Maria Cecília Marconi Pinheiro Lima

Detecção de perdas auditivas em neonatos de um hospital público

ABSTRACT Purpose: To analyze the results obtained in a neonatal hearing screening program that included two procedures, Transient Otoacoustic Emissions and Automated Brainstem Evoked Response Audiometry, in healthy neonates, born in a public hospital, regarding the variables gender (male or female) and ear that failed (left, right or bilateral). Methods: Neonates born in a public maternity hospi-eonates born in a public maternity hospi-born in a public maternity hospi-tal, who stayed in shared rooms and attended hearing screening after discharge were included in the study. The screening included the Transient Otoacoustic Emissions with pass/fail criterium , and a retest for neonates who failed the first test with the Automated Brainstem Evoked Response Audiometry. Results: A total of 5106 neonates were screened, 51.3% male and 48.7% female. Among them, 628 (12.3%) neonates failed the test, 368 (58.6%) male and 260 (41.4%) female. They were referred to the Brainstem Evoked Response Audiometry, and 223 (35.3%) came to the test. From these subjects, 199 (89.2%) passed and 24 (10.8%) failed the test: 17 (70.9%) male and seven (29.1%) female. Statistically significant difference was found between gender and fail in the Transient Otoacoustic Emissions. Ten percent of the neonates failed both screening procedures.

Acompanhamento de lactentes com baixo peso ao nascimento: aquisição de linguagem

The objective of this work was to follow-up language development of full-term infants/small for gestational age (RNT/PIG) and preterm infants/adequate for gestational age (RNPT/AIG). The assessments were done monthly, up to their 18th months of age. Twenty infants were evaluated, 10 of each group. The Ethical Committee of the institution approved the project. It was used the Protocol for Anamneses and the Early Language Milestone Scale - ELM Scale. Both groups were compared with 47 full term, adequate for gestational age infants. The results had shown that up to the 6th month, the infants showed a normal performance for their age. In the 9th month, there was a delay in babbling production. In the 12th month, infants of the RNT/PIG group showed a significant statistically delay expressing polysyllabic babbling and infants of the RNPT/AIG group showed delay in the production of the first words. In the 18th month, the delay persisted in one infant of the RNT/PIG group.

Método para avaliação da conduta visual de lactentes

The purpose of this study is to introduce a method to evaluate visual functions in infants in the first three months of life. An adaptation of the Guide for the Assessment of Visual Ability in Infants (Gagliardo, 1997) was used. The instrument was a ring with string. It was implemented a pilot study with 33 infants, selected according to the following criteria: neonates well enough to go home within two days of birth; 1 to 3 months of chronological age; monthly evaluation with no absence; subjects living in Campinas/SP metropolitan area. In the first month we observed: visual fixation (93,9%); eye contact (90,9%); horizontal tracking (72,7%); inspects surroundings (97,0%). In the third month, we observed: inspects own hands (42,4%) and increased movements of arms (36,4%). This method allowed the evaluation of visual functions in infants, according to the chronological age. Alterations in this function will facilitate immediate referral to medical services for diagnoses.

Improvement of return rates in a Neonatal Hearing Screening Program: the contribution of social work.

Abstract This paper aims to describe the implementation of a Neonatal Hearing Screening Program in a school hospital, focusing on the return rates among infants who failed the first screening. The population who goes to the school hospital for health services comes mainly from economically underprivileged groups. Even though our previous return rates were comparable to those reported elsewhere, we felt it was important to improve the methodology of the screening process in order to try and obtain better results. Our hypothesis was that scarce knowledge on early hearing loss detection and on the benefits of early intervention could be reasons for mothers to give less importance to the second screening. So, a strategy was developed around the idea of providing very detailed information to the mothers about the screening process since preliminary data, gathered with a different group of in-patients, had shown that mothers possessed little knowledge about neonatal hearing screening and the consequences of hearing loss for childrens development. The no-return rates decreased considerably (from 39.8% to 25.8%). The findings of this research showed both the need of an adequate way of imparting information to the mothers of newborns about hearing screening in economically underprivileged populations, and the role of social work in this process. Without adequate knowledge on hearing screening and the consequences of hearing loss, a high percentage of newborns may not take advantage of free universal hearing screening programs.

Knowledge, habits, preferences, and protective behavior in relation to loud sound exposures among Brazilian children

Abstract Objective: Identification of the beliefs and attitudes towards noise exposure and the risk of noise-induced hearing loss in Brazilian children. Design: Prospective cross-sectional study through interviews with children and their parents. Study sample: 753 children were selected and invited to participate. The final sample was 475 children and 404 parents. Results: In general, children disliked noisy places (67%). Although 87.4% of the children and 93.9% of the parents considered loud sounds damaging to the ears, children were poorly informed about hearing protection and did not have hearing protection devices. Children were mostly exposed to parties and concerts with loud music (51.9%), carnaval (Mardi Gras) parties (38.2%), firecrackers (36.8%), and loud music at home or in the car (33.1%), or from listening to loud music with earphones (17.3%). Compared to children from private schools, children from public schools had a greater preference for loud sounds and were less informed about hearing protection. Conclusions: Knowledge of hearing risk from loud sounds was not enough to prompt preventive behaviors, and adults exposed children to loud sounds.

