Development and Evaluation of the Italian Version of the Dichotic Digit Test: Insights from 39 Normal-Hearing Children Aged 11 to 13 years.

BACKGROUND The dichotic digit test (DDT) is one of the tests for the behavioral assessment of central auditory processing. Dichotic listening tests are sensitive ways of assessing cortical structures, the corpus callossum, and binaural integration mechanisms, showing strong correlations with learning difficulties. The DDT is presently available in a number of languages, each appropriate for the subject's native language. However, there is presently no test in the Italian language. The goal of this study was to develop an Italian version of the one-pair dichotic digit test (DDT-IT) and analyze results in 39 normal-hearing Italian children 11 to 13 years old. We used 2 conditions of presentation: free recall and directed attention (left or right ear), and looked at possible effects of sex and ear side. MATERIAL AND METHODS This study involved 3 steps: creation of the stimuli, checking their quality with Italian speakers, and assessment of the DDT-IT in our subject pool. The study involved 39 children (26 girls and 13 boys), aged 11-13 years. All participants underwent basic audiological assessment, auditory brainstem response, and then DDT-IT. RESULTS Results under free recall and directed attention conditions were similar for right and left ears, and there were no sex or age effects. CONCLUSIONS The Italian version of DDT (DDT-IT) has been developed and its performance on 39 normal-hearing Italian children was assessed. We found there were no age or sex effects for either the free recall condition or the directed attention condition.

Wideband Tympanometry and Pressurized Otoacoustic Emissions in Children with Surgical Excision of Palatine and/or Pharyngeal Tonsils.

Palatine and pharyngeal tonsil hypertrophy may lead to dysfunction of the auditory tube due to a propensity for infection, potentially giving rise to otitis media. This is a quantitative and longitudinal study, developed from 2019 to 2021, at the State University of Campinas (UNICAMP). The studied sample comprised 15 participants aged 5 to 12 years (mean 7.9 years), 12 male and 3 female, arranged into two groups: children diagnosed with pharyngeal and/or palatine tonsil hypertrophy who were candidates for surgery (G1), and children who were later evaluated after surgery (G2). As part of the test, an otoscopy and measurements of logoaudiometry, pure-tone threshold audiometry, wideband tympanometry (ambient and peak pressure), and otoacoustic emissions (TEOAEs and DPOAEs, both at ambient and peak pressure) were all performed. There were statistically significant differences between phases in pure-tone audiometry, in terms of 226 Hz tympanometry, wideband tympanometry in peak pressure conditions, in the amplitude measurement TEOAEs in both pressure conditions, in DPOAEs in ambient pressure conditions, and in the signal/noise measurement in both pressures in DPOAEs. Overall, it was found that hearing tests were different for subjects with palatine and pharyngeal tonsil hypertrophy compared to the post-surgical group.

Utilização do Potencial Auditivo de Estado Estável em lactentes com baixo risco para perda auditiva / Use of Auditory Steady State Response in infants at low risk for hearing loss / Uso del potencial auditivo de estado estacionario en bebés con bajo riesgo de pérdida auditiva

Introdução: Com base na necessidade do diagnóstico audiológico e da intervenção precoce na vida de uma criança com perda auditiva, faz-se necessário a elaboração de protocolos de avaliação auditiva que forneçam o maior número de informações. Objetivo: Analisar um programa de saúde auditiva infantil com relação à adesão à triagem auditiva e procedimentos de diagnóstico. Metodologia: Pesquisa de caráter transversal com análise quantitativa. Realizado em três etapas: 1ª etapa: triagem auditiva de neonatos de alojamento conjunto; 2ª etapa: reteste das falhas; 3ª etapa: diagnóstico audiológico dos lactentes que falharam nas etapas anteriores com a utilização do Potencial Evocado Auditivo de Estado Estável (PEAEE) em conjunto com o Potencial Evocado Auditivo de Tronco Encefálico (PEATE). Resultados: Em 2019, 1.898 neonatos foram triados e destes, 287 (15.2%) falharam na primeira testagem em pelo menos uma orelha. Um total de 197 (10.3%) foram retestados e 14 (0,73%) falharam em pelo menos uma orelha. Dez (0,52%) neonatos retornaram para diagnóstico compondo uma amostra homogênea de neonatos nascidos a termo. Um neonato apresentou perda auditiva unilateral. O tempo necessário para coleta de dados no PEAEE foi de 20 minutos. Conclusão: O PEAEE pode ser considerado uma alternativa a ser utilizado na bateria de testes na avaliação audiológica infantil, juntamente com outros procedimentos, utilizando-se do princípio de verificação cruzada e adicionando uma informação valiosa, especialmente com relação às baixas frequências. (AU)

Introduction: Based on the need for audiological diagnosis and intervention as soon as possible in the life of a child with hearing loss, it is necessary to elaborate of hearing evaluation protocols with high efficiency, which provide the greatest amount of information. Aim: To analyze a pediatric hearing health program regarding their adherence to hearing screening, failure rates, and diagnostic procedures. Method: This is a cross-sectional, descriptive, quantitative study, and consisted of tree stages: Performed in three steps: 1st step: hearing screening of rooming-in neonates; 2nd stage: retest of failures; 3rd stage: audiological diagnosis of infants who failed in the previous stages using the Steady State Response (ASSR) together with the Brainstem Evoked Response Audiometry (BERA). Results: In 2019, 1,898 infants were submitted to the program, of whom 287 (15.2%) failed the screening in at least one of the ears. A total of 197 (10.3%) infants attended the retest and 14 (0.73%) failed the TOAE in at least one of the ears. Ten (0.52%) infants returned for diagnosis. The sample was homogeneously full-term children. One child showed unilateral HL. The average amount of time required to collect information in the ASSR was 20 minutes. Conclusion: For diagnosis, ASSR can be an alternative to be used in the battery of examinations in pediatric hearing assessment along with the other procedures, using the cross-check principle and adding valuable information, especially regarding the low frequencies. (AU)

