CoDAS最新文献

Purpose: To discuss the use of a self-perception questionnaire on auditory abilities applied to children with behavioral dysphonia and compare it with the perception of auditory and voice symptoms, as well as with performance in temporal tests of auditory processing.

Methods: 17 children, aged 6-8 years, with a diagnosis of behavioral dysphonia. Individuals with peripheral hearing loss, severe visual and/or language impairments or neurodevelopmental disorders were excluded. The following instruments were applied: pediatric voice symptoms questionnaire (PVSQ, brazilian validated version); questionnaire of self-perception auditory skills (QAPAC) inserted into the online program AudBility with its self-assessment and parental versions; basic audiological evaluation and the temporal tests Random Gap Detection (RGDT), and Frequency Pattern (FPT). Parents' and children's responses were compared and Spearman's correlation measured correlation between the QAPAC and the PVSQ, as well as between questionnaires and temporal tests.

Results: QAPAC self-assessment version showed a mean score of 45.5±7.4, wherein seven (41.2%) children scored below the risk criteria for Central Auditory Processing Disorder (CAPD). The mean score on the parental version was 39.5±10.5, with 11 (64.7%) responses falling below the risk criteria. Parents' mean score was statistically lower (worse) compared to that of the children (p<0.005). A strong correlation was found between the self-assessment versions of QAPAC and PVSQ (r=0.671), alongside the parental versions (r=0.722). A poorer performance of the left ear in comparison to the right ear was observed in the FPT test (p<0.005), and a moderate correlation between QAPAC and FPT in the left ear during the imitation phase was noted (r=0.597).

Conclusion: The use of self-perception questionnaire on auditory abilities is a valid contribution to initial voice assessment in children with behavioral dysphonia.

Purpose: To compare the findings of speech-language-hearing evaluations, signs in fiberoptic endoscopic evaluation of swallowing, and nutritional risk between healthy older adults with and without self-reported swallowing difficulties and correlate the level of oral intake with the severity of pharyngeal residues and nutritional risk.

Methods: This cross-sectional retrospective study included 71 older people and divided them into two groups based on the presence of swallowing complaints. Data were collected from speech-language-hearing evaluations, oral health status, and videoendoscopy signs with four food consistencies classified by the International Dysphagia Diet Standardisation Initiative (IDDSI) to compare the groups. Pharyngeal residues were analyzed and classified using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS), the level of oral intake was assessed using the Functional Oral Intake Scale (FOIS), and nutritional risk was evaluated using the Malnutrition Screening Tool (MST).

Results: Differences were found in speech-language-hearing evaluations, as well as signs of posterior oral spillage and pharyngeal residues with levels 0, 2, and 4 consistencies and laryngeal penetration with level 0 consistency. The level of oral intake was moderately negatively correlated with the severity of pharyngeal residues and nutritional risk.

Conclusion: The group of older adults with complaints had differences in speech-language-hearing evaluations, posterior oral spillage, and pharyngeal residues with levels 0, 2, and 4 consistencies, and laryngeal penetration with level 0 consistency. The correlation indicated that the lower the level of oral intake, the greater the severity of pharyngeal residues and nutritional risk in the sample.

Purpose: To present an auditory training protocol in children with Central Auditory Processing Disorder (CAPD).

Methods: The study included nine children aged from 9 to 12, with five females and four males. Only children with auditory thresholds within the normal range and bilateral type A tympanometric curves were selected. Initially, a behavioral assessment of Central Auditory Processing (CAP) was conducted, and a self-perception questionnaire was administered. Subsequently, eight sessions of auditory training were conducted following a defined protocol with four specific activities per session, aimed at training distinct auditory skills. In a third phase, a new CAP behavioral assessment was carried out, and the questionnaire was reapplied.

Results: The quantitative analysis of the pre- and post-training behavioral tests showed statistically significant improvements in the Left Dichotic Digit Test (DDT), the Left Competing Dissyllable Test (SSW), the Left Synthetic Sentence Identification with Ipsilateral Competing Message Test (SSI), and the Random Gap Detection Test (RGDT). An improvement in auditory behavioral perception of the participants was also observed, as indicated by the self-perception questionnaire responses.

