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Pediatric hearing evaluation: visual reinforcement audiometry with speech sounds

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Author(s):
Maria Jaquelini Dias dos Santos
Total Authors: 1
Document type: Doctoral Thesis
Press: Bauru.
Institution: Universidade de São Paulo (USP). Faculdade de Odontologia de Bauru (FOB/SDB)
Defense date:
Examining board members:
Orozimbo Alves Costa Filho; Regina Celia Bortoleto Amantini; Andréa Cintra Lopes; Natália Barreto Frederigue Lopes; Maria Angelina Nardi de Souza Martinez
Advisor: Orozimbo Alves Costa Filho; Katia de Freitas Alvarenga
Abstract

Some theories postulate the auditory perception to complex sounds and simple sounds, occur differently. Theories about the existence of a special route for decoding speech, with distinctions from the detection of the acoustic spectrum, nonlinear depolarization of the auditory nerve fibers to the location of specialized neurons to interpret speech sounds at the cortical level. Is it possible this specific skill of speech perception a factor that would change the responses of children aged 6 to 24 months during a behavioral assessment? For audiological evaluation in this age group, with Visual Reinforcement Audiometry (VRA) is the test to obtain minimum response levels (MRL) or thresholds. Faced with these questions, determined to carry out a comparative study of the VRA with two stimuli: warble tones in the frequencies of 0.5, 1, 2 and 4 kHz, and speech stimuli, the six Ling sounds /a/, /i/, /u/, /s/, /?/, /m/. Both tests were applied in children with and without hearing impairment with the objective of determining the NMA, test time, number of sessions and the behavior observed during the assessment. In addition to quantitative research, we designed a guide guidelines for conducting the VRA. 123 children were evaluated, of which 57 were included in the survey, the main reasons for exclusion were changed tympanograms, multiple disabilities, delayed motor and auditory neuropathy spectrum disorder. Participated in the control group (CG) 33 children without hearing impairment, mean age 12 months, and 24 with hearing loss in the experimental group (GE), average age of 18 months. In total 718 were obtained NMA considering the 57 children and 10 evaluated stimuli. For the GC average of VRA-warble was 17.05 dBHL and for VRA-Ling of 13.60 dB HL; GE in the averages were respectively 95.51 and 85.88 dBHL dBNA, ie, statistically the values obtained with the sounds of Ling were lower than those obtained with the warble stimulus. The average time to achieve at least one or all of the NMA NMA with Ling and warble, did not differ compared intra groups, as well as the number of sessions. However, it was noted in comparison between groups, the number of sessions, the number of NMA obtained and the and the test time in achieving VRA-warble were higher in the EG. Other behaviors were observed during the course of the VRA: attention, orientation reflex, imitation of auditory stimuli, point to the phone, look appraiser / mother. Considering the results obtained: the test protocol used was effective for obtaining the NMA in both groups; Ling sounds can be used in the audiological evaluation of children to complement the findings with specific frequency stimuli. However, since Ling sounds have a wide range of frequencies, other studies correlating to NMA Ling sounds in different audiometric configurations are needed. (AU)