ABSTRACT Purpose: to synthesize the evidence of available studies in the literature regarding the benefit of the cochlear implant in children with additional diagnosis of autism spectrum disorder and to verify the protocols used to validate the abilities of auditory perception and oral language of this population. Methods: an integrative literature review, searching in LILACS, MEDLINE/PubMed and SciELO databases and in the Google Scholar. Studies in Portuguese and English that assessed auditory and/or spoken language skills of children using cochlear implants with autism spectrum disorder were included. Literature Review: 16 studies were included. In 72.18% of cases, autism spectrum disorder was diagnosed when the child was already using a cochlear implant. Studies have shown limited benefit from cochlear implants for the studied population. Parents need to be oriented regarding their expectations about the use of the device. Conclusion: the benefit of using a cochlear implant for children with an additional diagnosis of autism spectrum disorder is limited and lower than the results obtained by children who do not have additional diagnoses. There is no standardized protocol for assessing auditory and language skills in this population.

RESUMO Objetivo: sintetizar as evidências de estudos disponíveis na literatura a respeito do benefício do implante coclear em crianças com diagnóstico adicional de transtorno do espectro autista e verificar quais os protocolos utilizados para a avaliação das habilidades de percepção auditiva e de linguagem falada dessa população. Métodos: trata-se de revisão integrativa da literatura. A busca foi realizada nas bases de dados LILACS, PubMed e SciELO e no Google Acadêmico. Foram incluídos estudos nos idiomas português e inglês, que avaliaram habilidades auditivas e/ou de linguagem falada de crianças usuárias de implante coclear com transtorno do espectro autista. Revisão de Literatura: 16 estudos foram incluídos. Em 72,18% dos casos, o diagnóstico do transtorno do espectro autista foi concluído quando a criança já fazia uso do implante coclear. Os estudos demonstram benefício limitado do dispositivo para a população estudada. É necessário que os pais sejam orientados a respeito das expectativas com o uso do dispositivo. Conclusão: o benefício obtido pelo uso do implante coclear por crianças com diagnóstico adicional de transtorno do espectro autista é limitado e inferior aos resultados obtidos por crianças que não apresentam diagnósticos adicionais. Não há um protocolo padronizado para a avaliação das habilidades auditivas e de linguagem dessa população.

ABSTRACT Purpose: to verify hearing difficulties related to everyday listening situations self-reported by normally-hearing adults. Methods: a cross-sectional observational study in which adult individuals with clinically normal hearing, verified through audiometry and tympanometry, were included. The participants answered the Brazilian Portuguese version of the Speech, Spatial and Qualities of Hearing Scale (SSQ) questionnaire. Statistical analysis comprised descriptive and Spearman’s correlation test with a significance level of 5%. Results: the sample consisted of 28 participants, aged between 20 and 44 years. The median SSQ score was 8.75, in the Hearing to Speech domain, 8.11, in the Spatial Hearing domain, and 8.91, in the Quality-of-Hearing domain. There was an association between the participant's age and the score on five questions, demonstrating less self-reported difficulty as age increased. Conclusion: difficulties in everyday listening situations, self-reported by normally-hearing adults, participating in this study, were more related to situations with competitive noise and listening effort.

RESUMO Objetivo: verificar as dificuldades auditivas relacionadas a situações cotidianas de escuta autorrelatadas por adultos normo-ouvintes. Métodos: trata-se de um estudo observacional transversal. Foram incluídos indivíduos adultos com limiares auditivos normais, verificados por meio de audiometria e timpanometria. Os participantes responderam à versão no português brasileiro do questionário Speech, Spatial and Qualities of Hearing Scale (SSQ). Os resultados foram analisados descritiva e estatisticamente. A análise estatística compreendeu teste descritivo e de correlação de Spearman com nível de significância de 5%. Resultados: a amostra foi composta por 28 participantes, com idades entre 20 e 44 anos. A mediana da pontuação no SSQ foi de 8,75 pontos no domínio Audição para a Fala; 8,11 no domínio Audição Espacial e 8,91 pontos no domínio Qualidade da Audição. Observou-se associação entre a idade do participante e a pontuação em cinco questões, demonstrando menor dificuldade autorrelatada conforme o aumento da idade. Conclusão: as dificuldades em situações cotidianas de escuta autorrelatadas pelos adultos normo-ouvintes participantes desse estudo foram mais relacionadas a situações com ruído competitivo e esforço de escuta.

