Hearing rehabilitation of children and adolescents with unilateral hearing loss / Reabilitação auditiva de crianças e adolescentes com perda auditiva unilateral

ABSTRACT Purpose To describe the audiological characteristics and the type of intervention chosen on unilateral hearing loss cases in children and adolescents as well as to analyze correlations between the degree of hearing loss, the indication and the use of electronic devices. Methods Observational, descriptive and retrospective study, carried out with information of 34 medical records from children and adolescents with unilateral hearing loss, assessed by two auditory rehabilitation services of medium complexity, throughout 2016 to 2019. Descriptive and Inferential statistical analysis were performed with the data. Results A predominance of profound sensorineural unilateral hearing loss in the right ear, of pre-lingual character, with 20.6% of malformations. The most adopted intervention was the hearing aid indication, although its use is low, regardless of the degree of the hearing loss. An association was found between the degree of the hearing loss and the healthcare professionals in indicating the use of the devices. Conclusion The indication of hearing aids is the most frequent and this decision is influenced by the degree of the hearing loss, in which the devices are mostly indicated for mild to severe losses, with bigger divergence of conduct for profound hearing losses.

RESUMO Objetivo Descrever as características audiológicas e o tipo de intervenção tomada em casos de perda auditiva unilateral em crianças e adolescentes e analisar correlações entre o grau da deficiência auditiva, a indicação e o uso de auxiliares de audição. Método Estudo observacional, descritivo e retrospectivo, realizado com informações dos prontuários de 34 crianças e adolescentes com perda auditiva unilateral, atendidos em dois serviços de reabilitação auditiva de média complexidade, no período de 2016 a 2019. Realizou-se a análise estatística descritiva e inferencial dos dados. Resultados Predomínio de perda auditiva unilateral do tipo neurossensorial, de grau profundo à direita, pré-lingual com 20,6% de malformações. A intervenção mais adotada foi a indicação de prótese auditiva, porém o uso é baixo, independente do grau da perda. Houve associação entre o grau da perda auditiva e a decisão dos profissionais em indicar o uso dos dispositivos. Conclusão A indicação de próteses auditivas é a mais frequente e esta decisão é influenciada pelo grau da perda auditiva, sendo os aparelhos auditivos indicados para as perdas leves a severas, com uma maior divergência de condutas para as perdas profundas.

O impacto da deficiência auditiva nas relações familiares de escolares usuários de dispositivos eletrônicos de amplificação sonora / The impact of hearing impairment on family relationships of schoolchildren who use individual sound amplification devices

RESUMO Objetivo Analisar o impacto do diagnóstico da deficiência auditiva nas relações familiares de escolares usuários de dispositivos eletrônicos de amplificação sonora. Métodos A amostra foi composta por 26 pais de escolares com deficiência auditiva, usuários de dispositivos eletrônicos de amplificação sonora, com idades entre 4 e 14 anos, atendidos em um Programa de Saúde Auditiva público. Os pais responderam a um questionário objetivo, elaborado pelas autoras, sem validação prévia, com sete perguntas sobre a temática. Realizou-se análise estatística inferencial sempre que possível. Resultados A maioria dos pais não relatou ter apresentado dificuldades pessoais e/ou desgaste nas relações familiares com seus filhos deficientes auditivos. Não foi encontrada associação entre grau da deficiência auditiva e dificuldade de comunicação em ambos os grupos familiares. Também não se observou associação entre modalidade linguística e dificuldade de comunicação nos dois grupos, apesar de as respostas do grupo familiar mais amplo não terem sido tão unânimes como as do grupo familiar principal. Conclusão Os pais não relataram impacto significativo entre as relações familiares e a comunicação com seus filhos com deficiência auditiva, usuários de dispositivos eletrônicos de amplificação sonora, independentemente do grau da deficiência auditiva e da modalidade linguística. No grupo familiar mais amplo, também não houve associação importante entre grau da deficiência auditiva ou a modalidade linguística utilizada e dificuldade de comunicação entre a criança e a família, mesmo com respostas mais heterogêneas do que no grupo familiar principal.

ABSTRACT Purpose To analyze the impact of the diagnosis of hearing loss on the family relationships of schoolchildren who use hearing aids. Methods The sample consisted of 26 parents from schools with hearing aid hearing aid users aged between 4 and 14 years, assisted in a public Hearing Health Program. Parents responded to an objective, prepared by the authors without prior validation, with seven questions on the subject. Inferential statistical analysis was performed whenever possible. Results Most parents do not report having had personal difficulties and/or strain in family relationships with their hearing-impaired child. No association was found between the degree of hearing loss and the communication difficulties between both family groups. There was also no association between language modality and communication difficulty between the two groups, although in the broader family group the responses were not as unanimous as in the main family group. Conclusion Parents did not report a significant impact on family relationships and communication with their children with hearing loss who use hearing aids, regardless of the degree of hearing impairment and language modality. Among the broader family group, there was also no significant association between the degree of hearing impairment or the language modality used and communication difficulties between the child and the family, even with more heterogeneous responses than in the main family group.

Hearing rehabilitation of children and adolescents with unilateral hearing loss.

PURPOSE: To describe the audiological characteristics and the type of intervention chosen on unilateral hearing loss cases in children and adolescents as well as to analyze correlations between the degree of hearing loss, the indication and the use of electronic devices. METHODS: Observational, descriptive and retrospective study, carried out with information of 34 medical records from children and adolescents with unilateral hearing loss, assessed by two auditory rehabilitation services of medium complexity, throughout 2016 to 2019. Descriptive and Inferential statistical analysis were performed with the data. RESULTS: A predominance of profound sensorineural unilateral hearing loss in the right ear, of pre-lingual character, with 20.6% of malformations. The most adopted intervention was the hearing aid indication, although its use is low, regardless of the degree of the hearing loss. An association was found between the degree of the hearing loss and the healthcare professionals in indicating the use of the devices. CONCLUSION: The indication of hearing aids is the most frequent and this decision is influenced by the degree of the hearing loss, in which the devices are mostly indicated for mild to severe losses, with bigger divergence of conduct for profound hearing losses.

