Rapid syllable transition treatment (ReST) em crianças com atraso motor de fala: estudos de casos
Rapid syllable transition treatment (ReST) in children with speech motor delay: case studies
Ana Carolina Bucci; Camila Goulart; Aline Mara de Oliveira
Resumo
O Atraso Motor de Fala (AMF) caracteriza-se por dificuldade na execução motora, resultando em fala ininteligível, com alterações na precisão articulatória, estabilidade, voz e prosódia, além de dificuldades na dissociação dos articuladores e na presença de movimentos excessivos para a idade. O objetivo deste estudo foi descrever, por meio de quatro estudos de caso longitudinais, o desempenho de crianças brasileiras com AMF submetidas ao Rapid Syllable Transition Treatment (ReST), verificando aquisição, retenção e generalização. Participaram quatro crianças monolíngues, entre cinco e oito anos, diagnosticadas com AMF. A intervenção foi realizada por teleatendimento síncrono, duas vezes por semana, durante seis semanas. Foram aplicadas sondagens em diferentes momentos da terapia, envolvendo pseudopalavras treinadas e não treinadas, frases, palavras reais e itens de controle. Os resultados mostraram aumento progressivo da pontuação em todos os aspectos avaliados. Observou-se melhora significativa na acurácia dos fonemas, no acento lexical e na coarticulação, confirmando aquisição, retenção e generalização. Conclui-se que o ReST mostrou-se um método promissor para crianças com AMF, inclusive em formato de teleatendimento, configurando-se como alternativa terapêutica promissora fundamentada nos princípios da aprendizagem motora e em critérios linguísticos na seleção de estímulos.
Palavras-chave
Abstract
Speech Motor Delay (SMD) is characterized by difficulties in motor execution, resulting in unintelligible speech, with changes in articulatory precision, stability, voice, and prosody, as well as reduced articulatory dissociation and excessive movements for age. The objective of this study was to describe, through four longitudinal case studies, the performance of Brazilian children with SMD submitted to the Rapid Syllable Transition Treatment (ReST), verifying acquisition, retention, and generalization. Four monolingual children, aged five to eight years and diagnosed with SMD, participated. The intervention was conducted via synchronous telepractice, twice a week, over six weeks. Probes of trained and untrained pseudowords, sentences, real words, and control items were applied at different stages of therapy. The results showed progressive improvement in all evaluated aspects. Significant gains were observed in phoneme accuracy, lexical stress, and coarticulation, confirming acquisition, retention, and generalization. It is concluded that ReST is effective for children with SMD, including when applied through telepractice, representing a promising evidence-based therapeutic alternative grounded in motor learning principles and supported by linguistically controlled stimuli selection.
Keywords
Referências
- 1ASHA: American Speech-Language-Hearing Association. Speech sound disorders-articulation and phonology [Internet]. Rockville: American Speech-Language-Hearing Association; 2023 [citado em 2023 Out 24]. Disponível em: www.asha.org/Practice-Portal/Clinical-Topics/Articulation-and-Phonology/
» www.asha.org/Practice-Portal/Clinical-Topics/Articulation-and-Phonology/ - 2Shriberg LD, Fourakis M, Hall SD, Karlsson HB, Lohmeier HL, McSweeny JL, et al. Extensions to the Speech Disorders Classification System (SDCS). Clin Linguist Phon. 2010;24(10):795-824. https://doi.org/10.3109/02699206.2010.503006 PMid:20831378.
» https://doi.org/10.3109/02699206.2010.503006 - 3Shriberg LD, Kwiatkowski J, Mabie HL. Estimates of the prevalence of motor speech disorders in children with idiopathic speech delay. Clin Linguist Phon. 2019;33(8):679-706. https://doi.org/10.1080/02699206.2019.1595731 PMid:30987467.
» https://doi.org/10.1080/02699206.2019.1595731 - 4Shriberg LD, Strand EA, Jakielski KJ, Mabie HL. Estimates of the prevalence of speech and motor speech disorders in persons with complex neurodevelopmental disorders. Clin Linguist Phon. 2019;33(8):707-36. https://doi.org/10.1080/02699206.2019.1595732 PMid:31221012.
» https://doi.org/10.1080/02699206.2019.1595732 - 5Namasivayam AK, Pukonen M, Goshulak D, Yu VY, Kadis DS, Kroll R, et al. Relationship between speech motor control and speech intelligibility in children with speech sound disorders. J Commun Disord. 2013;46(3):264-80. https://doi.org/10.1016/j.jcomdis.2013.02.003 PMid:23628222.
» https://doi.org/10.1016/j.jcomdis.2013.02.003 - 6Namasivayam AK, Huynh A, Granata F, Law V, van Lieshout PV. PROMPT intervention for children with severe speech motor delay: a randomized control trial. Pediatr Res. 2021;89(3):613-21. https://doi.org/10.1038/s41390-020-0924-4 PMid:32357364.
