Regina Tangerino de Souza Jacob

FM listening evaluation for children: adaptação para a língua portuguesa

INTRODUCTION: The inclusion of children with hearing impairments in schools is guaranteed by the Brazilian government by means of official legislation. The FM system is an assistive technology instrument to which regular teachers should have access. OBJECTIVE: To translate and adapt to Portuguese the FM Listening Evaluation questionnaire for children and assess its reliability. METHODS: The translation and adaptation to the FM Listening Evaluation included translation into Portuguese, linguistic adaptation and revision of the grammatical and idiomatic equivalences and adaptation; inter-researcher reproducibility was also evaluated. The questionnaire was administered to the teachers and speech-language pathologists of 12 children aged seven to thirteen years with hearing impairment; the children used hearing aids and had been adapted to the FM system. RESULTS: The translation and adaptation of the questionnaire resulted in new inventory: FM EVALUATION SYSTEM, presenting a significant difference between the results of noise and: hearing pathways and silence; - distance and: hearing pathways and silence; - hearing pathways and: noise, distance and silence; - silence and: noise, distance and hearing pathways. There was significant difference with and without the FM system, in which the score was always higher. Intra-examiner comparison revealed a significant difference between the total score with FM, via FM and hearing no noise with FM. CONCLUSION: The questionnaire Rating System FM was considered a reliable instrument for verifying and monitoring the benefits of FM system, in order to promote the process of educational inclusion for students with hearing impairments.

Percepção da fala em crianças em situação de ruído

INTRODUCAO: A habilidade em compreender a fala e afetada por muitos fatores durante as avaliacoes, principalmente no ruido, sendo ainda mais complexa para criancas nessas condicoes. OBJETIVO: Analisar a percepcao da fala em criancas com audicao normal em diferentes situacoes de ruido. METODO: Forma de estudo corte transversal. Foi utilizado o Brazilian Hearing in Noise Test (HINT) em 21 criancas de sete a 14 anos com audicao dentro dos padroes de normalidade, e sem alteracoes cognitivas. Foram aplicadas, aleatoriamente, as listas de sentencas nas seguintes situacoes: silencio (S); ruido de frente (RF); ruido a direita (RD); ruido a esquerda (RE); ruido a 180o. (RT) e comparado o resultado de ruido composto (RC) com ruido difuso a partir de quatro campos de som em 45o; 135o; 225o e 315o (4CXS). RESULTADOS: A analise estatistica revelou diferenca significativa entre as seguintes situacoes: RD com RF; RT com RF; sendo pior com 4CXS, onde foi encontrada diferenca para RD, RT, RC, RE e RF. Para a analise de correlacao com a idade, houve significância entre a idade em funcao dos valores HINT apenas para o ruido a frente. CONCLUSAO: As diferencas significativas nos resultados de percepcao da fala entre as diferentes condicoes de escuta no ruido na populacao estudada sugerem cautela na escolha do estimulo em avaliacoes de percepcao da fala no ruido em criancas deficientes auditivas. Assim, pesquisas nessa linha sao necessarias para estabelecer os parâmetros e variaveis relacionadas a sua aplicacao e a interpretacao dos resultados.

Early Listening Function (ELF): adaptação para a língua portuguesa

PURPOSE: To translate and adapt the Early Listening Function (ELF) questionnaire into the Brazilian Portuguese language, and to evaluate the reliability of the test. METHODS: It was carried out the translation of the ELF questionnaire into Brazilian Portuguese, the review of grammatical and idiomatic equivalents (reversed translations), and linguistic and cultural adaptation. Moreover, the intra-researcher reproducibility was evaluated. After the translation, the ELF was carried out with 30 children between zero and three years old, with no history of hearing loss risk, lack of family complaint regarding the overall development of the child, and no indicators of hearing loss disability. The questionnaire was applied in 12 cases of hearing detection at different distances, in quiet and noisy environments. RESULTS: Results were analyzed using a descriptive statistical study based on the results obtained on the ELF score sheet. CONCLUSION: The ELF questionnaire was translated and culturally adapted for the studied population. In Brazilian Portuguese, its designation maintained the acronym ELF. The study verified the instruments reliability for observing and monitoring the initial stages of hearing behavior.

