Prevalência de alterações fonoaudiológicas em crianças de 4 a 6 anos de idade de escolas públicas da área de abrangência de um centro de saúde de Belo Horizonte

Abstract

Objectives: To study the prevalence of speech-language disorders of oral language, Orofacial and auditory processing in children from four to six years old in public schools in the area covered by the Health Center São Marcos; to correlate them to the variables age, sex and school; and to investigate the association between the presence of the different speech-language disorders studied. Methods: This is a descriptive cross-sectional study with random sample stratified by school and age. The evaluation consisted of three steps: (1) Assessment of Orofacial myology using a protocol for the verification of the myofunctional aspects of stomatognathic system, adapted from the Roadmap for Myofunctional Evaluation (JUNQUEIRA, 2005), (2) Assessment of oral language using the language assessment test ABFW - Phonology (WERTZNER, 2000), (3) Simplified Assessment of auditory processing, comprising: Sequential Memory for Verbal Sounds test, Sequential Memory for Non-verbal Sounds test, Test for the Location of Sound (PEREIRA, 1997; CORONA et al., 2005). For statistical analysis we used Epi Info version 6.04. Was established 5% (p <0.05) as threshold for statistical significance. Results: We analyzed the results of 242 children. The children ranged between 4.0 and 6.9 years. The median age was 5.7 years. About 60% of the children (n = 147) had some type of disorder investigated. Prevalence rates were: oral language disorders, 36.0% (n = 87); Orofacial disorders, 19.0% (n = 46); auditory processing disorders, 39.0% (n = 92), in this population. Association with statistical significance was observed between the presence of auditory processing disorders and age (p <0.001), presence of oral language disorders and age (p = 0.009), presence of phonological disorders and age (p <0.001). A higher number of children with one of these changes was found in the age of four to five years, which supposedly indicates the presence of more disorders in young children. We also observed association with statistical significance between the presence of phonetic disorders and Orofacial disorders (p <0.001) and between the presence of phonological disorders and auditory processing disorders (p <0.001). Another interesting finding of this study was the high number of children without oral language impairments that had some productive phonological process considered normal for their age according to the analysis of the test (80.0%), predominantly the processes of simplification of final consonant and consonant cluster simplification, which could indicate a linguistic variation of Brazilian Portuguese spoken in Minas Gerais. Conclusion: The high prevalence found in this study shows the need to formulate actions in primary health care in order to prevent the emergence of these disorders, improve access to intervention and make the prevention of more severe learning problems possible. Other important aspects observed were the associations between auditory processing disorders and Orofacial disorders with oral language impairments. The methodology does not allow the establishment of causal or temporal relationship between these variables. The results of this study show that the speech-language disorders are very present in the population from early on. The high number of oral language impairments in the population aged from four to five years suggests that this is a good stage for the identification and prevention of these disorders. When the adequate referral is made, in time to overcome these difficulties, intervention with children with speech-language problems may occur as effectively as possible, before the aggravation and / or involvement of the school life of children and their relationship with family and friends (ZORZI, 2005). Our suggestion is that new studies of prevalence, follow-up and associated factors are done in both this and other areas of Belo Horizonte, for comparison of results and better knowledge about these disorders in preschoolers.