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Background: The Direct Assessment of Functional Status (DAFS) is the only instrument validated in Brazil that assesses functionality directly with the patient. However, this clinical tool takes a long time to be administered. This limits its use in hospitals and outpatient clinics that require brief assessment instruments. Additionally, we need to count with a direct assessment because the number of older adults living alone is increasing and we thus lack reliable informants. Objective: This study aimed to present the development and content validity evidence of a direct complex functionality test for older adults, the Brief Instrument for Direct Functionality Assessment (BIDFA). Method: A total sample of 30 older adults and eight expert judges took part in the study stages. The BIDFA construction stages were: (1) literature review of functionality instruments; (2) development of seven ecological tasks to evaluate the performance of daily complex activities with the older adults; (3) content analysis by eight expert judges; (4) pilot study with 30 older adults; (5) the ecological analysis of items; (6) focus group analysis; and (7) final version of the BIDFA. Results: The BIDFA had evidence of content validity with an agreement index of 96.5%. The final version of BIDFA was left with six domains of complex functionality divided into semantic memory and time orientation; shopping skills; executive attention, math and finance skills; organization; planning and procedural memory; and problem-solving. The complex functionality score by BIDFA ranges from 0 to 100 points. Conclusion: The BIDFA was found to have good content validity by the expert judges and by the ecological analysis of the items by the older adults. The new instrument is expected to help assess the functional status of older adults, in an abbreviated context including complex functionality demands, with a wider range of total and subdomain scores.

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We investigate the association of short- and long-range recurrences (speech connectedness) with age, education, and reading and writing habits (RWH) in typical aging using an oral narrative production task. Oral narrative transcriptions were represented as word-graphs to measure short- and long-range recurrences. Speech connectedness was explained by the combination of age, education, and RWH, and the strength of RWH's coefficient reflects the aging effect.

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During normal aging there is a decline in cognitive functions that includes deficits in oral discourse production. A higher level of education and more frequent reading and writing habits (RWH) might delay the onset of the cognitive decline during aging. This study aimed at investigating the effect of education and RWH on oral discourse production in older adults. Picture-based narratives were collected from 117 healthy adults, aged between 51 and 82 years (68.6 ± 6.38) with 0-20 years of formal education (10.1 ± 5.69). Measures of macro, microlinguistic and modalizations were computed and entered as dependent variables in hierarchical regression analyses that included age, education and RWH as regressors. Results revealed that higher education explained a better performance at the macrostructure and microstructure dimensions. Higher frequency of RWH explained the production of fewer modalizations. These results demonstrate the positive effect of education and RWH in oral discourse production in older adults. Therefore, higher attention should be given to these social factors.

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In the last decades, a series of studies has explored the role of morphological awareness on reading comprehension. Path analysis studies performed in English have shown that morphological awareness benefits reading comprehension both directly and indirectly, through word decoding. This issue has seldom been explored in Spanish. The aim of this study was to replicate in Spanish the results previously found in English. We used path analysis to assess three alternative models of the relationship between morphological awareness, word decoding and reading comprehension in 4th grade Spanish-speaking children. Contrary to English, we found that morphological awareness benefits reading comprehension only directly. We conclude that in Spanish, in which accurate and fluent pronunciation of written words can be achieved through grapheme-to-phoneme conversion rules, morphological awareness does not help the correct pronunciation of words. Thus, morphological awareness is not relevant for word decoding in Spanish but is related to reading comprehension since this type of morphological knowledge provides access to the semantic and syntactic information of new words.

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Several studies in Spanish and other languages have shown that, in a lexical decision task, children are more likely to accept pseudowords with a known morphological structure as words as compared to non-morphological pseudowords. Morphology also facilitates visual word recognition of actual words in children with reading difficulties. In the present study, we explored the role of morphology, frequency and reading proficiency (measured by school grade) in visual word recognition. Typically developing readers of Spanish from 2nd, 4th and 6th grades performed a lexical decision task in which the morphological complexity and the frequency of the words were factorially manipulated. Our results showed that morphology benefited the accuracy of visual word recognition for low frequency words only. We conclude that decomposition in morphemes occurs in Spanish only for less frequent words. These results in Spanish support models that posit the decomposition of morphologically complex words in the orthographic lexicon.

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BACKGROUND: The grammatical class effect in aphasia, i.e. dissociated processing of words according to their respective grammatical class, has been attributed to either grammatical, lexical or semantic (i.e., imageability) deficits. This study explores the hypotheses of impaired semantic treatment as the source of the grammatical class effect in aphasia. METHOD: A synonym judgement task that includes nouns and verbs of high and low imageability has been administered to 30 Spanish-speaking patients suffering from receptive or productive aphasia and 30 controls. RESULTS: Normal controls performed significantly better than aphasic patients. Although globally the productive aphasics performed significantly better than the receptive aphasics, grammatical class (nouns better than verbs) and imageability (high imageability better than low imageability) affected performance in both subgroups. No significant interaction emerged between these two factors. CONCLUSION: The results suggest that the grammatical class effect may emerge from semantic impairment and that it is -at least partially- independent of the imageability of words.

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The classification of aphasic patients' symptoms into a syndrome is a crucial procedure that favours and simplifies the communication among the clinicians involved in patient treatment and follow-up. Nevertheless, the aphasic population usually presents a very heterogeneous symptomatology; consequently, classical syndromes do not offer a good basis to plan their rehabilitation relying on their specific language impairments. Current rehabilitation strategies frequently require the identification of specific cognitive abilities affected. This is why it is common in clinical practice to assess aphasic patients with a syndromic protocol in order to classify them as well as a cognitive battery to plan their rehabilitation. The aim of the present article is to present a quick and reliable tool (i.e., a syndromic classification sheet) to help clinicians classify their clients' symptomatology in a syndrome by means of only one cognitive neuropsychological assessment. Two groups of speech therapists (5 experienced and 5 inexperienced) were asked to classify 5 aphasic patients from a syndromic classification sheet and their assessment protocols. Results indicate an acceptable inter-rater agreement for the experienced group but not for the inexperienced one. In conclusion, the classification sheet turned out to be a useful and reliable tool to classify aphasic patients in a given syndrome and by means of only some subtests from a cognitive assessment battery, provided that clinicians had some years of experience. In addition, this new instrument enables language clinicians to shorten the assessment of their aphasic clients.(AU)

Assuntos

RESUMO

The classification of aphasic patients' symptoms into a syndrome is a crucial procedure that favours and simplifies the communication among the clinicians involved in patient treatment and follow-up. Nevertheless, the aphasic population usually presents a very heterogeneous symptomatology; consequently, classical syndromes do not offer a good basis to plan their rehabilitation relying on their specific language impairments. Current rehabilitation strategies frequently require the identification of specific cognitive abilities affected. This is why it is common in clinical practice to assess aphasic patients with a syndromic protocol in order to classify them as well as a cognitive battery to plan their rehabilitation. The aim of the present article is to present a quick and reliable tool (i.e., a syndromic classification sheet) to help clinicians classify their clients' symptomatology in a syndrome by means of only one cognitive neuropsychological assessment. Two groups of speech therapists (5 experienced and 5 inexperienced) were asked to classify 5 aphasic patients from a syndromic classification sheet and their assessment protocols. Results indicate an acceptable inter-rater agreement for the experienced group but not for the inexperienced one. In conclusion, the classification sheet turned out to be a useful and reliable tool to classify aphasic patients in a given syndrome and by means of only some subtests from a cognitive assessment battery, provided that clinicians had some years of experience. In addition, this new instrument enables language clinicians to shorten the assessment of their aphasic clients.

Assuntos