The effect of child development on the components of the Frequency Following Response: Child development and the Frequency Following Response.

During childhood, neuronal modifications occur so that typical childhood communicative development occurs. This work aims to contribute to the understanding of differences in the speech encoding of infants and school-age children by assessing the effects of child development, in different phases of early childhood, on the encoding of speech sounds. There were 98 subjects of both sexes, aged from 1 day to 8 years and 9 months who participated in the study. All subjects underwent a Frequency Following Response (FFR) assessment. A regression and linear correlation showed the effects of age in the FFR components, i.e., significant decrease in the latency and increased amplitude of all FFR waves with age. An increase in the slope measure was also observed. Younger infants require more time and show less robust responses when encoding speech than their older counterparts, which were shown to have more stable and well-organized FFR responses.

Monitoramento audiológico de lactentes em diferentes programas de triagem auditiva neonatal: uma revisão sistemática / Audiological monitoring of infants in different newborn hearing screening programs: a systematic review

RESUMO Objetivos Buscar na literatura informações quanto aos aspectos que guiam o monitoramento audiológico infantil, descrevendo os procedimentos utilizados, a idade em que são realizados, qual a população monitorada e os países que mais estudam sobre o assunto. Além de discutir a importância dessa etapa e a eficácia desses aspectos. Estratégia de pesquisa A revisão foi conduzida com base nas recomendações PRISMA e registrada na plataforma PROSPERO. Os estudos foram pesquisados nas bases de dados eletrônicas Medline (Pubmed), Web of Science e SciELO, com os descritores hearing, neonatal screening e follow up. Critérios de seleção Foram incluídos estudos que descrevessem o monitoramento audiológico. Não foram empregados filtros do ano de publicação, tampouco para os idiomas dos mesmos. Resultados Foram encontrados 432 artigos e 21 foram incluídos nesse estudo, sendo que a maioria foi produzida em países desenvolvidos. O Potencial Evocado Auditivo de Tronco Encefálico e a Avaliação Comportamental foram os procedimentos mais utilizados. Quanto a idade e população, a maioria realiza o monitoramento até os três anos e em crianças com Indicadores para a Deficiência Auditiva. Conclusão Os estudos demonstraram que não há padrão entre os protocolos para a realização do monitoramento audiológico, porém foi possível identificar que as pesquisas apresentam uma maior concordância quanto a idade em que tal monitoramento acontece e qual a população que deve ser monitorada. Entretanto, embora haja discordâncias, os métodos de avaliação utilizados pelos estudos são eficazes para a detecção de perdas auditiva de caráter leve, progressivo e/ou tardio, além dos casos de falso negativo.

ABSTRACT Purpose To search the literature for guidelines on infant's audiological monitoring, most commonly used procedures, the age at which they are performed, which population should be monitored and the countries that study the subject the most. Besides, the importance and effectiveness of these measures will be discussed. Research strategy The review was conducted based on the PRISMA recommendations, registered on the PROSPERO platform. The studies were searched for in the electronic databases Medline (Pubmed), Web of Science and SciELO, using the descriptors hearing, neonatal screening and follow up. Selection criteria studies reporting the audiological monitoring were included. No filters on year and language of publication were used. Results A total of 432 articles were found and 21 were included in this study, mostly produced in developed countries. The Auditory Brainstem Response and the Behavioral Assessment were the most frequently used procedures. As to age and population, most infants are subjected to audiological monitoring up to three years of age and have Risk Factors for Hearing Loss in their clinical history. Conclusion The studies pointed that there is no standard among the protocols for performing audiological monitoring, but it was possible to identify agreement as to the age at which such monitoring takes place and which population should be monitored. However, although there is some disagreement, the assessment methods used in the studies are effective in detecting mild, progressive and/or late hearing loss, in addition to false negative cases.

Verbal and Nonverbal Mismatch Negativity in Children with Typical Development: Variables Analysis.

Introduction Mismatch negativity (MMN) is a promising instrument for the investigation of different auditory disorders, as it does not need behavioral responses. Objective To analyze the influence of the ear, gender and age variables in the MMN in children with typical development; and to compare the different measures of this potential, using verbal and nonverbal stimuli in the sample studied, providing reference values. Methods Observational, descriptive, cross-sectional, quantitative study, with 23 children, aged from 5 to 11 years and 11 months old, divided by age group. Mismatch negativity was performed using verbal and nonverbal stimuli, and the data was analyzed by means of the statistical Student t -test. Results No significant differences were noted for the ear, gender and age variables in the MMN with both stimuli. There were significant differences for the latency, duration and area variables when the stimuli were compared. The reference values established for nonverbal stimuli were: latency 249.8 milliseconds, amplitude 2.28 µv, duration 82.97 milliseconds, and area 137.3 microvolt x microseconds (µVx µs); as for the verbal stimuli, they were: latency 265.3 milliseconds, amplitude - 2.82 µv, duration 110.5 milliseconds, and area 225.5 microvolt x microseconds (µVx µs). Conclusion The variables studied did not influence the recordings of the MMN. Latency, duration and area of the MMN with verbal stimuli were higher. It was possible to furnish reference values for children with typical development in the age group studied.

Effect of Auditory Maturation on the Encoding of a Speech Syllable in the First Days of Life.

