Ivone Ferreira Neves-Lobo

Potenciais evocados auditivos de longa latência e processamento auditivo central em crianças com alterações de leitura e escrita: dados preliminares

INTRODUCAO: Atualmente, admite-se que individuos com alteracoes de leitura e escrita podem apresentar atraso no desenvolvimento das habilidades auditivas, o que pode interferir no processo de aprendizagem. A avaliacao das habilidades auditivas pode ocorrer de forma comportamental, por meio dos testes do processamento auditivo central (PAC), ou por meio da avaliacao eletrofisiologica, destacando-se os potenciais evocados auditivos de longa latencia (PEALL). A utilizacao dos PEALL como meio de avaliacao complementar de individuos com alteracoes de leitura e escrita pode se tornar um importante dado tanto para uma caracterizacao mais detalhada das alteracoes, como para o direcionamento terapeutico dessa populacao. OBJETIVO: Caracterizar o PAC e o PEALL em criancas com alteracoes de leitura e escrita. METODO: Pesquisa aprovada pela Comissao de Etica da Instituicao sob no 305/10. A avaliacao do PAC e do PEALL foi realizada em 12 criancas com idade entre oito e 12 anos (media de 10,6 anos), com alteracao de leitura e escrita confirmada em avaliacao especifica. RESULTADOS: As habilidades do PAC mais alteradas foram ordenacao temporal e figura-fundo para sons linguisticos. Foram encontrados resultados alterados no P300 e no MMN. CONCLUSAO: Os individuos com alteracoes de leitura e escrita apresentaram desempenho abaixo do esperado em testes do PAC. O MMN possibilitou uma melhor caracterizacao da funcao auditiva desta populacao. Houve indicios de associacao entre resultados do PAC e alteracao nos PEALL.

Effectiveness verification of an educational program about hearing protection for noise-exposed workers

PURPOSE: To verify the effectiveness of an educational action in the form of training, emphasizing the importance of hearing protection for workers exposed to occupational noise. METHODS: The study included 78 male individuals. All participants answered a questionnaire before they were submitted to audiological evaluation. For the second application of the questionnaire, participants were randomly divided into two groups: Research Group, constituted by 44 subjects that received educational training before the second questionnaire application, and Control Group, comprising 34 individuals that answered the questionnaire before the educational training. Training was based on material with graphic images and text, in the form of conversation. The topics covered included: the importance of hearing, noise effects on health, importance of preventing hearing loss and using hearing protection, conservation and cleaning of hearing protectors, levels of noise in the workplace and noise attenuation provided by hearing protectors. The questionnaire contained 14 multiple choice questions that addressed the same themes explored in the educational training. RESULTS: There was a significant increase of correct responses in the second application of the questionnaire, only in the Research Group, in all comparisons. CONCLUSION: Educational action performed with workers exposed to occupational noise are effective, and the questionnaire is a stable and viable tool to evaluate the effectiveness of educational programs

Processamento temporal de crianças com transtorno fonológico submetidas ao treino auditivo: estudo piloto

PURPOSE: This study compared the temporal processing performance of children with phonological disorders submitted to formal and informal auditory training. METHODS: Fifteen subjects with phonological disorder (pure tone thresholds ≤20 dBHL from 0.50 to 4 kHz, and age between 7 years and 10 years and 11 months) were evaluated, divided into three groups: Control Group: five subjects (mean age 9.1 years) without auditory processing disorder, who passed through two evaluations of the auditory processing at intervals of six to eight weeks and without any intervention; Formal Training Group with five subjects (average 8.3 years) with auditory processing disorder submitted to eight sessions of formal training; and Informal Training Group, with five subjects (average 8.1 years) with auditory processing disorder submitted to eight sessions of informal training. RESULTS: After eight sessions the formal training group showed an improvement of 8% and the informal training group of 22.5% in comparison with the pitch pattern sequence test. For the duration pattern sequence test, the average of the formal training group improved by 12.9% and the informal training group by 18.7%. There was no statistical difference between the means obtained by both groups after intervention, neither in the pitch pattern nor in the duration pattern sequence test. CONCLUSION: Although the results did not present significant differences, this pilot study suggests that both formal and informal trainings provide improvement in the temporal processing abilities of children with phonological and auditory processing disorders.

