Effect of Tinnitus on Sleep Quality and Insomnia

Abstract Introduction Tinnitus is a conscious perception of a sound resulting from abnormal activity within the nervous system. A relevant percentage of tinnitus patients report symptoms severe enough to significantly affect quality of life, including sleep disorders. Objectives To analyze the sleep quality, insomnia, daytime sleepiness, and risk of obstructive sleep apnea (OSA) in participants with tinnitus. Methods The sample comprised 18 adults and older adults aged between 18 and 85 years old (mean age = 58.7 ± 17.5 years old), females and males, with complaint of continuous tinnitus for > 1 month. The instruments used were the Tinnitus Handicap Inventory (THI) questionnaire, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the STOP-Bang questionnaire. Results By means of the THI questionnaire, the tinnitus severity degree reported by most participants was mild (27.8%) and moderate (27.8%), having a positive (r = 0.582) and significant (0.011) correlation to sleep quality, measured by means of the Pittsburgh questionnaire. There was a positive correlation between the Insomnia Severity Index and tinnitus handicap (r = 0.499; p = 0.035). A total of 72.2% of the participants self-assessed their sleep quality as poor, in addition to moderate insomnia (27.8%), although there is low risk of OSA (66.7%), without complaints of excessive daytime sleepiness (72.2%). Conclusion Subjects with tinnitus complaint self-rated their sleep quality as poor. Moreover, the higher the reported tinnitus handicap, the greater the symptoms of insomnia. There was no influence of tinnitus in relation to daytime sleepiness and no relationship between the severity of tinnitus and the risk of OSA.

Difficulties of normally-hearing adults in daily listening situations / Dificuldades de adultos ouvintes em situações cotidianas de escuta

ABSTRACT Purpose: to verify hearing difficulties related to everyday listening situations self-reported by normally-hearing adults. Methods: a cross-sectional observational study in which adult individuals with clinically normal hearing, verified through audiometry and tympanometry, were included. The participants answered the Brazilian Portuguese version of the Speech, Spatial and Qualities of Hearing Scale (SSQ) questionnaire. Statistical analysis comprised descriptive and Spearman's correlation test with a significance level of 5%. Results: the sample consisted of 28 participants, aged between 20 and 44 years. The median SSQ score was 8.75, in the Hearing to Speech domain, 8.11, in the Spatial Hearing domain, and 8.91, in the Quality-of-Hearing domain. There was an association between the participant's age and the score on five questions, demonstrating less self-reported difficulty as age increased. Conclusion: difficulties in everyday listening situations, self-reported by normally-hearing adults, participating in this study, were more related to situations with competitive noise and listening effort.

RESUMO Objetivo: verificar as dificuldades auditivas relacionadas a situações cotidianas de escuta autorrelatadas por adultos normo-ouvintes. Métodos: trata-se de um estudo observacional transversal. Foram incluídos indivíduos adultos com limiares auditivos normais, verificados por meio de audiometria e timpanometria. Os participantes responderam à versão no português brasileiro do questionário Speech, Spatial and Qualities of Hearing Scale (SSQ). Os resultados foram analisados descritiva e estatisticamente. A análise estatística compreendeu teste descritivo e de correlação de Spearman com nível de significância de 5%. Resultados: a amostra foi composta por 28 participantes, com idades entre 20 e 44 anos. A mediana da pontuação no SSQ foi de 8,75 pontos no domínio Audição para a Fala; 8,11 no domínio Audição Espacial e 8,91 pontos no domínio Qualidade da Audição. Observou-se associação entre a idade do participante e a pontuação em cinco questões, demonstrando menor dificuldade autorrelatada conforme o aumento da idade. Conclusão: as dificuldades em situações cotidianas de escuta autorrelatadas pelos adultos normo-ouvintes participantes desse estudo foram mais relacionadas a situações com ruído competitivo e esforço de escuta.

How the speech-language pathologist interacts with cystic fibrosis patients? a scoping review / Qual a relação da fonoaudiologia com a fibrose cística? uma revisão de escopo / ¿Cuál es la relación entre la logopedia y la fibrosis quís- tica? una revisión del alcance

Objective: The review describes the changes related to sleep-breathing disorders, com- munication and feeding processes in subjects with CF, through a scoping review. Meth- ods: A scoping review based on the PRISMA protocol was carried out in Pubmed, Lilacs and Scopus databases, to investigate the possibility of including SLP in the treatment of patients with CF. The inclusion criteria included studies that addressed communication and eating processes and disorders related to CF. Studies with a sample that presented other comorbidities that would justify the worsening of the condition, or secondary stud- ies, were excluded. There was no time or language delimitation. Results: The search found 1566 works, 27 Lilacs, 1009 Pubmed and 530 Scopus, by analysis of titles, abstract and reading in full. A total of 30 articles were selected for inclusion, 2 Lilacs, 22 Pubmed and 6 Scopus, all related to Speech-Language Pathology. Conclusion: It was observed that there is a poor sleep quality due to nocturnal desaturation, mild and moderate obstructive apnea. In studies related to hearing, individuals had sensorineural hearing loss. Speech-Language Pathology is of paramount importance in monitoring these sub- jects.

