Water-based communication intervention integrating SCERTS for young children with autism: an explanatory sequential mixed-methods pilot study Rita Alegria, Joana Rocha, Susan Nachimson, Jane Styer-Acevedo, Christina César Praça Brasil, Pedro Pestana, Vânia Peixoto International Journal of Developmental Disabilities, 2026 Objectives Communication challenges are a core feature of autism spectrum disorder (ASD), highlighting the necessity for interventions that effectively engage young children and facilitate functional gains. This pilot study aimed to examine patterns of change in intentional communication in young children with ASD participating in a structured, water-based communication intervention integrating the SCERTS model. Furthermore, it sought to explain these observed patterns through caregivers’ accounts of perceived changes, contextual factors, and mechanisms of progress.Methods An explanatory sequential mixed-methods design was employed. A group of ten children diagnosed with ASD (aged between three and five years) participated in a 12-month programme of individualized communication intervention, delivered in a water-based setting by certified speech-language pathologists. Quantitatively, intentional communicative acts were coded from video recordings sessions using the SCERTS chart at baseline, 6 months, and 12 months, focusing on frequency, symbolic complexity (presymbolic vs. symbolic means), and communicative functions. The analysis of the semi-structured caregiver interviews was conducted using thematic analysis, with the objective of providing a contextual interpretation of the quantitative trajectories.Results The mean number of intentional communicative acts increased over time (baseline 7.8; 12 months 24.8), with non-parametric testing indicating reliable change (Friedman χ2(2)=20.0, p < 0.001). A qualitative shift occurred in communicative means, from presymbolic forms (e.g. motor actions) to symbolic ones (e.g. sign language, word combinations). The communicative functions expanded from behavior regulation to include social interaction and joint attention. Thematic analysis revealed that the water-based environment was identified as a sensory regulator that facilitated engagement.Conclusions Across participants, intentional communicative acts demonstrated an increasing trajectory over time, accompanied by a shift from predominantly presymbolic communication toward symbolic forms and an expansion of communicative functions beyond behavior regulation. Caregiver themes converged with the quantitative trends, highlighting the water environment’s role in fostering engagement and emotional regulation, which in turn facilitated communication opportunities. Caregivers also reported perceived generalization of emerging communication skills to home and school contexts, attributing progress to the consistent application of SCERTS principles.
Assessment of patient perception in clinical practice in mechanical dysphagia Rita Alegria, Daniela Vieira Holistic Approaches to Health Recovery, 2025 Head and neck cancer treatment is closely associated with functional changes, such as dysphagia, which have a negative impact on quality of life. This study aims to compare the clinical assessment, intervention of the speech therapist and patient's perception. This chapter reports to a retrospective, quantitative, and descriptive study, based on a series of five participants, according to inclusion and exclusion criteria. Of the five cases included in this study, most were males aged between 50 and 65 years, and all had undergone radiotherapy. Most of them (60%) had oropharyngeal cancer and performed between 24 and 36 speech therapy sessions. A clinical evaluation of the swallow at initial and final moments was performed. Results show agreement between patient's perception, through SWAL-QOL-PT and FOIS results. This study shows the interception between patient perception and physiological findings; thus, we can increase the effectiveness of intervention results and therapeutic adherence, with real health gains.
Preface Holistic Approaches to Health Recovery, 2025
Complementary approaches for autism spectrum disorder intervention: A holistic view Vânia Peixoto, Inês Cadório, Rita Alegria, Pedro Pestana Holistic Approaches to Health Recovery, 2025 Autism Spectrum Disorder (ASD) is a neurodevelopmental condition marked by deficits in social interaction, communication, and repetitive behaviors or interests. The prevalence of ASD has risen in recent years, with an estimated one in 36 children in the US affected. This has led to increased research into effective interventions. Today, many individuals with ASD have better outcomes than in the past, with more becoming verbal, reading, and living in the community. This progress is due in part to improved knowledge and evidence-based treatments. Alongside traditional therapies, complementary therapies—used alongside conventional treatments—have gained attention. This chapter provides an overview of ASD's defining traits and explores innovative interventions, including water-based speech therapy, music therapy, and animal-assisted therapy. These approaches not only enhance speech, sensory integration, and social skills but also support relaxation and inclusion, empowering individuals with ASD to achieve their full potential and contributing to a more inclusive future.