O Potencial Evocado Auditivo com estímulo de fala pode ser uma ferramenta útil na prática clínica

Purpose : To discuss the clinical applicability of the speech-evoked Auditory Brainstem Response (speech-evoked ABR) to help identifying auditory processing disorders. Methods : We analyzed the records of 27 children and adolescents, aged between seven and 15, who presented abnormal speech-evoked ABR. Then, the data from the behavioral auditory processing evaluation of these individuals were surveyed. Results : It was observed that, among the 27 children with abnormal speech-evoked ABR, 23 also had auditory processing disorders. Therefore, from this sample, an 85.15% probability of observing abnormal behavioral assessment of auditory processing in a child who presented abnormal speech-evoked ABR was obtained. Conclusion : It is argued that the speech-evoked ABR can be used in clinical practice as an important aid tool in the diagnosis of auditory processing disorder, because, in this study, an abnormal speech-evoked ABR usually represented a deficit in the results of behavioral assessment of auditory processing. Thus, it can be used to obtain information about the perception of speech sounds in children under seven years or with challenging behavioral assessment.PURPOSE To discuss the clinical applicability of the speech-evoked Auditory Brainstem Response (speech-evoked ABR) to help identifying auditory processing disorders. METHODS We analyzed the records of 27 children and adolescents, aged between seven and 15, who presented abnormal speech-evoked ABR. Then, the data from the behavioral auditory processing evaluation of these individuals were surveyed. RESULTS It was observed that, among the 27 children with abnormal speech-evoked ABR, 23 also had auditory processing disorders. Therefore, from this sample, an 85.15% probability of observing abnormal behavioral assessment of auditory processing in a child who presented abnormal speech-evoked ABR was obtained. CONCLUSION It is argued that the speech-evoked ABR can be used in clinical practice as an important aid tool in the diagnosis of auditory processing disorder, because, in this study, an abnormal speech-evoked ABR usually represented a deficit in the results of behavioral assessment of auditory processing. Thus, it can be used to obtain information about the perception of speech sounds in children under seven years or with challenging behavioral assessment.

Cortical inhibition effect in musicians and non-musicians using P300 with and without contralateral stimulation

INTRODUCTION Musicians have more robust and efficient neural responses in the cortical and sub-cortical regions, demonstrating that musical experience benefits the processing of both non-linguistic and linguistic stimuli. OBJECTIVE This study aimed to verify P300s latency and amplitude behavioral using contralateral stimulation in musicians and non-musicians. METHODS This was a case-control study. Subjects were divided in two groups: musicians, comprising 30 professional musicians, and non-musicians, comprising 25 subjects without musical experience. RESULTS The present study showed that the musicians had lower latencies and higher amplitudes than the non-musicians in the P300 without contralateral noise. For the P300 amplitude values, the difference between groups persisted, and the musicians presented significantly higher amplitude values compared with the non-musicians; additionally, the analysis of the noise effect on the P300 response showed that the latency values were significantly increased in the musicians. CONCLUSION The central auditory nervous system of musicians presents peculiar characteristics of electrophysiological responses probably due to the plasticity imposed by musical practice.

Manutenção das habilidades auditivas pós treinamento auditivo

Purpose The aim of the current study was to determine the efficacy of auditory training and to establish the long-term effectiveness of the acquired auditory abilities one, two or three years following the completion of the program. Methods Ten children, who presented abnormal auditory processing ranging in degree from mild-moderate, moderate, to moderate-severe, underwent an 8-week auditory training program. All participants were reassessed immediately after training (POST-1) and one, two or three years after training (POST-2). Results Significant differences were detected in average performance between the assessment made prior to auditory training (PRE) and POST-1 assessment, and between PRE and POST-2 assessments, but no significant differences were found between POST-1 and POST-2 assessments. No correlations were detected between POST-1 and POST-2 time interval, and the difference in performance between these two evaluations. The auditory processing assessments in POST-1 were considered normal, or were mildly altered. Further, 60% of the individuals achieved the same results in POST-2 assessment. Conclusion In the current study, we verified that auditory training is an effective intervention for Auditory Processing Disorders, and that the benefits obtained after training persist even after intervals of one, two or three years following intervention.

Training on hearing protector insertion improves noise attenuation

PURPOSE To determine the efficacy of hearing protector insertion by comparing attenuation values measured by objective (MIRE) and subjective (REAT) methods in groups with and without training. METHODS The study included 80 male subjects assigned to experimental (with training) and control (without training) groups. The following procedures were performed: occupational history, objective and subjective assessment of hearing protectors. Only subjects in the experimental group received training and guidance on proper hearing protector insertion. RESULTS Attenuation values were significantly higher in the experimental group than in the control group at all frequencies (500, 1000, 2000, and 4000 Hz) investigated through the objective (MIRE) and subjective (REAT) methods. In addition, attenuation values in the control group were lower than those provided by the hearing protector manufacturer. CONCLUSION Both objective and subjective attenuation tests demonstrated the efficacy of training on insertion of hearing protectors because the group that received training on proper hearing protection insertion exhibited higher attenuation values than the untrained group.

