Evidências de validade e fidedignidade do Teste de Fala Comprimida com Figuras / Evidence of validity and reliability of the Compressed Speech Test with Figures

RESUMO Objetivo Buscar evidências de validade e fidedignidade para o Teste de Fala Comprimida com Figuras. Método O estudo foi subdividido em três etapas: validação de construto, critério e fidedignidade. Todos os participantes tinham idade entre 6:00 e 8:11. Para o construto, aplicou-se o Fala Comprimida com Figuras e o teste padrão ouro Fala Comprimida Adaptado em crianças com desenvolvimento fonológico típico. Para análise de critério, aplicou-se o Fala Comprimida com Figuras em dois grupos, com desenvolvimento fonológico típico (G1) e atípico (G2). Por fim, os protocolos de aplicação passaram pela análise de duas Fonoaudiólogas, com experiência na área do Processamento Auditivo Central, buscando obter uma análise de fidedignidade interavaliadores. Resultados O teste de correlação indicou um construto quase perfeito (Rho=0,843 para orelha direita e Rho=0,823 para orelha esquerda). Na análise de critério, percebeu-se que ambos os grupos apresentaram resultados satisfatórios (G1 = 99,6 a 100%; G2 = 96 a 96,5%). Já a análise de fidedignidade demonstrou que o protocolo é de fácil análise, pois ambos os profissionais apresentaram respostas unânimes. Conclusão Foi possível obter evidências de validade e fidedignidade para o instrumento de Fala Comprimida com Figuras. A análise de construto evidenciou que o instrumento mede a mesma variável que o teste padrão outro, com correlação quase perfeita. Na análise de critério, ambos os grupos apresentaram desempenho semelhante, demonstrando que o instrumento não parece diferenciar populações com e sem transtorno fonológico leve. A análise de fidedignidade interavaliador demonstrou que o protocolo é de fácil análise e pontuação.

ABSTRACT Purpose To seek evidence of validity and reliability for the Compressed Speech Test with Figures. Methods The study was subdivided into three stages: construct validation, criteria and reliability. All participants were aged between 6:00 and 8:11. For the construct, Compressed Speech with Figures and the gold standard Adapted Compressed Speech test were applied to children with typical phonological development. For criterion analysis, Compressed Speech with Figures was applied in two groups, with typical (G1) and atypical (G2) phonological development. Finally, the application protocols underwent analysis by two Speech Therapists, with experience in the area of Central Auditory Processing, seeking to obtain an inter-evaluator reliability analysis. Results The correlation test indicated an almost perfect construct (correlation 0.843 for the right ear and 0.823 for the left ear). In the criterion analysis, it was noticed that both groups presented satisfactory results (G1 = 99.6 to 100%; G2 = 96 to 96.5%). The reliability analysis demonstrated that the protocol is easy to analyze, as both professionals presented unanimous responses. Conclusion It was possible to obtain evidence of validity and reliability for the Compressed Speech with Figures instrument. The construct analysis showed that the instrument measures the same variable as the gold standard test, with an almost perfect correlation. In the criterion analysis, both groups presented similar performance, demonstrating that the instrument does not seem to differentiate populations with and without mild phonological disorder. The inter-evaluator reliability analysis demonstrated that the protocol is easy to analyze and score.

Aging process and central auditory pathway: a study based on auditory brainstem evoked potential and frequency-following response

ABSTRACT Objective To analyze age-related changes in the central auditory pathway in healthy elderly individuals. Methods A prospective, quantitative cross-sectional study. The caseload comprised 18 adults (mean age, 22.78 years) and 18 elderly individuals (mean age, 66.72 years) of both sexes, who met inclusion criteria. Subjects were submitted to basic audiological evaluation and related electrophysiologic tests: brainstem auditory evoked potential with click stimulus and frequency-following response. Results Elderly individuals had higher wave and interpeak latencies (waves I, III and V and interpeaks I-V and III-V) of brainstem auditory evoked potential. Latencies of frequency following response waves A, E, F and O were also higher in elderly individuals. Frequency following response amplitudes were better in A than in D, F and O waves in these subjects. Likewise, interpeak intervals (V-A and V-O) were larger in elderly relative to adult individuals. Lower slope values were observed in elderly individuals. Conclusion Brainstem auditory evoked potential and frequency-following response allowed appropriate assessment of age-related changes in the auditory pathway. Slower neural response to auditory stimuli suggests reduced synchrony between neural structures.