Introducción: En base a la necesidad de diagnóstico audiológico e intervención lo antes posibles en la vida de un niño con pérdida auditiva, es necesario elaborar protocolos de evaluación auditiva de alta eficiencia, que proporcionan la mayor cantidad de información. Objetivo: Analizar un programa de salud auditiva infantil en cuanto a la adherencia al tamizaje auditivo, tasa de fracaso y procedimientos diagnósticos. Metodología: Investigación transversal con análisis cuantitativo, Realizado en tres pasos: 1er paso: tamizaje auditivo de los neonatos en alojamiento conjunto; 2ª etapa: retest de fallas; 3ª etapa: diagnóstico audiológico de los lactantes que fracasaron en las etapas anteriores utilizando el Potencial Evocado Auditivo de Estado Estacionario junto con el Potencial Evocado Auditivo de Tallo Cerebral. Resultados: Em 2019, se cribaron 1,898 neonatos y de estos, 287 (15,2%) no pasaron la primera prueba en al menos un oído. Un total de 197 (10,3) fueron reevaluados y 14 (0,73%) fallaron en al menos un oído. Diez (0,52%) neonatos regresaron para diagnóstico, conformando una muestra homogénea de neonatos a término, con una edad gestacional media de 39 semanas y dos días. Un neonato tuvo pérdida auditiva unilateral. El tiempo de recogida de los resultados en el ASSR fue de 20 min. Conclusión: Para el diagnóstico, la ASSR puede considerarse una alternativa para ser utilizada en la batería de pruebas en la evaluación audiológica infantil, junto con otros procedimientos, utilizando el principio de verificación cruzada y agregando información valiosa, especialmente en lo que se refiere a las bajas frecuencia. (AU)

AudBility: an online program for central auditory processing screening in school-aged children from 6 to 8 years old.

PURPOSE: To analyze the performance of students aged between in an auditory skills screening software program, considering the influence of biological determinants and the correlation of auditory tasks with the behavioral assessment tests of central auditory processing (PAC), as well as to present the cutoff points of the battery. METHODS: In the first stage, the sample consisted of 96 students with typical development, who underwent hearing screening at school. A self-perception questionnaire and the auditory tasks of sound localization (SL), temporal resolution (TR), temporal ordering of frequency (OT-F) and duration (OT-D), auditory closure (AC), dichotic digit- binaural integration (DD) and figure-ground (FG) were applied. Of these, 66 children participated in the second stage of the study, including basic and behavioral audiological assessment from PAC. RESULTS: The gender variable influenced the DD task to the right ear. Age influenced the outcome of five auditory tasks. The right ear performed better in the DD and OT-F tasks. At the age between 6 and 7 years, there was a correlation between screening and diagnosis in the tasks of AC, TR, DD, FG, and OT-F. At the age of 8 years, there was a correlation in the DD and OT-F tasks. The pass/fail criteria varied according to the task and biological determinants. CONCLUSION: There was a correlation between screening and diagnosis in a greater number of tasks in the age group between 6 and 7 years. The cut-off points for the auditory tasks should be analyzed according to age, sex and/or ear side.

AudBility: an online program for central auditory processing screening in school-aged children from 6 to 8 years old / AudBility: programa online para triagem do processamento auditivo central em escolares de 6 a 8 anos

ABSTRACT Purpose To analyze the performance of students aged between in an auditory skills screening software program, considering the influence of biological determinants and the correlation of auditory tasks with the behavioral assessment tests of central auditory processing (PAC), as well as to present the cutoff points of the battery. Methods In the first stage, the sample consisted of 96 students with typical development, who underwent hearing screening at school. A self-perception questionnaire and the auditory tasks of sound localization (SL), temporal resolution (TR), temporal ordering of frequency (OT-F) and duration (OT-D), auditory closure (AC), dichotic digit- binaural integration (DD) and figure-ground (FG) were applied. Of these, 66 children participated in the second stage of the study, including basic and behavioral audiological assessment from PAC. Results The gender variable influenced the DD task to the right ear. Age influenced the outcome of five auditory tasks. The right ear performed better in the DD and OT-F tasks. At the age between 6 and 7 years, there was a correlation between screening and diagnosis in the tasks of AC, TR, DD, FG, and OT-F. At the age of 8 years, there was a correlation in the DD and OT-F tasks. The pass/fail criteria varied according to the task and biological determinants. Conclusion There was a correlation between screening and diagnosis in a greater number of tasks in the age group between 6 and 7 years. The cut-off points for the auditory tasks should be analyzed according to age, sex and/or ear side.

RESUMO Objetivo Analisar o desempenho de escolares em um programa de triagem das habilidades auditivas, considerando a influência de determinantes biológicos e a correlação das tarefas auditivas com os testes da avaliação comportamental do processamento auditivo central (PAC), bem como apresentar os pontos de corte da bateria. Método Na primeira etapa a amostra foi constituída por 96 escolares com desenvolvimento típico, que passaram pela triagem auditiva escolar. Foi aplicado o questionário de autopercepção e as tarefas auditivas de localização sonora (LS), resolução temporal (RT), ordenação temporal de frequência (OT-F) e duração (OT-D), fechamento auditivo (FA), dicótico de dígitos- integração binaural (DD) e figura-fundo (FF). Dessas, 66 crianças participaram da segunda etapa, incluindo avaliação audiológica básica e comportamental do PAC. Resultados A variável sexo influenciou a tarefa DD à orelha direita. A idade influenciou o resultado de cinco tarefas auditivas. A orelha direita teve melhor desempenho nas tarefas DD e OT-F. Na idade entre 6 e 7 anos houve correlação entre triagem e diagnóstico nas tarefas de FA, RT, DD, FF e OT-F. Na idade de 8 anos houve correlação nas tarefas DD e OT-F. Os critérios de passa/ falha variaram de acordo com a tarefa e determinantes biológicos. Conclusão Houve correlação entre triagem e diagnóstico em um maior número de tarefas na faixa etária entre 6 e 7 anos. Os pontos de corte das tarefas auditivas devem ser analisados de acordo com a idade, sexo e/ou lado da orelha.