Sistema de freqüência modulada no transtorno do processamento auditivo: prática baseada em evidências?

TEMA: uso do sistema de frequencia modulada (FM) no transtorno do processamento auditivo. OBJETIVO: verificar a existencia de evidencia cientifica que comprove a efetividade do sistema FM para tratamento do transtorno do processamento auditivo (TPA) por meio de revisao sistematica da literatura pertinente encontrada em bases de dados eletronicas (Medline, Lilacs e registro de ensaios clinicos da biblioteca Cochrane) e buscadores da internet, sendo os artigos recuperados analisados com base na declaracao CONSORT e classificados quanto ao nivel de evidencia. CONCLUSAO: a busca resultou em 1589 referencias, das quais somente 19 enquadraram-se nos criterios de inclusao. Todos os artigos analisados foram classificados com baixo nivel de evidencia (opinao de especialista ou estudo de casos). Nao foi encontrada forte evidencia cientifica que comprove a efetividade do uso do sistema FM na intervencao de individuos com TPA. Uma vez que este equipamento e frequentemente recomendado para a intervencao nos casos do TPA, se torna imprescindivel a realizacao de estudos com alta evidencia cientifica que possam guiar seguramente as tomadas de decisoes clinicas a este respeito.

Sistema de frequência modulada em crianças com deficiência auditiva: avaliação de resultados

ABSTRACT Purpose: To evaluate the speech perception of hearing impaired children fitted with hearing aids and frequency modulation (FM) system in noisy environments, as well as in the classroom. Methods: Participants were 13 hearing impaired children with ages between 7 and 17 years. The Hearing in Noise Test (HINT) was applied with hearing aids and with FM systems. The FM System Evaluation Questionnaire was answered by the children’s teachers, in order to assess individually the children’s performances in different hearing situations wearing only hearing aids, and with both the hearing aid and an FM system. Results: Difference was found for every situation with and without FM in the HINT. The same holds true for the results obtained with the questionnaire, and the score without the FM system was always lower than with FM, regardless of the condition. Conclusion: The use of subjective measures, such as the questionnaire, is essential to determine the efficacy of recommending auxiliary devices for hearing impaired people. The FM system’s effectiveness can be observed by the “FM advantage”, which is the mean minimum difference of 10 dB found in speech perception assessments with and without FM in noisy situations. The benefits found in this study with the use of FM systems for better speech perception might be extrapolated not only to the classroom and inclusive education legislation, but also to social and recreational activities.

Hearing in Noise Test Brazil: standardization for young adults with normal hearing.

INTRODUCTION Individuals with the same ability of speech recognition in quiet can have extremely different results in noisy environments. OBJECTIVE To standardize speech perception in adults with normal hearing in the free field using the Brazilian Hearing in Noise Test. METHODS Contemporary, cross-sectional cohort study. 79 adults with normal hearing and without cognitive impairment participated in the study. Lists of Hearing in Noise Test sentences were randomly in quiet, noise front, noise right, and noise left. RESULTS There were no significant differences between right and left ears at all frequencies tested (paired t-1 test). Nor were significant differences observed when comparing gender and interaction between these conditions. A difference was observed among the free field positions tested, except in the situations of noise right and noise left. CONCLUSION Results of speech perception in adults with normal hearing in the free field during different listening situations in noise indicated poorer performance during the condition with noise and speech in front, i.e., 0°/0°. The values found in the standardization of the Hearing in Noise Test free field can be used as a reference in the development of protocols for tests of speech perception in noise, and for monitoring individuals with hearing impairment.