Objetivo: Descrever alterações relacionadas aos processos de distúrbios respiratórios do sono, comunicação e alimentação em sujeitos com FC, por meio de uma scoping review. Métodos: Foi realizada uma scoping review nas bases de dados Pubmed, Lilacs e Scopus, para investigar a possibilidade de incluir o fonoaudiólogo no tratamento de pacientes com FC, utilizando o checklist PRISMA. Os critérios de inclusão incluíram estudos que abor- dassem processos de comunicação e alimentação e distúrbios relacionados à FC. Foram excluídos estudos com amostra que apresentasse outras comorbidades que justificassem o agravamento do quadro, ou estudos secundários. Não houve delimitação de tempo ou idioma. Resultados: A busca encontrou 1566 trabalhos, sendo 27 Lilacs, 1009 Pubmed e 530 Scopus, por meio de análise de títulos, resumo e leitura na íntegra. Foram seleciona- dos para inclusão 30 artigos, sendo 2 Lilacs, 22 Pubmed e 6 Scopus, todos relacionados à Fonoaudiologia. Conclusão: Observou-se que há má qualidade do sono devido à dessa- turação noturna, apneia obstrutiva leve e moderada. Em estudos relacionados à audição, os indivíduos apresentaram perda auditiva neurossensorial. A Fonoaudiologia é de suma importância no acompanhamento desses sujeitos.

Objetivo: Describir las alteraciones relacionadas con los procesos de trastornos respira- torios del sueño, comunicación y alimentación en sujetos con FQ, a través de una revisión de alcance. Métodos: Se realizó una revisión de alcance en las bases de datos Pubmed, Lilacs y Scopus, para investigar la posibilidad de incluir al logopeda en el tratamiento de pacientes con FQ, utilizando la lista de verificación PRISMA. Los criterios de inclusión incluyeron estudios que abordaran los procesos de comunicación y alimentación y los trastornos relacionados con la FQ. Se excluyeron los estudios con una muestra que pre- sentaba otras comorbilidades que justificasen el empeoramiento del cuadro, o estudios secundarios. No había delimitación de tiempo ni de idioma. Resultados: La búsqueda en- contró 1566 trabajos, de los cuales 27 fueron Lilacs, 1009 Pubmed y 530 Scopus, me- diante análisis de títulos, resúmenes y lectura completa. Se seleccionaron 30 artículos para inclusión, 2 Lilacs, 22 Pubmed y 6 Scopus, todos relacionados con Logopedia. Con- clusión: Se observó que existe mala calidad del sueño por desaturación nocturna, apnea obstructiva leve y moderada. En estudios relacionados con la audición, los individuos tenían pérdida auditiva neurosensorial. La logopedia es de suma importancia en el segui- miento de estos sujetos.

Could speech disorders in children with cleft lip and palate be justified by impaired central auditory skills?

ABSTRACT Purpose: to verify the association between central auditory skills and speech disorders related to velopharyngeal dysfunction. Methods: forty-five children, with repaired non-syndromic cleft lip and palate or cleft lip only, aged 7-11 years old, were divided into three groups: G1 (n=15), children with hypernasality, nasal air emission, and compensatory articulations; G2 (n=15), children with hypernasality and nasal air emission, but without compensatory articulations; and G3 (n=15), children without hypernasality, nasal air emission, and compensatory articulations. The medical records of all participants were analyzed to verify the eligibility criteria and obtain speech assessments, and then, they were submitted to an assessment of central auditory skills. Statistical analysis comprised descriptive and chi-square test with a significance level of 5%. Results: G1 presented a higher occurrence of impairment in central auditory skills differing from the other groups, particularly in the temporal ordering and binaural integration skills. A significant difference was observed among groups in temporal ordering ability. No significant association was found between the use of specific types of compensatory articulations and impaired auditory skills. Conclusion: there was an association between changes in temporal ordering auditory skills and binaural integration in children with velopharyngeal dysfunction, regardless of the presence or type of compensatory articulation found.

Salivary Cortisol and Sustained Auditory Attention in Children with and without Cleft Lip and Palate

Abstract Introduction Cortisol is a hormone involved in the response to stress. Attention is a function that can change due to exposure to stress. Objectives To verify the correlation between the level of salivary cortisol and sustained auditory attention in children with cleft lip and palate, as well as to compare the results of the variables analyzed between female and male patients. Methods In total, 103 children aged 6 to 11 years, were divided into 2 groups: those with cleft lip and palate (experimental group, EG; n = 69) and the control group (CG; n = 34). The Sustained Auditory Attention Ability Test (SAAAT) and salivary cortisol levels, measured by an enzyme immunoassay kit (Salimetrics, Stage College, PA, US), were calculated and compared regarding the two groups. The statistical tests used were the Mann-Whitney test and the Spearman correlation. Results The median level of salivary cortisol was of 0.03615 μl/dL and 0.18000 μl/dL respectively for the EG and CG, with a significant difference between the groups (p =0.000). Absence of statistical significance (total error score = 0.656; vigilance decrement = 0.051) was observed the for SAAAT among the EG (median total error score = 12.00; 25th percentile [25%] = 7.00; 75th percentile [75%] = 21.00; and vigilance decrement = 1.00; 25% = 0.00; 75% = 2.50) and the CG (median total error score = 12.00; 25% = 6.00; 75% = 24.00; and vigilance decrement = 0.00; 25% = -1.00; 75% = 2.00). Conclusion All children had median levels of salivary cortisol and scores for sustained auditory attention within normal parameters. A significant correlation between the level of salivary cortisol and the ability to sustain auditory attention was observed in children without cleft lip and palate. There were no differences regarding the SAAAT and salivary cortisol between female and male patients.

