Maria Inês Vieira Couto

Auditory pathways' maturation after cochlear implant via cortical auditory evoked potentials ,

INTRODUCTION Evaluation of cortical auditory evoked potentials in children with cochlear implants has been proven to be an effective method for assessing cortical maturation after electrical stimulation. OBJECTIVE To analyze the changes in latency values of cortical auditory evoked potentials before and three months after cochlear implant use. MATERIAL AND METHODS This was a case-control study with a group of five children using cochlear implant awaiting activation of the electrodes, and a control group composed of five normal-hearing children. Auditory electrophysiological assessment was performed by the testing of the cortical auditory evoked potentials at two different periods: prior to cochlear implant activation and after three months of cochlear implant use. RESULTS A significant decrease in the latency time of the P1 component was observed after three months of stimulation via cochlear implant, whose values were higher than those from the control group. The younger the child was at electrode activation, the greater the reduction in latency of the P1 component. CONCLUSION Changes in the characteristics of cortical auditory evoked potentials can be observed in children who receive cochlear implants; these changes are related to the age of intervention, suggesting a rapid maturation of the auditory pathways after electrical stimulation.

Perfil pragmático de crianças surdas em diferentes fases lingüísticas

PURPOSE: The aim of this study was to ascertain and to assess the interference of deaf childrens linguistic level in their communicative abilities. METHODS:Thirty deaf children participated in this study, 15 in the pre-linguistic phase and 15 in the linguistic phase, independent of the communicative modality used - either oral or sign language. Their age ranged from 41 to 59 months. Thirty videotape recordings of the deaf childrens communicative abilities assessment during their interaction with the examiner were analyzed. The Communicative Abilities Pragmatic Profile was used in order to identify the communicative abilities and their frequency of occurrence. RESULTS: Both groups basically presented the same communicative abilities; however, the linguistic group presented higher frequency of occurrence, especially in the abilities regarding communicative intentions and responses for communication. CONCLUSIONS:There is a direct relationship between linguistic complexity (independent of any kind of modality) and the deaf childs communicative profile, that is, the linguistic level child presents higher frequency of occurrence of more complex and elaborated communicative abilities.

Efeitos da amplificação sonora sobre as modalidades comunicativas utilizadas pelos pais

BACKGROUND auditory rehabilitation in deaf children users of sign language. AIM to verify the effects of sound amplification on parents communicative modalities when interacting with their deaf children. METHOD participants were twelve deaf children, aged 50 to 80 months and their hearing parents. Children had severe or profound hearing loss in their better ear and were fitted with hearing aids in both ears. Children communicated preferably through sign language. The cause-effect relation between the childrens auditory skills profile (insertion gain, functional gain and The Meaningful Auditory Integration Scale--MAIS) and the communicative modalities (auditive-oral, visuo-spacial, bimodal) used by parents was analyzed. Communicative modalities were compared in two different experimental situations during a structured interaction between parents and children, i.e. when children were not fitted with their hearing aids (Situation 1) and when children were fitted with them (Situation 2). Data was analyzed using descriptive statistics. RESULTS the profile of the deaf childrens auditory skills demonstrated to be lower than 53% (unsatisfactory). Parents used predominately the bimodal modality to gain childrens attention, to transmit and to end tasks. A slight positive effect of sound amplification on the communicative modalities was observed, once parents presented more turn-takings during communication when using the auditory-oral modality in Situation 2. CONCLUSION hearing parents tend to use more turn-takings during communication in the auditory-oral modality to gain childrens attention, to transmit and to end tasks, since they observe an improvement in the auditory skills of their children.

Avaliação e acompanhamento audiológico após meningite bacteriana

Hearing loss is the more frequent sequel of bacterial meningitis in children. This study describes the audiological profile (peripheric and central) of 89 children admitted to the hospital wards with the diagnosis of bacterial meningitis. Those children attended audiological follow up, after their hospital descharge, and were submitted to audiological tests. The results showed that 85.4% among them presented normal hearing in both ears 10.1% presented bilateral neurosensorial hearing loss and 4.5% presented unilateral neurosensorial hearing loss. The results from the auditory processing skills assessment showed that 10% of those children presented auditory localization and recognition of sentences with competitive messages (Paediatric Sentences Identification - ipsilateral) disorders.

Assessing deaf and hearing children's communication in Brazil

UNLABELLED In Brazil there are no specific tests for either signed or spoken language for deaf children. A protocol evaluating communicative abilities independent of modality of communication (sign language or spoken language), and comprising assessments of (a) pragmatic profile; (b) modality of communication and linguistic level; (c) complexity of communication; and (d) style and efficacy of communication between parent and child was administered to 127 deaf and hearing children. The children, aged 3-6 years old, were distributed in three groups: 20 with severe hearing loss, 40 with profound hearing loss and 67 normally hearing. Deaf children were found to be delayed, independent of their linguistic level and preferred modality of communication. The protocol in this study proved to be an useful instrument for gathering relevant information about the three groups of preschool childrens communicative abilities, and particularly suitable for use in countries where standardized assessments are not available. LEARNING OUTCOMES The reader will be introduced to the use of an assessment protocol comprising its development, application and data analysis. The reader will be informed about assessment of deaf childrens preferred modality of communication, by the participation of a bilingual (sign language user) professional. Communication abilities can be assessed independently of the linguistic modality. In developing countries in general, where simple and easy to administer assessments tools are scarce, such a protocol is of specific value.