Behavioral tests in adults: reference values and comparison between groups presenting or not central auditory processing disorder / Testes comportamentais em adultos: valores de referência e comparação entre grupos com e sem transtorno do processamento auditivo central

ABSTRACT Purpose: to generate reference values for different behavioral central auditory processing (CAP) tests in normally hearing adults, with age stratification, as well as to compare the results, according to the presence or absence of CAP disorder (CAPD). Methods: the study sample consisted of 94 adults with normal auditory thresholds, with at least 11 years of schooling, who were divided into two groups, according to the performance in the Dichotic Sentences Identification Test (DSI), Masking Level Difference (MLD), Random Gap Detection Test (RGDT), Adapted Time-Compressed Speech (ATCS) and Duration and Frequency Pattern Tests (DPT/FPT).The 64 subjects who presented normality in all the tests formed the G1 group and the 30 subjects who presented alteration in at least one of them, originated the G2 group. To accomplish the analysis it was used the Mann-Whitney U Test. In all analyzes, the significance level was 5% (p≤0.05). Results: the sum of the two standard deviations for the mean performance of G1 yielded reference values for the different tests addressed. When G1 and G2 groups were compared, G1 presented better results, this being significant in the DSI (left ear), MLD, RGDT, DPT and FPT tests, for the group aged between 18 and 29 years and, DSI (right ear), RGDT and ATCS (right ear), for the group from 30 to 58 years. Conclusion: it was possible to generate reference values for different behavioral tests of CAP in normally hearing adults, as well as to verify a better performance for the group with no CAPD.

RESUMO Objetivos: gerar valores de referência para diferentes testes comportamentais de processamento auditivo central (PAC) em adultos normo-ouvintes, com estratificação de faixa etária, assim como, comparar os resultados segundo a variável presença ou ausência de transtorno do PAC(TPAC). Métodos: a casuística foi composta por 94 adultos normo-ouvintes, com pelo menos 11 anos de escolaridade, os quais foram distribuídos em dois grupos, conforme o desempenho nos testes de Identificação de Sentenças Dicóticas(DSI), Masking Level Difference(MLD), Randon Gap Detection Test(RGDT), Fala Comprimida Adaptado(FCA) e Testes de Padrão de Duração e Frequência(TPD/TPF). Os 64 sujeitos que apresentaram normalidade em todos os testes formaram o G1 e os 30 sujeitos com alteração em pelo menos um deles originaram o G2. Foi realizada uma descrição com valores de média, desvio padrão (DP), mínima, máxima e intervalo de confiança. Posteriormente, foi utilizado o teste não paramétrico de comparação entre variáveis U de Mann-Whitney. Em todas as análises foi considerado nível de significância de 5% (p≤0,05). Resultados: o somatório de dois desvios padrões ao desempenho médio do G1, originou valores de referência para os diferentes testes abordados. Quando comparados os grupos G1 e G2, o G1 apresentou melhores resultados, sendo esta significante nos testes DSI(orelha esquerda), MLD,RGDT,TPD e TPF para a faixa etária entre 18 e 29 anos e, DSI(orelha esquerda), RGDT e FCA(orelha direita) na faixa etária de 30 a 58 anos. Conclusão: foi possível gerar valores de referência para diferentes testes comportamentais de PAC, em adultos normo-ouvintes, assim como, constatar um melhor desempenho para o grupo com ausência de TPAC.

Frequency-Following Response with Speech Stimulus: Comparison between Two Methods of Stimulation

Introduction: Frequency-following response with speech stimulus (FFR-speech) is a subcortical potential that satisfactorily evaluates the processing of verbal information. However, there still are differences in the literature regarding its analysis and stimulation protocol. Objective: To compare two stimulation protocols for the capture of FFR-speech, to identify the percentage of occurrence of the waves among them and to compare it with the specialized literature, as well as to describe the interpeaks of its waves. Method: Considering the eligibility criteria, the sample consisted of 30 normal-hearing adults, with no complaints of speech comprehension. All of them were submitted to a basic audiological evaluation, to brainstem auditory evoked potential with click stimulus, and to FFR-speech. In the latter, 2 types of stimulation were performed, 3 series of 1,000 sweeps, and 2 series of 3,000 sweeps, for subsequent analysis of the resulting wave, in which we tried to mark the peak V followed by valleys A, C, D, E, F, and O. Results: Differences in latency and interpeaks were not found between the protocols. In general, a higher occurrence of waves in the stimulation of 2 series of 3,000 sweeps was observed, but only the A valley presented a significant difference. When the values of the waves were compared with the literature, the V and A waves showed fewer occurrences in the present study. Conclusion: The protocol of 2 series of 3,000 sweeps was better for FFR-speech in the studied equipment, considering the higher occurrence of waves, even though it is inferior to the specialized literature. Furthermore, it was possible to describe interpeak values and to observe no difference between the studied protocols (AU)