(1) Background: In neonates and infants, the physiological modifications associated with language development are reflected in their Frequency Following Responses (FFRs) in the first few months of life. (2) Objective: This study aimed to test the FFRs of infants in the first 45 days of life in order to evaluate how auditory maturation affects the encoding of a speech syllable. (3) Method: In total, 80 healthy, normal-hearing infants, aged 3 to 45 days old, participated in this study. The sample was divided into three groups: GI, 38 neonates from 3 to 15 days; GII, 25 infants from 16 to 30 days; and GIII, 17 infants from 31 to 45 days. All participants underwent FFR testing. Results: With age, there was a decrease in the latency of all FFR waves, with statistically significant differences among the groups studied for waves V, A, E, F, and O. The mean amplitudes showed an increase, with a statistically significant difference only for wave V. The slope measure increased over the 45 days, with a statistically significant difference between GIII and GI and between GIII and GII. (4) Conclusions: The encoding of a speech sound changes with auditory maturation over the first 45 days of an infant's life.

The Effect of Learning English on P300 in Children.

Introduction Learning a second language is an essential task in today's world, and is experienced by many children. The cognitive auditory-evoked potential (P300) is related to cognitive activity, attention and concentration, enabling the investigation of the effect of a second language on the central auditory pathway. Objective To analyze the effects of learning English on P300 latency and amplitude in children and to correlate them with age, time of exposure to English, and time in class. Method An observational, descriptive, cross-sectional and quantitative study, in which 33 children, aged between 5 and 9 years and 11 months, of both genders participated, 14 of them in the process of learning English (study group) and 19 without this experience (control group). All subjects had their P300 evaluated using the Intelligent Hearing Systems (IHS, Miami, FL, US) Smart EP equipment. A total of 300 binaural stimuli were used in 75 dBnHL, as well as 240 frequent and 60 rare stimuli, using the pairs /ba/ and /di/ respectively. Results There was a statistically significant difference regarding P300 latency between the groups, and children exposed to English classes had lower latency in this component. No statistical difference was found between P300 amplitudes. No correlation was observed regarding age, time of exposure to English, time in class, and electrophysiological responses. Conclusion The Children exposed to English classes had the most stimulating auditory pathway, because their P300 had lower latency, being a resource for the speech therapy clinic.

The Effect of Learning English on P300 in Children

Abstract Introduction Learning a second language is an essential task in today's world, and is experienced by many children. The cognitive auditory-evoked potential (P300) is related to cognitive activity, attention and concentration, enabling the investigation of the effect of a second language on the central auditory pathway. Objective To analyze the effects of learning English on P300 latency and amplitude in children and to correlate them with age, time of exposure to English, and time in class. Method An observational, descriptive, cross-sectional and quantitative study, in which 33 children, aged between 5 and 9 years and 11 months, of both genders participated, 14 of them in the process of learning English (study group) and 19 without this experience (control group). All subjects had their P300 evaluated using the Intelligent Hearing Systems (IHS, Miami, FL, US) Smart EP equipment. A total of 300 binaural stimuli were used in 75 dBnHL, as well as 240 frequent and 60 rare stimuli, using the pairs /ba/ and /di/ respectively. Results There was a statistically significant difference regarding P300 latency between the groups, and children exposed to English classes had lower latency in this component. No statistical difference was found between P300 amplitudes. No correlation was observed regarding age, time of exposure to English, time in class, and electrophysiological responses. Conclusion The Children exposed to English classes had the most stimulating auditory pathway, because their P300 had lower latency, being a resource for the speech therapy clinic.

Cortical Auditory Evoked Potentials in 2-Year-Old Subjects

Abstract Introduction Cortical auditory evoked potentials (CAEPs) can be used to evaluate both peripheral and cortical components of auditory function, and contribute to the assessment of functional sensitivity and auditory thresholds, especially in neonates and infants. Auditory evoked potentials reflect auditory maturity and precede the acquisition of more complex auditory and cognitive skills, and are therefore crucial for speech and language development. Objective The aim of the present study was to determine the presence, latency and amplitude of CAEP components in response to verbal stimuli in children aged 2 years old. Methods The sample consisted of 19 subjects, 10 of whom were male while 9 were female. All of the participants were 24 months old at the time of assessment. Results A total of 17 of the participants displayed all components of the CAEP. Additionally, no significant differences were observed between genders or ears in the present sample. The presence of all components of the CAEP in subjects aged 2 years old confirms the existence of a critical period for the maturation of auditory pathways in the first 2 years of life. Conclusion In the present study, in addition to the P1/N1 components, it was possible to observe the presence of the CAEP P2/N2 components in individuals aged 24 months, confirming the existence of a critical period for the maturation of the auditory pathways in the first 2 years of life.

Cortical Auditory Evoked Potentials in 2-Year-Old Subjects.

Introduction Cortical auditory evoked potentials (CAEPs) can be used to evaluate both peripheral and cortical components of auditory function, and contribute to the assessment of functional sensitivity and auditory thresholds, especially in neonates and infants. Auditory evoked potentials reflect auditory maturity and precede the acquisition of more complex auditory and cognitive skills, and are therefore crucial for speech and language development. Objective The aim of the present study was to determine the presence, latency and amplitude of CAEP components in response to verbal stimuli in children aged 2 years old. Methods The sample consisted of 19 subjects, 10 of whom were male while 9 were female. All of the participants were 24 months old at the time of assessment. Results A total of 17 of the participants displayed all components of the CAEP. Additionally, no significant differences were observed between genders or ears in the present sample. The presence of all components of the CAEP in subjects aged 2 years old confirms the existence of a critical period for the maturation of auditory pathways in the first 2 years of life. Conclusion In the present study, in addition to the P1/N1 components, it was possible to observe the presence of the CAEP P2/N2 components in individuals aged 24 months, confirming the existence of a critical period for the maturation of the auditory pathways in the first 2 years of life.