Fatores que influenciam na participação dos pais de crianças usuárias de implante coclear na (re)habilitação oral: revisão sistemática

PURPOSE: To identify and analyze factors that influence the participation of parents in the rehabilitation process of children with cochlear implants (CI). RESEARCH STRATEGY: Question formulation and articles selection in three databases using the following keywords: cochlear implant (implante coclear) and parents (pais). SELECTION CRITERIA: Complete original articles published in Brazilian Portuguese or English, with direct participation of parents of children with CI. DATA ANALYSIS: Articles were fully read. Data regarding characterization of the centers, research methodology and content were analyzed. RESULTS: Thirteen articles were selected based on the established criteria. The types of studies were cross-sectional and case-control (interview technique). The following influential factors were identified: pre-CI surgery factors (knowledge about CI, quality and quantity of information, specialists advices, ethical and biomedical aspects, rehabilitation engagement, contact with experienced families, social service support and overall costs); rehabilitation aspects (CI use, oral communication modality, regular school, other disabilities, social and demographic aspects and rehabilitation programs effectiveness); other important influential processes (communication modality, auditory and language development, second oral language learning, as well as parents behavior and satisfaction). CONCLUSION: The engagement of parents in the rehabilitation process of children with CI depends on several distinct influential factors which audiologists should understand and consider when elaborating a rehabilitation program.

Relação entre níveis de compreensão e estratégias de leitura utilizadas por surdos sinalizadores em um programa terapêutico

OBJETIVO: Determinar as mudancas referentes as estrategias de aprendizagem nos niveis de compreensao de leitura durante um programa de intervencao fonoaudiologica direcionado aos surdos sinalizadores. METODOS: Participaram cinco estudantes surdos, com idades entre dez anos e 15 anos, cuja lingua preferencial para comunicacao era a Lingua Brasileira de Sinais. Todos frequentaram um programa de intervencao fonoaudiologica fundamentada na tecnica de scaffolding (andaime). As variaveis consistiram dos desempenhos das avaliacoes individuais do nivel de compreensao de leitura e das estrategias utilizadas para esta compreensao, antes de iniciar o programa e ao termino do mesmo. RESULTADOS: Ao termino do programa de intervencao, mais estudantes surdos utilizaram estrategias de elaboracao (p=0,197) e menos estudantes utilizaram estrategias de monitoramento (p=0,197). Houve mudanca significativa quanto a pontuacao do nivel de decodificacao (p=0,109) e tendencia a significância no nivel de compreensao literal (p=0,197), com aumento da pontuacao. Verificou-se significância somente entre a utilizacao da estrategia de elaboracao e os dois momentos da avaliacao (inicial e final) (p=0,059). CONCLUSAO: O programa de intervencao baseado na tecnica de scaffolding propiciou que estudantes surdos sinalizadores utilizassem mais estrategias de elaboracao e menos de monitoramento; consequentemente, uma tendencia para a passagem do nivel de decodificacao para o nivel de compreensao literal do texto.

Long latency auditory evoked potentials in children with cochlear implants: systematic review

The aim of this study was to analyze the findings on Cortical Auditory Evoked Potentials in children with cochlear implant through a systematic literature review. After formulation of research question and search of studies in four data bases with the following descriptors: electrophysiology (eletrofisiologia), cochlear implantation (implante coclear), child (criança), neuronal plasticity (plasticidade neuronal) and audiology (audiologia), were selected articles (original and complete) published between 2002 and 2013 in Brazilian Portuguese or English. A total of 208 studies were found; however, only 13 contemplated the established criteria and were further analyzed; was made data extraction for analysis of methodology and content of the studies. The results described suggest rapid changes in P1 component of Cortical Auditory Evoked Potentials in children with cochlear implants. Although there are few studies on the theme, cochlear implant has been shown to produce effective changes in central auditory path ways especially in children implanted before 3 years and 6 months of age.

Longitudinal Analysis of the Absence of Intraoperative Neural Response Telemetry in Children using Cochlear Implants

Introduction Currently the cochlear implant allows access to sounds in individuals with profound hearing loss. The objective methods used to verify the integrity of the cochlear device and the electrophysiologic response of users have noted these improvements. Objective To establish whether the evoked compound action potential of the auditory nerve can appear after electrical stimulation when it is absent intraoperatively. Methods The clinical records of children implanted with the Nucleus Freedom (Cochlear Ltd., Australia) (CI24RE) cochlear implant between January 2009 and January 2010 with at least 6 months of use were evaluated. The neural response telemetry (NRT) thresholds of electrodes 1, 6, 11, 16, and 22 during surgery and after at least 3 months of implant use were analyzed and correlated with etiology, length of auditory deprivation, and chronological age. These data were compared between a group of children exhibiting responses in all of the tested electrodes and a group of children who had at least one absent response. Results The sample was composed of clinical records of 51 children. From these, 21% (11) showed no NRT in at least one of the tested electrodes. After an average of 4.9 months of stimulation, the number of individuals exhibiting absent responses decreased from 21 to 11% (n = 6). Conclusion It is feasible that absent responses present after a period of electrical stimulation. In our sample, 45% (n = 5) of the patients with intraoperative absence exhibited a positive response after an average of 4.9 months of continued electrical stimulation.

Correction: Cortical maturation in children with cochlear implants: Correlation between electrophysiological and behavioral measurement

[This corrects the article DOI: 10.1371/journal.pone.0171177.].