Avaliação auditiva periférica em crianças com síndrome de Down

ABSTRACT Purpose: This study sought to characterize the peripheral auditory sys-tem of individuals with Down syndrome (DS) using conventional and high-frequency audiometry. Methods: We performed a cross-sectional and observational study. Fifteen individuals with DS, who were of both genders and between 7 and 15 years of age, participated in this study. The following procedures were performed: otoscopy, tympanometry with ipsilateral and contralateral acoustic reflex, pure-tone audiometry, vocal audiometry and high-frequency audiometry. Results: There was a predominance of mild conductive hearing loss in one or both ears. The mean hearing thresholds for conventional audiometry were below 20 dB HL and between 20 and 40 dB HL for high-frequency audiometry. The Pearson correlation coefficient indicated a moderate positive correlation between the 9-14 kHz thresholds and age. Conclusion: Overall, no significant differences were observed when comparing the right and left ears of individuals with DS, in regards to pure-tone audiometry, immit-tance testing and speech audiometry. Most children showed middle ear abnormalities and conductive hearing loss. Moreover, high-frequency audiometry suggested the onset of impaired cochlear function, which may be associated with frequent otitis media episodes and/or early cochlear degeneration.

Caracterização eletrofisiológica da audição em indivíduos com Síndrome de Down

Introduction Few studies have performed Brainstem (BAEP) and P300 Auditory Evoked Potentials simultaneously to assess central auditory pathways in normal hearing individuals with Down syndrome (DS), mainly because of the difficulty in applying these procedures to this population. Previous studies have suggested that individuals with DS might present different patterns of response compared with those of individuals with typical development; nevertheless, the identification of these potentials would be crucial for the establishment of an accurate audiological diagnosis. Purpose To characterize BAEP and P300 in normal-hearing individuals with DS. Methods BAEP and P300 were analyzed in 17 individuals with DS and in 21 individuals with typical development aged 7 to 15 years. The results were quantitatively and qualitatively analyzed using descriptive measures and hypothesis tests. Results In the quantitative analysis, latency values were lower in the BAEP for the DS group, with statistically significant difference for wave V and interpeaks III-V and I-V; there were no significant differences in the P300 latency values. In the qualitative analysis, there were a larger number of individuals with early values for BAEP latencies and late latencies for P300 in the DS group; both comparisons showed statistically significant differences. Conclusion Children and adolescents with DS can present early responses to the components of BAEP, suggesting that their auditory pathway requires less time for the neural transmission of acoustic stimuli to the brainstem. Concerning P300, individuals with DS may present increased latencies, suggesting impairment in the central auditory pathway for the cortical processing of auditory information.Introduction Few studies have performed Brainstem (BAEP) and P300 Auditory Evoked Potentials simultaneously to assess central auditory pathways in normal hearing individuals with Down syndrome (DS), mainly because of the difficulty in applying these procedures to this population. Previous studies have suggested that individuals with DS might present different patterns of response compared with those of individuals with typical development; nevertheless, the identification of these potentials would be crucial for the establishment of an accurate audiological diagnosis. Purpose To characterize BAEP and P300 in normal-hearing individuals with DS. Methods BAEP and P300 were analyzed in 17 individuals with DS and in 21 individuals with typical development aged 7 to 15 years. The results were quantitatively and qualitatively analyzed using descriptive measures and hypothesis tests. Results In the quantitative analysis, latency values were lower in the BAEP for the DS group, with statistically significant difference for wave V and interpeaks III-V and I-V; there were no significant differences in the P300 latency values. In the qualitative analysis, there were a larger number of individuals with early values for BAEP latencies and late latencies for P300 in the DS group; both comparisons showed statistically significant differences. Conclusion Children and adolescents with DS can present early responses to the components of BAEP, suggesting that their auditory pathway requires less time for the neural transmission of acoustic stimuli to the brainstem. Concerning P300, individuals with DS may present increased latencies, suggesting impairment in the central auditory pathway for the cortical processing of auditory information.

Middle ear muscle reflex measurement in neonates: Comparison between 1000 Hz and 226 Hz probe tones

INTRODUCTION Middle ear muscle reflex (MEMR) evaluation assists in diagnosing hearing problems because normal responses depend on preconditions of a healthy auditory system. Studies in neonates recording the acoustic reflex with 226Hz probes have described high rates of absence. Other studies using a high frequency probe have found higher rates of presence in normal neonates. However, few studies have compared results between low and high frequency probes in the same newborns. OBJECTIVE To comparatively assess the ipsilateral acoustic reflex recorded by 226Hz and 1000Hz probes in newborns. METHOD A total of 77 newborns, with the presence of transient otoacoustic emissions, underwent tympanometry, wideband acoustic immittance, and ipsilateral reflex investigations with 226Hz and 1000Hz tone probes. RESULTS The acoustic reflex was activated at a much lower intensity with all activating stimuli using the 1000Hz probe compared with the values of the 226Hz probe. There was a higher incidence of ipsilateral acoustic reflexes recorded by the 1000Hz tone probe compared to the 226Hz tone probe. There was no correlation between the acoustic reflex thresholds and otoacoustic emissions. CONCLUSION In newborns, the acoustic reflex measurements obtained with the 1000Hz probe showed advantages over the 226Hz probe.