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OBJECTIVE: To validate the Vocal Tract Discomfort Scale for the Brazilian Portuguese (VTDS-BR), based on internal consistency, reliability, and accuracy. METHODS: The participants were 431 adults of both sexes, divided in two groups: dysphonia (DG) and vocally healthy (VHG). We built a digital database with personal, professional information and the item-by-item VTDS-BR responses of the participants. We applied Cronbach's alpha, exploratory factor analysis; confirmatory factor analysis; Item Response Theory (IRT) using the Samejima model; and ROC (Receiver Operating Characteristic) curve analysis to obtain the VTDS-BR cut-off point. RESULTS: The VTDS-BR has an eight-item structure and two factors: vocal hyperfunction without phonotraumatic injury and with phonotraumatic injury. Each item is evaluated based on two facets related to frequency and intensity, with a Likert scale response key. There are four possible answers: never, sometimes, often, and always for frequency and none, mild, moderate, and intense for intensity. We applied an IRT model, which allowed the identification of which items are more related to dysphonia, based on higher values in the parameters discrimination (a) and difficulty (b), which contributed to the calculation of each participant's aptitude for the development of voice problems, by means of a score. The cut-off value was determined using the ROC curve, in which values greater than - 1.432 indicate a higher probability of voice alterations. CONCLUSION: VTDS-BR went through the stages of validation of internal consistency, reliability, and accuracy. It presents an 8-item, two-factor, and two-facet structure to assess frequency and intensity of vocal tract discomfort symptoms. VTDS-BR is suitable for clinical use or in screening activities, as it is quick to apply and its interpretation is indicative of people with and without phonotraumatic injury.

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RESUMO Objetivo Determinar evidências de validade de critério concorrente e preditiva do Instrumento de Rastreio da Comunicação de crianças de 0 a 36 meses (IRC-36). Método Participaram da pesquisa 78 pais/responsáveis de crianças que frequentam o serviço de puericultura das Unidades de Saúde da Família, além de 33 crianças com idades entre 0 e 36 meses, convidadas para segunda etapa do estudo. Na primeira etapa do estudo, 13 profissionais de saúde foram treinados para realizar a aplicação do IRC-36 nos pais/responsáveis das crianças. No segundo momento, os pais responderam a uma nova aplicação do IRC-36 e as crianças foram avaliadas com o Denver II. Resultados O IRC-36 apresentou correlação com o Denver II em mais da metade dos casos, confirmando a validade de critério concorrente do instrumento. Os resultados do IRC-36 da primeira etapa quando correlacionados com o Denver II, não apresentaram valores significativos. O valor de ponto de corte do instrumento foi 12, sendo este o valor de referência entre crianças em risco e sem risco para alteração da comunicação. O instrumento apresentou valor de acurácia dentro dos níveis preconizados e alta sensibilidade. A ocorrência de risco para alteração da comunicação apresentou-se maior na segunda aplicação do IRC-36. Conclusão O estudo apresentou evidências de validade de critério concorrente, indicando que o instrumento possui evidências de medidas de acurácia e de validade para o rastreio da comunicação de crianças de 0 a 36 meses sendo capaz de identificar risco para as alterações da comunicação.

ABSTRACT Purpose To determine evidence of concurrent and predictive criterion validity of the Communication Screening Instrument for children aged 0 to 36 months (IRC-36). Methods 78 parents/guardians of children who attend the childcare service of the Family Health Centers participated in the research, in addition to 33 children aged between 0 and 36 months, invited to the second stage of the study. In its first stage, 13 health professionals were trained to apply the IRC-36 to the children's parents/guardians. In the second moment, the parents responded to a new IRC-36 application, and the children were evaluated with Denver II. Results IRC-36 correlated with Denver II in more than half of the cases, confirming the instrument's concurrent criterion validity. IRC-36 results in the first stage did not significantly correlate with Denver II. The instrument's cutoff value was 12, which is the reference value between children at risk and not at risk of communication disorders. The instrument had high sensitivity and an accuracy value within the recommended levels. The occurrence of risk of communication changes was higher in the second IRC-36 application. Conclusion The study presented evidence of concurrent criterion validity, indicating that the instrument has evidence of accuracy and validity measures to screen communication in children aged 0 to 36 months, being able to identify the risk for communication disorders.

