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

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

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

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

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

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

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

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

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

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

Auditory and language skills in children with cleft lip and palate.

OBJECTIVES: to investigate auditory and language skills in children with repaired cleft lip and palate. METHODS: The sample was composed of 22 children registered at the hospital where the study was conducted, seven to nine years old, 50% being female, with repaired unilateral cleft lip and palate (right or left), without associated malformations. Auditory skills were assessed using four central auditory processing tests: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test, Sustained Auditory Attention Ability Test. Language performance was evaluated by four standardized instruments: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test and Phonological Skills Profile. The association between auditory and language skills was evaluated by the Fisher exact test at a significance level of 5% (p<.05). RESULTS: The central auditory processing tests evidenced that only one child presented adequate performance in all skills analysed, five children presented impaired performance in all skills, and 16 exhibited deteriorations in one to three auditory skills, highlighting that temporal resolution was the most impaired skill (81%). Concerning language, three children presented adequate performance in all tests applied, and Visual Association and Auditory Association were the most impaired skills (40%). No association was observed between deteriorations in auditory and language skills. CONCLUSION: There was high occurrence of impairment of auditory skills, which compose the central auditory processing, as well as of language skills, with greatest impairment of receptive language.

Auditory and language skills in children with cleft lip and palate

Objectives: to investigate auditory and language skills in children with repaired cleft lip and palate. Methods: The sample was composed of 22 children registered at the hospital where the study was conducted, seven to nine years old, 50% being female, with repaired unilateral cleft lip and palate (right or left), without associated malformations. Auditory skills were assessed using four central auditory processing tests: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test, Sustained Auditory Attention Ability Test. Language performance was evaluated by four standardized instruments: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test and Phonological Skills Profile. The association between auditory and language skills was evaluated by the Fisher exact test at a significance level of 5% (p<.05). Results: The central auditory processing tests evidenced that only one child presented adequate performance in all skills analysed, five children presented impaired performance in all skills, and 16 exhibited deteriorations in one to three auditory skills, highlighting that temporal resolution was the most impaired skill (81%). Concerning language, three children presented adequate performance in all tests applied, and Visual Association and Auditory Association were the most impaired skills (40%). No association was observed between deteriorations in auditory and language skills. Conclusion: There was high occurrence of impairment of auditory skills, which compose the central auditory processing, as well as of language skills, with greatest impairment of receptive language.(AU)

Objetivos: Investigar las habilidades auditivas y lingüísticas en niños con labio leporino y paladar reparados. Métodos: La muestra se compuso de 22 niños registrados en el hospital en el que se realizó el estudio, de 7 a 9 años de edad, siendo el 50% niñas con labio leporino unilateral y paladar (derecho o izquierdo) reparados, sin malformaciones. Las habilidades auditivas se evaluaron utilizando 4 pruebas de procesamiento auditivo central: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test y Sustained Auditory Attention Ability Test. El desempeño lingüístico se evaluó utilizando diversos instrumentos estandarizados: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test y Phonological Skills Profile. La asociación entre las habilidades auditivas y lingüísticas se evaluó mediante la prueba exacta de Fisher, con un nivel de significación del 5% (p<0,05). Resultados: Las pruebas de procesamiento auditivo central evidenciaron que solo un niño presentó un desempeño adecuado en todas las habilidades analizadas, 5 niños presentaron una alteración del desempeño en todas las habilidades y 16 niños mostraron alteraciones en una de las 3 habilidades auditivas, subrayando que la resolución temporal fue la habilidad más deficiente (81%). Con relación al lenguaje, 3 niños presentaron un desempeño adecuado en todas las pruebas aplicadas, siendo las habilidades más deficientes la asociación visual y la asociación auditiva (40%). No se observó asociación entre las alteraciones de las habilidades auditivas y lingüísticas. Conclusión: Existió una alta incidencia de alteraciones de las habilidades auditivas que componen el procesamiento auditivo central, así como habilidades lingüísticas con gran alteración del lenguaje receptivo.(AU)

Adult Perfomance on the Sustained Auditory Attention Skill Test.

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

Auditory and language skills in children with cleft lip and palate.

