ABSTRACT Purpose: to verify the association between central auditory skills and speech disorders related to velopharyngeal dysfunction. Methods: forty-five children, with repaired non-syndromic cleft lip and palate or cleft lip only, aged 7-11 years old, were divided into three groups: G1 (n=15), children with hypernasality, nasal air emission, and compensatory articulations; G2 (n=15), children with hypernasality and nasal air emission, but without compensatory articulations; and G3 (n=15), children without hypernasality, nasal air emission, and compensatory articulations. The medical records of all participants were analyzed to verify the eligibility criteria and obtain speech assessments, and then, they were submitted to an assessment of central auditory skills. Statistical analysis comprised descriptive and chi-square test with a significance level of 5%. Results: G1 presented a higher occurrence of impairment in central auditory skills differing from the other groups, particularly in the temporal ordering and binaural integration skills. A significant difference was observed among groups in temporal ordering ability. No significant association was found between the use of specific types of compensatory articulations and impaired auditory skills. Conclusion: there was an association between changes in temporal ordering auditory skills and binaural integration in children with velopharyngeal dysfunction, regardless of the presence or type of compensatory articulation found.

Abstract Introduction Cortisol is a hormone involved in the response to stress. Attention is a function that can change due to exposure to stress. Objectives To verify the correlation between the level of salivary cortisol and sustained auditory attention in children with cleft lip and palate, as well as to compare the results of the variables analyzed between female and male patients. Methods In total, 103 children aged 6 to 11 years, were divided into 2 groups: those with cleft lip and palate (experimental group, EG; n = 69) and the control group (CG; n = 34). The Sustained Auditory Attention Ability Test (SAAAT) and salivary cortisol levels, measured by an enzyme immunoassay kit (Salimetrics, Stage College, PA, US), were calculated and compared regarding the two groups. The statistical tests used were the Mann-Whitney test and the Spearman correlation. Results The median level of salivary cortisol was of 0.03615 μl/dL and 0.18000 μl/dL respectively for the EG and CG, with a significant difference between the groups (p =0.000). Absence of statistical significance (total error score = 0.656; vigilance decrement = 0.051) was observed the for SAAAT among the EG (median total error score = 12.00; 25th percentile [25%] = 7.00; 75th percentile [75%] = 21.00; and vigilance decrement = 1.00; 25% = 0.00; 75% = 2.50) and the CG (median total error score = 12.00; 25% = 6.00; 75% = 24.00; and vigilance decrement = 0.00; 25% = -1.00; 75% = 2.00). Conclusion All children had median levels of salivary cortisol and scores for sustained auditory attention within normal parameters. A significant correlation between the level of salivary cortisol and the ability to sustain auditory attention was observed in children without cleft lip and palate. There were no differences regarding the SAAAT and salivary cortisol between female and male patients.

Abstract Introduction The use of auditory behavioral tests, which specifically assess sustained attention, is necessary, due to its relationship with learning, language production, cognitive development and school performance. Objective To evaluate how children performed using software developed to investigate the ability of sustained auditory attention, and to compare the scores obtained in this format with those of the original, non-computerized test. Methods This cross-sectional study included 52 children of both genders, aged 6 to 11 years, with normal hearing and no history of complaints regarding inattention and/or hyperactivity. The computerized test was administered to all 52 children. The total error score (inattention and impulsivity) and the vigilance decrement were used to define the children’s performance when using the software. The scores obtained in the two formats (computer software and original on compact disc) were then compared. Results Statistically significant differences were found in the scores for innattention, impulsivity, and total error score (inattention and impulsivity) when comparing genders, and a negative correlation coefficient was found when comparing ages. Increased scores were found for all variables of the sustained auditory attention ability test (SAAAT) compared with the original format. Conclusion Females performed worse than males in all aspects except for vigilance decrement when using the SAAATsoftware developed to evaluate the ability of SAAAT vigilance; younger children made more errors when using the SAAAT software; inattention errors were more frequent than impulsivity. Overall, higher values were obtained using the SAAAT software, when compared with the original version.