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ABSTRACT Purpose: to describe the development, focusing on language, of children affected by congenital Zika syndrome and compare it with that of typically developing children. Methods: a quantitative, observational, cross-sectional, case-control study. Data from the group of children with congenital Zika virus syndrome (case) were matched for sex and age with data from the group of typically developing children without comorbidities (control). The research included 20 parents/guardians of the children in the case group and 20 parents/guardians of the children in the control group, using interview as an adapted instrument. The data underwent descriptive and inferential statistical analysis, through association tests and comparison of means, with the significance level set at 5%. Results: there was a statistical difference in motor, auditory, and language development between the groups, according to the parents' perception. Conclusion: Based on the caregivers' reports, most of the case group communicated non-verbally through babbling, shouting, and eye contact, whereas the minority communicated through dialogue, understood simple orders, and performed imitative behaviors, symbolic play, and shared attention. On the other hand, the control group communicated through complex sentences constructed into narratives.

RESUMO Objetivo: descrever o desenvolvimento infantil, com enfoque na linguagem, de crianças acometidas da síndrome congênita do Zika e compará-lo com o de crianças com desenvolvimento típico. Métodos: trata-se de um estudo observacional, transversal, do tipo caso-controle, e de natureza quantitativa. Os dados do grupo de crianças com Síndrome Congênita do Zika vírus (caso) foram pareados por sexo e idade com os dados do grupo de crianças sem comorbidades e desenvolvimento típico (controle). Participaram da pesquisa, 20 responsáveis pelas crianças do grupo caso e 20 pelas crianças do grupo controle e o instrumento utilizado foi uma entrevista adaptada. Os dados foram examinados por meio de uma análise estatística descritiva e inferencial por meio de testes de associação e de comparação de médias, com nível de significância de 5%. Resultados: foi observada diferença estatística entre os grupos estudados, referente ao desenvolvimento infantil, no âmbito motor, auditivo e de linguagem, com base na percepção dos pais. Conclusão: diante das informações dos cuidadores, a comunicação da maioria do grupo caso ocorre de forma não verbal por meio de gorjeios, gritos e contato visual; e a minoria comunica-se por diálogo, compreende ordens simples, realiza condutas imitativas, brincar simbólico e tem atenção compartilhada. Diferentemente, o grupo controle comunica-se por meio de frases complexas presentes em narrativas.

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PURPOSE: To determine evidence of concurrent and predictive criterion validity of the Communication Screening Instrument for children aged 0 to 36 months (IRC-36). METHODS: 78 parents/guardians of children who attend the childcare service of the Family Health Centers participated in the research, in addition to 33 children aged between 0 and 36 months, invited to the second stage of the study. In its first stage, 13 health professionals were trained to apply the IRC-36 to the children's parents/guardians. In the second moment, the parents responded to a new IRC-36 application, and the children were evaluated with Denver II. RESULTS: IRC-36 correlated with Denver II in more than half of the cases, confirming the instrument's concurrent criterion validity. IRC-36 results in the first stage did not significantly correlate with Denver II. The instrument's cutoff value was 12, which is the reference value between children at risk and not at risk of communication disorders. The instrument had high sensitivity and an accuracy value within the recommended levels. The occurrence of risk of communication changes was higher in the second IRC-36 application. CONCLUSION: The study presented evidence of concurrent criterion validity, indicating that the instrument has evidence of accuracy and validity measures to screen communication in children aged 0 to 36 months, being able to identify the risk for communication disorders.