OBJECTIVES: to investigate auditory and language skills in children with repaired cleft lip and palate. METHODS: The sample was composed of 22 children registered at the hospital where the study was conducted, seven to nine years old, 50% being female, with repaired unilateral cleft lip and palate (right or left), without associated malformations. Auditory skills were assessed using four central auditory processing tests: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test, Sustained Auditory Attention Ability Test. Language performance was evaluated by four standardized instruments: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test and Phonological Skills Profile. The association between auditory and language skills was evaluated by the Fisher exact test at a significance level of 5% (p<.05). RESULTS: The central auditory processing tests evidenced that only one child presented adequate performance in all skills analysed, five children presented impaired performance in all skills, and 16 exhibited deteriorations in one to three auditory skills, highlighting that temporal resolution was the most impaired skill (81%). Concerning language, three children presented adequate performance in all tests applied, and Visual Association and Auditory Association were the most impaired skills (40%). No association was observed between deteriorations in auditory and language skills. CONCLUSION: There was high occurrence of impairment of auditory skills, which compose the central auditory processing, as well as of language skills, with greatest impairment of receptive language.

Unilateral hearing loss: benefit of amplification in sound localization, temporal ordering and resolution.

PURPOSE: To assess the hearing abilities of temporal ordering, temporal resolution and sound localization before and after the fitting of a hearing aid (HA) in individuals with unilateral hearing loss (UHL). METHODS: There were evaluated 22 subjects, aged 18 to 60 years, diagnosed with sensorineural or mixed UHL, from mild to severe degrees. The study was divided into two stages: the pre and post-adaptation of HA. In both phases, subjects performed an interview, application of Questionnaire for Disabilities Associated with Impaired Auditory Localization, auditory processing screening protocol (APSP) and Random Gap Detection Test (RGDT). RESULTS: This study found no statistically significant difference in sound localization and memory evaluations for verbal sounds in sequence, in RGDT and Questionnaire for Disabilities Associated with Impaired Auditory Localization. CONCLUSION: With the effective use of hearing aids, individuals with UHL showed improvement in the auditory abilities of sound localization, ordering and temporal resolution.

Development and Evaluation of a Blog about Cleft Lip and Cleft Palate and Hearing.

Introduction Cleft lip and cleft palate can result in impairments in communication, specifically in hearing, making the use of technological resources such as blogs a fundamental guideline for health professionals. Objective The aim of this study was to prepare and analyze the access to a blog about cleft lip and cleft palate and hearing as a pedagogical tool for health professionals. Methods The first stage for the development of the blog was the selection of the content that would be addressed and the respective illustrations. The second stage was making the blog available through the WordPress platform, and the third stage included the evaluation of the blog, of the access to the WordPress statistical features, and of the quality of the blog through the Emory questionnaire, which was answered by 75 professionals. Results The blog, titled "Fissure and Hearing", was developed with the architecture of a digital information environment containing a system of organization, navigation, labeling and search (first stage). The address hosting the blog was: http://fissuraeaudicao.wordpress.com (second stage). The result of the third stage included 56,269 views of the blog from different countries, and Brazil was the country with the highest viewing. Regarding the assessment by the Emory questionnaire, we found that for most of the major issues, the percentages obtained were or equal to 90%, while the analysis of the scales, navigation and structure presented the lowest scores. Conclusion The blog was developed and enabled greater access to information available on the web about cleft lip and cleft palate and hearing.

Development and Evaluation of a Blog about Cleft Lip and Cleft Palate and Hearing

Abstract Introduction Cleft lip and cleft palate can result in impairments in communication, specifically in hearing, making the use of technological resources such as blogs a fundamental guideline for health professionals. Objective The aim of this study was to prepare and analyze the access to a blog about cleft lip and cleft palate and hearing as a pedagogical tool for health professionals. Methods The first stage for the development of the blogwas the selection of the content that would be addressed and the respective illustrations. The second stage was making the blog available through theWordPress platform, and the third stage included the evaluation of the blog, of the access to theWordPress statistical features, and of the quality of the blog through the Emory questionnaire, which was answered by 75 professionals. Results The blog, titled "Fissure and Hearing", was developed with the architecture of a digital information environment containing a system of organization, navigation, labeling and search (first stage). The address hosting the blog was: http://fissuraeaudicao. wordpress.com (second stage). The result of the third stage included 56,269 views of the blog from different countries, and Brazil was the country with the highest viewing. Regarding the assessment by the Emory questionnaire, we found that for most of the major issues, the percentages obtained were or equal to 90%, while the analysis of the scales, navigation and structure presented the lowest scores. Conclusion The blog was developed and enabled greater access to information available on the web about cleft lip and cleft palate and hearing.