Professionals’ reflections on the use of the Estimule Portal in the development of autistic children Christina César Praça Brasil, Francisca Francisete de Sousa Nunes Queiroz, Jonas Loiola Gonçalves, Fabiana Neiva Veloso Brasileiro, Tainá Christiane Mello, Vânia Peixoto, Rita Alegria, Juliana Carneiro Melo Ciencia E Saude Coletiva, 2025 Resumo O Portal Estimule é uma ferramenta tecnológica de a assistência à saúde da criança autistas, incorporando 97 atividades lúdicas com habilidades comunicativas, sociais e motoras. Objetivou-se conhecer as experiências de uso do Portal Estimule sob a perspectiva dos profissionais de saúde que acompanham crianças autistas em serviços ambulatoriais públicos e privados, em uma capital do Nordeste brasileiro. Pesquisa metodológica, com abordagem qualitativa. O Portal foi utilizado por 32 profissionais de saúde, que preencheram um instrumento sobre o perfil socioeconômico e o uso da tecnologia. A análise fundamentou-se na Semiótica. Reflete-se experiências positivas e relevantes, evidenciando o incremento da tecnologia como recurso coadjuvante para as práticas profissionais face o desenvolvimento infantil. Traz também aspectos negativos e necessidades de melhoria. O Portal Estimule emerge como uma ferramenta na assistência à saúde de crianças autistas, desde que conduzida por profissionais de saúde capacitados. Sua implementação pode fomentar a colaboração entre equipes multiprofissionais de saúde, promovendo um acompanhamento especializado.
Mothers’ perceptions on interaction-communication with their preterm babies in Neonatal Intensive Care Units Moisés Andrade dos Santos de Queiroz, Christina César Praça Brasil, Joana Angélica Marques Pinheiro, Andrea Cintia Laurindo Porto, Waléria Tomaz Pacífico, Raimunda Magalhães da Silva, Pedro Melo Pestana, Rita Feio da Gama Alegria Ciencia E Saude Coletiva, 2025 The present study aimed to investigate mothers’ perceptions of interaction and communication with their premature babies in Neonatal Intensive Care Units. A descriptive, cross-sectional, qualitative, and quantitative study was conducted at the Integrated Medical Care Center in the city of Fortaleza, from January to December 2022, with 30 mothers of premature babies. Sociodemographic and baby health questionnaires were applied, along with a semi-structured interview. Thematic contente analysis, supported by theories on language development care, was adopted. Mothers’ perceptions of interaction and communication were associated with uncertainties related to the baby’s developmental difficulties, influenced by hospital settings and healthcare professionals. It was concluded that mothers’ knowledge level about the language development of their premature babies is vague, making them passive spectators of their babies’ care, generating negative emotions.
EHealth technologies in parental care for preterm infants: an integrative review Moisés Andrade dos Santos de Queiroz, Christina César Praça Brasil, Cláudia Belém Moura Cabral, Andrea Cintia Laurindo Porto, Priscilla Mayara Estrela Barbosa, Rachel Cassiano de Sousa, Rita Feio da Gama Alegria, Vânia Peixoto Ciencia E Saude Coletiva, 2024 The eHealth technologies promote parental care practices for preterm infants. Nonetheless, we should underscore the abundant information and available apps and disparities in these resources’ quality, usability, and reliability. This article examines eHealth technologies directed at parents to care for preterm infants. An integrative review was conducted across the principal health databases (Capes, EBSCO, BVS, PubMed, Scholar, and SciELO), selecting works published from 2011 to 2022 in Portuguese and English, focusing on the use of eHealth technologies for the care of preterm infants. We identified 13 articles related to information and communication technologies in strategies for educating and promoting the health of preterm infants and their parents and the importance of evaluating and validating eHealth technologies in maternal and child health promotion. Properly validated eHealth technologies can be crucial in supporting parents in promoting health and providing care for preterm infants after hospital discharge, which, in turn, can drive the evolution of healthcare systems and improve clinical practices.
Early literacy intervention program: Closing the linguistic gap of socially disadvantaged children Vânia Peixoto, Rita Alegria, Pedro Pestana Closing the Educational Achievement Gap for Students with Learning Disabilities, 2023 A child's early literacy experiences have a long-term impact on reading and writing ability and academic success. Children with more and diverse literacy experiences are at a clear advantage to do better in school. Given that socioeconomic adversity is negatively correlated with children's language development, rich literacy experiences become even more relevant in this population. Children who enter primary school with fewer emergent literacy skills often continue to struggle to achieve academic success and are more likely to be unemployed as adults, hence the need to act from a prevention perspective by universally promoting these skills in preschool children is fundamental. The authors present as an intervention proposal, an emergent literacy program especially targeted to socially disadvantaged pre-school age children. In this program, mediated through storytelling, several emergent literacy skills will be worked on, namely vocabulary, conventions about print, narrative structure, phonological awareness, the child's concept as a reader, and motivation for writing.