OBJETIVO: Determinar evidências de validade de critério concorrente e preditiva do Instrumento de Rastreio da Comunicação de crianças de 0 a 36 meses (IRC-36). MÉTODO: Participaram da pesquisa 78 pais/responsáveis de crianças que frequentam o serviço de puericultura das Unidades de Saúde da Família, além de 33 crianças com idades entre 0 e 36 meses, convidadas para segunda etapa do estudo. Na primeira etapa do estudo, 13 profissionais de saúde foram treinados para realizar a aplicação do IRC-36 nos pais/responsáveis das crianças. No segundo momento, os pais responderam a uma nova aplicação do IRC-36 e as crianças foram avaliadas com o Denver II. RESULTADOS: O IRC-36 apresentou correlação com o Denver II em mais da metade dos casos, confirmando a validade de critério concorrente do instrumento. Os resultados do IRC-36 da primeira etapa quando correlacionados com o Denver II, não apresentaram valores significativos. O valor de ponto de corte do instrumento foi 12, sendo este o valor de referência entre crianças em risco e sem risco para alteração da comunicação. O instrumento apresentou valor de acurácia dentro dos níveis preconizados e alta sensibilidade. A ocorrência de risco para alteração da comunicação apresentou-se maior na segunda aplicação do IRC-36. CONCLUSÃO: O estudo apresentou evidências de validade de critério concorrente, indicando que o instrumento possui evidências de medidas de acurácia e de validade para o rastreio da comunicação de crianças de 0 a 36 meses sendo capaz de identificar risco para as alterações da comunicação.

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PURPOSE: To compare the efficiency of different vocal self-assessment instruments for dysphonia screening. METHODS: 262 dysphonic and non-dysphonic individuals participated in the research. The mean age was 41.3 (±14.5) years. The diagnosis of dysphonia was based on the auditory-perceptual analysis of the sustained vowel "é" and on laryngological diagnosis. The responses of the instruments were collected: Voice-Related Quality of Life (V-RQOL), Voice Handicap Index (VHI), VHI-10, Voice Symptoms Scale (VoiSS), and the Brazilian Dysphonia Screening Tool, (Br-DST) called in Brazilian Portuguese Instrumento de Rastreio da Disfonia (IRDBR). To analyze assertiveness in relation to the presence of dysphonia, the cutoff points of each instrument and the decision rule recommended by the IRDBR were used. An exploratory analysis was performed to compare mean scores of instruments and verify associations between variables. RESULTS: The instruments evaluated were sensitive to capture the impact of dysphonia in a similar way regardless of professional voice use and type of dysphonia. There was a difference only in VoiSS scores for the variable gender, with a higher score for females. Regarding global assertiveness, the instruments showed high rates of success in classification, with emphasis on the VoiSS, which had the highest rate (86.3%), followed by the IRDBR (84.0%), VQL (80.9%), VHI (78.2%), and VHI-10 (75.2%). CONCLUSION: The VoiSS has the highest assertiveness index in the identification of dysphonia, followed by the IRDBR. The IRDBR is a short, simple, and easy-to-apply tool for screening procedures.

OBJETIVO: Comparar a eficiência de diferentes instrumentos de autoavaliação vocal para o rastreio da disfonia. MÉTODO: Participaram 262 indivíduos disfônicos e não disfônicos, com média de idade de 41,3 (±14,5) anos. O diagnóstico da disfonia foi dado a partir da análise perceptivo-auditiva da vogal sustentada "é" e do diagnóstico laringológico. Foram coletadas as respostas dos instrumentos: Questionário de Qualidade de Vida em Voz (QVV), Índice de Desvantagem Vocal (IDV), IDV-10, Escala de Sintomas Vocais (ESV) e do Br-DST (Brazilian Dysphonia Screening Tool), denominado no português brasileiro como Instrumento de Rastreio da Disfonia (IRDBR). Para análise da assertividade destes em relação à presença da disfonia, foram utilizados os pontos de corte de cada instrumento e a regra de decisão preconizada pelo IRDBR. Foi realizada uma análise exploratória para comparação das médias dos escores dos instrumentos e verificação de associações entre as variáveis. RESULTADOS: Os instrumentos avaliados foram sensíveis para captar o impacto da disfonia de forma semelhante independentemente do uso profissional da voz e tipo de disfonia. Foi observada diferença apenas nos escores da ESV para a variável sexo, com maior pontuação observada no sexo feminino. Em relação à assertividade global, os instrumentos apresentaram elevados índices de acerto na classificação, com destaque para a ESV que apresentou maior índice (86,3%), seguida do IRDBR (84,0%), QVV (80,9%), IDV (78,2%) e IDV-10 (75,2%). CONCLUSÃO: A ESV apresenta maior índice de assertividade na identificação da disfonia, seguida do IRDBR. O IRDBR é uma ferramenta curta, simples e de fácil aplicação para procedimentos de rastreio.

