Maria Isabel Ramos do Amaral

Estudo da audição em crianças com fissura labiopalatina não-sindrômica

UNLABELLED Children with cleft lip/palate often present otitis media as a result of anatomic and/or functional alterations of the Eustachian tube. AIM To analyze the results of Basic Audiologic Evaluation (BAE) and Auditory Processing Screening (APS) in children with cleft lip/palate. STUDY DESIGN Prospective cross-sectional cohort. MATERIALS AND METHODS Forty-four male and female children, within the 8 to 14 age range with non-syndromic cleft lip/palate, referred by the institution where the study was carried out. The BAE was made up by an interview, otoscopy, threshold tonal audiometry, logoaudiometry and impedance test. The APS was made up of 3 basic tests: Sound Localization Test, Sequential Memory for verbal and non-verbal sounds and Dichotic Listening Test. RESULTS The BAE revealed that 77.27% of the children presented normal hearing; 13.6% had conductive hearing loss and 2.2% presented mixed hearing loss. 21.2% of the children had type C tympanometry curve; 7.1% had a type B curve and 3.5% had an Ad curve. The APS was altered in 72.7% of the children and 45.5% of them presented altered results on the Dichotic Listening Test. CONCLUSION Children with cleft lip/palate had altered results on BAE and APS, which justifies audiological and medical follow-up.

Resolução temporal: desempenho de escolares no teste GIN - Gaps-in-noise

UNLABELLED Time resolution hearing skill is the minimum time necessary to solve acoustic events, which is fundamental for speech understanding, and which may be assessed by gap-detection tests, such as the Gaps-in-noise test (GIN). AIM the purpose of this study was to verify the performance of time processing ability in children with no hearing and/or education difficulties by applying the GIN test in both genders and ages from 8 to 10 years. STUDY DESIGN a prospective cross-sectional contemporary cohort. MATERIAL AND METHOD The GIN test was applied to 75 school-aged children separated into three groups by age. RESULTS The findings showed no statistical differences among age groups or ears. Males had slightly better responses than females on the percentage of correct responses only. CONCLUSION The gap threshold and percentage of correct responses were calculated regardless of the ear, gender or age, and were respectively 4.7ms and 73.6%. Based on a 95% confidence interval, the cut-off criterion for normal and abnormal performance was 6.1ms for the mean gap detection threshold and 60% for the percentage of correct responses.A habilidade auditiva denominada resolucao temporal consiste no tempo minimo necessario para resolver eventos acusticos, sendo fundamental para a compreensao de fala, e pode ser avaliada por testes de deteccao de gaps, dentre eles o teste GIN - Gaps In Noise. OBJETIVO: Verificar o desempenho da resolucao temporal em criancas sem queixas auditivas e/ou dificuldades escolares, no teste GIN, considerando-se o genero masculino e feminino e a faixa etaria de 8, 9 e 10 anos. FORMA DO ESTUDO: Coorte contemporânea com corte transversal prospectivo. MATERIAL E METODO: O teste GIN foi aplicado em 75 escolares, reunidos em tres grupos por faixa etaria. RESULTADOS: Nao foram encontradas diferencas significantes em relacao as variaveis orelha e faixa etaria. O genero masculino obteve desempenho levemente melhor do que o feminino em relacao apenas a porcentagem de acertos. CONCLUSAO: A media do limiar de deteccao de gaps e porcentagem de acertos foram calculados independente das variaveis orelha, genero e faixa etaria, sendo encontrados os valores de 4,7ms e 73,6%. Baseado no criterio de intervalo de confianca 95% como corte para normalidade, os valores do limiar de deteccao de gap e porcentagem de acertos foram 6,1ms e 60%, respectivamente.

Newborn Hearing Screening and Early Diagnostic in the NICU

The aim was to describe the outcome of neonatal hearing screening (NHS) and audiological diagnosis in neonates in the NICU. The sample was divided into Group I: neonates who underwent NHS in one step and Group II: neonates who underwent a test and retest NHS. NHS procedure was automated auditory brainstem response. NHS was performed in 82.1% of surviving neonates. For GI, referral rate was 18.6% and false-positive was 62.2% (normal hearing in the diagnostic stage). In GII, with retest, referral rate dropped to 4.1% and false-positive to 12.5%. Sensorineural hearing loss was found in 13.2% of infants and conductive in 26.4% of cases. There was one case of auditory neuropathy spectrum (1.9%). Dropout rate in whole process was 21.7% for GI and 24.03% for GII. We concluded that it was not possible to perform universal NHS in the studied sample or, in many cases, to apply it within the first month of life. Retest reduced failure and false-positive rate and did not increase evasion, indicating that it is a recommendable step in NHS programs in the NICU. The incidence of hearing loss was 2.9%, considering sensorineural hearing loss (0.91%), conductive (1.83%) and auditory neuropathy spectrum (0.19%).

Temporal Auditory Processing and Phonological Awareness in Children with Benign Epilepsy with Centrotemporal Spikes

The aim of this research was to analyze temporal auditory processing and phonological awareness in school-age children with benign childhood epilepsy with centrotemporal spikes (BECTS). Patient group (GI) consisted of 13 children diagnosed with BECTS. Control group (GII) consisted of 17 healthy children. After neurological and peripheral audiological assessment, children underwent a behavioral auditory evaluation and phonological awareness assessment. The procedures applied were: Gaps-in-Noise test (GIN), Duration Pattern test, and Phonological Awareness test (PCF). Results were compared between the groups and a correlation analysis was performed between temporal tasks and phonological awareness performance. GII performed significantly better than the children with BECTS (GI) in both GIN and Duration Pattern test (P < 0.001). GI performed significantly worse in all of the 4 categories of phonological awareness assessed: syllabic (P = 0.001), phonemic (P = 0.006), rhyme (P = 0.015) and alliteration (P = 0.010). Statistical analysis showed a significant positive correlation between the phonological awareness assessment and Duration Pattern test (P < 0.001). From the analysis of the results, it was concluded that children with BECTS may have difficulties in temporal resolution, temporal ordering, and phonological awareness skills. A correlation was observed between auditory temporal processing and phonological awareness in the suited sample.