Preliminary Study of the Applicability of Software in the Investigation of Sustained Auditory Attention

Abstract Introduction The use of auditory behavioral tests, which specifically assess sustained attention, is necessary, due to its relationship with learning, language production, cognitive development and school performance. Objective To evaluate how children performed using software developed to investigate the ability of sustained auditory attention, and to compare the scores obtained in this format with those of the original, non-computerized test. Methods This cross-sectional study included 52 children of both genders, aged 6 to 11 years, with normal hearing and no history of complaints regarding inattention and/or hyperactivity. The computerized test was administered to all 52 children. The total error score (inattention and impulsivity) and the vigilance decrement were used to define the children's performance when using the software. The scores obtained in the two formats (computer software and original on compact disc) were then compared. Results Statistically significant differences were found in the scores for innattention, impulsivity, and total error score (inattention and impulsivity) when comparing genders, and a negative correlation coefficient was found when comparing ages. Increased scores were found for all variables of the sustained auditory attention ability test (SAAAT) compared with the original format. Conclusion Females performed worse than males in all aspects except for vigilance decrement when using the SAAATsoftware developed to evaluate the ability of SAAAT vigilance; younger children made more errors when using the SAAAT software; inattention errors were more frequent than impulsivity. Overall, higher values were obtained using the SAAAT software, when compared with the original version.

Percepção auditiva e desenvolvimento de linguagem oral após cirurgia de implante auditivo de tronco encefálico: uma revisão de escopo / Auditory perception and oral language in brainstem auditory implant users: a scoping review

RESUMO Objetivo mapear as evidências atuais em relação à percepção auditiva da fala e desenvolvimento de linguagem oral em usuários de implante auditivo de tronco encefálico (auditory brainstem implant - ABI), para responder à seguinte questão norteadora: "O que se sabe sobre a habilidade de percepção auditiva da fala e de linguagem oral em indivíduos usuários de implante auditivo de tronco encefálico?" Estratégia de pesquisa a busca foi realizada nas bases de dados BVSalud, PubMed e SciELO e, para literatura cinzenta, utilizou-se a fonte de informação Google Acadêmico, por meio dos descritores: implante auditivo de tronco encefálico (auditory brainstem implantation), linguagem (language), audição (hearing) e percepção auditiva (auditory perception). Critérios de seleção foram incluídos estudos nos quais foram aplicados testes para avalição da percepção auditiva ou para verificar desenvolvimento de linguagem oral em crianças e/ou adultos usuários de ABI. Foram incluídos artigos publicados nos últimos cinco anos e excluídos estudos secundários. Resultados Foram encontrados 1767 artigos nas bases de dados e fonte de informação, dos quais, 27 foram incluídos na revisão. Observou-se que a maioria dos usuários de ABI torna-se capaz de perceber alguns sons ambientais, alguns tornam-se capazes de reconhecer vocábulos, porém, poucos atingem o reconhecimento de frases. Conclusão a maioria dos usuários de ABI não avança para a habilidade de reconhecimento auditivo em conjunto aberto e há unanimidade na recomendação de métodos de comunicação visual para esses indivíduos.

ABSTRACT Purpose This scope review aims to map current evidence in relation to auditory perception of speech and oral language development in users of Auditory Brainstem Implant - ABI, to answer the following guiding question: "what do we know about the ability of auditory perception of speech and oral language in auditory brainstem implants users?" Research strategy The search was performed in the BVSalud, PubMed and SciELO databases and for gray literature the source of information Google Academic, using the descriptors: auditory brainstem implantation , language, hearing and auditory perception. Selection criteria Studies were included in which tests were applied to assess auditory perception or to verify oral language development in children and/or adults using ABI. Articles published in the last five years were included and secondary studies were excluded. Results 1767 articles were found in the databases and source of information, of which 27 studies were included. It was observed that most users of ABI become able to perceive some environmental sounds, some become able to recognize words, but few reach the recognition of sentences. Conclusion Most ABI users do not advance towards the open set auditory recognition skill and there is unanimity in recommending visual communication methods for these individuals.