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OBJECTIVE: this study aims to verify the stages of evidence of validity of the voice-adapted present perceived control scale (V-APPCS) in its translated and cross-culturally adapted version for the Brazilian Portuguese "Voice-Adapted Present Perceived Control Scale" and to estimate the psychometric measurements of the properties of its items based on the item response theory (IRT). METHODS: the instrument underwent a process of translation and cross-cultural adaptation for the Brazilian Portuguese, the process was carried out by two qualified translators, native in the destination language, and fluent in the language and culture of origin. The first translated version of the protocol was forwarded to a back-translation, performed by a third bilingual Brazilian translator. The translations were analyzed and compared by a committee composed of five speech therapists who are specialists in voice and with proficiency in the English language. The empirical study used data from 168 individuals, 127 had voice problems and 41 vocally healthy ones. For the stages of validity evidence, the following analyses were performed: Cronbach's alpha, exploratory factor analysis, confirmatory factor analysis and IRT. RESULTS: The stages of translation and cross-cultural adaptation allowed linguistic adjustments to be made so that the items were understandable and suitable for use in Brazil. The adequacy, structure, and application of the items were confirmed through the application of the final version of the scale in twenty individuals in a real context. The instrument in its Brazilian version presented good internal consistency, with bifactorial structure the exploratory factor analysis, besides presenting satisfactory values in the adjustment indexes of the model, confirming the structure of the confirmatory factor Analysis. The IT was applied to evaluate the parameters discrimination (a) and difficulty (b) of the items of the instrument; item 5 "I have control over my day-to-day reactions to the voice problem." Presented itself as a more discriminative item and item 8 "My reaction to the voice problem is not under my control." As an item of greater difficulty. CONCLUSION: The V-APPCS, translated, cross-culturally adapted, and validated, is robust and adequate to represent the construct in the Brazilian versions.

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RESUMO Objetivo Comparar a eficiência de diferentes instrumentos de autoavaliação vocal para o rastreio da disfonia. Método Participaram 262 indivíduos disfônicos e não disfônicos, com média de idade de 41,3 (±14,5) anos. O diagnóstico da disfonia foi dado a partir da análise perceptivo-auditiva da vogal sustentada "é" e do diagnóstico laringológico. Foram coletadas as respostas dos instrumentos: Questionário de Qualidade de Vida em Voz (QVV), Índice de Desvantagem Vocal (IDV), IDV-10, Escala de Sintomas Vocais (ESV) e do Br-DST (Brazilian Dysphonia Screening Tool), denominado no português brasileiro como Instrumento de Rastreio da Disfonia (IRDBR). Para análise da assertividade destes em relação à presença da disfonia, foram utilizados os pontos de corte de cada instrumento e a regra de decisão preconizada pelo IRDBR. Foi realizada uma análise exploratória para comparação das médias dos escores dos instrumentos e verificação de associações entre as variáveis. Resultados Os instrumentos avaliados foram sensíveis para captar o impacto da disfonia de forma semelhante independentemente do uso profissional da voz e tipo de disfonia. Foi observada diferença apenas nos escores da ESV para a variável sexo, com maior pontuação observada no sexo feminino. Em relação à assertividade global, os instrumentos apresentaram elevados índices de acerto na classificação, com destaque para a ESV que apresentou maior índice (86,3%), seguida do IRDBR (84,0%), QVV (80,9%), IDV (78,2%) e IDV-10 (75,2%). Conclusão A ESV apresenta maior índice de assertividade na identificação da disfonia, seguida do IRDBR. O IRDBR é uma ferramenta curta, simples e de fácil aplicação para procedimentos de rastreio.

