Voice Disorders Research and Treatment in Brazil Despite the variety of academic training programs in communication disorders worldwide and the various programs and philosophical orientations that exist, improving communication is the ultimate goal of any professional in the field. Although university programs for speech-language pathology and audiology in Brazil (“Fonoaudiologia”-one profession) started in the early 1960s, the ... World Beat
Free
World Beat  |   May 01, 2006
Voice Disorders Research and Treatment in Brazil
Author Notes
  • Mara Behlau, is a voice specialist and the coordinator of the “Centro de Estudos da Voz-CEV” (Center for Voice Studies), São Paulo, Brazil. She is an advisor to the Graduate Program in Communication Disorders at “Universidade Federal de São Paulo” (Federal University of São Paulo), and is currently IALP president-elect. Contact her at mbehlau@uol.com.br.
    Mara Behlau, is a voice specialist and the coordinator of the “Centro de Estudos da Voz-CEV” (Center for Voice Studies), São Paulo, Brazil. She is an advisor to the Graduate Program in Communication Disorders at “Universidade Federal de São Paulo” (Federal University of São Paulo), and is currently IALP president-elect. Contact her at mbehlau@uol.com.br.×
  • Gisele Gasparini, is a voice specialist and the vice-coordinator of the “Centro de Estudos da Voz-CEV” (Center for Voice Studies), São Paulo, Brazil. She earned her M. S. in communication disorders at “Universidade Federal de São Paulo” (Federal University of São Paulo) and is currently a doctoral student. Contact her at giselegasparini@uol.com.br.
    Gisele Gasparini, is a voice specialist and the vice-coordinator of the “Centro de Estudos da Voz-CEV” (Center for Voice Studies), São Paulo, Brazil. She earned her M. S. in communication disorders at “Universidade Federal de São Paulo” (Federal University of São Paulo) and is currently a doctoral student. Contact her at giselegasparini@uol.com.br.×
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / International & Global / World Beat
World Beat   |   May 01, 2006
Voice Disorders Research and Treatment in Brazil
The ASHA Leader, May 2006, Vol. 11, 6-8. doi:10.1044/leader.WB3.11062006.6
The ASHA Leader, May 2006, Vol. 11, 6-8. doi:10.1044/leader.WB3.11062006.6
Despite the variety of academic training programs in communication disorders worldwide and the various programs and philosophical orientations that exist, improving communication is the ultimate goal of any professional in the field. Although university programs for speech-language pathology and audiology in Brazil (“Fonoaudiologia”-one profession) started in the early 1960s, the profession was not officially recognized until 1981.
The profession, however, has grown in the ensuing 25 years; Brazil currently has 28,000 SLPs, of whom 2,700 are specialists, 800 hold master’s degrees, and 210 hold PhDs. The area of voice is very active: Brazil now has 11 specialization courses and 515 certified specialists.
In Brazil, approximately 100 undergraduate programs in communication disorders sciences, including audiology, and 74 specialization areas have been established. Master’s and doctorate degrees, however, are offered by only eight programs. Five areas of specialty are officially recognized: language, audiology, voice, orofacial myology, and public health.
Earning specialization and master’s and doctoral degrees is the ultimate dream of all communication disorders students in Brazil; however, opportunities are few and scholarships are practically nonexistent. Some Brazilians have taken the difficult step of obtaining a degree abroad, in more advanced centers, such as the U.S., Canada, and Sweden. These individuals have created an enormous impact in Brazilian work because of their international experience.
Research
Brazilian research accounts for 1% of the voice research published worldwide. From 1997 to 2000, a total of 34,274 papers were published in journals indexed by the Institute for Scientific Information. The majority of these publications (93%) originated from governmental institutions.
Since 1996 government funding has decreased by more than 70%, but competition among scientists and the urge to publish has increased (Meis et al., 2003). The publication of Brazilian papers in international journals, however, is hard to achieve due to language difficulties and differences in writing style for scientific purposes, which require longer paragraphs, more detailed and descriptive information, a longer review of the literature, and different technical terms.
The Brazilian association for SLPs and audiologists (Sociedade Brasileira de Fonoaudiologia-SBFa) organizes national congresses. In each of the last two national events, approximately 1,000 papers were presented, with 210 related to voice research presented in 2005; there were 64% on evaluation, 24% on treatment, 11% on prevention, and 6% exploring a philosophical aspect of the area.
Treatment
Individuals who use their voices professionally, such as teachers, are a focus of interest, and that area is frequently investigated. Brazilian pop-music singers also have received special attention because of the importance and worldwide recognition of Brazilian music.
Voice specialists in Brazil work with both pathological and normal voices, but the development of scientific approaches to improve normal communication is a novelty and has its main application in TV and radio; an estimated 100 SLPs have been hired for this specific service. Recently corporate speech-language pathology has become important in contexts as diverse as telemarketing, media training, job interviewing, and communication for teamwork effectiveness.