Adult Perfomance on the Sustained Auditory Attention Skill Test

Abstract Introduction The Sustained Auditory Attention Ability Test (SAAAT) is an instrument used to assess sustained auditory attention in children. Difficulties related to this ability are not unique to children alone, as adults have been observed to present with the same deficits. Therefore, there is a need to adapt instruments like the SAAAT and provide reference values for adults. Objective To assess adult performance on the SAAAT. Methods Approved by the Human Research Ethics Committee under n° 034/2011. The sample consisted of 30 participants aged between 18 and 30 years old (average age = 24.2 years old), female and male. The inclusion criteria were: peripheral hearing within normal limits, type A tympanometric curve, and no attention-related complaints. The participants were submitted to Tonal Audiometry, Logoaudiometry, Immitanciometry and to the SAAAT. Results The following mean values and standard deviations (SD) were observed: inattention = 1.7 (SD = 2.2) and impulsivity = 0.8 (SD = 0.9) error types. For the SAAAT, the mean value for the total error score was 2.4 (SD = 2.6), and for the decrease in vigilance, it was 0.3 (SD = 0.5). When comparing the performance of adults and children, a statistically significant difference was observed for inattention (p = 0.000) and impulsivity (p = 0.001) error types, as well as in the total error score (p = 0.000) and in decreased vigilance (p = 0.0003). Conclusion The performance of adults in the SAAAT differed from the children's parameters, since adults showed lower scores in all variables of the instrument.

The Use of Exergames in the Neurorehabilitation of People with Parkinson Disease: The Impact on Daily Life

Abstract Introduction Parkinson disease (PD) is a progressive degeneration characterized by motor disorders, such as tremor, bradykinesia, stiffness and postural instability. Objective To evaluate the independence, confidence and balance in the development of daily activities in patients with PD before and after rehabilitation. Methods A descriptive, retrospective cross-sectional study was carried out with 16 patients (mean 57.6 ± 18.7 years), submitted to anamnesis, otolaryngological evaluation and vestibular assessment. The Vestibular Disorders Activities of Daily Living (VADL) and the Activities-Specific Balance Confidence (ABC) scales were applied before and after rehabilitation with virtual reality. Results a) The instrumental subscale of the questionnaire showed statistically significant result (p = 0.022; 95 % CI 1.21; 2.21) between the first and second assessments; b) The correlation between the questionnaires showed statistically significant result in the ambulation subscale (p = 0.011; 95 % CI -0.85; -0.17) first and (p = 0.002, 95 % CI -0.88; -0.31) second assessments, and the functional subscale was only verified in the second assessment (p = 0.011, 95 % CI -0.85; -0.17); and c) The patients presented clinical improvement in the final assessment after rehabilitation with significant result for the tightrope walk (p = 0.034, 95 % CI -12.5; -0.3) and ski slalom games (p = 0.005, 95 % CI -34.8; -6.6). Conclusions Our results showed that the VADL and ABC questionnaires, applied before and after rehabilitation, were important tools to measure the independence, confidence and balance while developing daily activities. The VADL and ABC questionnaires may effectively contribute to quantify the effect of the applied therapeutics and, consequently, its impact on the quality of life of patients with PD.

Pure-Tone Hearing Thresholds and Brainstem Auditory Evoked Potentials in Sporadic Ataxia

Abstract Introduction Spinocerebellar ataxia (SCA) is part of a genetic and clinical heteroge- neous group of neurodegenerative diseases characterized by progressive cerebellar ataxia. Objective To describe the results of audiological and electrophysiological hearing evaluations in patients with sporadic ataxia (SA). Methods A retrospective cross-sectional study was carried out with 11 patients submitted to the following procedures: anamnesis, otorhinolaryngological evaluation, tonal and vocal audiometry, acoustic immittance and brainstem auditory evoked potential (BAEP) tests. Results The patients presented with a prevalence of gait imbalance, of dysarthria, and of dysphagia; in the audiometric and BAEPs, four patients presented with alterations; in the acoustic immittance test, five patients presented with alterations, predominantly bilateral. Conclusion The most evident alterations in the audiological evaluation were the prevalence of the descending audiometric configuration between the frequencies of 2 and 4 kHz and the absence of the acoustic reflex between the frequencies of 3 and 4 kHz bilaterally. In the electrophysiological evaluation, the patients presented changes with a prevalence of increased I, III and V wave latencies and the interval in the interpeak I-III, I-V and III-V. In the present study, it was observed that auditory complaints did not have a significant prevalence in this type of ataxia, which does not occur in some types of autosomal recessive and dominant ataxia.

Elaboration of an instrument to evaluate the recognition of Brazilian melodies in children / Criação de um instrumento para avaliar o reconhecimento de melodias brasileiras em crianças

