Pro-fono : revista de atualizacao cientifica最新文献

Background: a number of changes in the speech of normally aging adults have been described in the literature. However age-related changes in fluency have received little attention.

Aim: to verify the Fluency Profile of elderly regarding all of the different fluency parameters.

Method: participants were 128 elderly, of both genders, aged above 60 years. Speech samples of all participants were gathered. They were analyzed according to: type of speech disruption; speech rate and frequency of speech disruptions, based on the analyses of 200 fluent syllables. Participants were compared between themselves regarding the decades of life. Individuals with ages above 80 years constituted a single group.

Results: statistical analysis indicated significant differences between the decades only for syllables per minute. For the group of individuals with ages above 80 years, statistical significance was observed indicating an increase in the number of speech disruptions and a decrease in speech rate.

Conclusion: regarding the fluency parameters analyzed in this study, the effect of aging seems to be more expressive after the age of 80 years.

Background: the use of monothermal caloric testing as a screening tool for vestibular asymmetry has been considered as an alternative to bithermal caloric testing.

Aim: to evaluate the effectiveness of monothermal stimulation when compared to bithermal stimulation in the diagnosis of labyrinth asymmetry.

Method: the results of 389 vectoelectronystagmography, performed between 1998 and 2007, were analyzed. Monothermal stimulation at 30°C and 44°C with unilateral weakness (UW) cut-off at 20% and 25% was compared to bithermal stimulation with cut-off at 25% (gold standard). The analysis was aimed at finding which kind of monothermal caloric test (30°C or 44°C) and which kind of cut-off (20% or 25%) presented the highest specificity and sensitivity values in comparison with bithermal caloric testing.

Results: sensitivity and specificity of monothermal caloric tests were: 84% and 80%, at 30°C with UW at 20%; 78% and 90%, at 30°C with UW at 25%; 81% and 78%, at 44°C with UW at 20%; 76% and 85%, at 44°C with UW at 25%.

Conclusion: monothermal caloric testing with 30°C stimulus presented the highest sensibility and specificity values in comparison to the results obtained with bithermal stimulation. However, no significant difference was observed between such values and those obtained with 44°C stimulus. In all of the analyses, monothermal testing presented low sensitivity. Thus, the abnormal result of bithermal caloric testing might be seen as normal in monothermal stimulation. The use of monothermal testing as a screening tool is better recommended for individuals whose medical history suggests a low probability of vestibular disease.

Background: electrophysiological assessment of hearing in autistic individuals.

Aim: to characterize the findings obtained in the electrophysiological assessments of autistic individuals, as well as to compare these to the results obtained for individuals of the same age who present typical development.

Method: 16 individuals with autism (study group) and 25 normal individuals (control group), ranging in age from eight to 20 years underwent anamnesis, pure tone audiometry, speech audiometry, acoustic immitance measures, brainstem auditory evoked potential (BAEP), middle latency response (MLR) and cognitive potential (P300).

Results: the study group presented altered results in all auditory evoked potentials, showing statistically significant differences when compared to the control group. Concerning the types of alterations found in the study group the following results were observed: higher occurrence of lower brainstem alteration in the BAEP, both (electrode and ear effects occurring simultaneously) in the MLR, and absence of response in the P300. In the quantitative data analysis, statistically significant differences between the groups were found only for the BAEP regarding the latencies of waves III and V and interpeaks I-III and I-V.

Conclusion: autistic individuals present altered BAEP and P300, suggesting impairment in the brainstem auditory pathway and cortical/subcortical areas.

Background: Many situations may raise difficulties when obtaining hearing thresholds for each ear separately. These situations demand the use of masking. The plateau method has been used for more than four decades. Nevertheless, in 2004 a different masking protocol was suggested, called the optimized method, to replace the plateau method in specific cases.

Aim: To evaluate the feasibility of two clinical masking methods, plateau and optimized, in the testing of hearing thresholds.

Method: Participants of this study were 40 individuals aged 15 to 65 years, with either unilateral or bilateral hearing losses. All participants underwent air and bone conduction pure tone audiometry for both ears, with and without the use of the two masking methods, considering unilateral, bilateral, symmetrical and bone-only patterns.

Results: There was no statistically significant difference between the two masking methods for obtaining the air conduction hearing thresholds considering the tested situations. However, there was a higher percentage difference for the symmetrical pattern in the air conduction retest situation. There was a statistically significant difference between the plateau and optimized methods regarding the bone conduction thresholds for the symmetrical and bone-only patterns.

Conclusion: The plateau method can be used for all patterns and the optimized method is the most effective for unilateral and bilateral patterns. Therefore, it is important for the audiologist to have the knowledge about the application of both masking methods in order to obtain more reliable results.

Background: Children with hearing loss do not acquire language at the same time nor at the same rate of normal hearing children because the learning process of oral language is essentially auditory. Child development consists in gradually acquiring motor and psychocognitive abilities. Entering the symbolic world is decisive for the child to reach higher levels of linguistic complexity.