Abstract Introduction The Sustained Auditory Attention Ability Test (SAAAT) is an instrument used to assess sustained auditory attention in children. Difficulties related to this ability are not unique to children alone, as adults have been observed to present with the same deficits. Therefore, there is a need to adapt instruments like the SAAAT and provide reference values for adults. Objective To assess adult performance on the SAAAT. Methods Approved by the Human Research Ethics Committee under n° 034/2011. The sample consisted of 30 participants aged between 18 and 30 years old (average age = 24.2 years old), female and male. The inclusion criteria were: peripheral hearing within normal limits, type A tympanometric curve, and no attention-related complaints. The participants were submitted to Tonal Audiometry, Logoaudiometry, Immitanciometry and to the SAAAT. Results The following mean values and standard deviations (SD) were observed: inattention = 1.7 (SD = 2.2) and impulsivity = 0.8 (SD = 0.9) error types. For the SAAAT, the mean value for the total error score was 2.4 (SD = 2.6), and for the decrease in vigilance, it was 0.3 (SD = 0.5). When comparing the performance of adults and children, a statistically significant difference was observed for inattention (p = 0.000) and impulsivity (p = 0.001) error types, as well as in the total error score (p = 0.000) and in decreased vigilance (p = 0.0003). Conclusion The performance of adults in the SAAAT differed from the children's parameters, since adults showed lower scores in all variables of the instrument.

RESUMO Objetivo Verificar as habilidades auditivas de ordenação temporal, resolução temporal e localização sonora, antes e após a adaptação do aparelho de amplificação sonora individual (AASI) em indivíduos com perda auditiva unilateral (PAUn). Método Foram avaliados 22 indivíduos, com idades de 18 a 60 anos, com diagnóstico de PAUn sensorioneural ou mista, de graus leve a severo. O estudo foi dividido em duas etapas: a pré- e a pós-adaptação do AASI. Em ambas as etapas, os indivíduos realizaram anamnese, bem como a aplicação do Questionário de Habilidade Auditiva da Localização da Fonte Sonora (QHALFS), avaliação simplificada do processamento auditivo (ASPA) e Random Gap Detection Test (RGDT). Resultados O presente estudo encontrou diferenças estatisticamente significantes nas avaliações de localização sonora e memória para sons verbais em sequência, no RGDT e no QHALFS. Conclusão Com o uso efetivo do AASI, indivíduos com PAUn apresentaram melhora nas habilidades auditivas de localização sonora, ordenação e resolução temporal.

ABSTRACT Purpose To assess the hearing abilities of temporal ordering, temporal resolution and sound localization before and after the fitting of a hearing aid (HA) in individuals with unilateral hearing loss (UHL). Methods There were evaluated 22 subjects, aged 18 to 60 years, diagnosed with sensorineural or mixed UHL, from mild to severe degrees. The study was divided into two stages: the pre and post-adaptation of HA. In both phases, subjects performed an interview, application of Questionnaire for Disabilities Associated with Impaired Auditory Localization, auditory processing screening protocol (APSP) and Random Gap Detection Test (RGDT). Results This study found no statistically significant difference in sound localization and memory evaluations for verbal sounds in sequence, in RGDT and Questionnaire for Disabilities Associated with Impaired Auditory Localization. Conclusion With the effective use of hearing aids, individuals with UHL showed improvement in the auditory abilities of sound localization, ordering and temporal resolution.

Abstract Introduction Cleft lip and cleft palate can result in impairments in communication, specifically in hearing, making the use of technological resources such as blogs a fundamental guideline for health professionals. Objective The aim of this study was to prepare and analyze the access to a blog about cleft lip and cleft palate and hearing as a pedagogical tool for health professionals. Methods The first stage for the development of the blogwas the selection of the content that would be addressed and the respective illustrations. The second stage was making the blog available through theWordPress platform, and the third stage included the evaluation of the blog, of the access to theWordPress statistical features, and of the quality of the blog through the Emory questionnaire, which was answered by 75 professionals. Results The blog, titled “Fissure and Hearing”, was developed with the architecture of a digital information environment containing a system of organization, navigation, labeling and search (first stage). The address hosting the blog was: http://fissuraeaudicao. wordpress.com (second stage). The result of the third stage included 56,269 views of the blog from different countries, and Brazil was the country with the highest viewing. Regarding the assessment by the Emory questionnaire, we found that for most of the major issues, the percentages obtained were or equal to 90%, while the analysis of the scales, navigation and structure presented the lowest scores. Conclusion The blog was developed and enabled greater access to information available on the web about cleft lip and cleft palate and hearing.

