Fleming Salvador Pedroso

Hipersensibilidade auditiva no transtorno do espectro autístico

BACKGROUND auditory hypersensitivity in the autistic spectrum disorder has been described in the literature since the very first reports. However, this symptom has not been sufficiently explored, especially regarding possible causes, diagnosis and consequences. AIM to study sensory-perceptual abnormalities in the autistic spectrum disorder, emphasizing auditory hypersensitivity and to discuss their effects in speech therapy based on the literature found until September 2007 in the following database: Scielo, Lilacs, Web of Science, and Medline. CONCLUSION sensory-perceptual abnormalities are present in approximately 90% of individuals with autism; no theory has been found to explain this fact. Although the cause of auditory hypersensitivity remains unknown, it is the most common sensory-perceptual abnormality--its prevalence ranges between 15% to 100%. A few rare studies exist on behavioral, electroacoustic and electrophysiological hearing evaluation of autistic children; these studies discuss auditory hypersensitivity. The early diagnosis of this alteration is considered relevant for the possible identification of atypical sensorial markers, especially in hearing and for the better understanding of their impact on the development of communication in autistic individuals.

Auditory hypersensitivity in children and teenagers with autistic spectrum disorder

OBJECTIVE To verify if the clinical behavior of auditory hypersensitivity, reported in interviews with parents/caregivers and therapists/teachers of 46 children and teenagers suffering from autistic spectrum disorder, correspond to audiological findings. METHOD The clinical diagnosis for auditory hypersensitivity was investigated by means of an interview. Subsequently, a test of the acoustic stapedial reflex was conducted, and responses to intense acoustic stimulus in open field were observed. RESULTS Of the 46 subjects, 11 (23.9%) were clinically diagnosed as oversensitive to sound and only 2 showed discomfort when exposed to intense acoustic stimulus in open field. There was no statistically significant difference for the test of the ipsilateral acoustic stapedial reflex between the groups. CONCLUSION Behavioral manifestations to sounds are not associated to hypersensitivity of the auditory pathways, but instead these are associated to difficulties in the upper processing, involving systems that usually are impaired in autistic spectrum patients, such as the limbic system.

Neurological examination in the healthy term newborn

We carried out a cross-sectional study with a sample of 106 normal full-term newborns examined within 24 to 72 hours of birth. The following findings were evaluated: head and chest measurements, muscle strength, tone, tendon reflexes, superficial reflexes, primitive reflexes, and cranial nerves. All 106 newborns were considered neurologically normal. We found no differences in the neurological examination findings for newborns with different gestational ages. Primitive reflexes and appendicular tone in newborns examined at earlier postnatal ages tended to be less intense. We were able to determine the prevalence of certain neurological examination findings for the normal newborn and to discuss some differences between our results and those of other studies. Prevalence estimations for the different findings in our study may be valid for different populations as long as the same methodology is adopted.

Evolution of anterior fontanel size in normal infants in the first year of life.

To analyze cranial growth and size of anterior fontanel during the first year of life, we undertook a cohort study with a sample of 33 infants assessed at birth and reexamined at 1, 2, 3, 4, 5, 6, 9, and 12 months. Examination included assessment of head circumference, anterior fontanel size, anteroposterior distance, biauricular distance, and cephalic index. All infants were neurologically normal. Mean size of the anterior fontanel at birth was 1.77 cm2 and, in disagreement with literature data, fontanel size increased up to 2 months of age; fontanel was closed at 1 year for 27.3% of infants. Significant differences in cranial anthropometry were not found in relation to method of delivery (vaginal or cesarean section), gender and gestational age. Our results indicate the need to reevaluate anthropometric examination data and to establish patterns of normality, particularly for miscegenated populations that have not been widely investigated.

Latência do potencial evocado auditivo P300 em idosos

Auditory cortical disorders in the elderly can be assessed by the P300. The lack of contemporary reference values of P300 latency in healthy elderly motivated this study. AIM: To estimate the effect of age on P300 latency in a group of elderly. METHODS: We studied 62 elderly patients with pure tone thresholds up to 40 dB HL at the frequencies of 1000 and 2000 Hz, divided into groups according to age (60-64, 65-69 and 70-74 years). Were assessed by the P300 latency in response to the rare stimulus of 2000 Hz and 1000 Hz frequencies, both in the intensity of 80 dB HL. STUDY DESIGN: clinical, cross-sectional observational individual compared prospective. RESULTS: The latency in Group 60 was 337.26 ms (SD 11.31) in Group 65 was 351.86 ms (SD 29.05) and in Group 70 it was 370.19 ms (SD 23.40). The linear regression of the values of P300 latency showed an increase of 2.85 ms per year of age. The statistical analysis showed that the results were significant. CONCLUSION: The P300 latency increases with age at a rate of 2.85 ms per year between the ages of 60 and 74 years.

