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O desenvolvimento fonológico de crianças com otites médias com derrame : estudo longitudinal
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Resumo(s)
Ear and hearing problems caused by Otitis Media are highly prevalent in infants and young children (almost 80–90% of all children experience at least one episode before the age of 1 year (Bluestone & Klein, 2004). The purposes of this investigation are: (i) to contribute with empirical data for the linguistic profile (and, more specifically, the phonological profile) of children with Otitis Media with Effusion (OME), testing the impact of early (late OME episodes in the children´s verbal performance; (ii) to test the relevance of the phonological variables such as natural class, syllable constituency, word stress and position within the word, on the phonological development of children with OME. In addition, we intend to further describe the impact of myringotomy with placement of TVTT on language development, in general, and specifically on phonological development, through a longitudinal observation, up to one year after surgery. The debate on the impact of OME in the language development is based on the observation of grammatical and lexical aspects, although phonological structures are often mentioned as the most relevant ones in this context (Stoel-Gammon & Dunn, 1985). The question of how OME may affect language development is therefore a matter of debate and further empirical evidence is needed. As far as we know, no studies on this topic are available for the Portuguese population. OME has been considered a risk factor for phonological disorders (Ingram, 1976; Stoel-Gammon & Dunn, 1985; Paden, Novak & Beiter, 1987; Shriberg et al., 2000; Bauman-Waengler, 2004; Dodd, 2005). Under this context fricatives and liquids are reported as the most problematic natural classes (Mody et al., 1999; Borg et al., 2002). In the present research, a sample of 9 children aged 4;7 to 6;4 years was gathered: a control group (CG) (n=3); two experimental groups with OME (EG1: OME during the 1st year of life (n=3); EG2: OME after 3;0 (n=3)). All children are monolingual speakers of European Portuguese, showing no history of other diseases with potential impact on language development; they have not been previously been followed in Speech Therapy. A mild and bilateral hearing loss was identified (EG1=32,5dB; EG2=29,7dB). The children in the two experimental groups were longitudinally observed for a period of 12 months (1 session one month before surgery; 5 sessions after surgery). To assess language development, a standardized test for European Portuguese (EP) was used, TICL (Viana, 2004). Phonological development was evaluated with a picture-naming test (FLIQ), designed for this study and controlling the phonological variables natural class, syllable constituency, position within the word and word stress. The empirical data collected showed how a deficit assessing the acoustic input during the first year of life may affect the processing of all grammatical components (Werker & Tees; 1984; 2005; Nazzi, Bertoncini & Mehler, 1998; Swingley, 2003; Van der Feest, 2007; Friedmann & Costa, 2011), the data described showed that the early onset of episodes of OME may have a negative impact on the language development in general (Gravel & Wallace, 1992), with particular reference to phonology, since these children are exposed to a degraded auditory input during relevant stages of perceptual development during the first year of life, crucial for language development (Gervain & Mehler, 2010; Werker & Hensch, 2015). The natural class was considered the most relevant variable in this study. The contrast [± voice] in the class of fricatives and performance on the lateral [l/ɫ], especially in Coda, were the most problematic structures and may be considered as potential phonological markers of children with early history of OME. The surgery performed showed a positive effects in restoring the hearing ability of children in both experimental groups, although these effects are smaller with regard to language skills (Maw et al., 1999; Kubba, 2000; Lous et al., 2011; Rovers et al., 2005), specifically in the case of phonological development. The results obtained so far need to be tested with larger samples and exported into the medical community.
Descrição
Tese de doutoramento, Linguística (Linguagem e Comunicação), Universidade de Lisboa, Faculdade de Letras e Faculdade de Medicina, 2015
Palavras-chave
Teses de doutoramento - 2015