Daniela Gil

Formal auditory training in adult hearing aid users.

INTRODUCTION Individuals with sensorineural hearing loss are often able to regain some lost auditory function with the help of hearing aids. However, hearing aids are not able to overcome auditory distortions such as impaired frequency resolution and speech understanding in noisy environments. The coexistence of peripheral hearing loss and a central auditory deficit may contribute to patient dissatisfaction with amplification, even when audiological tests indicate nearly normal hearing thresholds. OBJECTIVE This study was designed to validate the effects of a formal auditory training program in adult hearing aid users with mild to moderate sensorineural hearing loss. METHODS Fourteen bilateral hearing aid users were divided into two groups: seven who received auditory training and seven who did not. The training program was designed to improve auditory closure, figure-to-ground for verbal and nonverbal sounds and temporal processing (frequency and duration of sounds). Pre- and post-training evaluations included measuring electrophysiological and behavioral auditory processing and administration of the Abbreviated Profile of Hearing Aid Benefit (APHAB) self-report scale. RESULTS The post-training evaluation of the experimental group demonstrated a statistically significant reduction in P3 latency, improved performance in some of the behavioral auditory processing tests and higher hearing aid benefit in noisy situations (p-value < 0,05). No changes were noted for the control group (p-value <0,05). CONCLUSION The results demonstrated that auditory training in adult hearing aid users can lead to a reduction in P3 latency, improvements in sound localization, memory for nonverbal sounds in sequence, auditory closure, figure-to-ground for verbal sounds and greater benefits in reverberant and noisy environments.

Auditory evoked potentials in premature and full-term infants

UNLABELLED Accurate information about type, degree, and configuration of hearing loss are necessary for successful audiological early interventions. Auditory brainstem response with tone burst stimuli (TB ABR) and auditory steady-state response (ASSR) exams provide this information. AIM To analyze the clinical applicability of TB ABR and ASSR at 2 kHz in infants, comparing responses in full-term and premature neonates. MATERIAL AND METHOD The study was cross-sectional, clinical and experimental. Subjects consisted of 17 premature infants and 19 full-term infants. TB ABR and ASSR exams at 2000 Hz were done during natural sleep. RESULTS The electrophysiological minimum response obtained with TB ABR was 32.4 dBnHL (52.4 dBSPL); the ASSR minimum was 13.8 dBHL (26.4 dBSPL). The exams required 21.1 min and 22 min, respectively. Premature and full-term infant responses showed no statistically significant differences, except for auditory steady-state response duration. CONCLUSIONS Both exams have clinical applicability at 2 kHz in infants, with 20 min of duration, on average. In general, there are no differences between premature and full-term individuals.

A efetividade do treinamento auditivo formal em idosos usuários de próteses auditivas no período de aclimatização

OBJETIVO: Verificar a efetividade de um programa de treinamento auditivo formal em idosos usuarios de proteses auditivas intraaurais no periodo de aclimatizacao. METODOS: A amostra foi composta por 18 idosos (idade media: 71, 38 anos), de ambos os sexos, adaptados ha uma semana com proteses auditivas intra-aurais binaurais. Os participantes foram randomizados em dois grupos: Grupo Experimental (submetidos ao treinamento auditivo) e Grupo Controle (nao submetidos ao treinamento auditivo). O Grupo Experimental participou de sete sessoes de treinamento auditivo em cabina acustica, uma sessao por semana, com duracao de 50 minutos cada. Os procedimentos de avaliacao incluiram testes de reconhecimento de fala e questionario de auto-avaliacao do handicap auditivo. Estes foram aplicados em duas oportunidades, antes (1a avaliacao) e depois (2a avaliacao) do treinamento auditivo no Grupo Experimental e na avaliacao inicial e final do estudo no Grupo Controle. RESULTADOS: No Grupo Experimental, o Indice de Reconhecimento de Fala e Fala com Ruido Branco foram significantemente melhores apos o treinamento auditivo (2a avaliacao). Ja o estudo das relacoes sinal/ruido no teste de reconhecimento de sentencas no ruido revelou uma tendencia (p-valor proximo a 0,05) de melhora na avaliacao pos-treinamento. Observou-se nos idosos do Grupo Experimental que os resultados obtidos na 2a avaliacao nao foram significantemente melhores aos obtidos no Grupo Controle em todos os testes. CONCLUSAO: Pode-se concluir que um programa de reabilitacao aural, incluindo treinamento auditivo formal beneficia os idosos no periodo de adaptacao das proteses auditivas, bem como modifica o comportamento auditivo destes individuos.