Objetivo Identificar as repercussões sociais em indivíduos com distúrbios da comunicação associados às fissuras labiopalatinas com e sem perda auditiva. Métodos Participaram crianças e adolescentes de 7 anos a 15 anos e 11 meses de idade, de ambos os gêneros, com fissuras de lábio e palato ou de palato isolado, com e sem perda auditiva associada. A pesquisa foi composta por 52 participantes, divididos em dois grupos: um constituído por 36 crianças e adolescentes com fissuras labiopalatinas e sem perda auditiva e outro, por 16 sujeitos com fissuras labiopalatinas e com perda auditiva associada. Resultados Constatou-se que as repercussões socioeconômicas, familiares, educacionais e sociais são comuns aos grupos. Conclusão As crianças e adolescentes com perda auditiva associada à fissura labiopalatina não estão em “desvantagem” no que se refere às repercussões econômicas, familiares, escolares e sociais, em relação às que não têm o distúrbio de audição. Ambos os grupos vivenciam o acirramento de conviver com o comprometimento estético e funcional causado pela anomalia e de viver em uma sociedade totalmente preocupada com a imagem e julgadora das diferenças.

Purpose To identify the social impact on individuals with communication disorders associated with cleft lip and palate with and without hearing loss. Methods Participation by children and adolescents from 7 years to 15 years and 11 months old, of both genders, with cleft lip and palate or isolated cleft palate, with and without associated hearing loss. The survey consisted of 52 participants, divided into two groups: one consisting of 36 children and adolescents with cleft lip and palate without hearing loss and the other, 16 subjects with cleft lip and palate with associated hearing loss. Results It was found that the socio-economic, family, educational and social effects are common to both groups. Conclusion Children and adolescents with hearing loss associated with cleft lip and palate are not “disadvantaged” when referring to economic, family, school and social repercussions in relation to those who do not have hearing disorders. Both groups experience the worsening of living with the aesthetic and functional impairment caused by the anomaly and living in a society entirely concerned with the image and judging differences.

Introdução: Estudos anteriores têm demonstrado efeitos da exposição ao chumbo no sistema auditivo em crianças, porém a exposição deste metal em níveis baixos ainda precisa ser investigada. Objetivo: Investigar os efeitos da exposição crônica ao chumbo no sistema auditivo de crianças com histórico de baixo nível sanguíneo de chumbo por meio de um teste eletrofisiológico. Método: Estudo de coorte transversal contemporânea. Foram realizados imitanciometria, audiometria tonal liminar e vocal, emissões otoacústicas evocadas transientes e potenciais evocados auditivos de tronco encefálico, com o monitoramento sanguíneo de chumbo durante um período de 35,5 meses. Participaram 130 crianças na faixa etária de 18 meses a 14 anos e 5 meses (6a8 m ± 3a2 m). Resultados: A média estimada do índice de pumblemia foi 12 mg/dL (DP ± 5,7). Todos os participantes apresentaram limiares auditivos iguais ou inferiores a 20 dBNA e amplitude normal das emissões otoacústicas evocadas transientes. Não foi encontrada associação entre as latências absolutas das ondas I, III e V e interpicos I-III, III-V e I-V e os valores cumulativos de chumbo. Conclusão: Não foi observada evidência de efeitos tóxicos em baixas exposições crônicas ao chumbo sobre a função auditiva de crianças que vivem em uma área contaminada por este metal.