Abstract Introduction: There is evidence pointing to the importance of the evaluation of musical perception through objective and subjective instruments. In Brazil, there is a shortage of instruments that evaluates musical perception. Objective: To develop an instrument to evaluate the recognition of traditional Brazilian melodies and investigate the performance of children with typical hearing. Methods: The study was carried out after approval of the research ethics committee (1.198.607). The instrument was developed in software format with website access, using the languages PHP 5.5.12, Javascript, Cascade style sheets and "HTML5"; database "MYSQL 5.6.17" on the "Apache 2.4.9" server. Fifteen melodies of Brazilian folk songs were recorded in piano synthesized timbre, with 12 seconds per melody reproduction and four second intervals between them. A total of 155 schooled children, aged eight to 11 years, of both sexes, with typical hearing participated in the study. The test was performed in a silent room with sound stimuli amplified by a sound box at 65 dBNA, positioned at 0 azimuth, and at one meter from the participant, the notebook was used for children to play with on the screen on the title and illustration of the melody they recognized they were listening to. The responses were recorded on their own database. Results: The instrument titled "Evaluation of recognition of traditional melodies in children" can be run on various devices (computers, notebooks, tablets, mobile phones) and operating systems (Windows, Macintosh, Android, Linux). Access: http://192.185.216.17/ivan/home/login.php by login and password. The most easily recognized melody was "Cai, cai balão" (89%) and the least recognized was "Capelinha de melão" (25.2%). The average time to perform the test was 3′15″. Conclusion: The development and application of the software proved effective for the studied population. This instrument may contribute to the improvement of protocols for the evaluation of musical perception in children with hearing aid and/or cochlear implants users.

Resumo Introdução: Há evidências que apontam para a importância da avaliação da percepção musical através de instrumentos objetivos e subjetivos. No Brasil, há escassez de instrumentos que avaliem a percepção musical. Objetivo: Desenvolver um instrumento para avaliar o reconhecimento de melodias tradicionais brasileiras e investigar o desempenho de crianças com audição típica. Método: O estudo foi desenvolvido após aprovação do comitê de ética em pesquisa (1.198.607). O instrumento foi desenvolvido em formato de software com acesso ao site, com as linguagens de programação PHP 5.5.12, Javascript, Cascade Style Sheets e HTML5; banco de dados MYSQL 5.6.17 no servidor Apache 2.4.9. Quinze melodias de canções folclóricas brasileiras foram gravadas com timbre sintetizado em piano, com 12 segundos de reprodução da melodia e quatro segundos de intervalo entre elas. Participaram do estudo 155 crianças, alfabetizadas, entre oito e 11 anos, de ambos os sexos, com audição típica. O teste foi feito em sala silenciosa com estímulo sonoro amplificado por uma caixa sonora a 65 dB NA, posicionada a 0 azimute e a um metro do participante e o notebook foi usado para que as crianças brincassem na tela com o título e a ilustração da melodia que eles reconheceram que ouviam. As respostas foram registradas em seu próprio banco de dados. Resultados: O instrumento intitulado "Avaliação do reconhecimento de melodias tradicionais em crianças" pode ser executado em vários dispositivos (computadores, notebooks, tablets, telefones celulares) e sistemas operacionais (Windows, Macintosh, Android, Linux). Acesse: http://192.185.216.17/ivan/home/login.php através de login e senha. A melodia mais facilmente reconhecida foi "Cai cai balão" (89%) e a menos reconhecida foi "Capelinha de melão" (25,2%). O tempo médio para fazer o teste foi de 3′15″. Conclusão: O desenvolvimento e a aplicação do software se mostraram eficazes para a população estudada. Esse instrumento pode contribuir para o aprimoramento de protocolos de avaliação da percepção musical em crianças usuárias de próteses auditivas e/ou usuárias de implante coclear.

Teste da habilidade de atenção auditiva sustentada revisado e sua aplicabilidade em crianças / Revised sustained auditory attention ability test and its applicability in children

A atenção é uma função neuropsicológica, que envolve outras habilidades cognitivas e, é essencial para a aprendizagem. Na realidade nacional, verifica-se uma escassez de instrumentos padronizados que avaliem a habilidade de atenção auditiva sustentada, sendo esta fundamental em crianças que estão em idade escolar. A informatização de testes na área de saúde permite maior rapidez e precisão da avaliação e análise das respostas para obtenção do resultado final, em relação aos instrumentos que dependem da subjetividade do avaliador, e por isso facilita a aplicação e disponibilização do teste para um grande número de profissionais. Objetivos: elaborar uma nova versão do THAAS informatizado e verificar o desempenho de crianças neste instrumento. Material e métodos: A elaboração da nova versão no formato, foi realizada com a ajuda de um profissional especializado no desenvolvimento e manutenção de softwares. Foi realizada a revisão do THAAS informatizado original e promovidas adequações quanto à randomização da ordem de palavras, bem como da lista de palavras em cada criança que foi avaliada por este instrumento; modificação do tempo de duração de cada palavra do teste para 1,4 segundos. Foi elaborado um website contendo a versão revisada e informatizada do THAAS com as modificações propostas para a nova versão do teste. A casuística foi composta por 264 crianças de ambos os sexos, na faixa etária de seis a 11 anos e com audição normal bilateral. Com base na idade, seis grupos foram formados, pareado o mais próximo possível quanto a idade e ao sexo. Todas as crianças foram submetidas à triagem audiológica (nas frequências de 500Hz, 1000Hz, 2000Hz e 4000Hz), Imitanciometria, questionário de dificuldades e capacidades e, a nova versão do THAAS informatizado, os quais foram aplicados em escolas públicas e centros de convivência. Para determinar o desempenho da criança, foram considerados a pontuação total de erros (desatenção e impulsividade), o decréscimo de vigilância e o tempo de reação. Resultados: Na comparação entre as diferentes faixas etárias verificou-se diferença estatisticamente significante nos tipos de erro desatenção (p=0,000) e impulsividade (p=0,000), na pontuação total de erros (p=0,000), com correlação negativa moderada entre estas variáveis e a idade. Observou-se diferença estatisticamente significante no tempo de reação (p=0,000), com correlação positiva fraca quando relacionado com o fator idade. Não houve diferença estatisticamente significante entre os sexos masculino e feminino e os parâmetros analisados, exceto na pontuação total de erros (p=0,026) e decréscimo de vigilância (p=0,007) na idade de dez anos e, no tempo de reação (p=0,036) na idade de nove anos. Conclusão: Verificou-se que a idade foi um fator que influenciou o desempenho de crianças na nova versão do THAAS informatizado, pois as crianças menores apresentaram uma pontuação total de erros maior em relação as crianças maiores. O mesmo não foi observado no decréscimo de vigilância, pois as crianças tiveram desempenho semelhante em todas as idades avaliadas. Quanto ao tempo de reação, as crianças com menor idade tiveram menor tempo de reação (em milissegundos), quando comparado as crianças com maior idade, porém as primeiras demonstraram maior número de erros em relação as últimas.(AU)