Avaliação comportamental do processamento auditivo em indivíduos gagos

BACKGROUND: the behavioral auditory processing (AP) evaluation allows the investigation of neuroaudiological processes involved in speech fluency processing. AIM: the purpose of this study was to describe the results obtained in the AP evaluation in stutterers, comparing the type of AP disorder with the severity of stuttering. METHOD: 56 subjects, 49 male and 7 female, ranging in age from 4 to 34 years, were referred from the speech-language clinic of UNIFESP to the AP evaluation. All patients were submitted to the following evaluations: audiological, speech and language. Disfluency was classified according to the protocol proposed by Riley (1994) which includes the following stuttering severity levels: very mild, mild, moderate, severe and very severe. Behavioral AP tests were selected and analyzed according to the patients age and to the proposal of Pereira & Schochat (1997). RESULTS: subjects with ages between 4 to 7 years and between 12 to 34 years presented mostly mild stuttering, subjects between 8 to 11 years presented mostly moderate stuttering. From the total of 56 individuals who were evaluated, 92.85% presented AP disorders. The most common auditory processing disorders were supra-segmental and decoding. No statistical differences were found considering the results of the AP evaluation and the severity of stuttering for none of the age groups. CONCLUSION: the AP evaluation indicated deficits for most of the participants of all age groups, however no correlations were observed with the severity of stuttering.

Zumbido em indivíduos sem perda auditiva e sua relação com a disfunção temporomandibular

UNLABELLED Research has shown that dysfunction of the temporomandibular joint is often associated with tinnitus. AIM To characterize tinnitus in individuals with normal hearing and search for a possible relationship with Temporomandibular Disorders (TMD). STUDY DESIGN prospective and cross-sectional. MATERIALS AND METHODS The participants included 20 adults of both genders with tinnitus and normal hearing thresholds on audiometry. We studied tinnitus psychoacoustic characteristics and employed the checklist of TMD signs and symptoms from the Tinnitus Handicap Inventory (THI). RESULTS The high pitch, continuous and bilateral tinnitus was the most frequent. Upon acuphenometry, the average tinnitus pitch reported by the subjects was 8.6 kHz and the average loudness was 14.1 dBSL. The degree of discomfort caused by tinnitus was mild. We observed that the higher the pitch, the lower was the loudness and the higher was the THI score. We found that 90% of the patients had at least one TMD sign or symptom. CONCLUSIONS The most common was the high pitch, continuous and bilateral tinnitus; 90% of patients had at least one sign or symptom of TMD and there was no correlation between the tinnitus and acuphenometry, THI and the TMD checklist.

PEATE automático em recém nascidos de risco: estudo da sensibilidade e especificidade

OBJETIVO: verificar a sensibilidade e especificidade do teste de potencial evocado auditivo de tronco encefalico em equipamento automatico (PEATEa), comparando-o ao teste de potencial evocado auditivo de tronco encefalico em equipamento diagnostico (PEATE) em um programa de triagem auditiva neonatal em neonatos de risco. METODO: foram avaliados 186 neonatos, 83 nascidos a termo e 103 pre-termo, sendo 88 do sexo masculino e 98 feminino. A triagem constou de emissoes otoacusticas evocadas por estimulos transientes (EOAT), PEATEa e ao PEATE na mesma semana. RESULTADOS: dos 186 neonatos avaliados, 156 (83,9%) apresentaram audicao normal. A perda condutiva foi encontrada em 9 neonatos (4,8%),sendo 7 bilaterais e 2 unilaterais. A perda auditiva coclear foi observada em 5 neonatos (2,7%) sendo um unilateral. Alteracao central foi obtida em 11 neonatos (5,9%) e um neonato foi diagnosticado como espectro da neuropatia auditiva -ENA(0,5%).Em 4 casos houve atraso maturacional na avaliacao inicial com normalizacao das respostas no mes seguinte Comparando-se os resultados do PEATEa com o PEATE, observou-se alta sensibilidade ( superior a 99%) para identificacao de perda coclear,condutiva, central, atraso maturacional e ENA .A especificidade do PEATEa foi de 100% para ENA, mediana para perda coclear (75% na OD e 60% na OE), e para alteracoes centrais (54,5%OD e 63,6% OE). Para identificacao de perdas condutivas (inferior a 43%). CONCLUSAO: o PEATEa foi eficaz na identificacao das neuropatias auditivas com elevada especificidade e sensibilidade. Contudo, falsos negativos foram observados para perdas cocleares, condutivas, para alteracoes centrais e atraso maturacional.

A eficácia do treinamento auditivo formal em adultos com distúrbio do processamento auditivo (central)

OBJETIVO: comparar o desempenho de adultos com disturbio do processamento auditivo em testes comportamentais pre e pos-treinamento auditivo formal, visando verificar a eficacia desse treinamento. METODOS: trata-se de um estudo retrospectivo quantitativo com 18 individuos com disturbio do processamento auditivo comprovado pela avaliacao comportamental, idade entre 16 e 38 anos. Todos os individuos foram submetidos a um programa de treinamento auditivo formal realizado em oito sessoes de 45 minutos cada, duas vezes por semana, cujas sessoes foram organizadas em ordem crescente de complexidade visando o treinamento das habilidades auditivas de fechamento auditivo, figura-fundo para frases, palavras, silabas e sons nao verbais e de processamento temporal dos sons (analise da intensidade, duracao e frequencia dos sons). Foram comparados os resultados dos testes SSW em Portugues, SSI (MCI) e Reconhecimento de Padrao de Duracao e de Frequencia obtidos no pre e pos - treinamento auditivo, envolvendo as variaveis: orelha e sexo. RESULTADOS: nao foram observadas diferencas estatisticamente significantes entre as orelhas. Tanto homens quanto mulheres quando analisados separadamente demonstraram resultados melhores no pos-treinamento. Estas diferencas foram estatisticamente significantes nos testes de padrao de duracao e frequencia, para homens e mulheres. No SSW melhora no sexo masculino e no SSI R/S -15 no sexo feminino, respectivamente. Alem disso, todos os individuos relataram melhor desempenho comunicativo e de atencao no pos-treinamento. CONCLUSAO: o treinamento auditivo formal melhora as habilidades auditivas de figura - fundo para sons verbais e de processamento temporal medidas por testes comportamentais em adultos diagnosticados com disturbio de processamento auditivo.