Latency and Interpeak Interval Values of Auditory Brainstem Response in 73 Individuals with Normal Hearing.

BACKGROUND Auditory brainstem response (ABR) potential is important for audiological diagnosis, reflecting the integrity of the structures of the auditory system up to the brainstem. The click stimulus is the best known and is most used in clinical practice. However, different devices and examiners may yield distinct results, and each institution tends to use its own parameters. We aimed to analyze the latency values of wave I, III, V, and interpeak intervals I-III, III-V, I-V values obtained in assessing ABR using a new device. MATERIAL AND METHODS We performed a cross-sectional study of 73 participants with normal hearing thresholds and no hearing problems. All underwent basic audiological (air and bone conduction, Speech Recognition Threshold, Speech Recognition Index, acoustic reflex, and tympanometry) and electrophysiological evaluation (ABR assessment). RESULTS Absolute latency and interpeak values from ABR showed earlier responses in women, faster than international standards suggest. The responses were similar to other studies carried out previously, with the exception of wave I values, which were a little earlier in females. CONCLUSIONS We assessed normative data from measurement of latency values of wave I, III, V, and interpeak intervals I-III, III-V, and I-V applying 2 standard deviations in the assessment of ABR using the new Neuro-Audio/ABR device created by Neurosoft.

AudBility: test-retest reliability in typically developing children aged 6 to 7 years. / AudBility: confiabilidade teste-reteste em crianças com desenvolvimento típico de 6 e 7 anos.

PURPOSE: to investigate the test-retest reliability of the AudBility program in typically developing children aged six-seven years. METHODS: 29 children, male and female, right-handed, native Portuguese speakers and adequate school performance for the age group studied, underwent previous meatoscopy, immittance measurements and the AudBility program was applied, composed of a self-perception questionnaire and auditory tasks, being analyzed the abilities of sound localization, auditory closure, figure-ground, dichotic digits test, temporal resolution, and temporal ordering of frequency and duration. The program was designed and reapplied with an interval of one week under the same conditions. The performance in each task was presented from central tendency and dispersion data and was conducted using the Intraclass Correlation Coefficient (ICC), based on the 95% confidence interval (CI). RESULTS: The analyses showed a positive and significant ICC (p<0.01) for the questionnaire and auditory tasks, except for auditory closure, in the right and left ears and figure-ground in the left ear. The questionnaire mean ICC was 0.742 and ranged from -0.012 to 0.698 for the auditory tasks. CONCLUSION: Based on mean results and upper limit of the CI, the findings showed agreement between moments, classified as good for the questionnaire and moderate to good for five of the seven auditory analyzed tasks (ICC>0.05 and <0.9). The results of the reliability study represent an important parameter for validating the program for the studied age group.

OBJETIVO: investigar a confiabilidade teste-reteste do programa AudBility em crianças com desenvolvimento típico de seis a sete anos. MÉTODO: 29 crianças, sexo masculino e feminino, destros, falantes nativos do Português e desempenho escolar adequado para a faixa etária estudada de acordo com o professor foram submetidas aos procedimentos de meatoscopia, imitanciometria e foi aplicado o programa AudBility, composto por questionário de autopercepção e tarefas auditivas. As tarefas incluíram localização sonora, fechamento auditivo, figura fundo, escuta dicótica, resolução temporal e ordenação temporal de frequência e duração. O programa foi reaplicado com um intervalo de 1 semana sob as mesmas condições de avaliação. O desempenho em cada tarefa foi apresentado a partir de dados de tendência central e dispersão e a confiabilidade a partir do Cálculo do Coeficiente intra-classe (CCI), com base no intervalo de confiança (IC) de 95%. RESULTADOS: As análises demonstraram CCI positivo e significante para o questionário e tarefas auditivas, exceto fechamento auditivo, nas orelhas direita e esquerda e figura-fundo na orelha esquerda. O CCI médio do questionário foi de 0,742 e variou de -0,012 a 0,698 para as tarefas auditivas. CONCLUSÃO: Com base no resultado médio e no limite superior do IC, os achados demonstraram concordância entre os momentos de grau bom para o questionário, e de grau bom a moderado para cinco das sete variáveis auditivas analisadas (CCI>0,05 e < 0,9). Os achados do estudo de confiabilidade representam um parâmetro importante de validação do programa para a faixa etária estudada.