Attention is a neuropsychological function that involves other cognitive abilities and is essential for children during the learning stages. In Brazil there is a lack of standardized tools to assess the sustained auditory attention ability, which is critical for children who are at school age. Computerized testing tools in healthcare provide fast and accurate evaluation and analysis of responses to obtain the final results, regarding the instruments that depend on the subjectivity of the evaluator, and therefore facilitate the application and availability of such tests for a large number of professionals. Objectives: To develop a new version of computerized Sustained Auditory Attention Ability Test (SAAAT), and to verify the performance of children in this instrument. Material and methods: The elaboration of the new version was carried out with the help of a professional specialized in the development and maintenance of software. A review of the original Computerized THAAS was carried out and adjustments were made regarding randomization of the word order as well as the list of words in each child that was evaluated by this instrument; modification of the duration of each test word to 1.4 seconds. A website containing the revised and computerized version of THAAS was prepared with the proposed modifications to the new version of the test. The sample consisted of 264 children of both sexes, in the age group of six to 11 years old and with normal bilateral hearing. Based on age, six groups were formed, matched as closely as possible to age and sex. All children underwent hearing screening (at frequencies of 500Hz, 1000Hz, 2000Hz and 4000Hz), immittance, Strengths and Difficulties Questionnaire, and the new version of computerized THAAS, which were applied in public schools and Public Community Center. To determine the performance of the child, the total error score (inattention and impulsivity), the vigilance decrease and the reaction time were considered. Results: In the comparison between the different age groups, there was a statistically significant difference in the types of error inattention (p=0.000) and impulsivity (p=0.000), in the total error score (p=0.000), with a moderate negative correlation between these variables and age. There was a statistically significant difference in reaction time (p=0.000), with a weak positive correlation when related to the age factor. There was no statistically significant difference among male and female and the analyzed parameters, except for the total score of errors (p=0.026) and vigilance decrease (p=0.007) at the age of ten and, at reaction time (p=0.036) at the age of nine. Conclusion: It was verified that age was a factor that influenced the performance of children in the new version of computerized THAAS, since the smaller children had a greater total error score in relation to the older children. The same was not observed in the vigilance decrease, since the children had similar performance in all ages evaluated. As for the reaction time, the younger children had shorter reaction time (in milliseconds), when compared to the older children, but the former showed more errors than the last ones.(AU)

Speech perception in noise in unilateral hearing loss / Percepção da fala no ruído em perda auditiva unilateral

ABSTRACT INTRODUCTION: Unilateral hearing loss is characterized by a decrease of hearing in one ear only. In the presence of ambient noise, individuals with unilateral hearing loss are faced with greater difficulties understanding speech than normal listeners. OBJECTIVE: To evaluate the speech perception of individuals with unilateral hearing loss in speech perception with and without competitive noise, before and after the hearing aid fitting process. METHODS: The study included 30 adults of both genders diagnosed with moderate or severe sensorineural unilateral hearing loss using the Hearing In Noise Test - Hearing In Noise Test-Brazil, in the following scenarios: silence, frontal noise, noise to the right, and noise to the left, before and after the hearing aid fitting process. RESULTS: The study participants had a mean age of 41.9 years and most of them presented right unilateral hearing loss. In all cases evaluated with Hearing In Noise Test, a better performance in speech perception was observed with the use of hearing aids. CONCLUSION: Using the Hearing In Noise Test-Brazil test evaluation, individuals with unilateral hearing loss demonstrated better performance in speech perception when using hearing aids, both in silence and in situations with a competing noise, with use of hearing aids.