Avaliação do grau de envolvimento familiar nos atendimentos de crianças com deficiência auditiva

Purpose: The aim of the present study was to assess family participation in the therapeutic process of children with hearing impairment using hearing aids and/or cochlear implants enrolled at the Educational Audiology Clinic and Center for Interdisciplinary Studies on Hearing, Language and Education. Methods: This study was conducted with 25 families of children with hearing impairment between 0 and 14 years old enrolled in speech and hearing therapy for at least six months. Data was collected from the patient charts. The Family Involvement Rating Scale (Moeller) translated into Portuguese was administered to characterize the quality of family participation in the therapeutic process. Results: The mean degree of family involvement among the 25 families studied was 3.28. The therapists classified 40% of the families as presenting an average level of participation (score: 3); 20% were classified as presen ting below-average participation and 8% were classified as presenting an ideal degree of participation. Conclusion: A large portion of the families analyzed exhibited an average level of participation in the therapeutic process of their children. No correlation was found between the different categories of family involvement and the degree of hearing impairment with or without hearing aids or cochlear implants. Additionally, no correlation was found between the duration of therapy and the degree of family involvement.

Tradução e adaptação do questionário ABEL: Auditory Behavior in Everyday Life para o Português Brasileiro

OBJETIVO: Traduzir e adaptar o questionario ABEL - Auditory Behavior in Everyday Life - para o Portugues Brasileiro e estabelecer o perfil do comportamento auditivo de criancas usuarias de aparelhos de amplificacao sonora individual (AASI) por meio de sua aplicacao. METODOS: Foi realizada a traducao do questionario ABEL, seguida pela retrotraducao. Esta versao foi comparada a original em relacao a equivalencia semântica, sendo gerada uma nova versao em Portugues. A partir disso, foram entrevistados 31 pais de criancas adaptadas com AASI. Todos responderam a uma anamnese e a versao em Portugues do questionario ABEL. Os escores obtidos na aplicacao do instrumento foram relacionados as variaveis investigadas na anamnese. RESULTADOS: A analise do escore oral-aural revelou diferencas segundo as variaveis grau de perda auditiva e tempo de uso diario dos AASI, sendo que criancas com menores graus de perda e/ou que fazem uso dos AASI por mais tempo apresentam melhor desempenho. Em relacao ao escore total e ao escore de consciencia auditiva, houve diferencas segundo o tempo de uso diario dos AASI, indicando melhor desempenho daquelas que fazem uso dos AASI por mais tempo. CONCLUSAO: Ha coerencia entre as versoes geradas nas etapas de traducao do questionario, possibilitando a formulacao de sua versao em Portugues. Criancas com menores graus de perda auditiva e/ou que referem maior tempo de uso diario de AASI tem suas atividades diarias menos comprometidas pela perda auditiva. O questionario ABEL e um instrumento apropriado para detalhar o desenvolvimento dos comportamentos auditivos de criancas usuarias de AASI.

Elaboração da versão em Português Brasileiro do teste de identificação de sentenças dicóticas (DSI)

PURPOSE: To develop the Brazilian Portuguese version of the dichotic sentence idenfication test (DSI). METHODS: The sentences used in the Portuguese version of DSI test were extracted from the Synthetic Sentece Identification (SSI) test in Portuguese. A method of combination was used in order to create 45 pairs of sentences, each pair corresponding to a test item. The items were divided into five groups, each group corresponding to a specific test condition. For this purpose, a computer program was designed in the Matlab 7.0 computing platform, using the Monte Carlo method, or the brute force method, for the distribution of items in each group. The sentences were edited, recorded and finalized; for manipulation of data it was used the CaKewalk Sonar 2.2 program. Finally, the Sound Forge program was used for finalization and standardization of the recording. RESULTS: As a result, a compact disc with six tracks was obtained to be used as part of the behavioral assessment of auditory processing, including the following tracks: calibration, practice, binaural integration, directed attention to the right and to the left ears. The use of the calibration and auditory training tracks is recommended for use in the rehabilitation of auditory processing disorders. CONCLUSION: The compact disc with the Brazilian Portuguese version of the DSI test consisted of six tracks: calibration, practice, binaural integration, directed attention to the right and to the left ears and auditory training.