ABSTRACT Purpose To describe the development and validation of a test, called BATUTA, that assesses the musical perception of people with hearing impairment that are hearing aid (HA) users. BATUTA is a computerized test with 35 subtests, divided into the rhythm, pitch, and timbre modules, and the participants must answer whether the sound samples and/or parts of the songs, presented in pairs, are the same or not. Methods The BATUTA creation process consisted of four stages: test development, submission to the expert committee for content validation; pilot application with 51 normal hearing participants and retest to validate reliability. The process was based on several recommendations for the development and validation of musical assessment instruments. A deep investigation of the guidelines related to sound samples used, musical attributes evaluated, testing environment and the most appropriate response method was undertaken to ensure dependability. Results The Content Validity Index (CVI) and expert agreement rates, when analyzed with the committee's recommendations, resulted in corrections and new audio recordings to ensure compliance to the test. The pilot test scores indicated internal consistency and the retest confirmed the reliability of BATUTA. Conclusion The results demonstrated the viability of BATUTA to assess the musical perception of people with hearing impairment that are HA users.

RESUMO Objetivo Descrever o desenvolvimento e a validação de um teste de percepção musical, denominado BATUTA, destinado a avaliar a percepção musical de pessoas com deficiência auditiva, usuárias de aparelhos de amplificação sonora individual (AASI). O BATUTA é um teste computadorizado composto por 35 subtestes divididos nos módulos ritmo, pitch e timbre para os quais os participantes devem responder se as amostras sonoras e/ou os trechos musicais apresentados, aos pares, são iguais ou diferentes. Método O processo de construção do BATUTA foi composto por quatro etapas: desenvolvimento do teste, submissão da versão inicial ao comitê de especialistas para validação de conteúdo; aplicação do piloto em 51 participantes com audição normal e reteste para validação da confiabilidade, fundamentadas em reconhecidas recomendações para elaboração e validação de instrumentos de avaliação. Diretrizes relacionadas à natureza das amostras sonoras utilizadas, aos atributos musicais avaliados, ao ambiente de testagem e ao tipo de resposta indicada para a finalidade do BATUTA foram amplamente investigadas, com o propósito de lhe conferir fidedignidade. Resultados Os índices de Validação de Conteúdo (IVC) e de concordância entre os especialistas, quando analisados juntamente com as recomendações do comitê, resultaram em correções e em novas gravações dos áudios para garantir o cumprimento do teste. Os escores da aplicação do teste piloto indicaram boa consistência interna e o reteste confirmou a confiabilidade do BATUTA. Conclusão Os resultados demonstraram a viabilidade do BATUTA para avaliar a percepção musical de pessoas com deficiência auditiva usuárias de AASI.

RESUMO Objetivo Investigar a influência da prática musical instrumental nas habilidades auditivas temporais e nos resultados de potenciais corticais relacionados a eventos auditivos (P300) em um grupo de jovens músicos em comparação com indivíduos sem experiência prática musical. Método Trata-se de um estudo prospectivo, observacional, analítico e transversal. Participaram 34 indivíduos entre 18 a 30 anos, de ambos os sexos, divididos em dois grupos: Grupo I (GI), composto por indivíduos músicos (n=16) e Grupo II (GII), composto por indivíduos não músicos (n=18). Todos os participantes realizaram avaliação comportamental do processamento auditivo temporal, composta pelos testes de Padrão de Duração (TPD), Padrão de Frequência (TPF), Random Gap Detection (RGDT) e avaliação eletrofisiológica - Potencial Evocado Auditivo de Longa Latência (PEALL) - P300. O GI respondeu também a um questionário específico para caracterização da prática musical. Resultados Foram observadas diferenças estatisticamente significantes com desempenho superior do GI em relação ao GII em todos os testes comportamentais aplicados (p<0,001*). Não foram encontradas diferenças significantes entre os grupos com relação aos parâmetros de latência e amplitude analisados a partir da obtenção do PEALL-300 (p>0,05). Conclusão Os achados demonstraram influência positiva da prática musical em relação ao aprimoramento de habilidades auditivas de ordenação e resolução temporal. Todos os participantes apresentaram adequado funcionamento cortical do sistema nervoso auditivo central, sem diferenças significantes entre músicos e não músicos nos parâmetros de amplitude e latência do P300.

ABSTRACT Purpose To investigate the influence of musical instrument practice on temporal auditory abilities and on the results of cortical potentials related to auditory events (P300) in a group of young musicians compared to individuals without experience in musical practice. Methods This is a prospective cross-sectional observational study. In total, 34 individuals between 18 and 30 years old, of both sexes, took part and were divided in two groups: Group I (GI), composed of musicians (n=16), and Group II (GII), composed of non-musicians (n=18). All participants underwent behavioral evaluation of temporal auditory processing, composed of Duration Pattern Sequence Test (DPS), Pitch Pattern Sequence Test (PPS), Random Gap Detection Test (RGDT) and electrophysiological evaluation – Long Latency Auditory Evoked Potential – P300. GI also answered a specific questionnaire to characterize musical practice. Results We observed statistically significant differences with superior performance of GI compared with GII in all behavioral tests (p<0.001*). The groups’ performance was similar regarding the latency and amplitude parameters analyzed from LLAEP-300 data (p>0.05). Conclusion The findings show a positive influence of musical practice toward the improvement of auditory abilities of temporal ordering and resolution. All participants presented adequate cortical functioning of the central auditory nervous system, without significant differences between musicians and non-musicians when considering P300 amplitude and latency.