From the foot-mouth reflex to the hand-mouth reflex a continuum of responses to Appendicular Compression

We studied the mouth opening response to appendicular compression in two groups of children. This study was performed with the intention of testing the semiologic role of the act of mouth opening following stimulation of various regions, based on the hand mouth reflex of Babkin. Group I was formed by 33 normal children who underwent monthly follow up assessments since birth; and group II consisted of 50 children older than 6 months of age, known to have a neurologic deficit and a neuro-psychomotor development equivalent to that of a child in the first trimester of life. We observed that the normal mouth opening response in group I was more pronounced following compression of the hand and forearm when compared to compression of the arm (p < 0.001). This response could persist for as long as the first 6 months of life. We were not able to elicit a mouth opening response following compression of the lower limb in this group. Among children from group II, we observed mouth opening responses to stimulation of all limb segments. Within the upper limb, the response was more pronounced following compression of the hand in comparison to the forearm (p < 0.01), and forearm in comparison to the proximal arm (p < 0.01). Stimulation of the foot was more effective in eliciting a mouth opening response when compared to equivalent stimulation of the lower leg (p < 0.05). However, there was no statistical difference when responses to stimulation of the lower leg and thigh were compared. The presence of the previously unreported foot-mouth response may serve as an indicator of central nervous system compromise and could be associated with a poorer prognosis. We believe that our observations of the specific foot-mouth response patterns may serve as a marker of early neuro-psychomotor development dysfunction during childhood.

Evolução das manifestações pré-linguísticas em crianças normais no primeiro ano de vida

PURPOSE: The aim of this study was to determine the frequency and occurrence of pre-linguistic elements in normally developing infants during their first year of life. METHODS: The sample comprised 33 full-term normal children, born at the Hospital de Clinicas de Porto Alegre, randomly selected for a cohort study. The information regarding the variables social smile, inarticulate sounds, monosyllabic babbling, polysyllabic babbling, first words, jargon and sentences, were obtained through an inquiry (parental information), spontaneous observation by the examiner, and facilitating stimuli. RESULTS: These results set a pattern of normal development of pre-linguistic manifestations. CONCLUSIONS: The results showed the need to review language assessment data already established by previous studies and evaluations currently applied.

Sentimentos manifestados por mães frente à triagem auditiva neonatal

PURPOSES: to identify feelings expressed by the mothers during their childrens Neonatal Auditory Screening (NAS), to check the sufficiency of the provided information; to find out their opinions on the possibility of having a hearing impaired child. METHODS: during three months 75 mothers that gave birth at the University Hospital were interviewed after signing the Permission Form when they arrived for the Optional Neonatal Auditory Screening. Information on the purposes and procedures of NAS were provided, showing the importance of the screening done between the age of 8 and 12 months. A questionnaire was applied by undergraduate Audiology students. The questionnaire was applied individually. RESULTS: 58 (77.3%) mothers affirm that NAS is an early way of identifying hearing impairment; 64 (85.3%) consider that the provided information is sufficient; 27 (36%) point out having positive feelings during their childrens screening, 23 (30.7%) point out negative feelings, while 25 (33.3%) point out having mixed feelings about the subject. As to the possibility of having a hearing impaired child, 57 (76%) mothers showed negative opinions. CONCLUSIONS: the majority of the interviewed mothers were able to answer correctly on what NAS was, as well as they considered the information given about the test to be sufficient; there was a predominance of positive feelings during the screening; the possibility of having a hearing impaired child was considered null by three-thirds of the studied mothers.

Language and Focal Brain Lesion in Childhood

Childhood ischemic strokes can lead to problems like hemiplegias, epilepsies, cognitive changes (memory and mathematical solutions), and language ability (reading, writing, and aphasias). The purpose of this study was to evaluate language and its aspects in children with unilateral ischemic stroke and associate them with the age during the event, injured side, and occurrence of epilepsy. Thirty-two children between 8 months and 19 years of age were evaluated. Among them, 21 (65%) had a change in their language skills, there being a connection between age and the time of injury (P < .05). The most impaired aspects were their phonology, semantics, and syntax. In this sample, there was a persistent change in the semantic aspect, which is an alert for the early detection of learning and future development problems.

ASSOCIATION BETWEEN DYNAMIC ASYMMETRY OF THE NEWBORN'S HEAD AND INTRAUTERINE FACTORS

A non-comparable, individual, observational and contemporary cross-sectional study in newborns was made to determine the dynamic lateralization in the head turning after release from the midline and its relationship with obstetric variables. From October to December of 2005, 320 newborns were admitted to the Adjacent Lodgings of the University Hospital of Santa Maria. From those, 89 were selected for assessment of the vestibular function since they have had previously fetal static control through ultrasound. Our results show that the right-sided head lateralization was significantly greater than the left-sided. The predominancy of the lateralization towards the right side also occurred in cephalic presentations and left-sided back, however these were not significant. Results corroborate with the existing literature and suggest an association between fetal static and vestibular function.