Correlation between Voice and Auditory Processing.

PURPOSE: To compare and to correlate the performance of women with behavioral dysphonia and without voice disorders in auditory processing tests and in the Voice Tone Reproduction Test (VTRT). METHODS: Forty women aged from 18 to 44 years participated and were divided in two groups: dysphonic (DG) and non-dysphonic (NDG). The participants underwent interview, hearing, otorhinolaryngology and voice assessments (voice record, VTRT through phonetography), and auditory processing assessment-using the Pitch Pattern Sequence (PPS) test and the Duration Pattern Sequence (DPS) test. The statistical analysis compared both groups, and there was a correlation test (P < 0.05). RESULTS: The NDG had a better performance in the PPS test (P = 0.000), in the VTRT test in the first attempt (P = 0.025), and in the total of correct answers (P = 0.017). There was a positive correlation between the PPS and both the first attempt of the VTRT and the total number of attempts. Regarding the DPS, there was a positive correlation for the left ear with the total number of VTRT attempts. CONCLUSIONS: Dysphonic women presented disorders in temporal auditory processing skills, revealing an important relation between vocal production and impairment of some central auditory functions. There was a positive correlation between the performance in the auditory processing assessment and the performance in voice tone reproduction in both groups. The VTRT may assist speech therapists and voice trainers in verifying difficulties of auditory perception of dysphonic women when the cause is due to behavioral tdysphonia.

Sleep quality and communication aspects in children.

OBJECTIVES: To correlate quality of life of children in terms of sleep, with their oral language skills, auditory processing and orofacial myofunctional aspects. METHODS: Nineteen children (12 males and seven females, in the mean age 9.26) undergoing otorhinolaryngological and speech evaluations participated in this study. The OSA-18 questionnaire was applied, followed by verbal and nonverbal sequential memory tests, dichotic digit test, nonverbal dichotic test and Sustained Auditory Attention Ability Test, related to auditory processing. The Phonological Awareness Profile test, Rapid Automatized Naming and Phonological Working Memory were used for assessment of the phonological processing. Language was assessed by the ABFW Child Language Test, analyzing the phonological and lexical levels. Orofacial myofunctional aspects were evaluated through the MBGR Protocol. Statistical tests used: the Mann-Whitney Test, Fisher's exact test and Spearman Correlation. RESULTS: Relating the performance of children in all evaluations to the results obtained in the OSA-18, there was a statistically significant correlation in the phonological working memory for backward digits (p = 0.04); as well as in the breathing item (p = 0.03), posture of the mandible (p = 0.03) and mobility of lips (p = 0.04). CONCLUSION: A correlation was seen between the sleep quality of life and the skills related to the phonological processing, specifically in the phonological working memory in backward digits, and related to orofacial myofunctional aspects.

A relação entre o nível socioeconômico e a ocorrência de bullying escolar em crianças com fissuras labiopalatinas / The relationship between socioeconomic status and the incidence of school bullying in children with cleft lip and palate

Este artigo se propõe a identificar a relação entre o nível socioeconômico e a incidência de bullying escolar em crianças com fissuras labiopalatinas. Este é um estudo descritivo transversal, realizado em um hospital de referência para lábio leporino e fenda palatina e anomalias relacionadas. A população foi composta de 56 crianças na faixa etária de 7 a 12 anos, de ambos os sexos, com fissura de lábio e palato, inscrita no hospital e moradores da mesma cidade. Os dados foram coletados através de um instrumento de estudo socioeconômico, um protocolo de serviço social da instituição, aplicado aos pais dos pacientes no período entre outubro de 2012 e julho de 2013. A relação entre o nível socioeconômico e a incidência de bullying escolar foi identificado através de um método de análise descritiva. Os dados revelaram que o bullying escolar ocorreu com maior prevalência entre as crianças pertencentes aos níveis socioeconômicos baixos: inferior (20%) e superior (71%), 92% de alunos de escolas públicas regulares, 80% frequentam a escola fundamental incompleto I e 82% com fendas envolvendo lábio e palato simultaneamente (CLP). Em crianças com fissura labiopalatina, situações de bullying escolar estão relacionados com o baixo nível socioeconômico. Portanto, sugerimos a elaboração e execução, por parte da comunidade científica, de pesquisa e políticas públicas, a fim de prevenir o bullying escolar nas classes sociais de nível inferior, como uma estratégia de habilitação ou reabilitação psicossocial.