AudBility: confiabilidade teste-reteste em crianças com desenvolvimento típico de 6 e 7 anos / AudBility: test-retest reliability in typically developing children aged 6 to 7 years

RESUMO Objetivo investigar a confiabilidade teste-reteste do programa AudBility em crianças com desenvolvimento típico de seis a sete anos. Método 29 crianças, sexo masculino e feminino, destros, falantes nativos do Português e desempenho escolar adequado para a faixa etária estudada de acordo com o professor foram submetidas aos procedimentos de meatoscopia, imitanciometria e foi aplicado o programa AudBility, composto por questionário de autopercepção e tarefas auditivas. As tarefas incluíram localização sonora, fechamento auditivo, figura fundo, escuta dicótica, resolução temporal e ordenação temporal de frequência e duração. O programa foi reaplicado com um intervalo de 1 semana sob as mesmas condições de avaliação. O desempenho em cada tarefa foi apresentado a partir de dados de tendência central e dispersão e a confiabilidade a partir do Cálculo do Coeficiente intra-classe (CCI), com base no intervalo de confiança (IC) de 95%. Resultados As análises demonstraram CCI positivo e significante para o questionário e tarefas auditivas, exceto fechamento auditivo, nas orelhas direita e esquerda e figura-fundo na orelha esquerda. O CCI médio do questionário foi de 0,742 e variou de -0,012 a 0,698 para as tarefas auditivas. Conclusão Com base no resultado médio e no limite superior do IC, os achados demonstraram concordância entre os momentos de grau bom para o questionário, e de grau bom a moderado para cinco das sete variáveis auditivas analisadas (CCI>0,05 e < 0,9). Os achados do estudo de confiabilidade representam um parâmetro importante de validação do programa para a faixa etária estudada.

ABSTRACT Purpose to investigate the test-retest reliability of the AudBility program in typically developing children aged six-seven years. Methods 29 children, male and female, right-handed, native Portuguese speakers and adequate school performance for the age group studied, underwent previous meatoscopy, immittance measurements and the AudBility program was applied, composed of a self-perception questionnaire and auditory tasks, being analyzed the abilities of sound localization, auditory closure, figure-ground, dichotic digits test, temporal resolution, and temporal ordering of frequency and duration. The program was designed and reapplied with an interval of one week under the same conditions. The performance in each task was presented from central tendency and dispersion data and was conducted using the Intraclass Correlation Coefficient (ICC), based on the 95% confidence interval (CI). Results The analyses showed a positive and significant ICC (p<0.01) for the questionnaire and auditory tasks, except for auditory closure, in the right and left ears and figure-ground in the left ear. The questionnaire mean ICC was 0.742 and ranged from −0.012 to 0.698 for the auditory tasks. Conclusion Based on mean results and upper limit of the CI, the findings showed agreement between moments, classified as good for the questionnaire and moderate to good for five of the seven auditory analyzed tasks (ICC>0.05 and <0.9). The results of the reliability study represent an important parameter for validating the program for the studied age group.

AudBility: Effectiveness of an online central auditory processing screening program.

OBJECTIVE: To contribute to the validation of AudBility, an online central auditory processing screening program, considering the tasks for age between 6 and 8 years-old, from the investigation of sensitivity and specificity, as well as to suggest a minimum central auditory processing (CAP) screening protocol in this age group. METHOD: In the first stage of the study, 154 schoolchildren were screened. Children were aged between 6 and 8 years old, native speakers of Brazilian Portuguese. The auditory tasks of AudBility analyzed in this study were: sound localization (SL), auditory closure (AC), figure-ground (FG), dichotic digits-binaural integration (DD), temporal resolution (TR) and temporal frequency ordering (TO-F). In the second stage, 112 children attended to CAP assessment in the institution's laboratory. The calculation of efficacy (sensitivity/specificity) was obtained through the construction of the ROC curve for the tests with more than five children altered in the diagnosis. RESULTS: For the 6-7-year-old age group the accuracy values were: AC (76.9%); FG (61.6%); DD 78.8% for the right ear and 84.4% for the left ear in females and 63.2% for the left ear in males; TR (77.1%) and TO-F (74.4% for the right ear and 82.4% for the left ear). For the 8-year-old age group the values were: FF (76.5%); DD (71.7% for the left ear for females and 77% for the right ear for males); TR (56.5%) and TO-F (54.1% for the right ear and 70% for the left ear). CONCLUSIONS: AudBility showed variations in sensitivity and specificity values between the auditory tasks and age groups, with better effectiveness in schoolchildren between the ages of 6 and 7 than eight-year-olds, except for the FG task. For screening purposes, the application of the protocol involving five tasks for the 6 to 7-year-olds group and with four tasks for the 8-year-olds group is suggested.

Lactentes egressos de Unidade de Terapia Intensiva: estudo das respostas auditivas, de linguagem, motoras e as oportunidades para o desenvolvimento motores presentes no ambiente familiar / Egressed infants from Intensive Care Units: a study in hearing, language and motor responses and the opportunities for the development in the home environment / Infantes egresados ​​de las Unidades de Cuidados Intensivos: estudio de las respuestas auditivas, del lenguaje y motoras y las oportunidades para el desarrollo en el entorno familiar

Introdução: Os recém-nascidos que experimentam o ambiente da UTIN podem ter anormalidades neurológicas, motoras, de aprendizagem e possíveis distúrbios do desenvolvimento. O desenvolvimento da audição, da linguagem e motor deve ser acompanhado e é fundamental para tomar condutas adequadas como encaminhamentos a serviços especializados e de intervenção precoce. Objetivo: Analisar as respostas auditivas, de linguagem, motoras e as oportunidades para o desenvolvimento motor, presentes no ambiente familiar dos lactentes em risco para deficiência auditiva egressos de Unidade de Terapia Intensiva Neonatal. Método: A amostra foi composta por 15 lactentes com até seis meses de idade corrigida. Foi realizada avaliação auditiva comportamental, timpanometria, aplicada a Escala Bayley-III e a versão brasileira do questionário Affordances no Ambiente Domiciliar para o Desenvolvimento Motor - Escala Bebê com os pais. O nível de significância adotado foi p-valor<0,05. Resultados: Todos os lactentes apresentaram respostas auditivas esperadas para a faixa etária. A correlação entre o escore da Bayley linguagem e quantidade de Indicadores de Risco para Deficiência Auditiva é negativa (r=-0,578, p=0,024) e a correlação entre o escore da Bayley linguagem e o escore da Bayley motora é positiva (r=0,726; p=0,002). A maioria dos lactentes está inserida em ambientes moderadamente adequados ou menos do que adequados. Conclusão: Houve relação entre maior quantidade de Indicadores de Risco para Deficiência Auditiva com pior desempenho nos testes de linguagem e entre maior escore de linguagem com maior escore motor.