» https://doi.org/10.1038/s41390-020-0924-4 - 7Maas E, Robin DA, Austermann Hula SN, Freedman SE, Wulf G, Ballard KJ, et al. Principles of motor learning in treatment of motor speech disorders. Am J Speech Lang Pathol. 2008;17(3):277-98. https://doi.org/10.1044/1058-0360(2008/025) PMid:18663111.
» https://doi.org/10.1044/1058-0360(2008/025) - 8Preston JL, Leece MC, Maas E. Intensive treatment with ultrasound visual feedback for speech sound errors in childhood apraxia. Front Hum Neurosci. 2016;10:440. https://doi.org/10.3389/fnhum.2016.00440 PMid:27625603.
» https://doi.org/10.3389/fnhum.2016.00440 - 9Murray E, McCabe P, Ballard KJ. A systematic review of treatment outcomes for children with childhood apraxia of speech. Am J Speech Lang Pathol. 2014;23(3):486-504. https://doi.org/10.1044/2014_AJSLP-13-0035 PMid:24686844.
» https://doi.org/10.1044/2014_AJSLP-13-0035 - 10Murray E, McCabe P, Ballard KJ. A randomized controlled trial for children with childhood apraxia of speech comparing rapid syllable transition treatment and the nuffield dyspraxia programme-Third edition. J Speech Lang Hear Res. 2015;58(3):669-86. https://doi.org/10.1044/2015_JSLHR-S-13-0179 PMid:25807891.
» https://doi.org/10.1044/2015_JSLHR-S-13-0179 - 11Bahar N, Namasivayam AK, Van Lieshout P. Telehealth intervention and childhood apraxia of speech: a scoping review. Speech Lang Hear. 2022;25(4):450-62. https://doi.org/10.1080/2050571X.2021.1947649
» https://doi.org/10.1080/2050571X.2021.1947649 - 12McCabe P, Thomas DC, Murray E. Rapid syllable transition treatment – A treatment for childhood apraxia of speech and other pediatric motor speech disorders. Perspect ASHA Spec Interest Groups. 2020;5(4):821-30. https://doi.org/10.1044/2020_PERSP-19-00165
» https://doi.org/10.1044/2020_PERSP-19-00165 - 13Bucci ACF. Efeito da Intensidade do tratamento ReST por meio de teleatendimento em crianças com Atraso Motor de Fala [dissertação]. Florianópolis (SC): Universidade Federal de Santa Catarina; 2023 [citado em 2023 Out 24]. Disponível em: https://repositorio.ufsc.br/handle/123456789/251690
» https://repositorio.ufsc.br/handle/123456789/251690 - 14Oliveira B, Oliveira AM. Tradução e adaptação cultural do manual de intervenção terapêutica Rapid Syllable Transition Treatment (ReST) para o português brasileiro. CoDAS. 2023;35(2):e20210257. PMid:36946860.
- 15REST: Rapid Syllable Transition Training. Componentes das sessões [Internet]. Florianópolis (SC): Universidade Federal de Santa Catarina; 2023 [citado em 2023 Nov 27]. Disponível em: https://rest.paginas.ufsc.br/
» https://rest.paginas.ufsc.br/ - 16Gubiani MB, Pagliarin KC, Keske-Soares M. Instrumentos para avaliação de apraxia de fala infantil. CoDAS. 2015;27(6):610-5. https://doi.org/10.1590/2317-1782/20152014152 PMid:26691627.
» https://doi.org/10.1590/2317-1782/20152014152 - 17Oliveira B, Oliveira AM. Manual clínico do método de Terapia Transição Rápida de Sílabas (Rapid Syllable Transition Treatment - ReST) [Internet]. Florianópolis (SC): Universidade Federal de Santa Catarina; 2023 [citado em 2023 Nov 10]. Disponível em: https://rest.paginas.ufsc.br/
» https://rest.paginas.ufsc.br/ - 18Bearzotti F, Tavano A, Fabbro F. Development of orofacial praxis of children from 4 to 8 years of age. Percept Mot Skills. 2007;104(3 Suppl):1355-66. https://doi.org/10.2466/pms.104.4.1355-1366 PMid:17879670.
» https://doi.org/10.2466/pms.104.4.1355-1366 - 19Yavas M, Hernandorena CLM, Lamprecht RR. Avaliação fonológica da Criança: reeducação e terapia. Porto Alegre: Art Med; 1991.
- 20Oliveira AM, Veschi GV, Polli L, Esperandino CE, Berti LC. Speech production measures in Brazilian Portuguese children with and without Speech Sound Disorder. In: Babatsouli E, editor. On under-reported monolingual child phonology. Bristol: Multilingual Matters; 2020. p. 380-400. https://doi.org/10.2307/jj.22730613.20
» https://doi.org/10.2307/jj.22730613.20 - 21Shriberg LD, Austin D, Lewis BA, McSweeny JL, Wilson DL. The percentage of consonants correct (PCC) metric: extensions and reliability data. J Speech Lang Hear Res. 1997;40(4):708-22. https://doi.org/10.1044/jslhr.4004.708 PMid:9263938.
» https://doi.org/10.1044/jslhr.4004.708
Submetido em:
02/10/2025
Aceito em:
21/02/2026