With the advent of low-cost software in recent decades, the use of acoustical analysis for clinical purposes has dramatically changed routine evaluation. Some of this software is already produced in Brazil (CTS Informática), or freeware available on the Internet (GRAM and PRAAT).
Voice treatment in Brazil started with a humanistic and dialectic vision that gradually changed to a more behavioral and direct approach, moving in the last two decades to a global view of an individual’s voice problem, without excluding the emotional and technical perspectives.
In 1995 Behlau and Pontes presented a global and eclectic treatment method for dysphonia rehabilitation. An approach of this nature not only synthesizes the different phonatory apparatus subsystems, but also combines them with awareness of the individual’s biological, psychological, and emotional dimensions, integrating the individuals with their communication relationships with the world. The method bases its procedures on understanding the dysphonia as a communication disorder.
Recently Behlau (2005) presented seven general categories of approaches for voice rehabilitation: Body Method, Speech Organs Method, Auditory Method, Speech Method, Facilitating Sounds Method, Phonatory Competence Method, and Voice Activation Method. All categories are not completely described; this was an initial attempt to organize various types of exercises, techniques, and interventions available in the literature.
The need for evidence-based practice and clinical trials research is becoming urgent for the survival of the profession and for purposes of reimbursement, which is outrageously low and limited in Brazil. A major difference between the young American and Brazilian clinician is that immediately after the four-year undergraduate program, the Brazilian SLP faces clinical challenges in treating all communication disorders, which is a heavy and nearly impossible responsibility.
Despite all the economic, geographical, and linguistic constraints, our contributions have been well received at important international scientific congresses such as the ASHA Convention, The Voice Foundation Symposium, The Pacific Voice and Speech Conference, and the International Association for Logopedics and Phoniatrics (IALP) Congresses. The impact of Brazilian work in the communication disorders world has been tremendous. As a single example, World Voice Day, April 16, was a Brazilian initiative to call the attention of the media and policy makers to the voice patient.
A long and hard path is still ahead for Brazilian researchers and clinicians. Major goals are the better understanding of the physiology of vocal exercises (dosage, duration, frequency, intensity, and maintenance); vocal rehabilitation limits; the difference between short-term and long-term treatment outcomes; the influence of complaint duration and degree of dysphonia on treatment result; and the role of personality on idiosyncratic dysphonia.
References
Behlau, M. (Ed). (2005). Voz. O livro do especialista. Vol. I and II. Rio de Janeiro: Revinter.
Behlau, M. (Ed). (2005). Voz. O livro do especialista. Vol. I and II. Rio de Janeiro: Revinter.×
Behlau, M., & Pontes, P. (1995). Avaliação e tratamento das disfonias. São Paulo, Brazil: Lovise.
Behlau, M., & Pontes, P. (1995). Avaliação e tratamento das disfonias. São Paulo, Brazil: Lovise.×
Cheng, L-R. L. (Ed). (2006). Planting seeds for the future: An examination of education of speech-language pathology. Folia Phoniatrica Logopedica, 58(1), 5–63. [Article]
Cheng, L-R. L. (Ed). (2006). Planting seeds for the future: An examination of education of speech-language pathology. Folia Phoniatrica Logopedica, 58(1), 5–63. [Article] ×
Instituto Brasileiro de Geografia e Estatística (IBGE; database on the Internet). Brasil. (Retrieved Feb. 28, 2006; http://www.ibge.gov.br/censo).
Instituto Brasileiro de Geografia e Estatística (IBGE; database on the Internet). Brasil. (Retrieved Feb. 28, 2006; http://www.ibge.gov.br/censo).×
Meis, L. de, Velloso, A., Lannes, D., Carmo, M. S., & Meis, C. de. (2003). The growing competition in Brazilian science: Rites of passage, stress and burnout. Brazilian Journal of Medical Biology, 36, 1135–1141. [Article]
Meis, L. de, Velloso, A., Lannes, D., Carmo, M. S., & Meis, C. de. (2003). The growing competition in Brazilian science: Rites of passage, stress and burnout. Brazilian Journal of Medical Biology, 36, 1135–1141. [Article] ×
Sistema Integrado de Administração Financeira do Governo Federal (SIAF; database on the Internet). Brasil, Ministério da Fazenda (Retrieved Feb. 28, 2006; http://www.stn.fazenda.gov.br/siafi).
Sistema Integrado de Administração Financeira do Governo Federal (SIAF; database on the Internet). Brasil, Ministério da Fazenda (Retrieved Feb. 28, 2006; http://www.stn.fazenda.gov.br/siafi).×
0 Comments
Submit a Comment
Submit A Comment
Name
Comment Title
Comment


This feature is available to Subscribers Only
Sign In or Create an Account ×
FROM THIS ISSUE
May 2006
Volume 11, Issue 6