Resumo Introdução: A perda auditiva unilateral (PAUn) é caracterizada pela diminuição da audição em apenas uma orelha. Em presença de ruído ambiental, indivíduos com PAUn encontram maiores dificuldades que os ouvintes normais para compreender a fala. Objetivo: Avaliar o desempenho de indivíduos com perda auditiva unilateral, na percepção da fala sem e com ruído competidor, antes a após adaptação do AASI. Método: Estudo com 30 adultos, e de ambos os sexos, com diagnóstico de perda auditiva unilateral sensorioneural, de graus moderado e severo, utilizando o Hearing In Noise Test - HINT - Brasil, nas seguintes situações: silêncio, ruído à frente, ruído a direita e ruído a esquerda. Antes e após adaptação do AASI. Resultados: Os participantes da pesquisa apresentavam média de idade de 41,9 anos e PAUn predominante à direita. Em todas as situações propostas pelo HINT foi constatado melhor desempenho na percepção da fala com o uso do AASI. Conclusão: No teste HINT - Brasil, indivíduos com PAUn demonstraram melhor desempenho napercepção da fala, em tanto no silêncio quanto nas situações com ruído competidor, com usodo AASI.

Intervenção fonoaudiológica em um caso de toxoplasmose congênita / Speech therapy intervention in a case of congenital toxoplasmosis / Intervención fonoaudiológica en un caso de la toxoplasmosis congénita

Introdução: Os pontos de calcificação no cérebro e alterações nas vias de recepção provocadas pela toxoplasmose congênita implicam na necessidade de investigação do desempenho na linguagem e nas habilidades psicolinguísticas. Objetivo: descrever o processo de avaliação de Linguagem de uma criança com histórico de toxoplasmose congênita, assim como a proposta terapêutica e os resultados obtidos com a intervenção fonoaudiológica. Apresentação do caso clínico: O paciente V., gênero masculino, seis anos, cursando o ensino fundamental, foi submetido a 45 sessões de terapia fonoaudiológica, durante oito meses. Quanto à intervenção, foi utilizado o modelo psicolinguístico. Foram realizadas avaliações pré e pós-intervenção, utilizando testes para avaliar o nível fonológico, semântico, sintático e pragmático da linguagem. Resultados: Em relação à fonologia constatou-se que o total de processos fonológicos na imitação pré-intervenção foi de 56 e pós de 44. Já na prova de nomeação, foram observados 50 processos pré e 48 pós. Nos achados psicolinguísticos foi evidenciada evolução nas habilidades auditivo-vocais pós-intervenção fonoaudiológica. Comentários finais: Ressaltou-se a necessidade de uma avaliação abrangente da linguagem e das habilidades psicolinguísticas neste caso. De acordo com a proposta terapêutica utilizada, observou-se evolução nos níveis fonológico, semântico, sintático e pragmático da linguagem, porém estes ainda encontraram-se em defasagem quando relacionados à idade cronológica do paciente.

Introduction: Points of calcification in the brain and alteration in routes reception caused by congenital toxoplasmosis imply in the necessity of realizing an investigation of the performance of language and psycholinguistic abilities. Objective: to describe the language evaluation process in a case with history of congenital toxoplasmosis, as well as intervention proposed and the results obtained with speech therapy. Clinical case presentation: The patient, male, with six years old, student in elementary school, underwent 45 sessions of speech therapy during eight months. Regarding intervention, it was used the psycholinguistic model. The evaluations were performed pre and post-intervention, using tests to evaluate the phonological, semantic, syntactic and pragmatic language levels. Results: Regarding the phonology, it was found that the total phonological processes, in imitation test, before intervention was 56 processes and 44 processes after. In the naming test, 50 process cases were observed before, and 48 process cases after. In psycholinguistics results showed bigger gains in the auditory-vocal abilities post-intervention. Final comments: It was emphasized the need of a extensive assessment of language and psycholinguistic abilities in this case. According to the therapeutic proposed we observed changes in phonological, semantic, syntactic and pragmatic levels, but they still are in lag considering the chronological age of the patient.

Introducción: Puntos de calcificación en el cerebro y las alteraciones en las vías de recepción causados por toxoplasmosis congénita implican la necesidad de una investigación de la actuación en lenguaje y en las habilidades psicolingüísticas. Objetivo: describir el proceso de evaluación de lenguaje de un niño con antecedentes de toxoplasmosis congénita, así como la propuesta terapéutica y los resultados obtenidos con la intervención fonoaudiológica. Presentación del caso clínico: El paciente V., varón de 6 años, en la escuela primaria, se sometió a 45 sesiones de terapia fonoaudiológica durante ocho meses. Para la intervención se utilizó un modelo psicolingüístico. Se realizaron evaluaciones pre y post-intervención, mediante pruebas para evaluar el nivel fonológico, semántico, sintáctico y pragmático del lenguaje. Resultados: En cuanto a la fonología se encontró que el total de los procesos fonológicos en la imitación pre-intervención fue de 56 y post de 44. Ya en la prueba de denominación, se observaron 50 procesos pre y 48 post. En los hallazgos psicolingüísticos se observó la evolución en las habilidades auditivo-vocales post-intervención fonoaudiológica. Comentarios finales: Se subrayó la necesidad de una evaluación amplia del lenguaje y de las habilidades psicolingüística en este caso. De acuerdo con la propuesta terapéutica utilizada, se observó evolución en los niveles fonológico, semántico, sintáctico y el pragmático de lenguaje, todavía estes se encuentran en retraso cuando se los relaciona con la edad cronológica del paciente.

