therapy action are pertinent to face the demands derived from the pandemic in PHC. There is an extension of scope of speech therapy practice that considers the continuity of care and therapeutic accompaniment. Such an extension incorporates the need to strengthen prevention and health promotion actions, observing communication as a tool for this purpose. In this context, it is necessary to reflect on the disciplinary role of the speech therapist from his practice in generic and specific areas at the local level, recognizing the existence of a hybridization in the provision of services both individually and collectively. It becomes also necessary to formulate position papers, based on evidence and supported by international recommendations as well as the requirements of the community, regarding the role of the speech therapist in PHC. The formulation and dissemination of research that make visible the contributions of speech therapy in this area seem fundamental.

Swallowing intervention protocols in dysphagia do not specify the parameters of the exercises, namely the duration, frequency and number of series, all of which present a challenge in speech therapy intervention in swallowing disorders. The purpose of this review is to provide Speech and Language Pathologists with background information concerning crucial muscle fibres used in swallowing therapy and to subsequently indicate appropriate skull-cervical-oral muscle exercises. We describe the primary muscle and its characteristics such as fatigue resistance and contraction speed, review the types of fibres of some of the main muscles that participate in the swallowing process, and present the particularities of the muscles of the cranio-cervical-oral area in comparison with the rest of the skeletal muscles. We also provide information regarding the difficulties in evaluating the musculature involved in the swallowing process before finally highlighting the relevance of understanding the roles and characteristics of these muscles for clinical practice.

International institutions have suggested one Speech and Language Therapist per ten critical beds, and possibly even more for high-complexity institutions. However, there are no similar recommendations in Chile, although the Ministry of Health has developed recommendations to calculate the number of professionals required according to the number and type of clinical bed. The aim of this study is to describe the number of Speech and Language Therapists along with the number of theorical working hours per week required for the attention of hospitalised adult patients in high-complexity hospitals in Chile, for which a descriptive, observational and transversal study was performed. High-complexity hospitals were included, excluding psychiatric and paediatric institutions. Microsoft Excel, the “Modelo de Gestión Red de Rehabilitación” guideline from the Ministry of Health, and the updated database of the clinical network beds were also used. This study was previously approved by a Research Ethics Committee from Hospital San Juan de Dios, and a total of 59 out of 188 hospitals were included. According to the analysis based on features of the clinical beds, 269 Speech and Language Therapists are required for 44 hours per week to attend adult patients in high-complexity hospitals across the country. Of the 269 professionals, 104 are needed in the Metropolitan region, approximately 31 in the Bío-Bío region and circa 24 in the Valparaíso region. According to these results, it is suggested the Ministry review its guidelines and undertake a further project in order to identify the current professional gap in Chile.

This paper analyzes, from a community-based approach, a speech, language and hearing sciences therapy experience for the promotion of children’s rights, carried out in a social organization, with the participation of a group of speech, language and hearing sciences therapy undergraduate students at the Universidad de Chile in 2013. In community approaches, all community members build knowledge and take actions to build stronger social relationships and welfare, justice, autonomy and emancipation. The analysis of this experience was conducted by selecting sections from the fieldwork diaries of the team of participating students, based on the principles and dimensions of the paradigm of construction and critical transformation of Maritza Montero (2004). The results were divided into three moments (beginning, transition and reset of the work), which account for the level of complexity of the process and the goals achieved based on the ontological, epistemological, methodological, ethical and political dimensions of the community-based approach. The discussion emphasizes the importance of critical reflection on the foundations and practices of speech, language and hearing sciences therapy in the approach to communication and human development, to contribute to social justice from a community perspective.

There is a need to develop tools that demonstrate the impact of speech therapy intervention in the hospital setting, which requires the implementation of care and management models that favor clinical demand and efficiency of processes and equipment. Various professions in the health area have used categorization models that, along with satisfying the demands of patients, translate the activities of their discipline into management terms. Currently, in the speech therapy field, there are no tools of this kind available that allow determining the amount of care necessary for a person in a hospital context. Due to the above circumstances, this article presents the creation, development and application of a qualitative-quantitative matrix. The objective of the matrix is to assess and standardize the speech therapy workload required for each hospitalized adult patient, considering their global clinical context. This categorization matrix considers five clinical variables evaluated during the patient's rehabilitation and four qualifiers in relation to the order of severity. Different categories of care that deliver a recommended therapeutic load (from 1 to 2 weekly visits in mild cases to 2 daily visits in complex cases) are established and proposed. Finally, their use and the benefits of their implementation are discussed as a tool that allows optimizing management processes, determining gaps and justifying the inclusion of new speech therapists in the hospital context.

The study of fluency of speech, at different stages of the life cycle, is relevant in that it contributes both to the understanding of typical speech development and to the understanding of pathological speech, which is useful for diagnosis and treatment. The objectives of this work are a) to determine the presence and distribution of the disfluencies present in different age groups and b) to determine if there is variation in the distribution of disfluencies in relation to the gender of the informants. The sample consisted of 60 children and adolescents between 4.01 years old and 15.0 years old distributed in three groups. The results indicate that vowel prolongation was the most frequent disfluency, while syllable repetition was the least present in the groups analyzed. In the group of younger women, there was a significantly high amount of word repetition when comparing the presence of this disfluency in the other two groups. There were no more differences reported in relation to the gender of the informants. Finally, the results and some considerations related to the methodology in this type of research are discussed.