Influência do sexo nas respostas do potencial evocado auditivo de tronco encefálico com diferentes estímulos em neonatos / The influence of gender on brainstem auditory evoked potentials responses to different stimuli in newborns

RESUMO Objetivo avaliar a influência da variável sexo nos valores da latência e amplitude da onda V do potencial evocado auditivo de tronco encefálico, com diferentes estímulos em neonatos. Métodos participaram deste estudo 62 neonatos nascidos a termo (29 do sexo feminino e 33 do sexo masculino). Realizou-se a pesquisa de limiar eletrofisiológico do potencial evocado auditivo de tronco encefálico com quatro estímulos diferentes (clique, Ichirp banda larga-BL, tone burst e Ichirp-frequência específica-FE), nas intensidades de 60, 40 e 20 dBnNA. A variável sexo foi comparada para cada estímulo e intensidade. Resultados os resultados obtidos demonstraram menor latência e maior amplitude no sexo feminino para o estímulo clique. Entretanto, para o estímulo tone burst, o sexo feminino apresentou maior latência e maior amplitude. Quando utilizados os estímulos Ichirp-BL e Ichirp-FE, a variável sexo não apresentou diferença estatisticamente significativa para os valores de latência e amplitude. Conclusão a onda V do PEATE de neonatos sofre influência da variável sexo, quando utilizados os estímulos clique e tone burst. Entretanto, não houve tal influência quando utilizado o estímulo Ichirp banda larga-BL e o estímulo Ichirp frequência específica-FE.

ABSTRACT Purpose To evaluate the influence of gender on the brainstem auditory evoked potentials V-wave latency and amplitude values in newborns, with different stimuli. Methods 62 full-term newborns (29 females and 33 males) participated in this study. The electrophysiological threshold of the brainstem auditory evoked potential was investigated with four different stimuli - click, broadband (BB) Ichirp, tone-burst, and specific-frequency (SF) Ichirp -, in intensities of 60, 40 and 20 dBnHL. The genders were compared in each stimulus and intensity. Results The results obtained showed lower latency and greater amplitude in females for the click stimulus. However, for tone-burst, the females presented higher latency and greater amplitude. When the BB-Ichirp and SF-Ichirp stimuli were used, the gender did not present a statistically significant difference in the latency and amplitude values. Conclusion The BAEP V-wave in newborns is influenced by gender when the click and tone-burst stimuli are used. However, such influence was not noted when the BB-Ichirp and SF-Ichirp stimuli were used.

Treinamento auditivo: zumbido e habilidades auditivas em idosos com perda auditiva / Hearing Training: Tinnitus and Hearing Skills on Elderly People with Hearing Loss / Entrenamiento auditivo: zumbido y habilidad auditiva en ancianos con pérdida auditiva

Introdução: O zumbido juntamente com a perda auditiva, é uma percepção acústica anormal que pode levar a uma desorganização no Sistema Nervoso Auditivo Central. Por isso sujeitos portadores são suscetíveis ao Transtorno do Processamento Auditivo Central. O Treinamento Auditivo, baseado nos conceitos de neuroplasticidade pode auxiliar na redução do incômodo com o zumbido, por objetivar sincronia na via auditiva. Objetivo: Estimar os efeitos do Treinamento Auditivo Acusticamente Controlado Computadorizado na redução do incômodo com o zumbido e nas alterações das habilidades auditivas em idosos com perda auditiva usuários de próteses auditivas. Material e Método: Estudo transversal quantitativo e qualitativo, no qual foram reabilitados cinco idosos com zumbido, alteração em pelo menos uma habilidade auditiva e perda auditiva. Foram realizadas avaliações pré e pós intervenção, sendo elas: anamnese e avaliação audiológica básica, aplicação do questionário Tinnitus Handicap Inventory, testes comportamentais do processamento auditivo e avaliação eletrofisiológica. Realizou-se o tratamento com o software Escuta Ativa, em 16 sessões de em média 30 minutos cada. Resultados: Houve diferença estatisticamente significante em relação aos valores pré e pós tratamento no questionário Tinnitus Handicap Inventory e nos testes comportamentais. Não houve mudanças eletrofisiológicas pré e pós tratamento. Conclusão: Foi possível avaliar os efeitos do Treinamento Auditivo Acusticamente Controlado Computadorizado na redução do incômodo com o zumbido, por meio do questionário escolhido.

Auditory Nervous System. Subjects with hearing loss are susceptible to Auditory Processing Disorder, as by sensory deprivation also disorganize the Central Auditory Nervous System. Auditory Training can help in reducing the annoyance with tinnitus, by objectifying synchrony in the auditory pathway. Objective: To estimate the effects of Computerized Auditory Training on the reduction of annoyance with tinnitus and changes in auditory abilities in elderly people with hearing loss and hearing aids users. Material and Method: A quantitative and qualitative cross-sectional study in which five elderly people with tinnitus were rehabilitated with difficulty at least in one auditory ability and hearing loss. Evaluations Pre and PostAuditory Training were performed, such as: anamnesis and basic audiological evaluation, application of the Tinnitus Handicap Inventory, behavioral auditory processing tests and electrophysiological evaluation. The treatment was performed with Escuta Ativa software, in 16 sessions with approximately 30 minutes each one. Results: There was a statistically significant difference in relation to the pre and post treatment values in the Tinnitus Handicap questionnaire and Behavioral auditory processing tests. There were no pre and post treatment electrophysiological changes. Conclusion: It was possible to evaluate the effects of the Computerized Auditory Training in the reduction of annoyance with tinnitus, through the chosen questionnaire applied pre and post-intervention. Furthermore, some behavioral auditory abilities also.