Applicability of Evoked Auditory Brainstem Responses with Complex Stimuli in Adults with Hearing Loss

Abstract Introduction The use of the speech-evoked auditory brainstem response (ABR) shows how the brainstem operates up to the subcortex in a more complexmanner than when the click-evoked ABR is used. Objective To study the applicability of the speech-evoked ABR in adults with hearing loss. Methods The sample was composed of a study group of 11 subjects, with ages ranging between 18 and 59 years, and auditory thresholds within normal standards, with loss of up to 65 dB at high frequencies or up to moderately severe symmetric sensorineural hearing loss. The sample underwent a basic audiological assessment, as well as speech-evoked ABR and click-evoked ABR, in which waves I, III and V, and V, A, C, D, E, F were respectively marked. The electrophysiological assessments were performed using the SmartEP device (Intelligent Hearing Systems, Miami, FL, US). Results For the speech-evoked ABR, the reference values were used in the identification and analysis of the study group. Those values found for the study group were: V = 8.56; A = 10.97; C = 21.33; D = 29.51; E = 37.93; F = 46.96; and O = 55.97. In the comparison between groups, the study group presented an increase in latency only in wave C. Conclusion The speech-evoked ABR can be performed in subjects with up to moderately severe hearing loss, and the test proved to be appropriate, because, unlike the click-evoked ABR, the former does not suffer influence of peripheral hearing loss.

Speech-evoked Brainstem Auditory Responses and Auditory Processing Skills: A Correlation in Adults with Hearing Loss

Abstract Introduction The auditory system consists of sensory structures and central connections. The evaluation of the auditory pathway at a central level can be performed through behavioral and electrophysiological tests, because they are complementary to each other and provide important information about comprehension. Objective To correlate the findings of speech brainstem-evoked response audiometry with the behavioral tests Random Gap Detection Test and Masking Level Difference in adults with hearing loss. Methods All patients were submitted to a basic audiological evaluation, to the aforementioned behavioral tests, and to an electrophysiological assessment, by means of click-evoked and speech-evoked brainstem response audiometry. Results There were no statistically significant values among the electrophysiological test and the behavioral tests. However, there was a significant correlation between the V and A waves, as well as the D and F waves, of the speech-evoked brainstem response audiometry peaks. Such correlations are positive, indicating that the increase of a variable implies an increase in another and vice versa. Conclusion It was possible to correlate the findings of the speech-evoked brainstem response audiometry with those of the behavioral tests Random Gap Detection and Masking Level Difference. However, there was no statistically significant correlation between them. This shows that the electrophysiological evaluation does not depend uniquely on the behavioral skills of temporal resolution and selective attention.

Resolução temporal em idosos / Temporal resolution in elderly

RESUMO Objetivo: detectar a sensibilidade, para avaliar a habilidade de resolução temporal, comparando os testes Randon Gap Detection Test (RGDT) e Gaps- In-Noise (GIN) além de sugerir valores de referência nestes testes para idosos. Métodos: participaram 38 idosos, 24 mulheres e 14 homens, com idades entre 60 e 82 anos, com audição normal ou perda auditiva neurossensorial até moderada; com simetria entre as orelhas; timpanograma tipo A, reflexos acústicos presentes, com queixa de processamento auditivo. Todos Foram submetidos a avaliação básica para caracterizar a audição periférica, RGDT e GIN. Resultados: a sensibilidade encontrada para o teste RGDT na identificação da habilidade de resolução temporal foi de 88,64% e no GIN de 67,65%. Os valores médios para o limiar de detecção de gap no teste GIN encontraram-se em torno de 8ms e para o teste RGDT em 23,13ms. Conclusão: o teste RGDT demonstrou maior sensibilidade para detecção da alteração da habilidade de resolução temporal. Os valores dos limiares de resolução temporal, sugeridos como valores de referência para idosos, são de 8ms para o GIN e 23,13 ms para o RGDT.

ABSTRACT Purpose: detecting the sensitivity to evaluate the temporal resolution ability, by comparing Randon Gap Detection Test (RGDT) and Gaps- In-Noise (GIN) tests, in addition to suggesting reference values in these tests for elderly people. Methods: 38 elderly people, 24 women and 14 men, aged between 60 and 82 years, with normal hearing or sensorineural to moderate hearing loss; with symmetry between the ears; Type A tympanogram, acoustic reflex, with auditory processing complaints. All patients underwent basic evaluations to characterize the peripheral hearing - RGDT and GIN. Results: the sensitivity found for RGDT regarding the identification of the temporal resolution ability was 88.64% and 67.65% in GIN. The mean values for the gap detection thresholds in GIN test were around 8ms and for the RGDT test in 23,13ms. Conclusion: RGDT test presented greater sensitivity for detecting the change in temporal resolution ability. The values of temporal resolution thresholds suggested as reference values for the elderly people, are 8ms for GIN and 23.13 ms for RGDT.