Aim: To correlate symbolic play and aspects of child development in deaf children and in hearing children.

Method: Participants of this study were 32 children, of both genders, with ages between 2 and 6 years, age matched. All participants were submitted to the Evaluation of Symbolic Maturation and to the Denver Developmental Screening Test II. Sixteen participants presented moderate to profound sensory-neural hearing loss and composed the research group (RG); the remaining 16 children had normal hearing and composed the control group (CG).

Results: Symbolism was observed in the play of 81.25% of RG and in 87.5% of CG. In the Denver Developmental Screening Test II, 100% of the RG was classified as being at risk. As for the CG, 94% of the children were classified as normal and the remaining 6% as being at risk (p<0.001).

Conclusion: A similar performance was observed between the groups for symbolic play. However, in a qualitative analysis, the RG presented less complex symbolic play than the CG. It was observed that the RG presented a performance in the symbolic play compatible to its performance in aspects of personal-social, refined motor and gross motor control in the Denver Developmental Screening Test II.

Background: The development of oral motor control depends partially on motor and sensory experiences.

Aim: To analyze the relationship between the duration of breastfeeding, artificial feeding and sucking habits, and of these parameters with the orofacial motor performance.

Method: Participants of this study were one hundred and seventy-six children aged 6 to 12 years. All subjects were submitted to an orofacial myofunctional clinical examination, using a protocol with scores, and parents/care takers were interviewed in respect to the feeding and sucking habits of their children. Correlations were calculated using the Spearman Test.

Results: In the studied sample, the mean duration of breastfeeding was of 10.30 months (ranging from zero to 60 months), of artificial feeding was of 44.12 months (zero to 122 months) and of sucking habits was of 39.32 months (0 to 144 months). There was a negative correlation of breastfeeding duration with artificial feeding duration and sucking habits duration (p < 0001). The duration of the artificial feeding was positively correlated to the duration of sucking habits (p < 0001). The duration of breastfeeding was positively correlated with the mobility of the tongue and jaw (p = 0.05). There was a negative correlation of the duration of artificial feeding and the duration of sucking habits with the performance in mastication and swallowing, respectively, as well as with the duration of both types of sucking with the performance in the diadochokinesia test (p = 0.05).

Conclusion: The duration of natural breastfeeding presented a positive effect over the mobility of the orofacial structures. Deleterious effects of the prolonged duration of artificial feeding and sucking habits in the oral motor control were confirmed.

Background: Different etiologies are related to tinnitus including metabolic disorders (blood glucose and lipids).

Aim: The aim of this study was compare tinnitus severity by self-report measures pre and post nutritional intervention, using the Tinnitus Handicap Inventory.

Method: Participants of this study were twenty one male and female subjects, with ages ranging from 40 to 82 years. Inclusion criteria involved the presence of tinnitus and metabolic disorder diagnosed by laboratory exams. All subjects were submitted to a nutritional intervention program. Audiological evaluation and the Tinnitus Handicap Inventory were applied pre and post intervention.

Results: When comparing the presence of tinnitus pre and post intervention, data analysis indicates statistical difference concerning tinnitus sensation--71.5% of the individuals referred less impact of tinnitus in daily activities.

Conclusion: An important difference was observed concerning tinnitus influence in subject's life by self-report measures. A direct relation between tinnitus and metabolic disorders in cases related with this symptom was verified.

Background: Several studies suggest the association of specific language impairment (SLI) to deficits in auditory processing. It has been evidenced that children with SLI present deficit in brief stimuli discrimination. Such deficit would lead to difficulties in developing phonological abilities necessary to map phonemes and to effectively and automatically code and decode words and sentences. However, the correlation between temporal processing (TP) and specific deficits in language disorders--such as syntactic comprehension abilities--has received little or no attention.

Aim: To analyze the correlation between: TP (through the Frequency Pattern Test--FPT) and Syntactic Complexity Comprehension (through a Sentence Comprehension Task).

Method: Sixteen children with typical language development (8;9 +/- 1;1 years) and seven children with SLI (8;1 +/- 1;2 years) participated on the study.

Results: Accuracy of both groups decreased with the increase on syntactic complexity (both p < 0.01). On the between groups comparison, performance difference on the Test of Syntactic Complexity Comprehension (TSCC) was statistically significant (p = 0.02).As expected, children with SLI presented FPT performance outside reference values. On the SLI group, correlations between TSCC and FPT were positive and higher for high syntactic complexity (r = 0.97) than for low syntactic complexity (r = 0.51).

Conclusion: Results suggest that FPT is positively correlated to syntactic complexity comprehension abilities.The low performance on FPT could serve as an additional indicator of deficits in complex linguistic processing. Future studies should consider, besides the increase of the sample, longitudinal studies that investigate the effect of frequency pattern auditory training on performance in high syntactic complexity comprehension tasks.