Adriane Lima Mortari Moret

Implante coclear: audição e linguagem em crianças deficientes auditivas pré-linguais

BACKGROUND Cochlear implant in children, speech perception and oral language, hearing and oral language performance in children with pre-lingual profound sensory-neural hearing impairment, users of cochlear implant. AIM To study the hearing and oral language performance of children with pre-lingual bilateral profound sensory neural hearing impairment, users of multi-channel cochlear implant considering the following aspects: age of the child when the research was carried out, time of hearing sensorial privation, time of cochlear implant use, type of cochlear implant, type of speech coding strategy used, familial permeability level in relation to the therapeutic process and cognitive style of the child. METHOD Participants of this study were 60 children who were assessed according to hearing and language categories. All of the variables were statistically analyzed. Psycho-social aspects, considering the childs cognitive style and the familys permeability level were also assessed. RESULTS Regarding the hearing and language performance with the use of cochlear implant, the intermediate and advanced hearing categories were accomplished by more than half of the children. The statistically significant aspects in the performance of hearing and oral language were: the age of the child upon evaluation, time of hearing sensorial privation, time of cochlear implant use, type of implant, speech sounds coding strategy and familial permeability. CONCLUSION The cochlear implant as a treatment for children with pre-lingual sensory-neural hearing impairment is highly effective, although complex, owing to the interaction of variables which interfere in the implanted childs performance. Further studies are needed for the understanding of the implantation complexity in young children.

The universal newborn hearing screening in Brazil: From identification to intervention

OBJECTIVE The objective of the study is to investigate the results of the newborn hearing screening program carried out in a Public Hospital in Brazil, in the first 3 years regarding: (1) the prevalence of hearing impairment; (2) the influence of the universal hearing screening program on the age at which the diagnosis of hearing loss is defined; (3) the cost effectiveness of the program; (4) the outcomes, in terms of the age in which the hearing rehabilitation started. METHODS A descriptive study of the first 3 years after starting the universal newborn hearing screening in a Public Hospital of Bauru, São Paulo state, Brazil. The screening method consists of a two-stage screening approach with transient otoacoustic emissions (TOAE), conducted by an audiologist. If the outcome in the second-stage screening is REFER, the infant is submitted to diagnostic follow-up testing and intervention at the Audiology and Speech Pathology Clinic at the University of São Paulo, campus of Bauru. The evaluation of the costs of the universal newborn hearing screening program per each screened newborn (around 4000/year) was done based on a proposal by the National Center for Hearing Assessment and Management, of the Utah State University, United States of America. RESULTS 11,466 newborns were submitted to hearing screening, corresponding to 90.52% of the living newborns. The prevalence of sensorineural hearing loss was 0.96:1000. Of the 11 children with sensorineural hearing loss, eight children received hearing aids and five started the therapeutic process before the age of 1. Currently, four children between the ages of 11 months and 2 years old were submitted to cochlear implant surgery. The cost of hearing screening was US

Percepção da fala em deficientes auditivos pré-linguais usuários de implante coclear

7.00 and the annual cost of the universal newborn hearing screening program was US

Implantes cocleares em crianças portadoras de deficiência auditiva decorrente de meningite

26,940.47. CONCLUSION The hospital-based universal newborn hearing screening carried out through the Brazilian National Health System is viable, with promising results. However, in a country such as Brazil, which presents large socio-economic differences, the same type of analyses should be performed in several regions, so as to take into account specific aspects, to implement the newborn hearing screening along with the Public System.

FM listening evaluation for children: adaptação para a língua portuguesa

BACKGROUND cochlear implant is a rather processing electronic device in terms of its benefits, as it provides the deaf child with the appropriation of incidental oral language. AIM to evaluate the hearing performance of the first 60 children with pre-lingual sensorineural hearing loss who were implanted at the Audiologic Research Centre of the Hospital de Reabilitação de Anomalias Craniofaciais of the University of São Paulo (CPA-HRAC/USP), 16 years after the implementation of the cochlear implant programme. METHOD 57 children aged between 9 and 18 years were evaluated using the following speech perception tests: lists of monosyllabic and disyllabic word recognition; lists of meaningless syllables recognition - Consonant Confusion Study - Confuse Program (presented in the System to Deploy Cochlear Nucleus software in its programming unit - version 6.90); lists of sentence recognition and list of words used for the assessment of speech sound perception for children with hearing impairment. RESULTS all children achieved satisfactory results with the cochlear implant. In the tests involving the index of phoneme and word recognition, the results were statistically significant for the type of cochlear implant Med-El when compared to the other types of implants. CONCLUSION the study indicates that the cochlear implant has brought real benefits for the group of studied children, as it allowed the maximum development of the auditory skills.

Percepção da fala em crianças em situação de ruído

Meningitis is the main cause of acquired sensorineural hearing loss in children. The patient may also present motor disorders, visual, vestibular, language and attention deficits as well as inability for learning. Characteristically the hearing loss due to meningitis is bilateral profound sensorineural symmetric and descendent and it is more common in males and in children under 5 years old and it brings severe implications in the emotional, social and development. AIM: To compare the performance of two groups of pre-lingually deaf implanted children, with age varying from 1 year and 10 months to 6 years, with hearing loss due to meningitis and other varied causes. STUDY DESIGN: Transversal cohorte. MATERIAL AND METHOD: 63 profoundly deaf implanted children were evaluated, 25 (40%) were male and 38 (60%) were females. In 12 cases (19%) the hearing loss was caused by meningitis and in 51 cases (81%) hearing loss was due to a variety of causes. All participants were submitted to ear nose throat examination and clinical and objective audiological evaluation. CONCLUSIONS: the occurrence of partial insertion was higher in the meningitis group. There were no statically significant differences on word and phoneme recognition as well as in the questionnaire for evaluation of the hearing (MAIS) and language (MUSS) skills between the groups.

