A longitudinal study of the peripheral and central auditory pathways in individuals with acute lymphoid leukemia

Abstract Objective To characterize the peripheral and central auditory pathways in individuals with Acute Lymphoid Leukemia (ALL) and compare assessment results before and during chemotherapy. Method The study included 17 subjects with ALL, divided into two age groups: 3 to 6 (11 individuals) and 7 to 16 years old (6 individuals). Each subject was evaluated twice (before and 3 to 6 months after chemotherapy treatment) with the following procedures: medical history survey, otoscopy, Pure-Tone Threshold (PTA) and speech audiometry, acoustic immittance measures, Brainstem Auditory Evoked Potentials (BAEP) and Long-Latency Auditory Evoked Potentials (LLAEP). Results PTA was normal. Tympanometry was abnormal in the second assessment in 2 individuals aged 3 to 6 years. One subject in each age group had absent ipsilateral acoustic reflexes. In high-frequency audiometry, 1 individual had abnormal results. BAEP was abnormal in 5 (first assessment) and 7 individuals (second assessment) aged 3 to 6 years and 2 (first assessment) and 1 individual (second assessment) aged 7 to 16 years. As for LLAEP, P1 latency was increased in 5 (first assessment) and 7 individuals (second assessment) aged 3 to 6 years. Conclusion No hearing loss was identified in the behavioral audiological assessment. BAEP was more affected in the 3-to-6-year-old group, with greater impairment in the lower brainstem in the first and second assessments. In LLAEP, P1 was the most impaired component in children aged 3 to 6 years, and P2 and N2 were so for those 7 to 16 years old, especially in the second assessment.

Brainstem auditory pathway of children with acute lymphoid leukemia on chemotherapy with methotrexate / Via auditiva em tronco encefálico de crianças com leucemia linfoide aguda em quimioterapia com metotrexato

Abstract Objective: Investigate the auditory pathway in the brainstem of children with acute lymphoblastic leukemia submitted to chemotherapy (by intravenous or intrathecal infusion). Methods: Fourteen children aged between 2 and 12 years with diagnosis of acute lymphoid leukemia were evaluated. The following procedures were used: meatoscopy, acoustic immitance measurements, tonal audiometry, vocal audiometry, transient otoacoustic emissions, and auditory brainstem response. Results: From the 14 children with normal auditory thresholds, 35.71% showed an alteration in auditory brainstem response, with a predominance of hearing impairment in the lower brainstem. It was found that 80% of the children with alteration had used intrathecal methotrexate less than 30 days and that 40% had the highest cumulative intravenous methotrexate doses. Conclusion: Children with acute lymphoblastic leukemia submitted to chemotherapy, present auditory pathway impairment in the brainstem, with a predominance of a low brainstem.

Resumo Objetivo: Investigar a via auditiva em tronco encefálico de crianças com leucemia linfoide aguda submetidas à quimioterapia (por infusão intravenosa ou por via intratecal). Métodos: Foram avaliadas 14 crianças com idade entre 2 e 12 anos, com diagnóstico de leucemia linfoide aguda. Foram utilizados os seguintes procedimentos: meatoscopia, medidas de imitância acústica, audiometria tonal, audiometria vocal, emissões otoacústicas transientes e potencial evocado auditivo de tronco encefálico. Resultados: Das 14 crianças com limiares auditivos normais, 35,71% demonstraram alteração no Potencial Evocado Auditivo de Tronco Encefálico, com predomínio de comprometimento de via auditiva em tronco encefálico baixo. Verificou-se que 80% das crianças com alteração haviam feito uso do metotrexato via intratecal a menos de 30 dias e que 40% tinham as maiores doses acumulativas de metotrexato por via endovenosa. Conclusão: Crianças com leucemia linfoide aguda submetidas à quimioterapia apresentam comprometimento na via auditiva em tronco encefálico, com predomínio em tronco encefálico baixo.

The role of phonological awareness in reading comprehension / O papel da consciência fonológica na compreensão leitora

ABSTRACT Purpose: to characterize the performance of 4th grade-Elementary School students with and without signs of reading and writing disorders as for phonological awareness and reading comprehension, and also verify possible correlations between them. Methods: 60 children enrolled in the 4th grade of Elementary School from two public schools, whose parents signed the Informed Consent Form, participated in the present study. They were selected and organized in groups, with and without signs of reading and writing disorders. All students were individually assessed regarding their phonological awareness and reading comprehension of sentences and texts through standardized tests. The data underwent statistical analysis. Results: those with signs of reading and writing disorders showed the lowest performance in the reading comprehension of sentences and texts. A correlation was found between phonological awareness and reading comprehension of sentences and texts in both groups. Conclusion: students with no signs of reading and writing disorders had a higher performance in the skills assessed. The correlation found between phonological awareness and reading comprehension of sentences and texts shows not only the importance of metaphonological skills for a proficient reading, but also for a comprehensive one.

RESUMO Objetivo: caracterizar o desempenho de escolares de 4º ano do Ensino Fundamental, com e sem indicativos de alterações de leitura e escrita, em consciência fonológica e compreensão de leitura e verificar possíveis correlações entre tais habilidades. Métodos: participaram deste estudo 60 crianças do quarto ano do Ensino Fundamental I de duas escolas públicas, cujos pais assinaram o Termo de Consentimento Livre e Esclarecido. Os escolares foram selecionados e organizados em grupos com e sem indicativos de alterações de leitura e escrita. Todos foram avaliados individualmente em relação à consciência fonológica e compreensão de leitura de orações e textos por meio de testes padronizados. Os dados passaram por análise estatística. Resultados: os escolares com indicativos de alterações de leitura e escrita tiveram pior desempenho em consciência fonológica e compreensão de leitura de orações e textos. Houve correlação entre a consciência fonológica e compreensão de leitura de textos nos dois grupos. Conclusão: os escolares sem indicativos de alterações apresentaram melhor desempenho nas habilidades avaliadas. A presença de correlação entre a consciência fonológica e a compreensão de leitura de orações e de textos, evidencia a importância das habilidades metafonológicas, não apenas para consolidação de uma leitura proficiente, mas também para a compreensão leitora.