Conclusion: Although the auditory training protocol did not result in complete normalization in the Central Auditory Processing (CAP) Behavioral Assessment tests, an improvement in the auditory skills of binaural integration, figure-ground and temporal resolution of participants was observed, as well as in their personal perception of these abilities.

Purpose: To investigate whether the cochlear responses of a group of children with normal temporal ordering tests would be different from those children with abnormal results in the same tests.

Methods: 25 children aged 8 to 13 years participated in the study, all with normal range pure-tone audiometry thresholds, type A tympanometry and distortion product otoacoustic emissions (DPOAE) present in both ears. Of these, 13 children formed the Study Group and 12 the Control Group. The Study Group differed from the Control Group by presenting changes in temporal auditory tests. In addition to the tests to verify the inclusion criteria, the DPOAE growth function were recorded for three different f2 frequencies, respectively 2002, 3003 and 4004 Hz. The stimuli were presented at level f2 (L2) from 20 to 65 dB SPL in steps of 5 dB and the stimulus level f1 (L1) followed the formula: L1=0.4L2+39 dB. The data were analyzed statistically, adopting a significance level of 5%.

Results: The groups did not differ in relation to conventional DPOAE values (DP-Gram). The Study Group differed from the Control Group by exhibiting both the threshold (p=0.034) and the higher slope (p=0.043) in the 2000 Hz DPOAE growth.

Conclusion: Children with alterations in temporal ordering tests require greater intensity to reach the DPOAE threshold at a frequency of 2000 Hz when compared to children without complaints, also presenting a more linear cochlear amplification at this same frequency, indicated by the increase in the value of slope.

Purpose: To analyze the evolution of speech and swallowing decline in patients with amyotrophic lateral sclerosis (ALS) over a ten-year period.

Methods: A retrospective and longitudinal cohort study. Data were collected using the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) from 101 medical records of ALS patients treated at the multidisciplinary neuromuscular diseases clinic of a University Hospital over a ten-year period. The data were statistically analyzed, adopting a significance level of p<0.05.

Results: The analysis of the studied functions indicated that speech, swallowing, and salivation are altered over ten years in ALS. There are differences in patterns between the variables sex and disease type concerning symptoms related to dysarthria and dysphagia in these individuals, which may indicate the rate of progression over a given time interval.

Conclusion: There is a decline in speech and swallowing over ten years in ALS. The bulbar type leads to a faster decline in the studied functions than the spinal type.

Purpose: To analyze the association between older people's health literacy and sociodemographic aspects, functioning, happiness, and perception of the COVID-19 pandemic.

Methods: This is a preliminary, cross-sectional, analytical, observational study with 37 older adults of both sexes. It used the Brazilian Economic Classification Criteria, WHODAS 2.0, SAHLPA-18, WHO-5 Well-Being Index, and Subjective Happiness Scale, estimated the perception of the pandemic through a questionnaire developed by the authors, and performed descriptive analysis, association analysis using the Pearson chi-square test, and Spearman correlation.

Results: Most participants had inadequate functional health literacy (FHL) results. A higher percentage of individuals from social classes C and D-E had inadequate FHL. The low education level was associated with an inadequate FHL. Most participants with adequate FHL reported feeling "calm and relaxed" for more than half the time or all the time. The SAHLPA-18 score was weakly negatively correlated with the Cognition and Self-Care domains of WHODAS 2.0, indicating that better health literacy is associated with better cognitive and self-care conditions.

Conclusion: Older people with better health literacy had better cognitive ability, better self-care management, higher education levels, and better quality of life.

Objective: To relate the self-perceived risk of dysphagia with the level of oral intake in hospitalized oncology patients.

Methods: This cross-sectional study had a convenience sample of adults and older adults diagnosed with cancer and hospitalized in an oncology hospital in southern Brazil. Data on sex, age, length of hospitalization, comorbidities, oncological diagnosis, treatment, and feeding route were obtained from the participants' medical records. The level of oral intake was classified using the Functional Oral Intake Scale (FOIS), and the risk of dysphagia was identified using the Eating Assessment Tool (EAT-10). The relationship between these variables was analyzed using Spearman's correlation coefficient.