Avaliação da produção de fala em crianças deficientes auditivas usuárias de Implante Coclear Multicanal

INTRODUCTION: The inclusion of children with hearing impairments in schools is guaranteed by the Brazilian government by means of official legislation. The FM system is an assistive technology instrument to which regular teachers should have access. OBJECTIVE: To translate and adapt to Portuguese the FM Listening Evaluation questionnaire for children and assess its reliability. METHODS: The translation and adaptation to the FM Listening Evaluation included translation into Portuguese, linguistic adaptation and revision of the grammatical and idiomatic equivalences and adaptation; inter-researcher reproducibility was also evaluated. The questionnaire was administered to the teachers and speech-language pathologists of 12 children aged seven to thirteen years with hearing impairment; the children used hearing aids and had been adapted to the FM system. RESULTS: The translation and adaptation of the questionnaire resulted in new inventory: FM EVALUATION SYSTEM, presenting a significant difference between the results of noise and: hearing pathways and silence; - distance and: hearing pathways and silence; - hearing pathways and: noise, distance and silence; - silence and: noise, distance and hearing pathways. There was significant difference with and without the FM system, in which the score was always higher. Intra-examiner comparison revealed a significant difference between the total score with FM, via FM and hearing no noise with FM. CONCLUSION: The questionnaire Rating System FM was considered a reliable instrument for verifying and monitoring the benefits of FM system, in order to promote the process of educational inclusion for students with hearing impairments.

Early Listening Function (ELF): adaptação para a língua portuguesa

INTRODUCAO: A habilidade em compreender a fala e afetada por muitos fatores durante as avaliacoes, principalmente no ruido, sendo ainda mais complexa para criancas nessas condicoes. OBJETIVO: Analisar a percepcao da fala em criancas com audicao normal em diferentes situacoes de ruido. METODO: Forma de estudo corte transversal. Foi utilizado o Brazilian Hearing in Noise Test (HINT) em 21 criancas de sete a 14 anos com audicao dentro dos padroes de normalidade, e sem alteracoes cognitivas. Foram aplicadas, aleatoriamente, as listas de sentencas nas seguintes situacoes: silencio (S); ruido de frente (RF); ruido a direita (RD); ruido a esquerda (RE); ruido a 180o. (RT) e comparado o resultado de ruido composto (RC) com ruido difuso a partir de quatro campos de som em 45o; 135o; 225o e 315o (4CXS). RESULTADOS: A analise estatistica revelou diferenca significativa entre as seguintes situacoes: RD com RF; RT com RF; sendo pior com 4CXS, onde foi encontrada diferenca para RD, RT, RC, RE e RF. Para a analise de correlacao com a idade, houve significância entre a idade em funcao dos valores HINT apenas para o ruido a frente. CONCLUSAO: As diferencas significativas nos resultados de percepcao da fala entre as diferentes condicoes de escuta no ruido na populacao estudada sugerem cautela na escolha do estimulo em avaliacoes de percepcao da fala no ruido em criancas deficientes auditivas. Assim, pesquisas nessa linha sao necessarias para estabelecer os parâmetros e variaveis relacionadas a sua aplicacao e a interpretacao dos resultados.

Development of P1 cortical auditory evoked potential in children presented with sensorineural hearing loss following cochlear implantation: a longitudinal study

OBJETIVO: Comparar a producao de fala de criancas com deficiencia auditiva neurossensorial a de criancas com neuropatia auditiva/ dessincronia auditiva, ambas submetidas a cirurgia de implante coclear. METODOS: Participaram do estudo cinco criancas com deficiencia auditiva neurossensorial e cinco criancas com neuropatia auditiva/dessincronia auditiva; os dois grupos foram pareados segundo idade e tempo de uso do implante coclear, sendo utilizada uma amostra da fala durante as tarefas de nomeacao de figuras e discurso espontâneo. RESULTADOS: A media de acertos no grupo de criancas com neuropatia auditiva/dessincronia auditiva foi de 59,32%, contra 51,32% no grupo com deficiencia auditiva neurossensorial, nao apresentando diferenca estatisticamente significante. CONCLUSAO: O implante coclear demonstrou ser benefico na reabilitacao da neuropatia auditiva/dessincronia auditiva e, assim como na deficiencia auditiva neurossensorial, o tempo de privacao sensorial influenciou a producao de fala dessas criancas.

Sistema de frequência modulada em crianças com deficiência auditiva: avaliação de resultados

PURPOSE: To translate and adapt the Early Listening Function (ELF) questionnaire into the Brazilian Portuguese language, and to evaluate the reliability of the test. METHODS: It was carried out the translation of the ELF questionnaire into Brazilian Portuguese, the review of grammatical and idiomatic equivalents (reversed translations), and linguistic and cultural adaptation. Moreover, the intra-researcher reproducibility was evaluated. After the translation, the ELF was carried out with 30 children between zero and three years old, with no history of hearing loss risk, lack of family complaint regarding the overall development of the child, and no indicators of hearing loss disability. The questionnaire was applied in 12 cases of hearing detection at different distances, in quiet and noisy environments. RESULTS: Results were analyzed using a descriptive statistical study based on the results obtained on the ELF score sheet. CONCLUSION: The ELF questionnaire was translated and culturally adapted for the studied population. In Brazilian Portuguese, its designation maintained the acronym ELF. The study verified the instruments reliability for observing and monitoring the initial stages of hearing behavior.