ABSTRACT Purpose To compare the efficiency of different vocal self-assessment instruments for dysphonia screening. Methods 262 dysphonic and non-dysphonic individuals participated in the research. The mean age was 41.3 (±14.5) years. The diagnosis of dysphonia was based on the auditory-perceptual analysis of the sustained vowel "é" and on laryngological diagnosis. The responses of the instruments were collected: Voice-Related Quality of Life (V-RQOL), Voice Handicap Index (VHI), VHI-10, Voice Symptoms Scale (VoiSS), and the Brazilian Dysphonia Screening Tool, (Br-DST) called in Brazilian Portuguese Instrumento de Rastreio da Disfonia (IRDBR). To analyze assertiveness in relation to the presence of dysphonia, the cutoff points of each instrument and the decision rule recommended by the IRDBR were used. An exploratory analysis was performed to compare mean scores of instruments and verify associations between variables. Results The instruments evaluated were sensitive to capture the impact of dysphonia in a similar way regardless of professional voice use and type of dysphonia. There was a difference only in VoiSS scores for the variable gender, with a higher score for females. Regarding global assertiveness, the instruments showed high rates of success in classification, with emphasis on the VoiSS, which had the highest rate (86.3%), followed by the IRDBR (84.0%), VQL (80.9%), VHI (78.2%), and VHI-10 (75.2%). Conclusion The VoiSS has the highest assertiveness index in the identification of dysphonia, followed by the IRDBR. The IRDBR is a short, simple, and easy-to-apply tool for screening procedures.

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ABSTRACT Purpose: to verify contributions of acoustic spectrographic analysis in the forensic identification of speakers with auditorily similar voices, considering the distinctive behavior of acoustic parameters: formants of vowel "é", of connected speech, mean fundamental frequency in Hz, linear prediction curve of vowel "é" and linear prediction curve area; and to propose an objective method to use the analyzed parameters. Methods: a quantitative, qualitative and descriptive study, conducted in Pernambuco on 16 pairs of male siblings, aged 18-60 years. The subjects recorded videos from which the audios were extracted, numbered and sent to three examiners, in two groups: older brothers and younger brothers, for perceptual-auditory pairing. The correct pairings, indicated by at least two examiners, were submitted to acoustic analysis. The statistical tests included Wilcoxon, Kruskal-Wallis and Bonferroni, with p<0.05. Results: the results of analyses of formants and the mean fundamental frequency were not enough to distinguish similar voices. Unprecedentedly, in the measurements of areas generated by the linear prediction curve graphs, a distinctive statistical significance was observed. Conclusion: it was concluded that, among the parameters studied, the measurements of areas of the linear prediction curve objectively indicated effectiveness in distinguishing speakers with auditorily similar voices.

RESUMO Objetivo: verificar contribuições da análise espectrográfica acústica na identificação forense de falantes em vozes auditivamente semelhantes, considerando o comportamento distintivo dos parâmetros acústicos: formantes da vogal "é", da fala encadeada, média da frequência fundamental em Hz, curva de predição linear da vogal "é" e área da curva de predição linear; propor um método objetivo da utilização dos parâmetros analisados. Métodos: estudo quantitativo, qualitativo e descritivo, realizado em Pernambuco com 16 pares de irmãos do sexo masculino, entre 18-60 anos. Os sujeitos gravaram vídeos de onde extraíram-se os áudios que foram numerados e enviados a três avaliadores, em dois grupos: dos irmãos mais velhos e dos irmãos mais novos, para pareamento perceptivo-auditivo. Os pareamentos corretos, apontados por pelo menos dois avaliadores, foram submetidos à análise acústica. Os testes estatísticos foram Wilcoxon, Kruskal-Wallis, Bonferroni, com p<0,05. Resultados: os resultados das análises dos formantes e da média da frequência fundamental não foram suficientes para distinguir as vozes semelhantes. Ineditamente nas medidas das áreas geradas pelos gráficos da curva de predição linear, foi verificada significância estatística distintiva. Conclusão: concluiu-se que entre os parâmetros estudados, as medidas das áreas da curva de predição linear apontaram, objetivamente, eficácia na distinção de falantes com vozes auditivamente semelhantes.