Introduction: Earlier studies have demonstrated an auditory effect of lead exposure in children, but information on the effects of low chronic exposures needs to be further elucidated. Objective: To investigate the effect of low chronic exposures of the auditory system in children with a history of low blood lead levels, using an auditory electrophysiological test. Methods: Contemporary cross-sectional cohort. Study participants underwent tympanometry, pure tone and speech audiometry, transient evoked otoacoustic emissions, and brainstem auditory evoked potentials, with blood lead monitoring over a period of 35.5 months. The study included 130 children, with ages ranging from 18 months to 14 years, 5 months (mean age 6 years, 8 months ± 3 years, 2 months). Results: The mean time-integrated cumulative blood lead index was 12 µg/dL (SD ± 5.7, range:2.433). All participants had hearing thresholds equal to or below 20 dBHL and normal amplitudes of transient evoked otoacoustic emissions. No association was found between the absolute latencies of waves I, III, and V, the interpeak latencies I-III, III-V, and I-V, and the cumulative lead values. Conclusion: No evidence of toxic effects from chronic low lead exposures was observed on the auditory function of children living in a lead contaminated area.

Objetivo verificar a ocorrência de perda auditiva sensorioneural em crianças com baixo nível de exposição cumulativa ao chumbo. Métodos 156 crianças intoxicadas por chumbo, 94 do sexo masculino e 62 do sexo feminino, na faixa etária entre 18 meses a 14 anos e 5 meses, foram submetidas a análise longitudinal do nível de Plumbemia em sangue, bem como audiometria tonal liminar e emissões otoacústicas evocadas por estímulo transiente. Resultados a população pesquisada apresentou um valor médio de Plumbemia estimada de 12,2±5,7mg/dL (faixa entre 2,4-33mg/dL); todas as crianças apresentaram resposta normal na audiometria tonal liminar em 20 dBNA nas frequências testadas, 0,5; 1; 2 e 4 kHz, para ambas as orelhas; as emissões otoacústicas evocadas por estímulo transiente estiveram presentes para todas as frequências bilateralmente, nas 79 crianças pesquisadas. Conclusão não foi constatada perda auditiva sensorioneural em crianças com histórico de baixo nível de exposição cumulativa por chumbo, assim como não foi encontrada lesão de células ciliadas externas na cóclea, mesmo que subclínicas.

Purpose to verify the occurrence of sensorineural hearing loss in children with low level of cumulative lead exposure. Methods 156 lead-poisoned children, 94 males and 62 females, ranging in age from 18 months old to 14 years and 5 months old were subjected to analysis of longitudinal lead level in blood as well as pure tone audiometry and transient evoked otoacoustic emissions. Results the population studied had a mean estimated blood lead level of 12,2±5,7mg/dL (range between 2,4 and 33mg/dL); all children had a normal response in pure tone audiometry at 20 dBHL in the frequencies tested, 0.5, 1, 2 and 4 kHz, in both ears; the transient evoked otoacoustic emissions were presented for all frequencies bilaterally in 79 children surveyed. Conclusion there has been no hearing loss in children with a history of low cumulative lead exposure, as there was no injury of cochlear outer hair cells, even if subclinical.

Objetivos : analisar o impacto das habilidades do processamento auditivo temporal e da fonologia na escrita de crianças contaminadas por chumbo.Método : participaram deste estudo 24 crianças de ambos os gêneros, com nível de plumbemia igual ou superior a 10µg/dL, sem alterações auditivas. Foram avaliados escrita espontânea, memória auditiva imediata, discriminação auditiva, consciência fonológica e feita triagem do processamento auditivo temporal. As crianças foram divididas em dois grupos (GE – crianças com trocas de consoante surda por sonora na escrita; GC – crianças sem alterações na escrita).Resultados : no GE, 8 crianças (67%) apresentaram alteração de discriminação auditiva, na PCF e desempenho não esperado no AFT-R (Subteste 1). No GC, apenas 1 criança (8%) apresentou alteração de discriminação auditiva e na PCF e desempenho não esperado no AFT-R (Subteste 1). O Teste Exato de Fisher indicou diferença significante entre os grupos nas habilidades de memória auditiva e discriminação auditiva.Conclusão : não houve diferença significante entre o desempenho na triagem do processamento auditivo temporal nos grupos avaliados. As crianças contaminadas pelo chumbo que apresentaram alteração de escrita obtiveram pior desempenho nas provas de consciência fonológica, discriminação auditiva, memória auditiva imediata.