Introducción: El zumbido junto con la pérdida auditiva, es una percepción acústica anormal que puede conducir a una desorganización en el Sistema Nervioso Auditivo Central. Por eso sujetos portadores son susceptibles al Trastorno del Procesamiento Auditivo Central. El Entrenamiento Auditivo, basado en los conceptos de neuroplasticidad puede auxiliar en la reducción de la incomodidad con el zumbido, por objetivar la sincronía en la vía auditiva. Objetivo: Estimar los efectos del Entrenamiento Auditivo Acústicamente Controlado Ordenado en la reducción de la incomodidad con el zumbido y los cambios de las habilidades auditivas en ancianos con pérdida auditiva usuarios de prótesis auditivas. Material y método: Estudio transversal cuantitativo y cualitativo, en el cual fueron rehabilitados cinco ancianos con zumbido, alteración en por lo menos una habilidad auditiva y pérdida auditiva. Se realizaron evaluaciones pre y post intervención, siendo ellas: anamnesis y evaluación audiológica básica, aplicación del cuestionario Tinnitus Handicap Inventory, pruebas conductuales del procesamiento auditivo y evaluación electrofisiológica. Se realizó el tratamiento con el software Escucha Activa, en 16 sesiones de en promedio 30 minutos cada una. Resultados: Hubo diferencia estadísticamente significativa en relación a los valores pre y post tratamiento en el cuestionario Tinnitus Handicap Inventory y en las pruebas de comportamiento. No hubo cambios electrofisiológicos pre y post tratamiento. Conclusión: Fue posible evaluar los efectos del Entrenamiento Auditivo Acusticamente Controlado Computadorizado en la reducción de la incomodidad con el zumbido, por medio del cuestionario escogido aplicado pre y post-intervención. Además, algunas habilidades auditivas de comportamiento también mejoraron con dicha intervención. Sólo no fue posible observar cambios electrofisiológicos en el Potencial Evocado Auditivo Larga Latencia.

Percepção da qualidade de vida em crianças e adolescentes usuárias de próteses auditivas / Perception of quality of life in children and teenagers hearing aids users / Percepción de la calidad de vida en niños y adolescentes usuarios de prótesis auditivas

Introdução: Com o avanço da tecnologia, os dispositivos eletrônicos relacionados com a reabilitação auditiva suprem de algum modo as necessidades dos usuários e melhoram a qualidade de vida e as habilidades comunicativas. Qualidade de Vida Relacionada à Saúde (QVRS), por ser um tema subjetivo de difícil mensuração, requer a utilização de questionários para tal aferição. Objetivo: Analisar e comparar a percepção de qualidade de vida de crianças e adolescentes usuárias de próteses auditivas na sua visão e de seus familiares/responsáveis, correlacionando-as com as características audiológicas e escolares. Método: Estudo transversal, quantitativo e descritivo, com entrevista estruturada e questionário. Amostra constituída por 25 sujeitos (crianças e adolescentes), idade entre 08 a 18 anos incompletos, diagnosticados com deficiência auditiva bilateral neurossensorial. Os procedimentos utilizados: anamnese; verificação das próteses auditivas; atualização dos dados audiológicos e o questionário Pediatric Quality of Life InventoryTM (PedsQL) versão 4.0 - Português - Brasil, para análise da percepção da QVRS de crianças /adolescentes e seus familiares/responsáveis. Conclusão: Sujeitos com diagnóstico de deficiência auditiva neurossensorial apresentaram semelhante percepção de QVRS comparada às respostas de seus familiares/responsáveis. As variáveis analisadas no perfil de uso da prótese auditiva não mostraram relação na QVRS dos sujeitos surdos. O grupo dos adolescentes evidenciou uma autopercepção de QVRS inferior à percebida pela faixa etária pediátrica.

Introduction: With the advancement of technology, electronic devices related to hearing rehabilitation somehow fulfill the needs of users and improve quality of life and communication skills. Healthrelated quality of life (HRQOL), it is a subjective theme of difficult measurement, requires the use of questionnaires for such measurement. Objective: To analyze and compare the perception of quality of life of children and adolescents who use hearing aids in their point of view and of their relatives/guardians, correlating them with the audiological and school characteristics. Method: Cross-sectional, quantitative and descriptive study, with structured interview and questionnaire. Sample was composed of 25 subjects (children and adolescents), aged between 08 and 18 years of age, diagnosed with bilateral sensorineural hearing loss. The procedures used: Anamnesis; verification of hearing aids; (PedsQL) version 4.0 - Portuguese - Brazil, to analyze the perception of HRQOL of children/adolescents and their relatives/ caregivers. Conclusion: Subjects with sensorineural hearing loss diagnosis presented a similar perception of HRQOL compared to their parents/guardians' answers. The analyzed variables in the hearing aid use profile did not demonstrate being associated to HRQOL of the deaf subjects. The group of adolescents suggested a lower self-perception of HRQOL than the pediatric age group.

Introducción: Con el avance de la tecnología, los dispositivos electrónicos relacionados con la rehabilitación auditiva suplen de alguna manera las necesidades de los usuarios y mejoran la calidad de vida y las habilidades comunicativas. Calidad de Vida Relacionada a la Salud (QVRS), por ser un tema subjetivo y de difícil mensuración, requiere la utilización de cuestionarios para tal verificación. Objetivo: Analizar y comparar la percepción de calidad de vida en niños y jóvenes usuarios de prótesis auditivas, correlacionándola con los rasgos audiológicos y escolares. Método: Estudio transversal, cuantitativo y descriptivo, con entrevista estructurada y cuestionario. Amuestra constituida por 25 sujetos (niños y adolescentes), edad entre 08 y 18 años incompletos, diagnosticados con pérdida auditiva bilateral neurosensorial. Los procedimientos utilizados: Anamnesis; verificación de las prótesis auditivas; actualización de los datos audiológicos y el cuestionario Pediatric Quality of Life InventoryTM (PedsQL) versión 4.0 - Portugués - Brasil, para el análisis de la percepción da QV de niños/adolescentes y sus familiares/responsables. Conclusión: Sujetos con diagnóstico de pérdida auditiva neurosensorial presentaron semejante percepción de QV comparada a las respuestas de sus familiares o responsables. Las variables analizadas en el perfil de uso de la prótesis auditiva no mostraron relación en la QVRS de los sujetos sordos. El grupo de los adolescentes evidenció una autopercepción de QVRS inferior a la percibida por la franja etaria pediátrica.