Adesão a um Programa de Triagem Auditiva Neonatal

Neonatal hearing screening programs have been developed worldwide. Since 2002, the newborns from the Center for Integral Assistance to Women’s Health at UNICAMP have been referred to hearing screening at the Center for Studies and Research on Rehabilitation “Prof. Dr. Gabriel Porto”. Nevertheless, not all newborns come to the screening and others drop out before the procedures are completed. The goal of this research was to characterize the newborns’ adherence rates to the Neonatal Hearing Screening Program. A retrospective investigation was carried out, collecting data on the records of all cases screened from February to November of 2007. A total of 2107 infants were referred to hearing screening and 1310 actually came. Among those who failed the test (92 infants), 73 returned for the retest with the use of BAEP. The adherence rate in the first stage of the screening was 62.17% and, in the second, 79.34%. These rates are bellow the ones recommended by the JCIH as well as bellow those reached by hearing screening programs of some developed countries. However, they are similar to other Brazilian experiences of neonatal hearing screening programs. A close follow up of the families of those infants who failed the first stage of the screening, as well as the orientation given to them about early detection of hearing loss and its consequences, may have contributed to the increase in the adherence rate in the second stage of the screening.

Association between breastfeeding and breathing pattern in children: a sectional study ☆ ☆☆

OBJECTIVE to determine the prevalence of mouth breathing and to associate the history of breastfeeding with breathing patterns in children. METHODS this was an observational study with 252 children of both genders, aged 30 to 48 months, who participated in a dental care program for mothers and newborns. As an instrument of data collection, a semi-structured questionnaire was administered to the childrens mothers assessing the form and duration of breastfeeding and the oral habits of non-nutritive sucking. To determine the breathing patterns that the children had developed, medical history and clinical examination were used. Statistical analysis was conducted to examine the effects of exposure on the primary outcome (mouth breathing), and the prevalence ratio was calculated with a 95% confidence interval. RESULTS of the total sample, 43.1% of the children were mouth breathers, 48.4% had been breastfed exclusively until six months of age or more, and 27.4% had non-nutritive sucking habits. Statistically significant associations were found for bottle-feeding (p<0.001) and oral habits of non-nutritive sucking (p=0.009), with an increased likelihood of children exhibiting a predominantly oral breathing pattern. A statistically significant association was also observed between a longer duration of exclusive breastfeeding and a nasal breathing pattern presented by children. CONCLUSION an increased duration of exclusive breastfeeding lowers the chances of children exhibiting a predominantly oral breathing pattern.

Audiological and genetics studies in high-risk infants

UNLABELLED Hearing is one of the main ways with which one person can contact the external world; it plays a key role in their integration with society. AIM The objective of this study was to analyze the results of the hearing, medical and genetic evaluation of high-risk infants who failed the newborn hearing screening. MATERIALS AND METHODS Clinical and experimental study. We assessed thirty-eight neonates, with ages between one and six months. The infants underwent the following procedures: medical interview; immittance testing; Brainstem Auditory Evoked Potential; Transient Evoked Otoacoustic Emission and otorhinolaryngological evaluation. DNA extraction from the oral mucosa was performed for genetic studies using the protocol method adapted from the Human Genetics Lab of the CBMEG/UNICAMP. RESULTS Regarding gender and presence of risk factors, significant statistically differences were not found in normal hearing infants and in those with hearing loss. Concerning gestational age, term infants were more affected by hearing loss. Hearing loss was identified in 58% of the sample, conduction hearing loss represented 31.5% (12/38) and neurossensory 28.9% of cases. There were none of the genetic mutations most commonly seen in cases with a genetic etiology. CONCLUSION Hearing loss was identified in the majority of High-risk infants.

Demanda para intervenção fonoaudiológica em uma unidade neonatal de um hospital-escola

PURPOSE: the aim of the present study was to characterize the demand for speech therapy among newborns with oral feeding difficulties at a neonatal unit of a public teaching school. METHODS: a descriptive, retrospective, cross-sectional study was carried out using data obtained from all charts of newborns interned between March 2008 and February 2010 who received at least one speech/hearing evaluation/intervention. RESULTS: two hundred five newborns were treated in the study period, 104 of whom met the inclusion criteria. The sample was predominantly male, composed of premature newborns with adequate gestational age (mean: 36 weeks) and low birth weight. The most frequent diagnoses were respiratory disorder, jaundice and cardiovascular disorder. The following were the predominant reasons for requesting an evaluation by a speech therapist: abnormal oral motor behavior, evaluation of readiness for oral feeding and difficulties using a cup. Most evaluations were requested by residents when the newborns had a mean of 28 days of life. A broader set of criteria was used by the team requesting a speech therapy evaluation in comparison to criteria described in the literature. CONCLUSION: the majority of newborns receive oral feeding without a prior evaluation by a speech therapist, which can lead to situations of risk with regard to safe, efficient feeding.

Avaliação de um programa de acompanhamento de lactentes sob a óptica da família

PURPOSE: the aim of our research was to evaluate a child development monitoring program conducted by speech and language therapists taking into account the point of view of the families. METHOD: a qualitative study analyzed a focus group attended by eight subjects during two meetings. All group participants had at least attended two evaluations of the program. Data was collected with the support of a moderator, an observer and a reporter; it was then analyzed by grouping the most relevant and frequent categories found in the speeches of the participants. The discussion focused on the following aspects: reception, health promotion, empowerment, health care team, interdisciplinary work, integrality and bonding. RESULTS: program participants recognized the importance of speech therapists for health promotion and prevention insofar as they offer awareness training to child care providers and empower family members regarding infant development, which results in bonding between professionals and child care providers and integrated work. CONCLUSION: we analyzed the quality of the current health management model and suggest it be continued. However, it should start during gestation, include a higher number of follow up consultations and develop more multidisciplinary work.