Habilidade auditiva de figurafundo em três diferentes grupos de idosos / Auditory ability of figure-background in three different groups of elderly / Habilidad auditiva de figura-fondo en três distintos grupos de adultos mayores

Objetivo: Comparar a habilidade auditiva de figura-fundo para sons verbais em três diferentes grupos de idosos. Método: Participaram 36 idosos, dos quais, 12 idosos hipertensos e diabéticos provenientes de uma UBS, 12 idosos ativos praticantes de atividade física, provenientes de um grupo de convivência e 12 idosos de uma ILPI. Todos os participantes foram submetidos aos mesmos procedimentos: Anamnese, Inspeção visual do meato acústico externo, Audiometria Tonal Liminar (ATL), Logoaudiometria, Medidas de Imitância Acústica e avaliação da habilidade auditiva de figura-fundo para sons verbais com o Teste Dicótico de Dígitos (TDD) na etapa de integração binaural. Foram inclusos na amostra apenas indivíduos com limiar de audibilidade normal ou perda auditiva até moderada (Lloyd e Kaplan, 1978). Resultados: Não foi observada diferença estatisticamente significante entre os grupos em relação à faixa etária e classificação do limiar auditivo. Houve diferença estatisticamente significante entre os grupos em relação ao percentual de acertos no TDD, em que o grupo de idosos ativos foi melhor que os demais e o grupo de idosos institucionalizados apresentou piores resultados para a habilidade. Conclusão: Os idosos ativos apresentam melhor desempenho na habilidade auditiva de figura-fundo para sons verbais se comparados com idosos diabéticos hipertensos e idosos institucionalizados.

Objective: Compare the auditory ability of figure background for verbal sounds in three different groups of elderly. Methods: A total of 36 elderly, of whom 12 are hypertensive and diabetics from a UBS (basic healthy unit), 12 are active and practice physical activity, from a living group and 12 elderly from a ILPI (long permanence institution for elderly). The totality of the participants was submitted to the same procedures: Anamnesis, Visual Inspection of External Acoustic Meatus, Pure-Tone Threshold Audiometry, Logoaudiometry, Acoustic Immitance Measure and Auditory Ability of Figure-Background Evaluation for verbal sounds using the Dichotic Digits Test (DDT) in the binaural integration. Were included in the sample individuals with normal auditory threshold or hearing loss from mild to moderate (Lloyd and Kaplan, 1978). Results: There were not observed statistical significant differences between groups related to age and classification of hearing threshold. There were statistical significant differences between groups concerning the DDT percentage of correct answers, where the active elderly group achieved better results than the other groups and the elderly from the institution obtained the worst results in the ability. Conclusion: The active elderly group presented better performance in the auditory ability of figure-background for verbal sounds compared to diabetic and hypertensive and the elderly from an institution.

Objetivo: Comparar la habilidad auditiva de figura-fondo para sonidos verbales en tres distintos grupos de adultos mayores. Método: Participaron 36 adultos mayores, de los cuales, 12 son hipertensos y diabéticos provenientes de una UBS, 12 adultos mayores físicamente activos provenientes de un Grupo de Convivencia 12 adultos mayores de una ILPI (Hogares para ancianos). Todos los participantes del estudio fueron sometidos a los mismos procedimientos: Anamnesis, Examen del Conducto Auditivo Externo, Audiometría Tonal, Logoaudiometría, Impedanciomentría y evaluación de la habilidad auditiva figura-fondo para sonidos verbales con el Teste Dicótico de Dígitos (TDD) en la etapa de integración binaural. Se incluyeron en el estudio sólo los sujetos con umbral auditivo normal o pérdida de audición hasta el grado moderado (Lloyd y Kaplan, 1978). Resultados: No hubo diferencias estadísticamente significativas entre los grupos con respecto a la edad y clasificación del umbral de audición. Hubo diferencia estadísticamente significativa entre los grupos en relación al porcentaje de éxito en el TDD, en el que el grupo de adultos mayores físicamente activos era mejor que los demás y el grupo de adultos mayores institucionalizados mostraron peores resultados en esta habilidad. Conclusión: Los adultos mayores que son activos tienen un mejor rendimiento en la capacidad auditiva de figura-fondo para sonidos verbales en comparación a los adultos mayores diabéticos, hipertensos e institucionalizados.