Language Disorders in Children with Unilateral Hearing Loss: A Systematic Review

Introduction: Childhood is a critical period for language development and maturation of the central auditory system. Unilateral hearing loss (UHL) is considered a minimal impairment, and little is discussed regarding its impact on the development of language, communication, and school performance. Objectives: A bibliographical survey of scientific articles published from 2001 to 2011 was performed to verify which language disorders can occur in children with UHL and which tests were performed to identify them. Data Synthesis Three databases were used: PubMed, Lilacs, and The Cochrane Library. As inclusion criteria, the articles should have samples of children with UHL, without other impairments, aged between 3 months and 12 years, and reference to language tests applied in this population. Out of 236 papers initially selected, only 5 met the inclusion criteria. In the articles studied, 12 tests were used for language assessment in children with UHL, out of which 9 were directed toward expressive language, and 3 toward receptive language. Children with UHL demonstrated lower scores on receptive and expressive language tests when compared with children with normal hearing. However, they obtained better scores on expressive language tests than children with bilateral hearing loss. Conclusion: The findings of this survey showed that only a small number of studies used language tests in children with UHL or addressed language alterations resulting from this type of impairment. Therefore we emphasize the importance of investments in new studies on this subject to provide better explanations related to language difficulties presented by children with UHL.

Auditory complaints and audiologic assessment in children with surgically repaired cleft lip and palate

INTRODUCTION: At the initial consultation, the speech-language pathologist and audiologist may consider possible diagnostic hypotheses based on the child's history and the parents' complaint. AIM:To investigate the association of hearing complaints with the findings obtained in the conventional audiologic assessment in children with cleft lip and palate. Retrospective study. METHODS: We analyzed medical charts of 1000 patients with cleft lip and palate who underwent surgical repair between 1988 and 1995 at a mean age of 6 years 8 months. We excluded charts with records of inconsistent audiological responses and charts with missing data for any of the audiologic evaluations considered. Thus, the sample consisted of 393 records. RESULTS: Two hundred thirty-nine patients presented hearing loss in one or both ears, but only 3.8% reported hearing complaints. The most frequent were otorrhea followed by otalgia. There was no statistical significance between the complaint and gender (p = 0.26) nor between the complaint and hearing loss (p = 0.83). CONCLUSION: This study showed no association between the hearing complaint and the conventional audiologic assessment.

Unilateral hearing loss: benefits and satisfaction from the use of hearing aids / Perda auditiva unilateral: benefício e satisfação com o uso do AASI

A unilateral hearing loss is characterized by reduced hearing in one ear. The problems caused by sensory deprivation can be minimized with the use of hearing aids (HA). AIM: To analyze the correlation between the prescribed grain and the insertion gain difference and with the results obtained regarding the benefit and satisfaction with the use of hearing aids in unilateral hearing impaired patients. MATERIALS AND METHODS: Prospective study with 15 subjects, mean age of 41.6 years, of both genders, users of hearing aids effectively. We used the International Questionnaire Results for hearing aids (International Outcome Inventory for Hearing Aids - IOI-HA), measured with a probe microphone. RESULTS: The mean values in the analyses of the IOI-HA per item were positive and higher than four points. In relation to the objective measures, the frequencies in which we obtained the gain values which were closer to the target were: 1K Hz, 2K Hz and 500 Hz, respectively. CONCLUSION: The satisfaction of individuals using hearing aid unilaterally is not completely correlated to the prescribed gain, because even if the target is not being reached in some frequencies, the individuals were pleased as to the use of their hearing aids.

Aperda auditiva unilateral é caracterizada pela diminuição da audição em apenas uma orelha. Os problemas acometidos pela privação sensorial podem ser minimizados com o uso do Aparelho de Amplificação Sonora individual (AASI). OBJETIVO: Analisar a correlação entre a diferença do ganho prescrito e ganho de inserção com os resultados obtidos em relação ao benefício e a satisfação quanto ao uso do AASI por pacientes deficientes auditivos unilaterais. MATERIAL E MÉTODO: Estudo prospectivo, com 15 indivíduos, com média de idade de 41,6 anos, de ambos os gêneros, usuários de AASI de maneira efetiva. Foi utilizado o Questionário internacional de Resultados para Aparelhos de Amplificação Sonora (International Outcome Inventory for Hearing Aids - iOi-HA) e medidas com microfone sonda. RESULTADOS: As médias obtidas nas análises do iOi-HA por item foram positivas e superiores a quatro pontos. Em relação às medidas objetivas, as frequências nas quais foram atingidos os valores do ganho obtido mais próximas ao target foram: 1K Hz, 2K Hz e 500 Hz, respectivamente. CONCLUSÃO: A satisfação em indivíduos usuários de AASI unilateralmente não está totalmente correlacionada ao ganho prescrito, pois mesmo não sendo atingido o target em algumas frequências, os indivíduos apresentam satisfação quanto ao uso de seus aparelhos auditivos.