Introduction: Newborns who experience the NICU environment may have neurological, motor, learning abnormalities and possible developmental disorders. To follow the development of hearing, language and motor is fundamental to take appropriate conducts as referrals to specialized services and early intervention. Objective: Analyze auditory, language and motor responses and motor development opportunities present in family environment of hearing loss risk infants egress from Neonatal Intensive Care Unit. Methods: The sample was composed by 15 infants up to six months corrected age. It was performed behavior hearing evaluation, tympanometry, applied the Bayley-III Scale and the Brazilian version of the Affordances in the Home Environment for Motor Development - Infant Scale questionnaire with parents. The adopted significance level was p-value<0,05. Results: All infants presented auditory responses expected for the age group. The correlation between the score of Bayley language and Hearing Loss Risk Indicators was negative (r=-0,578, p=0,024) and correlation between the score of Bayley language and Bayley motor was positive(r=0,726; p=0,002). Most of infants are in moderately adequate or less than adequate family environments. Conclusion: There was relation between quantity of Hearing Loss Risk Indicators with worse performance in language test development and between higher language score with higher motor score.

Introducción: Los recién nacidos que experimentan el entorno de la UCIN pueden tener anomalías neurológicas, motoras, de aprendizaje y posibles trastornos del desarrollo. Seguir el desarrollo de la audición, el lenguaje y la motricidad es fundamental para tomar conductas apropiadas como derivaciones a servicios especializados e intervención temprana. Objetivo: Analizar las respuestas auditivas, del lenguaje y motoras y las oportunidades de desarrollo motoras presentes en el entorno familiar de los bebés con riesgo de pérdida auditiva que salen de la Unidad de Cuidados Intensivos Neonatales. Metodos: La muestra estuvo compuesta por 15 lactantes de hasta seis meses de edad corregida. Se realizó una evaluación auditiva conductual, timpanometría, se aplicó la Escala de Bayley-III y la versión brasileña del cuestionario Affordances in the Home Environment for Motor Development - Infant Scale con los padres. El nivel de significación adoptado fue p-valor<0,05. Resultados: Todos los bebés presentaron las respuestas auditivas esperadas para el grupo de edad. La correlación entre la puntuación del lenguaje Bayley y los Indicadores de Riesgo de Pérdida Auditiva fue negativa (r=-0,578, p=0,024) y la correlación entre la puntuación del lenguaje Bayley y el motor Bayley fue positiva (r=0,726; p=0,002). La mayoría de los bebés se insertan en entornos familiares moderadamente apropiados o menos que apropiados. Conclusión: Hubo una relación entre la cantidad de indicadores de riesgo de pérdida de audición con peor desempeño en el desarrollo de la prueba de lenguaje y entre la mayor puntuación de lenguaje con mayor puntuación motora.

Long-term Effects of Unilateral and Bilateral Otitis Media and Myringotomy on Long-Latency Verbal and Non-Verbal Auditory-Evoked Potentials

Abstract Introduction Otitis media (OM) is considered one of the most common reasons patients seek medical care in childhood. The fluctuating nature of hearing loss in cases of OM leads to irregular sound stimulation of the central auditory nervous system. Objectives To analyze the long-latency auditory-evoked potential (LLAEP) by verbal and nonverbal sounds in children with a history of OM in the first six years of life. Methods A total of 106 schoolchildren participated in the study, 55 females and 51 males, aged between 8 and 16 years, who were divided into 3 groups: the control group (CG), the bilateral experimental group (BEG), and the unilateral experimental group (UEG). All children underwent a complete audiological evaluation (audiometry, logoaudiometry and immitance testing) and an electrophysiological evaluation (LLAEP with toneburst stimulus - LLAEP-TB, and LLAEP with speech stimulus - LLAEP-S). Results Both study groups (BEG and UEG) presented a statistically lower performance (p < 0.005) when compared with the CG regarding all of the electrophysiological tests with the prolongation of the latency values and decrease in the amplitude values: LLAEP-TB (BEG: latency - N1, P2, N2 [females] and P300, amplitude - N1 and P2), LLAEP-S (BEG: latency - P2 and N2 [females], amplitude - P2 /UEG: latency - P2 and P300, amplitude: N1 and P2). Conclusion Children who had suffered secretory OM in the first six years of life and who had undergone myringotomy for the placement of a ventilation tube, either unilaterally or bilaterally, presented worse performance in their electrophysiological responses to verbal and nonverbal LLAEPs.

Otoacoustic Emissions in Children with Long-Term Middle Ear Disease.

INTRODUCTION: Otoacoustic emissions (OAEs) evaluate the functional status of the cochlea. Repeated otitis media (OM) can cause changes in the peripheral structures of the auditory system, and, in this way, middle ear infection may irreversibly damage the middle ear, or even the cochlea. OBJECTIVES: To analyze the results of transiently evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) in individuals with a history of OM. METHOD: Participants with 8 to 16 years of schooling were split into two groups: a control group (CG) of 50 subjects who had no history of otological disease and an experimental group (EG) of 50 subjects who had a history of recurrent otitis in childhood and had consequently undergone myringotomy to insert bilateral ventilation tubes. All children underwent basic audiological assessment (tonal audiometry, speech audiometry, and immittance testing) and otoacoustic emission testing (TEOAEs and DPOAEs). RESULTS: There were no significant differences between the groups when audiometrically tested via air and bone conduction. OAEs were found in all CG subjects. For the EG, there were no TEOAE responses in 17 ears and no DPOAEs in nine ears; response amplitudes were lower at all frequencies. The emission level and the signal-to-noise ratio were statistically different between the two groups, and OAEs in the EG were statistically smaller compared to the GC. CONCLUSION: In the EG, responses were more likely to be absent and were of statistically smaller amplitude compared to the CG. A history of repeated OM apparently interferes with the generation and transmission of TEOAEs and DPOAEs.