Purpose : analyze the impact of temporal auditory processing in writing and phonology of children with lead poisoning.Method : this study included 24 children, both genders, with a blood lead level equal or higher than 10μg/dL, without hearing impairment. Were assessments the spontaneous writing, immediate auditory memory, auditory discrimination, phonological awareness and auditory processing screening. Were assessments the spontaneous writing, immediate auditory memory, auditory discrimination, phonological awareness and auditory processing screening. Children were divided in two groups (GE – children with exchange of the consonant surd by sound in writing, GC – children without alterations in writing).Results : in GE, eight children (67%) had results abnormal in auditory discrimination and in PCF, the not expected performance in the AFT-R (subtest 1). In GC, only one child (8%) had results abnormal in auditory discrimination, and in PCF; the not expected performance in AFT-R (subtest 1). Fisher’s Exact Test indicated significant difference between groups in the skills of auditory memory and auditory discrimination.Conclusion : there was no significant difference between performances in screening of temporal auditory processing in the groups. Children contaminated by lead and alterations in writing had worst performance in tests of phonological awareness, auditory discrimination, auditory memory.

Introduction  Any impairment in the hearing ability of a child with cleft lip and palate may cause difficulties in receptive and expressive language. Purpose  Check the association between velopharyngeal dysfunction (VPD), compensatory articulation (CA), and peripheral hearing loss in children with cleft palate surgery. Methods  Retrospective study with 60 children (group 1: presence of VPD and CA; group 2: absence of VPD, presence of CA; group 3: presence of VDP, absence of CA; group 4: absence of VPD and CA), age 4 to 5 years old, with cleft palate surgery, through the analysis of the hearing, VP, and speech evaluations. Results  Group 4 presented 80% normal hearing; group 1 had 60% hearing loss. The conductive hearing loss type was the most frequent. The glottal stop was the most frequent in group 1 and the middorsum palatal plosive in group 2. There was no significant association (p = 0.05) between hearing loss and the presence of compensatory articulations (groups 2 and 4), nor between hearing loss and the presence of VPD (groups 3 and 4; p = 0.12). Statistical significance (p = 0.025) was found when the group with VPD was associated with the group with CA, that is, group 1 with the control group (group 4). Conclusion  Significant association between peripheral hearing loss, compensatory articulations, and VPD was verified for the children in group 1, which not only presented compensatory articulations but also VPD.

Introduction Childhood is a critical period for language development and maturation of the central auditory system. Unilateral hearing loss (UHL) is considered a minimal impairment, and little is discussed regarding its impact on the development of language, communication, and school performance. Objectives A bibliographical survey of scientific articles published from 2001 to 2011 was performed to verify which language disorders can occur in children with UHL and which tests were performed to identify them. Data Synthesis Three databases were used: PubMed, Lilacs, and The Cochrane Library. As inclusion criteria, the articles should have samples of children with UHL, without other impairments, aged between 3 months and 12 years, and reference to language tests applied in this population. Out of 236 papers initially selected, only 5 met the inclusion criteria. In the articles studied, 12 tests were used for language assessment in children with UHL, out of which 9 were directed toward expressive language, and 3 toward receptive language. Children with UHL demonstrated lower scores on receptive and expressive language tests when compared with children with normal hearing. However, they obtained better scores on expressive language tests than children with bilateral hearing loss. Conclusion The findings of this survey showed that only a small number of studies used language tests in children with UHL or addressed language alterations resulting from this type of impairment. Therefore we emphasize the importance of investments in new studies on this subject to provide better explanations related to language difficulties presented by children with UHL.