Auditory training in autism spectrum disorder: a case report.

This study aimed to measure the effects of a Computer-based Auditory Training Program (CBATP) on an adolescent diagnosed with Autism Spectrum Disorder (ASD) and Central Auditory Processing Disorder (CAPD). This is the case report of a male, 14-year-old adolescent diagnosed with ASD. The individual was submitted to basic audiological evaluation, central auditory processing assessment and hearing electrophysiology (EP), pre- and post-therapeutic intervention. Central auditory processing (CAP) was assessed by means of the following instruments: Time-compressed Speech Test (TCST), Random Gap Detection Test (RGDT), Staggered Spondaic Word Test (SSWT), Frequency (Pitch) Pattern Sequence Test (FPST), and Duration Pattern Test (DPT). The P300 component of the Event-related Potential (ERP) was used in the hearing EP. Pre-intervention assessment of CAP showed changes in the auditory skills of closure, figure-ground and temporal ordering, but normal temporal resolution ability. Post-intervention evaluation of CAP showed improvement in all previously mentioned auditory skills, except for the figure-ground ability, which remained unchanged. Regarding the findings of the hearing EP, a decrease in the latency of the P300 component was observed pre- and post-intervention. This study demonstrated that the use of a CBATP resulted in improvement in the hearing abilities assessed in an adolescent diagnosed with ASD.

Evasion of Newborn Hearing Screening retest: relation with risk factors for hearing impairment / Evasão no reteste da Triagem Auditiva Neonatal: relação com indicadores de risco para deficiência auditiva

ABSTRACT Purpose: to analyze the evasion rate of the Newborn Hearing Screening program's retest, to verify whether the presence of risk indicators for hearing loss influences it, and to describe which risk indicators for hearing loss occur more frequently in these cases. Methods: 1,287 newborns/infants participated, who were screened between June 2015 and June 2018. All of them obtained "fail" as the Newborn Hearing Screening result, were referred to the retest and did not attend it. Information related to the occurrence of risk indicators for hearing loss was observed. Results: the study found that the evasion rate was of 15.23%. The presence of risk indicators for hearing loss did not show an association with non-attendance at this stage of the program (p-value = 0.087). The most frequent indicators in the cases of non-attendance at the retest were: ototoxic medication use and intensive care unit stay for more than five days. Conclusion: high evasion rate of the retest has been observed. It has been found that the presence of risk indicators did not influence the retest evasion rate. Use of ototoxic medication and stay at the intensive care unit were the most frequent indicators among those who did not attend the retest.

RESUMO Objetivo: analisar o índice de evasão no reteste do programa de Triagem Auditiva Neonatal, verificar se a presença de Indicadores de Risco para Deficiência Auditiva o influencia e descrever quais Indicadores de Risco para Deficiência Auditiva ocorrem com maior frequência nestes casos. Métodos: participaram 1287 neonatos/lactentes, triados no período de junho de 2015 a junho de 2018, que obtiveram resultado "falha" na Triagem Auditiva Neonatal, encaminhados para o reteste e não compareceram. Foram observadas informações relacionadas a ocorrência dos Indicadores de Risco para Deficiência Auditiva. Resultados: o estudo constatou que o índice de evasão foi de 15,23%. A presença de indicadores de risco para deficiência auditiva não demonstrou associação com o não comparecimento a essa etapa do programa (p-valor= 0,087). Os indicadores de maior ocorrência nos casos de não comparecimento no reteste foram: medicação ototóxica e permanência em Unidade de Tratamento Intensivo por período maior que cinco dias. Conclusão: observou-se elevado índice de evasão no reteste. Verificou-se que a presença dos indicadores de risco não influenciou no índice de evasão do reteste. O uso de medicação ototóxica e a permanência em Unidade de Terapia Intensiva foram os indicadores mais frequentes naqueles que não compareceram ao reteste.

Desempenho no treinamento auditivo computadorizado Performance in computerized auditory training / Computer-based auditory training: different type of performance analysis

RESUMO Objetivo Analisar e correlacionar o desempenho auditivo na etapa de avaliação existente no software escolhido e respostas eletrofisiológicas pré e pós-treinamento auditivo computadorizado. Métodos Trata-se de um estudo longitudinal, comparativo, clínico e experimental, realizado após aprovação do comitê de ética. A amostra foi composta por sete crianças, com idade entre 7 anos e 8 anos e 11 meses, de ambos os gêneros, diagnosticadas com transtorno do processamento auditivo. A intervenção terapêutica foi baseada no treinamento com o software Escuta Ativa® e composta por 12 sessões, realizadas duas vezes por semana, com duração aproximada de 30 minutos cada. Analisou-se a pontuação nas etapas de avaliação existente no software escolhido e os achados da medida eletrofisiológica potencial evocado auditivo de longa latência, especificamente o componente P3, pré e pós-treinamento, por meio de estudo estatístico adequado. Resultados Dentre as três etapas de avaliação pelo software, não houve resultado estatisticamente significativo pós-treinamento. Quanto ao componente P3, 3 das 4 crianças com ausência do componente passaram a tê-lo, pós-intervenção terapêutica. Na busca de correlação entre resultados comportamentais e eletrofisiológicos, não houve significância estatística, em ambos os momentos de avaliação. Conclusão Não foi possível verificar diferença significativa entre os períodos pré e pós-treinamento, usando a etapa de avaliação do próprio software, mostrando necessidade de mais estudos de investigação para verificar a utilização desta ferramenta de avaliação em ambiente clínico. Percebeu-se efeito da plasticidade pós-treinamento, com o surgimento do componente P3 em algumas crianças. Não houve correlação entre as etapas de avaliação pelo software e a mensuração eletrofisiológica.

