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A intensidade da terapia fonoaudiológica está relacionada à resposta à intervenção de crianças com transtorno do desenvolvimento da linguagem? Uma revisão de escopo

Authors: Tiezzi, Giovanna Agamalian da Silva [UNIFESP];

A intensidade da terapia fonoaudiológica está relacionada à resposta à intervenção de crianças com transtorno do desenvolvimento da linguagem? Uma revisão de escopo

Abstract

INTRODUÇÃO: O Transtorno do Desenvolvimento da Linguagem (TDL) é caracterizado por dificuldades heterogêneas e persistentes na aquisição da linguagem, sem causas biomédicas aparentes, que afetam a comunicação funcional. As crianças com TDL necessitam de terapia individualizada para alcançar seus objetivos, o que implica na elaboração de planejamentos terapêuticos claros com a "dose" adequada. Dose é um conceito que envolve o número de episódios de ensino por sessão e a intensidade cumulativa do tratamento e, embora seja de difícil quantificação e aplicação, pode ser crucial para a resposta da criança à intervenção. OBJETIVO: Explorar se existe relação entre a intensidade da intervenção de linguagem oral em crianças e adolescentes com TDL e a melhora das habilidades trabalhadas. MÉTODO: A revisão de escopo seguiu as diretrizes preconizadas pelo Joanna Briggs Institute (JBI) e Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). As bases de dados pesquisadas foram: PubMed, Lilacs, MEDLINE, Web of Science e Scopus. Os textos foram selecionados conforme critérios de inclusão e grau de evidência segundo o Grading of Recommendations, Assessment, Development and Evaluation (GRADE), removendo os considerados "muito baixo". Em seguida, os dados foram tabulados e as variáveis da intensidade da intervenção “tempo de sessão” e “frequência cumulativa” foram classificados para os artigos com foco em cada habilidade de linguagem trabalhada (semântica, gramática ou consciência fonológica). RESULTADOS: Foram levantados 793 artigos. Após exclusão dos artigos que não preenchiam critérios para este estudo, 28 foram analisados em sua totalidade. Os estudos indicaram que, para a terapia focada em habilidades gramaticais, semânticas e de consciência fonológica, sessões mais longas e de intensidade alta geraram melhores resultados. CONCLUSÃO: A revisão identificou tendência de que sessões mais longas, com intensidades cumulativas maiores, sejam mais efetivas para crianças com TDL em todas as áreas da linguagem. O uso de terminologia padronizada em pesquisas futuras, com metodologia clara para avaliar a dose terapêutica, ajudaria fonoaudiólogos a comparar estudos e definir a melhor abordagem clínica.

INTRODUCTION: Developmental Language Disorder (DLD) is characterized by heterogeneous and persistent difficulties in language acquisition, with no apparent biomedical causes, that affect functional communication. Children with DLD require individualized therapy to achieve their goals, which implies the development of clear therapeutic plans with the appropriate "dose". Dose is a concept that involves the number of teaching episodes per session and the cumulative intensity of treatment and, although difficult to quantify and apply, can be crucial for the child's response to intervention. OBJECTIVE: To explore whether there is a relationship between the intensity of oral language intervention in children and adolescents with DLD and the improvement of the skills worked on. METHOD: The scoping review followed the guidelines recommended by the Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The databases searched were: PubMed, Lilacs, MEDLINE, Web of Science and Scopus. The texts were selected according to inclusion criteria and level of evidence according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE), removing those considered "very low". Then, the data were tabulated and the variables of intervention intensity "session time" and "cumulative frequency" were classified for the articles focusing on each language skill worked (semantics, grammar or phonological awareness). RESULTS: A total of 793 articles were collected. After excluding articles that did not meet the criteria for this study, 28 were analyzed in their entirety. The studies indicated that, for therapy focused on grammatical, semantic and phonological awareness skills, longer and high-intensity sessions generated better results. CONCLUSION: The review identified a tendency that longer sessions, with higher cumulative intensities, are more effective for children with DLD in all areas of language. The use of standardized terminology in future research, with a clear methodology to assess therapeutic dose, would help speech-language pathologists compare studies and define the best clinical approach.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

CAPES: 33009015

Keywords

Linguagem infantil, Transtorno Específico de Linguagem, 3. Saúde e bem-estar, Terapia da linguagem

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green