As repercussões sociais em indivíduos com distúrbios da comunicação associados às fissuras labiopalatinas com e sem perda auditiva / The social impact on individuals with communication disorders associated with cleft lip and palate with and without hearing loss

Objetivo Identificar as repercussões sociais em indivíduos com distúrbios da comunicação associados às fissuras labiopalatinas com e sem perda auditiva. Métodos Participaram crianças e adolescentes de 7 anos a 15 anos e 11 meses de idade, de ambos os gêneros, com fissuras de lábio e palato ou de palato isolado, com e sem perda auditiva associada. A pesquisa foi composta por 52 participantes, divididos em dois grupos: um constituído por 36 crianças e adolescentes com fissuras labiopalatinas e sem perda auditiva e outro, por 16 sujeitos com fissuras labiopalatinas e com perda auditiva associada. Resultados Constatou-se que as repercussões socioeconômicas, familiares, educacionais e sociais são comuns aos grupos. Conclusão As crianças e adolescentes com perda auditiva associada à fissura labiopalatina não estão em “desvantagem” no que se refere às repercussões econômicas, familiares, escolares e sociais, em relação às que não têm o distúrbio de audição. Ambos os grupos vivenciam o acirramento de conviver com o comprometimento estético e funcional causado pela anomalia e de viver em uma sociedade totalmente preocupada com a imagem e julgadora das diferenças. .

Purpose To identify the social impact on individuals with communication disorders associated with cleft lip and palate with and without hearing loss. Methods Participation by children and adolescents from 7 years to 15 years and 11 months old, of both genders, with cleft lip and palate or isolated cleft palate, with and without associated hearing loss. The survey consisted of 52 participants, divided into two groups: one consisting of 36 children and adolescents with cleft lip and palate without hearing loss and the other, 16 subjects with cleft lip and palate with associated hearing loss. Results It was found that the socio-economic, family, educational and social effects are common to both groups. Conclusion Children and adolescents with hearing loss associated with cleft lip and palate are not “disadvantaged” when referring to economic, family, school and social repercussions in relation to those who do not have hearing disorders. Both groups experience the worsening of living with the aesthetic and functional impairment caused by the anomaly and living in a society entirely concerned with the image and judging differences. .

Brainstem auditory evoked potentials in children with lead exposure / Potencial evocado auditivo de tronco encefálico em crianças com exposição ao chumbo

Introduction: Earlier studies have demonstrated an auditory effect of lead exposure in children, but information on the effects of low chronic exposures needs to be further elucidated. Objective: To investigate the effect of low chronic exposures of the auditory system in children with a history of low blood lead levels, using an auditory electrophysiological test. Methods: Contemporary cross-sectional cohort. Study participants underwent tympanometry, pure tone and speech audiometry, transient evoked otoacoustic emissions, and brainstem auditory evoked potentials, with blood lead monitoring over a period of 35.5 months. The study included 130 children, with ages ranging from 18 months to 14 years, 5 months (mean age 6 years, 8 months ± 3 years, 2 months). Results: The mean time-integrated cumulative blood lead index was 12 µg/dL (SD ± 5.7, range:2.433). All participants had hearing thresholds equal to or below 20 dBHL and normal amplitudes of transient evoked otoacoustic emissions. No association was found between the absolute latencies of waves I, III, and V, the interpeak latencies I-III, III-V, and I-V, and the cumulative lead values. Conclusion: No evidence of toxic effects from chronic low lead exposures was observed on the auditory function of children living in a lead contaminated area. .