Long-term Effects of Unilateral and Bilateral Otitis Media and Myringotomy on Long-Latency Verbal and Non-Verbal Auditory-Evoked Potentials.

Introduction Otitis media (OM) is considered one of the most common reasons patients seek medical care in childhood. The fluctuating nature of hearing loss in cases of OM leads to irregular sound stimulation of the central auditory nervous system. Objectives To analyze the long-latency auditory-evoked potential (LLAEP) by verbal and nonverbal sounds in children with a history of OM in the first six years of life. Methods A total of 106 schoolchildren participated in the study, 55 females and 51 males, aged between 8 and 16 years, who were divided into 3 groups: the control group (CG), the bilateral experimental group (BEG), and the unilateral experimental group (UEG). All children underwent a complete audiological evaluation (audiometry, logoaudiometry and immitance testing) and an electrophysiological evaluation (LLAEP with toneburst stimulus - LLAEP-TB, and LLAEP with speech stimulus - LLAEP-S). Results Both study groups (BEG and UEG) presented a statistically lower performance ( p < 0.005) when compared with the CG regarding all of the electrophysiological tests with the prolongation of the latency values and decrease in the amplitude values: LLAEP-TB (BEG: latency - N1, P2, N2 [females] and P300, amplitude - N1 and P2), LLAEP-S (BEG: latency - P2 and N2 [females], amplitude - P2 /UEG: latency - P2 and P300, amplitude: N1 and P2). Conclusion Children who had suffered secretory OM in the first six years of life and who had undergone myringotomy for the placement of a ventilation tube, either unilaterally or bilaterally, presented worse performance in their electrophysiological responses to verbal and nonverbal LLAEPs.

Processamento auditivo central em crianças com disfonia: avaliação comportamental e eletrofisiológica / Central auditory processing in children with dysphonia: behavioral and electrophysiological assessment / Procesamiento auditivo central en niños com disfonía: evaluación comportamental y electrofisiológica

Introdução: O transtorno do processamento auditivo central pode ocorrer em concomitância com outras alterações, assim como a disfonia. Objetivo: Analisar os resultados obtidos na avaliação do processamento auditivo central em crianças com disfonia. Método: Estudo comparativo e de coorte transversal, constituído por 16 crianças de oito a 11 anos reunidas em dois grupos: o Grupo Estudo composto por sete crianças com disfonia funcional ou organofuncional, e o Grupo Controle por nove crianças sem queixas e alterações vocais. Foram realizados os seguintes procedimentos: anamnese, gravação vocal, avaliação perceptivo-auditiva da voz, laringoscopia, avaliação audiológica básica, avaliação do processamento auditivo por meio de testes comportamentais e eletrofisiológicos. Resultados: Houve diferença estatisticamente significativa entre os grupos para as etapas de atenção direcionada no teste Dicótico não verbal, etapa de humming no Padrão de frequência, limiar de detecção de gap e porcentagem de acertos no Gaps in Noise e para a latência do P300. Conclusão: A partir da análise dos resultados verificou-se que o grupo com disfonia apresentou transtorno do processamento auditivo central com alteração nas habilidades auditivas de figura-fundo para sons não verbais, ordenação e resolução temporal e latência do P300 prolongada, sugerindo também um déficit no processamento cognitivo da informação acústica.

Introduction: Central auditory processing disorder may occur in parallel with other dysfunctions, such as dysphonia. Objective: To investigate auditory processing results in children with dysphonia. Methods: Comparative and cross-sectional study of 16 children aged 8 to 11 years old, who were divided into two groups: a study group of 7 children with functional or organic and functional dysphonia; and a control group of 9 children with no vocal complaints or disorders. After clinical assessment voices were recorded and children underwent perceptive voice evaluation, audiogram, and auditory processing with behavioral and electrophysiological tests. Results: A statistically significant difference was found between the groups with regard to dichotic nonverbal listening tests, humming in the frequency pattern test, and gap detection threshold, in addition to the percentage of correct answers in gap-in-noise test and for the P300 latency. Conclusion: Children with dysphonia had central auditory processing disorder with changes in listening skills for figure-ground to nonverbal sounds, ordering and temporal resolution and P300 latency suggesting a concomitant impairment in cognitive processing of acoustic information.

Introducción: El trastorno de procesamiento auditivo central puede estar en comorbilidad con otras alteraciones como la disfonía. Objetivo: Analizar los resultados obtenidos en la evaluación del procesamiento auditivo central en niños con disfonía. Métodos: Estudio comparativo y de corte transversal, constituido por 16 niños entre 8 y 11 años de edad reunidos en dos grupos: el Grupo de Estudio compuesto por siete niños con disfonía funcional u orgánico funcional y el Grupo Control compuesto por nueve niños sin quejas ni alteraciones vocales. Fueron realizados los siguientes procedimientos: Anamnesis, grabación vocal, evaluación perceptivo auditiva de la voz, laringoscopia, evaluación audiológica básica, evaluación del procesamiento auditivo por medio de tests comportamentales y electrofisiológicos. Resultados: Hubo diferencia estadísticamente significativa entre los grupos para las etapas de atención direccionada en el test Dicótico no verbal, etapa de humming en el Patrón de frecuencia, limiar de detección de gap y porcentaje de aciertos en el Gaps in Noise y para la latencia del P300. Conclusión: A partir del análisis de los resultados se verificó que el grupo con disfonía presentó trastorno de procesamiento auditivo central con alteración en las habilidades auditivas de figura-fondo para los sonidos no verbales, ordenamiento, resolución temporal y latencia del P300 prolongada; sugiriendo también un déficit en el procesamiento cognitivo de la información acústica.