Results: The study included 60 participants - 42 with solid tumors and 18 with hematological tumors; 35 females (58.3%) and 25 males(41.7%), with a mean age of 58.5 ± 13.1 years. Of these, 56 exclusively used the oral route for feeding (93.3%), and 18 were at risk of dysphagia (30%). Older patients were at higher risk for dysphagia than adults (p-value = 0.020). EAT-10 scores (median = 0; IQR = 0-4) were significantly inversely correlated (RHO = -0.463; p-value = 0.000) with FOIS classifications (N: level 2 = 2; level 3 = 2; level 4 = 2; level 5 = 12; level 7 = 42).

Conclusion: The study found that lower EAT-10 scores corresponded to higher FOIS levels. In other words, the lower the risk of dysphagia, the lower the susceptibility to using alternative feeding routes.

Purpose: This study analyzed tongue pressure in healthy older adults during maximum voluntary contraction in the anterior and posterior regions and verified whether it was associated with sex, age, and dental status.

Methods: This is a cross-sectional, observational, descriptive study with a non-probabilistic sample of 128 active and healthy older adults of both sexes. The evaluation consisted of a medical history survey to collect personal data, cognitive screening, and assessment of dental status and tongue pressure, using the Iowa Oral Performance Instrument. The anterior and posterior tongue pressures at maximum contraction were the response variables, and age, sex, number of natural teeth, and conditions related to dentures were the explanatory variables. The significance level was set at 5% for data analysis.

Results: Males had greater anterior tongue pressure. The anterior and posterior tongue pressure measurements were significantly different between participants aged 60 to 69 years and those over 80 years. No significant differences were found regarding dental status and denture fitting.

Conclusion: Anterior and posterior tongue pressure values were higher in men and decreased after the age of 80. The conditions related to the number of teeth and denture use and fitting did not influence the tongue pressure levels.

Purpose: To investigate potential association between different types of frailty and hearing handicap in the older population.

Methods: A study was conducted on frailty among older adults in the context of social vulnerability. The study involved 229 participants who underwent physical, cognitive, and social frailty assessments. Physical frailty was assessed using Fried's Frailty Phenotype, while cognitive frailty was characterized by the presence of physical frailty and cognitive decline. The Makizako index was used to assess social frailty, and the HHIE-S questionnaire was applied to quantify hearing handicap. Participation restrictions related to hearing difficulties were explored in relation to the three types of frailty using logistic regression.

Results: Hearing handicap were found to be associated with physical, cognitive, and social frailties. However, in a multivariate binary logistic regression analysis, the emotional scale of HHIE-S was only a predictive factor for physical frailty, along with older age, lower education, and the presence of comorbidities. Age and the presence of comorbidities were the only associated explanatory variables for cognitive frailty. Social frailty was only associated with the presence of cognitive changes.

Conclusion: Hearing loss-related participation restrictions can be a significant challenge for older adults. Those who also have an emotional impairment, caused by hearing loss, are even more vulnerable to becoming frail or pre-frail. It's important to prioritize the needs of this population and provide the necessary support to enhance their quality of life and prevent further decline.

Purpose: to verify the immediate effects of high-frequency oral oscillation using the Classic Shaker®, on acoustic, perceptual-auditory and vocal self-perception measures, in adults with and without vocal complaints.

Methods: 50 individuals were allocated into four groups - men with vocal symptoms, men without vocal symptoms, women with vocal symptoms and women without vocal symptoms. The participants completed the Vocal Symptoms Scale, the self-assessment of vocal discomfort, and were subjected to voice recording before and after performing the tested exercise, which consisted of blowing the Shaker® - Classic model - mouthpiece, while emitting the vowel U, for three minutes. The recordings were submitted to acoustic analysis and perceptual-auditory analysis. Paired T-test and Wilcoxon test were used, significance level of 5%.

Results: after the exercise, there was a decrease in jitter in the groups of men with symptoms and in shimmer in men without symptoms. Women with symptoms showed an increase in fundamental frequency, harmonic-to-noise ratio, CPP, and CPPS values and a decrease in jitter; women without symptoms showed an increase in GNE. The perceptual-auditory evaluation did not indicate changes after carrying out the exercise. A reduction in vocal discomfort was observed in all groups after the exercise.

Conclusion: The high-frequency oral oscillation exercise using the Shaker® was able to promote improvements in acoustic parameters and a reduction in self-reported vocal discomfort in the four groups evaluated.