Introdução: Estudos anteriores têm demonstrado efeitos da exposição ao chumbo no sistema auditivo em crianças, porém a exposição deste metal em níveis baixos ainda precisa ser investigada. Objetivo: Investigar os efeitos da exposição crônica ao chumbo no sistema auditivo de crianças com histórico de baixo nível sanguíneo de chumbo por meio de um teste eletrofisiológico. Método: Estudo de coorte transversal contemporânea. Foram realizados imitanciometria, audiometria tonal liminar e vocal, emissões otoacústicas evocadas transientes e potenciais evocados auditivos de tronco encefálico, com o monitoramento sanguíneo de chumbo durante um período de 35,5 meses. Participaram 130 crianças na faixa etária de 18 meses a 14 anos e 5 meses (6a8 m ± 3a2 m). Resultados: A média estimada do índice de pumblemia foi 12 mg/dL (DP ± 5,7). Todos os participantes apresentaram limiares auditivos iguais ou inferiores a 20 dBNA e amplitude normal das emissões otoacústicas evocadas transientes. Não foi encontrada associação entre as latências absolutas das ondas I, III e V e interpicos I-III, III-V e I-V e os valores cumulativos de chumbo. Conclusão: Não foi observada evidência de efeitos tóxicos em baixas exposições crônicas ao chumbo sobre a função auditiva de crianças que vivem em uma área contaminada por este metal. .

Brainstem auditory evoked potentials in children with lead exposure.

INTRODUCTION: Earlier studies have demonstrated an auditory effect of lead exposure in children, but information on the effects of low chronic exposures needs to be further elucidated. OBJECTIVE: To investigate the effect of low chronic exposures of the auditory system in children with a history of low blood lead levels, using an auditory electrophysiological test. METHODS: Contemporary cross-sectional cohort. Study participants underwent tympanometry, pure tone and speech audiometry, transient evoked otoacoustic emissions, and brainstem auditory evoked potentials, with blood lead monitoring over a period of 35.5 months. The study included 130 children, with ages ranging from 18 months to 14 years, 5 months (mean age 6 years, 8 months ± 3 years, 2 months). RESULTS: The mean time-integrated cumulative blood lead index was 12 µg/dL (SD ± 5.7, range: 2.433). All participants had hearing thresholds equal to or below 20 dBHL and normal amplitudes of transient evoked otoacoustic emissions. No association was found between the absolute latencies of waves I, III, and V, the interpeak latencies I-III, III-V, and I-V, and the cumulative lead values. CONCLUSION: No evidence of toxic effects from chronic low lead exposures was observed on the auditory function of children living in a lead contaminated area.

Avaliação audiológica em crianças com baixo nível de exposição cumulativa ao chumbo / Audiological evaluation in children with cumulative low-level of lead exposure

Objetivo verificar a ocorrência de perda auditiva sensorioneural em crianças com baixo nível de exposição cumulativa ao chumbo. Métodos 156 crianças intoxicadas por chumbo, 94 do sexo masculino e 62 do sexo feminino, na faixa etária entre 18 meses a 14 anos e 5 meses, foram submetidas a análise longitudinal do nível de Plumbemia em sangue, bem como audiometria tonal liminar e emissões otoacústicas evocadas por estímulo transiente. Resultados a população pesquisada apresentou um valor médio de Plumbemia estimada de 12,2±5,7mg/dL (faixa entre 2,4-33mg/dL); todas as crianças apresentaram resposta normal na audiometria tonal liminar em 20 dBNA nas frequências testadas, 0,5; 1; 2 e 4 kHz, para ambas as orelhas; as emissões otoacústicas evocadas por estímulo transiente estiveram presentes para todas as frequências bilateralmente, nas 79 crianças pesquisadas. Conclusão não foi constatada perda auditiva sensorioneural em crianças com histórico de baixo nível de exposição cumulativa por chumbo, assim como não foi encontrada lesão de células ciliadas externas na cóclea, mesmo que subclínicas. .

Purpose to verify the occurrence of sensorineural hearing loss in children with low level of cumulative lead exposure. Methods 156 lead-poisoned children, 94 males and 62 females, ranging in age from 18 months old to 14 years and 5 months old were subjected to analysis of longitudinal lead level in blood as well as pure tone audiometry and transient evoked otoacoustic emissions. Results the population studied had a mean estimated blood lead level of 12,2±5,7mg/dL (range between 2,4 and 33mg/dL); all children had a normal response in pure tone audiometry at 20 dBHL in the frequencies tested, 0.5, 1, 2 and 4 kHz, in both ears; the transient evoked otoacoustic emissions were presented for all frequencies bilaterally in 79 children surveyed. Conclusion there has been no hearing loss in children with a history of low cumulative lead exposure, as there was no injury of cochlear outer hair cells, even if subclinical. .

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

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