OBJETIVO: investigar a ocorrência da perda auditiva unilateral em indivíduos com fissura labiopaltina. MÉTODOS: estudo retrospectivo com 500 prontuários de pacientes com fissura labiopalatina. RESULTADOS: foram levantados 55 sujeitos com perda auditiva unilateral, 27(49,1%) do gênero masculino e, 28 (50,9%) do gênero feminino, com média de idade de 14,6 anos. Dezoito (32,73%) apresentaram perda auditiva na orelha direita e 37(67,27%) na orelha esquerda, 72,73% (40 sujeitos) com perda auditiva do tipo condutiva, 18,18% (10 sujeitos) do tipo neurossensorial e 9,09% (5 sujeitos) do tipo mista. Quanto ao grau da perda auditiva foi constatada maior ocorrência de perda auditiva de grau leve. CONCLUSÃO: a perda auditiva unilateral foi mais frequente nos indivíduos com faixa etária de 0 a 11 anos, com igual proporção em gênero. A perda auditiva unilateral pode comprometer aspectos sociais e emocionais do sujeito, levando-o a necessitar de uma intervenção apropriada.

PURPOSE: to investigate the occurrence of unilateral hearing loss in individuals with cleft palate. METHODS: a retrospective study of 500 medical records of patients with cleft palate. RESULTS: 55 subjects have been raised with unilateral hearing loss, 27 (49.1%) were male and 28 (50.9%) were female, mean age of 14.6 years. Eighteen (32.73%) had hearing loss in right ear and 37 (67.27%) in the left ear. Being 72.73% (40 subjects) with conductive hearing loss, 18.18% (10 subjects) sensorineural and 9.09% (5 subjects) of mixed type. Regarding the degree of hearing loss was found higher incidence of mild hearing loss. CONCLUSION: a unilateral hearing loss was more frequent in subjects aged 0-11 years, with equal gender ratio. A unilateral hearing loss may affect social and emotional aspects of the subject, leading him to need an intervention.

INTRODUCTION: At the initial consultation, the speech-language pathologist and audiologist may consider possible diagnostic hypotheses based on the child's history and the parents' complaint. AIM:To investigate the association of hearing complaints with the findings obtained in the conventional audiologic assessment in children with cleft lip and palate. Retrospective study. METHODS: We analyzed medical charts of 1000 patients with cleft lip and palate who underwent surgical repair between 1988 and 1995 at a mean age of 6 years 8 months. We excluded charts with records of inconsistent audiological responses and charts with missing data for any of the audiologic evaluations considered. Thus, the sample consisted of 393 records. RESULTS: Two hundred thirty-nine patients presented hearing loss in one or both ears, but only 3.8% reported hearing complaints. The most frequent were otorrhea followed by otalgia. There was no statistical significance between the complaint and gender (p = 0.26) nor between the complaint and hearing loss (p = 0.83). CONCLUSION: This study showed no association between the hearing complaint and the conventional audiologic assessment.

Introduction: The effects of lead on children's health have been widely studied. AIM: To analyze the correlation between the long latency auditory evoked potential N2 and cognitive P3 with the level of lead poisoning in Brazilian children. METHODS: This retrospective study evaluated 20 children ranging in age from 7 to 14 years at the time of audiological and electrophysiological evaluations. We performed periodic surveys of the lead concentration in the blood and basic audiological evaluations. Furthermore, we studied the auditory evoked potential long latency N2 and cognitive P3 by analyzing the absolute latency of the N2 and P3 potentials and the P3 amplitude recorded at Cz. At the time of audiological and electrophysiological evaluations, the average concentration of lead in the blood was less than 10 ug/dL. RESULTS: In conventional audiologic evaluations, all children had hearing thresholds below 20 dBHL for the frequencies tested and normal tympanometry findings; the auditory evoked potential long latency N2 and cognitive P3 were present in 95% of children. No significant correlations were found between the blood lead concentration and latency (p = 0.821) or amplitude (p = 0.411) of the P3 potential. However, the latency of the N2 potential increased with the concentration of lead in the blood, with a significant correlation (p = 0.030). CONCLUSION: Among Brazilian children with low lead exposure, a significant correlation was found between blood lead levels and the average latency of the auditory evoked potential long latency N2; however, a significant correlation was not observed for the amplitude and latency of the cognitive potential P3.