Long-term effect of middle ear disease on temporal processing and P300 in two different populations of children.

BACKGROUND/OBJECTIVE: The effects of otitis media on the function of the central auditory nervous system in different populations is unknown. Understanding how the history of otitis media affects children from different nations will guide health professionals worldwide on the importance of adequate auditory stimulus in childhood. For this reason, the aim of the present study was to investigate the long-term auditory effects of middle ear disease on temporal processing and P300 in two different populations of children: Australian and Brazilian. METHODS: Temporal processing tests (Frequency Pattern Tests-FPT and Gaps in noise-GIN) and P300 were measured in 68 Brazilian and Australian children, aged between 8 to 14 years. The Brazilian otitis media group (BrOM) and Australian otitis media group (AusOM) consisted of 20 children each who had a documented history of otitis media. Control groups of 14 children (BrControl and AusControl) were also recruited from each country, all with no documented history of otitis media. RESULTS: The BrOM group showed significantly poorer performance (p<0.001) for FPT and the GIN compared to BrControl. The P300 response showed significantly longer mean latencies (p = 0.02) compared to BrControls. The AusOM group also showed significant delayed latency of P300 (p = 0.04) compared to the AusControl. The FPT showed significantly poorer performance (p = 0.04) compared to AusControls. The two otitis media groups showed no significant differences between each other on P300. Significant differences were seen however in temporal processing tests performance between the two cohorts for the otitis media groups. The BrOM group had significantly poorer responses (p<0.001) for FPT and GIN compared to the AusOM group. CONCLUSIONS: These findings support that although differences exist between BrOM and AusOM groups, otitis media can be demonstrated to affect the underlying mechanisms of the P300 measures and behavioral auditory responses in two different populations of children.

The effects of otitis media with effusion on the measurement of auditory evoked potentials.

OBJECTIVE: The aim of this study was to explore the impact of otitis media on auditory evoked potentials in children with a history of otitis media in comparison to a control group. DESIGN: 90 children, with normal hearing and middle ear status at time of assessment, aged between 8 and 14 years (44 boys and 46 girls) were enrolled in this study. 50 children (28 boys and 22 girls) had a documented history of Otitis Media. The control group consisted of 40 children (17 boys and 23 girls) with no documented history of otitis media. All children completed the auditory evoked potentials tasks of Auditory Brainstem Response (ABR) and P300. RESULTS: Auditory Evoked Potentials results demonstrated significantly increased latencies and decreased amplitudes in the otitis media group. ABR showed significantly latency delay of waves III and V by 0.1 msec (p < 0.001) and reduced amplitude (0.06 µV, p = 0.002 and 0.05 µV, p = 0.008, respectively) in the otitis media group compared to control group. P300 also showed significant latency delays (13,41 ms, p = 0.008) in otitis media group. No significant difference was seen for amplitude between CG and otitis media group for P300. CONCLUSION: The results demonstrate the negative effects of otitis media on auditory evoked potentials in children with a history of middle ear disease as can be seen by changes on the ABR and P300 measures.

Procedures for central auditory processing screening in schoolchildren / Procedimentos de triagem do processamento auditivo central em escolares

Abstract Introduction: Central auditory processing screening in schoolchildren has led to debates in literature, both regarding the protocol to be used and the importance of actions aimed at prevention and promotion of auditory health. Defining effective screening procedures for central auditory processing is a challenge in Audiology. Objective: This study aimed to analyze the scientific research on central auditory processing screening and discuss the effectiveness of the procedures utilized. Methods: A search was performed in the SciELO and PUBMed databases by two researchers. The descriptors used in Portuguese and English were: auditory processing, screening, hearing, auditory perception, children, auditory tests and their respective terms in Portuguese. Inclusion criteria: original articles involving schoolchildren, auditory screening of central auditory skills and articles in Portuguese or English. Exclusion criteria: studies with adult and/or neonatal populations, peripheral auditory screening only, and duplicate articles. After applying the described criteria, 11 articles were included. Results: At the international level, central auditory processing screening methods used were: screening test for auditory processing disorder and its revised version, screening test for auditory processing, scale of auditory behaviors, children's auditory performance scale and Feather Squadron. In the Brazilian scenario, the procedures used were the simplified auditory processing assessment and Zaidan's battery of tests. Conclusion: At the international level, the screening test for auditory processing and Feather Squadron batteries stand out as the most comprehensive evaluation of hearing skills. At the national level, there is a paucity of studies that use methods evaluating more than four skills, and are normalized by age group. The use of simplified auditory processing assessment and questionnaires can be complementary in the search for an easy access and low-cost alternative in the auditory screening of Brazilian schoolchildren. Interactive tools should be proposed, that allow the selection of as many hearing skills as possible, validated by comparison with the battery of tests used in the diagnosis.