ABSTRACT Purpose Analyze and correlate the auditory performance in the evaluation stage in the chosen software and electrophysiological responses pre and post computer-based auditory training. Methods This is a longitudinal, comparative, clinical and experimental study, performed after the approval of the ethics committee. The sample consisted of seven children, aged 7 to 8 years and 11 months, from both genders, diagnosed with auditory processing disorder. The therapeutic intervention was based on the training with the Escuta Ativa® software and composed of 12 sessions, perforned twice a week, lasting approximately 30 minutes each. The score in the evaluation stage in the chosen software and the findings of the electrophysiological measurement on Long-Latency Potential Evoked Auditory, specifically P3 component, pre and post-training, were analyzed through an adequate statistical study. Results Among the three stages of the evaluation by the software, there was no statistically significant post-training result. As for the P3 component, 3 out of the 4 children started to have it post-intervention therapy. In the search for correlation between behavioral and electrophysiological results, there was no statistical significance in either moments of the evaluation. Conclusion It was not possible to verify a significant difference between the pre and post-training periods in the evaluation stage of the software itself, showing the need for further studies to verify the use of this evaluation tool in a clinical setting. An effect of post-training plasticity with the appearance of P3 component was noted in some children. There was no correlation between the evaluation steps by the software and the electrophysiological measurement.

Auditory training in autism spectrum disorder: a case report / Treinamento auditivo no transtorno do espectro autista: relato de caso

ABSTRACT This study aimed to measure the effects of a Computer-based Auditory Training Program (CBATP) on an adolescent diagnosed with Autism Spectrum Disorder (ASD) and Central Auditory Processing Disorder (CAPD). This is the case report of a male, 14-year-old adolescent diagnosed with ASD. The individual was submitted to basic audiological evaluation, central auditory processing assessment and hearing electrophysiology (EP), pre- and post-therapeutic intervention. Central auditory processing (CAP) was assessed by means of the following instruments: Time-compressed Speech Test (TCST), Random Gap Detection Test (RGDT), Staggered Spondaic Word Test (SSWT), Frequency (Pitch) Pattern Sequence Test (FPST), and Duration Pattern Test (DPT). The P300 component of the Event-related Potential (ERP) was used in the hearing EP. Pre-intervention assessment of CAP showed changes in the auditory skills of closure, figure-ground and temporal ordering, but normal temporal resolution ability. Post-intervention evaluation of CAP showed improvement in all previously mentioned auditory skills, except for the figure-ground ability, which remained unchanged. Regarding the findings of the hearing EP, a decrease in the latency of the P300 component was observed pre- and post-intervention. This study demonstrated that the use of a CBATP resulted in improvement in the hearing abilities assessed in an adolescent diagnosed with ASD.

RESUMO O objetivo deste estudo foi mensurar o efeito do treinamento auditivo computadorizado em um adolescente diagnosticado com Transtorno do Espectro Autista e Transtorno do Processamento Auditivo. Participou do estudo um adolescente de 14 anos, do sexo masculino, diagnosticado com Transtorno do Espectro Autista. O sujeito foi submetido à avaliação audiológica básica, avaliação do processamento auditivo central e avaliação eletrofisiológica da audição pré e pós-intervenção. A avaliação do processamento auditivo foi composta do Teste de Fala Comprimida (FC), Randon Gap Detection Test (RGDT), Staggered Spondaic Words (SSW), Teste de Padrão de Frequência (TPF) e Teste de Padrão de Duração (TPD). Na avaliação eletrofisiológica, utilizou-se o Potencial Evocado Auditivo Cognitivo (P300). Na avaliação do processamento auditivo central pré-intervenção terapêutica, observou-se alteração nas habilidades de fechamento auditivo, figura-fundo e ordenação temporal. Na habilidade auditiva de resolução temporal, o sujeito da pesquisa demonstrou desempenho dentro dos padrões de normalidade. Na realização do processamento auditivo central, foi possível observar melhora nos resultados de todas as habilidades auditivas citadas anteriormente, exceto na habilidade de figura-fundo, que permaneceu alterada. Quantos aos achados da avaliação eletrofisiológica da audição, verificou-se diminuição da latência do componente P300 na comparação dos resultados pré e pós-treinamento auditivo. Este estudo demonstrou que a utilização de treinamento auditivo trouxe como efeito uma melhora das habilidades auditivas avaliadas de um adolescente diagnosticado com Transtorno do Espectro Autista.

Treinamento auditivo computadorizado em uma adolescente portadora de neurofibromatose do tipo 2 / Computerized auditory training in an adolescent with neurofibromatosis type 2 / Entrenamiento auditivo computarizado en una adolescente portadora de neurofibromatosis tipo 2

A neurofibromatose do tipo 2 é uma doença genética que afeta o Sistema Nervoso Central, principalmente a via auditiva, sendo alguns dos principais sintomas a perda auditiva neurossensorial, o baixo reconhecimento de fala, zumbido e disfunção vestibular. Relata-se neste estudo um processo de intervenção terapêutica por meio do Treinamento Auditivo Computadorizado em uma adolescente com diagnóstico médico de Neurofibromatose tipo 2. Tal intervenção contou com 16 sessões de TA, realizadas com um software específico. Para o estudo realizou-se a avaliação, pré e pós-treinamento, por meio dos resultados da avaliação audiológica básica, Potencial Evocado Auditivo de Tronco Encefálico e avaliação da consciência fonológica, além de analisar os relatos referentes ao processo terapêutico. Os testes comportamentais de processamento auditivo não foram realizados, pois a paciente apresenta acentuada dificuldade de compreensão de fala. Paciente apresentou melhora no reconhecimento de fala e na habilidade de consciência fonológica, apesar do exame eletrofisiológico da audição não demonstrar tais benefícios diretamente na via auditiva em nível de tronco encefálico, para o estímulo clique. Destaca-se o relato da paciente de melhora na compreensão de fala após tal intervenção. Desse modo, observaram-se os efeitos positivos do treinamento auditivo na melhora da percepção auditiva, influenciando positivamente. na vida diária da paciente.