Frequency Modulation System and speech perception in the classroom: a systematic literature review

PURPOSE This review aimed at presenting the benefits regarding the speech perception in noise shown by children who wear hearing aid devices and/or cochlear implants with the Frequency Modulation (FM) System at school. RESEARCH STRATEGY A bibliographic survey was conducted in an electronic database with standardized search until the year 2012, and a manual search was performed by using specific keywords. SELECTION CRITERIA For the selection and evaluation of the scientific studies chosen in the search, criteria were established covering the following aspects: type of study, participants, adopted intervention, and evaluation of results. DATA ANALYSIS The FM system was verified to improve speech perception and speech threshold in noise in all studies. RESULTS Regarding the performance as to type, the best results were obtained when children used the personal FM system, followed by the table and the sound field systems. CONCLUSION After extensive review of national and international literature, it was concluded that the studies indicate the need for further research concerning mainly the impact of the FM system on the school performance of children who have sensory devices coupled to the FM system. Findings in the literature with relation to the publications focused on speech perception in noise did not relate educational and auditory aspects.

Perfil pragmático longitudinal de uma criança no espectro da neuropatia auditiva

Human communication depends mostly on the conversion of ideas into language, involving the interaction among all its components - phonological, semantic, syntactic and pragmatic. Pragmatics studies the relationship between the social meaning of language and its semantic content, expressed by the communicative act itself. Auditory neuropathy spectrum disorder generates a dyssynchrony in nerve conduction, contributing to an impairment in speech perception. In hearing impaired children the language acquisition and development process can be stimulated with intervention. The aim of this study was to present a longitudinal follow-up of the use of pragmatic communication abilities by a child with auditory neuropathy spectrum disorder. The child received speech-language pathology therapy during three years in the Educational Audiology area. Video recordings of spontaneous conversation were made in the beginning of each year. These recordings were transcribed and analyzed according to the verbal communicative abilities protocol. In the initial recording, the most frequent ability presented by the child was the direct response; however these were extended to more complex responses during the intervention. In the last recording the child proposes new topics of discourse, produce narratives and arguments. The emergence of more sophisticated communication skills is justified by the language development, which benefits from language therapy with hearing impaired children. This suggests that, for the case study described, speech-language pathology therapy contributed to the improvement of pragmatic communication abilities.

Measuring noise in classrooms: a systematic review

PURPOSE The aim of this systematic review is to outline the main methodologies used for measuring noise in classrooms and if the noise levels found are suitable standards. METHODS A survey of articles published in the last ten years, using six different databases. Were verified 1.088 publications and only eight studies met the inclusion criteria: (a) articles published in the last ten years, (b) articles available in full, (c) studies that have measured the noise in the classrooms of regular schools. DATA ANALYSIS descriptive analysis was performed of selected publications. RESULTS Five studies conducted to measure the noise using a sound level meter. One measurement performed using a dosimeter and two studies used a laptop with audio recording software. In all classrooms, the noise level was higher than allowed. CONCLUSION Classrooms are noisy environment and there is no standardization regarding the methodology that should be used to measure the noise in these places. Therefore, schools need to be guided constantly about the importance of acoustic adaptation in the classroom.

Evaluating effectiveness of dynamic soundfield system in the classroom

Research has reported on the use of soundfield amplification devices in the classroom. However, no study has used standardized tests to determine the potential advantages of the dynamic soundfield system for normally hearing students and for the teacher′s voice. Our aim was to evaluate the impact of using dynamic soundfield system on the noise of the classroom, teacher′s voice and students′ academic performance. This was a prospective cohort study in which 20 student participants enrolled in the third year of basic education were divided into two groups (i.e., control and experimental); their teacher participated. The experimental group was exposed to the dynamic soundfield system for 3 consecutive months. The groups were assessed using standardized tests to evaluate their academic performance. Further, questionnaires and statements were collected on the participants′ experience of using the soundfield system. We statistically analyzed the results to compare the academic performance of the control group with that of the experimental group. In all cases, a significance level of P < .05 was adopted. Use of the dynamic soundfield system was effective for improving the students′ academic performance on standardized tests for reading, improving the teacher′s speech intelligibility, and reducing the teacher′s vocal strain. The dynamic soundfield system minimizes the impact of noise in the classroom as demonstrated by the mensuration of the signal-to-noise ratio (SNR) and pupil performance on standardized tests for reading and student and teacher ratings of amplification system effectiveness.