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OBJECTIVE: To investigate the auditory perception of roughness and breathiness by dysphonic women. METHODS: Twenty-two dysphonic native Brazilian Portuguese women participated in this research. All participants underwent audiological evaluation and laryngeal examination to confirm the diagnosis. During the tests, they recorded the sustained vowel /Ɛ/. A speech-language pathologist performed the auditory-perceptual judgment of voice quality for these vocal samples, categorizing the general degree of vocal deviation (mild, moderate, and severe degree) and the predominant type of deviation (roughness or breathiness). Thirty-two (32) stimuli were selected from a voice database, including twenty-four (24) dysphonic voice samples and eight (8) voice samples from vocally healthy women. The authors conducted five perception experiments, being three categorization tasks (normal vs. deviated, breathy vs. nonbreathy, rough vs. nonrough) and two tasks for discriminating the degree of deviation (roughness degree and breathiness degree). RESULTS: The experiments showed a difference between the answers for presence/absence of deviation, presence/absence of breathiness, and presence/absence of roughness in the stimuli, and a difference in the proportion of similar answers of dysphonic women (P < 0.001) regarding the identification of the deviation. Participants classified a large part of the deviated (57.9%), breathy (63.13%), and rough (65.31%) voices as normal. The degree of vocal deviation (P = 0.008) and the degree of roughness in the stimuli correlated positively with the proportion of similar answers of the participants. As for the discrimination of breathiness degrees, less deviated (normal and mild) voices were less discriminated, and more deviated (moderate and severe) voices were better discriminated. Regarding the discrimination of roughness degrees, only the voices with severe deviations showed good discrimination. CONCLUSION: Dysphonic women had a high rate of not similar answers in the identification of normal and deviated voices. They identified more than half of the deviated voices as normal. Samples with more severe deviations were proportionally more identified as deviated by the participants. The greater the vocal deviation of the participants' voices, the smallest the number of similar answers. Participants had a high rate of not similar answers in the identification of normal and breathy voices. Dysphonic women show less ability to perceive mildly and moderately breathy voices in the breathy category. Participants had a high rate of similar answers in the identification of normal and rough voices. Dysphonic women show less ability to perceive mildly and moderately breathy voices in the breathy category. Participants show less ability to perceive only mildly roughness voices with similar responses. Dysphonic women could discriminate between voices with adjacent degrees of roughness but had a low percentage of similar answers for discrimination between voices with adjacent degrees of breathiness.

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OBJECTIVE: To verify the relationship between self-regulation and voice behavior according to national and international literature. METHODS: A literature survey was performed using the PubMed, LILACS, and SciELO databases. The search terms used were the following: self-regulation, self-control, combined with voice, voice disorders, and dysphonia, in Portuguese, English, and Spanish. Articles that addressed self-regulation and voice behavior or voice disorders published in English, Spanish, or Portuguese were included, without restriction of date. The variables preselected for the data organization were authors, database, country, impact factor, journal, type of study, sample size, sample characteristics, methods for data collection, group comparison, objective, and outcome. RESULTS: A total of 10,176 articles were identified in the databases, of which 10 were selected based on title, read in full, and kept for data analysis. The studies were found predominantly in American journals and were published between 2013 and 2019. The United States published most articles, and the predominant methodological aspect was observational and cross-sectional. CONCLUSION: Despite the small number of articles, the studies analyzed can show self-regulation as an important factor in vocal behavior and call attention to its performance in voice disorders.

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