Neurofibromatosis type 2 is a genetic disease that affects the Central Nervous System, mainly the auditory pathway, being some of the main symptoms: sensorineural hearing loss, low speech recognition, tinnitus and vestibular dysfunction. This study describes a process of therapeutic intervention through. Computerized Auditory Training in an adolescent with medical diagnosis of Neurofibromatosis type 2. This intervention was composed of 16 sessions of AT with a specific software. For this study, the pre and post-training evaluation was carried out through the results of basic audiological evaluation, Brainstem Evoked Response Audiometry and evaluation of phonological awareness, as well as analyzing the patient's reports regarding the therapeutic process. The auditory processing behavioral tests were not performed, since the patient presents difficulty in speech comprehension. Patient presented improvement in speech recognition and phonological awareness ability, although the electrophysiological test did not demonstrate such benefits directly in the auditory pathway at the brainstem level, for the click stimulus. Furthermore, the patient's report of improvement in speech comprehension after such intervention could also be highlighted. Thus, the positive effects of auditory training on the improvement of auditory perception could be observed, influencing positively the daily life of the patient.

La neurofibromatosis del tipo 2 es una enfermedad genética que afecta el Sistema Nervioso Central, principalmente la vía auditiva,siendo algunos de los principales síntomas la pérdida auditiva neurosensorial, el bajo reconocimiento de habla, zumbido e disfunción vestibular. En este estudio se relató un proceso de intervención terapéutica por medio de Entrenamiento Auditivo Computarizado en una adolescente diagnosticada con Neurofibromatosis tipo 2. La intervención contó con 16 sesiones de EA, realizadas con un software específico. Para el estudio se realizó la evaluación antes y después del entrenamiento, atreves de los resultados de la evaluación audiológica básica, Potenciales Evocados Auditivos del Tronco Encefálico y evaluación de la conciencia fonológica, además de analizar los relatos relacionados al proceso terapéutico. Los testes comportamentales de procesamiento auditivo no fueron realizados, pues la paciente presenta acentuada dificultad de comprensión de habla. La paciente presentó mejora en el reconocimiento de habla y en la habilidad de conciencia fonológica, por más que el examen electrofisiológico de la audición no tenga demostrado esos beneficios directamente en la vía auditiva en nivel de tronco encefálico, para el estímulo clic. Se destaca el relato de mejorapor la paciente en la comprensión de habla tras la intervención. De esa manera, se observaron los efectos positivos del entrenamiento auditivo en la mejora de la percepción auditiva, influyendo positivamente en la vida diaria de la paciente.

Potencial evocado auditivo de longa latência em crianças com desenvolvimento típico / Long-latency auditory potential in children with typical development / Potencial evocado auditivo de larga latencia en niños con desarrollo típico

Introdução: O Potencial Evocado Auditivo de Longa Latência é utilizado para avaliar o processamento cortical da informação acústica. Objetivo: Descrever e comparar os valores de latência e amplitude do Potencial Evocado Auditivo de Longa Latência em crianças. Além disso, fornecer valores de referência. Material e Método: Estudo transversal e quantitativo, no qual foram avaliados 20 indivíduos com idade entre 5 e 9 anos e 11 meses, com desenvolvimento típico. Realizou-se tal potencial auditivo, com o equipamento Smart EP (Intelligent Hearing Systems), com estímulos verbais utilizando fones de inserção. Teste de Wilcoxon e teste de Mann-Whitney foram utilizados. Resultados: Não houve diferença estatisticamente significante em relação aos valores de latência e amplitude dos componentes deste potencial, considerando as variáveis orelha e gênero. Forneceram-se os valores de referência para latência e amplitude dos componentes deste potencial. Conclusão: A partir deste estudo foi possível propor valores de referência para os componentes deste potencial para a amostra estudada, considerando que não houve diferença estatisticamente significante para as variáveis estudadas.

Introduction: The Long Latency auditory evoked potential is used to evaluate the cortical processing of the acoustic information. Objective: To describe and compare the values of latency and amplitude of the Long Latency Evoked Potential in children. Also, to provide reference values. Material and Method: Quantitative and cross-sectional study. 20 individuals were evaluated with ages between 5:00 -9:11 with typical development. Evoked Potential was performed with the equipment Smart Ep (Intelligent Hearing Systems) with verbal stimuli using insert headphones. Wilcoxon test and Mann-Whitney test were used. Results: There were no statistical significant differences between latency values and components amplitude of this potential, considering variables of ear and gender. The following reference values for components latency and amplitude potential were obtained. Conclusion: By this study, it was possible to propose values of reference for the components of the potential into the sample, considering that no statistically significance difference was found in the variables studied.

Introducción: El Potencial Evocado Auditivo de Larga Latencia es usado para evaluar el procesamiento cortical de la información acústica. Objetivo: Describir y comparar los valores de latencia y amplitud del Potencial Evocado Auditivo de Larga Latencia en niños. Además, proporcionar valores de referencia. Material y método: Estudio transversal y cuantitativo, en el cual fueron evaluados 20 individuos con edad entre 5 a 9 años y 11 meses, con desarrollo típico. El potencial auditivo se evaluó con el equipo Smart EP(Intelligent Hearing Systems), con estímulos verbales utilizando auriculares de inserción. La prueba de Wilcoxon y la prueba de Mann-Whitneyfueron utilizadas. Resultados: No hubo diferencia estadísticamente significativa en relación a los valores de latencia y amplitud de los componentes de este potencial, considerando las variables oreja y género. Se han proporcionado los valores de referencia para la latencia y la amplitud de los componentes de este potencial. Conclusión: A partir de este estudio fue posible proponer valores de referencia para los componentes de este potencial para la muestra estudiada, considerando que no hubo diferencia estadísticamente significativa para las variables estudiadas.