Resolução temporal: procedimentos e parâmetros de avaliação em escolares

UNLABELLED Temporal resolution enables the identification of fine differences in speech segmental aspects. Random Gap Detection Test (RGDT) and Gaps-In-Noise Test (GIN) evaluate such skills, by using different acoustic parameters. OBJECTIVE To compare the performance of normal school aged children without learning disabilities and/or hearing complaints in the GIN and RGDT, and analyze potential performance differences in these two procedures. METHOD Cross sectional contemporary cohort study. 28 children, aged 8-10 years were evaluated. After peripheral audiological evaluation, RGDT and GIN were performed. RESULTS There were no statistical differences in performance between gender and age on the RGDT and GIN tests, between the right and left ears on the GIN test, and between frequencies on the RGDT test. The mean detection threshold gap for RGDT was 9.25 ± 3.67 ms, and for GIN was 4.32 ± 0.61 ms (right ear) and 4.43 ± 0.79 ms (left ear). The results of the GIN Test were statistically lower than those from the RGDT (p < 0.001). CONCLUSION Both tests indicated normal temporal resolution for all 28 children. GIN test presents advantages regarding the ease of application, task variable, stimuli and presentations form. However, the RGDT has advantages concerning the time required for administration and scoring.

Comparison of auditory event-related potentials between children with benign childhood epilepsy with centrotemporal spikes and children with temporal lobe epilepsy

The abnormal brain discharges observed in benign childhood epilepsy with centrotemporal spikes (BECTS) and temporal lobe epilepsy (TLE) are located close to areas responsible for auditory and language processing. This study aimed to analyze the results of auditory event-related potentials (P300) in children with BECTS and TLE in order to assess whether the epileptic activity in centrotemporal and temporal regions may compromise the integrity and physiology of auditory system structures. This was a prospective, comparative, and cross-sectional study. Group I (GI) consisted of 13 children diagnosed with BECTS, group II (GII), 7 children diagnosed with TLE, and control group (GIII), 16 healthy children, with no hearing or academic complaints. After neurological and basic audiological assessments, P300 was applied. The P300 latency and amplitude were compared between groups. Regarding latency, GI showed 324.1 (+31.5) ms, GII 336.3 (+23.5) ms, and GIII 318 (+27.7) ms. Amplitudes were 4.80 (+3.2) μV in GI, 4.7 (+2.5) μV in GII, and 5.8 (+2.4) μV in GIII. Although children with BECTS showed prolonged latencies and reduced amplitudes, these differences were not considered statistically significant. Children with TLE showed statistically significant prolonged P300 latency compared with the control group (P=0.037). We speculate that abnormal electrical discharges in centrotemporal and temporal regions led to the slowing of auditory processing in our sample.

Procedures for central auditory processing screening in schoolchildren

INTRODUCTION Central auditory processing screening in schoolchildren has led to debates in literature, both regarding the protocol to be used and the importance of actions aimed at prevention and promotion of auditory health. Defining effective screening procedures for central auditory processing is a challenge in Audiology. OBJECTIVE This study aimed to analyze the scientific research on central auditory processing screening and discuss the effectiveness of the procedures utilized. METHODS A search was performed in the SciELO and PUBMed databases by two researchers. The descriptors used in Portuguese and English were: auditory processing, screening, hearing, auditory perception, children, auditory tests and their respective terms in Portuguese. INCLUSION CRITERIA original articles involving schoolchildren, auditory screening of central auditory skills and articles in Portuguese or English. EXCLUSION CRITERIA studies with adult and/or neonatal populations, peripheral auditory screening only, and duplicate articles. After applying the described criteria, 11 articles were included. RESULTS At the international level, central auditory processing screening methods used were: screening test for auditory processing disorder and its revised version, screening test for auditory processing, scale of auditory behaviors, childrens auditory performance scale and Feather Squadron. In the Brazilian scenario, the procedures used were the simplified auditory processing assessment and Zaidans battery of tests. CONCLUSION At the international level, the screening test for auditory processing and Feather Squadron batteries stand out as the most comprehensive evaluation of hearing skills. At the national level, there is a paucity of studies that use methods evaluating more than four skills, and are normalized by age group. The use of simplified auditory processing assessment and questionnaires can be complementary in the search for an easy access and low-cost alternative in the auditory screening of Brazilian schoolchildren. Interactive tools should be proposed, that allow the selection of as many hearing skills as possible, validated by comparison with the battery of tests used in the diagnosis.

Avaliação Simplificada do Processamento Auditivo e questionário de auto percepção em crianças com e sem dificuldades escolares

Resumo O estudo teve como objetivo analisar os dados obtidos em um questionário de auto-percepção sobre as dificuldades auditivas de crianças com e sem dificuldades escolares, e comparar com o desempenho na Avaliação Simplificada do Processamento Auditivo(ASPA). A amostra constituiu-se de 40 crianças de 8 a 11 anos de uma escola da rede estadual de Campinas. A partir dos mresultados, foi possível concluir que o questionário de autopercepção pode ser considerado uma ferramenta confiavel e complementar para ser utilizada em uma bateria de triagem do processamento auditivo.