Resumo Introdução: A triagem do processamento auditivo central em escolares tem suscitado discussões na literatura, tanto em relação ao protocolo a ser usado quanto à importância de ações voltadas para a prevenção e promoção da saúde auditiva. Um desafio na audiologia é definir procedimentos eficazes na triagem do processamento auditivo central. Objetivo: Analisar as pesquisas científicas que aplicaram triagem do processamento auditivo central e discutir a eficácia dos procedimentos usados. Método: Foi feita busca nas bases de dados SciELO e PUBMed por duas pesquisadoras. Os descritores usados em português e inglês foram: processamento auditivo, triagem, audição, percepção auditiva, crianças, testes auditivos. Critérios de inclusão: artigos originais que envolveram escolares, triagem auditiva das habilidades auditivas centrais e artigos em português ou inglês. Critérios de exclusão: pesquisas com a população adulta e/ou neonatal, apenas triagem auditiva periférica e artigos duplicados. Após aplicação dos critérios descritos foram incluídos 11 artigos. Resultados: No âmbito internacional, os métodos de triagem do processamento auditivo central foram o uso do Screening Test for Auditory Processing Disorder e sua versão revisada, Screening Test for Auditory Processing, os checklists Scale of Auditory Behaviors e Children's Auditory Performance Scale e o Feather Squadron. No cenário brasileiro, os procedimentos foram a avaliação simplificada do processamento auditivo e a bateria de Zaidan. Conclusão: No âmbito internacional, as baterias Screening Test for Auditory Processing e Feather Squadron se destacam pela avaliação mais completa das habilidades auditivas. Em âmbito nacional, há escassez de estudos que usem métodos que avaliem mais de quatro habilidades, com normatização para a faixa etária. A aplicação da avaliação simplificada do processamento auditivo e questionários pode se complementar na busca de uma opção de fácil acesso e baixo custo na triagem auditiva escolar brasileira. Devem ser propostas ferramentas interativas, que possibilite triar o maior número possível de habilidades auditivas, validada por meio da comparação com a bateria de testes usados no diagnóstico.

Computer-based central auditory processing screening for school-age children (audBility): an initial investigation. / Programa online de triagem do processamento auditivo central em escolares (audBility): investigação inicial.

PURPOSE: To study an initial version of a new computer-based program for auditory processing screening of school-age children: "audBility." Specifically, the study aimed to analyze performance in individual tasks, level of difficulty per age group, administration time and data management and propose adjustments for a final version to be validated in future research, based on the administration of "audBility" on children with good school performance. METHODS: Forty-three school-age children with good school performance were selected. The program assesses hearing skills related to sound localization, competitive dichotic listening, binaural integration, auditory figure-ground, auditory closure, temporal resolution and temporal ordering, as well as a self-perception questionnaire answered by the children. RESULTS: The mean score obtained in the questionnaire was 44.75 ± 6.3. Based on the analysis of performance in the individual tasks, improvements were made in the auditory closure and temporal resolution tests and also the research protocol was reduced and defined to adjust to administration time. It was identified a necessity of two separate modules: one for the age groups of 6 to 8 and other for 9 to 12 years, beyond the inclusion of two new versions of the questionnaire that can be answered by teachers and/or parents. CONCLUSION: The development of audBility is an advance in the area of central auditory processing screening in school-age children. New researches for the validation of audBility are underway, with an increased sample and comparison with the diagnostic battery. The initial results enabled the development of the final version of the protocol to be used in the validation study.

OBJETIVO: estudar a versão inicial de um novo programa online de triagem do processamento auditivo em escolares: "audBility". A partir da aplicação em crianças com bom desempenho escolar, a pesquisa teve como objetivo específico analisar o desempenho em cada tarefa, nível de dificuldade por faixa etária, tempo de aplicação, gerenciamento dos dados e propor ajustes e melhorias para a versão final, a qual posteriormente deverá ser validada em pesquisas futuras. MÉTODO: participaram 43 escolares com idades entre 8 e 11 anos e bom desempenho escolar. O programa avalia as habilidades auditivas de localização sonora, escuta dicótica competitiva (dígitos e dissílabos), integração binaural, figura-fundo, fechamento auditivo, resolução e ordenação temporal, além de um questionário de autopercepção direcionado aos escolares, baseado no instrumento "Scale of Auditory Behaviors .". RESULTADOS: o escore médio obtido no questionário foi de 44,75 ± 6,3 pontos. A partir do desempenho em cada atividade, foram realizadas melhorias no teste de fechamento auditivo e temporais; redução e definição do protocolo de pesquisa para adequar o tempo de aplicação. Observou-se a necessidade de dois módulos, divididos para crianças na faixa etária de 6 a 8 anos e de 9 a 12 anos, e o acréscimo de duas versões do questionário, direcionados para os pais e professores. CONCLUSÃO: o desenvolvimento do audBility é um avanço na área do processamento auditivo e triagem escolar. A validação do audBility está sendo realizada com o aumento da amostra e comparação com a bateria diagnóstica. Os resultados iniciais possibilitaram o desenvolvimento da versão final do protocolo a ser utilizado no estudo de validação.

Otitis Media: Long-Term Effect on Central Auditory Nervous System.

OBJECTIVES: To analyze the central auditory nervous system function through behavioral and electrophysiological tests in children with a history of otitis media and subsequent bilateral tubes placement surgery. METHODS: The participants were divided into two groups between eight and 14 years old: control group (CG) consisted of 40 children with no history of otitis media; experimental group (EG) consisted of 50 children with documented history of otitis media and undertook a surgery for bilateral tubes placement. All children completed audiological evaluation (audiometry, speech audiometry, and immittance audiometry), behavioral evaluation (tests: dichotic digits, synthetic sentence identification with ipsilateral competing message, gaps-in-noise, frequency pattern), and electrophysiological evaluation (Auditory Brainstem Response, ABR, Frequency Following Response, FFR (verbal), and Long Latency Auditory Evoked Potential, LLAEP). RESULTS: The EG group showed significantly poorer performance (p<0.001) than the CG for all auditory abilities studied. The results revealed significant latency delays and reduced amplitude (p<0.05) of waves III and V for ABR; significant latency delay was seen of potentials P2, N2, and P300 for LLAEP; significant latency delays and reduced amplitude (p<0.05) were observed for FFR in children with a history of otitis media. CONCLUSION: The results demonstrate negative effect of otitis media in the auditory abilities and electrophysiological measures in children with a history of otitis media.