OBJECTIVES: Assessing infants’ hearing is of utmost importance, as hearing at this phase is required for the development of oral language. Through hearing, human beings are capable of developing communication. The Brainstem Auditory Evoked Potentials are an indispensable test to diagnose deafness in infants. This study aimed to analyze the results of the Brainstem Auditory Evoked Potentials in children with risk factors for hearing loss. METHODS: This cross-sectional study analyzed the Brainstem Auditory Evoked Potentials in 123 infants aged 1 to 24 months at a hearing health care service. The Vivosonic Integrity V500 equipment, which enabled the child to be awake while the testing was carried out, was used in this study. The data were compared by gestational age and sex, according to the standards suggested in the equipment handbook. RESULTS: A significant difference was verified for age ranges 4 to 6 months, 13 to 15 months (waves I and V), and 7 to 9 months (wave V). The lower values in absolute wave latencies were comparable to data from the equipment handbook, justifying the need for standardization of the screening process. CONCLUSION: There are some differences between the standards in the equipment handbook and those observed in our study. These results will serve as a reference for the standardization of the equipment used in the hearing health care service.

Abstract Introduction Hearing is the main sensory access in the first years of life. Therefore, early detection and intervention of hearing impairment must begin before the first year of age. Objective To analyze the results of the electrophysiological hearing assessment of children at risk for hearing loss as part of the newborn hearing screening (NHS). Methods This is a cross-sectional study held at a hearing health public service clinic located in Brazil, with 104 babies at risks factors for hearing loss referred by public hospitals. A questionnaire was applied to parents, and the auditory brainstem response (ABR) test was held, identifying those with alterations in the results. The outcome of the NHS was also analyzed regarding risk factor, gestational age and gender. Results Among the 104 subjects,most of them weremale (53.85%), and the main risk factor found was the admission to the neonatal intensive care unit (NICU) for a period longer than 5 days (50.93%). Eighty-five (81.73%) subjects were screened by NHS at the maternity and 40% of them failed the test. Through the ABR test, 6 (5.77%) infants evidenced sensorineural hearing loss, 4 of them being diagnosed at 4months, and 2 at 6 months of age; all of them failed the NHS and had family history and admission atNICU for over 5 days as themost prevalent hearing risks; in addition, familymembers ofall children perceived their hearing impairment. Conclusion Advances could be observed regarding the age of the diagnosis after the implementation of the NHS held at the analyzed public service clinic.

Abstract Introduction Tobacco farming exposes workers to various health risks due to the high application of pesticides needed to control pests, weeds and fungal diseases that prevent the tobacco plant growth. Objective To analyze the perception of the quality of life of tobacco growers exposed to pesticides, with emphasis on general health, hearing, and working conditions. Method This is a descriptive, cross-sectional study using a quantitative approach with farmers from southern Brazil. Data were collected from November of 2012 to November of 2014. For data collection, we opted for the 36-item short form health survey (SF-36) questionnaire, and a questionnaire with closed questions about health, hearing and working conditions. We evaluated a total of 78 subjects; the study group, made up of 40 tobacco farmers exposed to pesticides, and a control group of 38 participants without occupational exposure to pesticides. Both groups are residents of the same municipality, and users of the federal public health system. Results The results showed that tobacco growers had lower quality of life scores compared with the control group. Significant differences were observed in the areas of pain and general health. There were correlations between physical elements and chronic diseases; hearing complaints and a lack of personal protective equipment use, occupation and hearing complaints, as well as general health and hearing complaints. Conclusion Tobacco farming is a risky activity for general and hearing health, and it can impact the quality of life of those working in this field.

Abstract Introduction Pitch-matching refers to the ability to vocally reproduce an acoustic model in a corresponding tone to the presented sound. This ability, which is dependent on pitch perception ability, can vary among individuals, and some are not able to sing in the correct tune or discriminate differences between tones. Objective To correlate pitch-matching accuracy and auditory processing in individuals without musical training. Methods A Pitch-Matching Test (vocal reproduction of synthesized and human voice sounds) and two commercially available tests of auditory temporal processing (the Pitch Pattern Sequence Test and the Random Gap DetectionTest) were administered to all participants. A total of 62 college students of both genders, aged between 18 and 35 years old, were divided into 2 groups, according to their performances in the Pitch- Matching Test (the accurate match group and the inaccurate match group). Results In the Pitch-Matching Test, both groups achieved better results when reproducing vocalized sounds. The accurate match group achieved a significantly higher pitch pattern sequence test performance. In the Random Gap Detection Test analysis, there were no differences between the two groups. The Pearson’s chi-squared test showed a direct correlation between the Pitch-Matching Test and the Pitch Pattern Sequence Test. Conclusion The findings of this study suggest the existence of a significant relationship between temporal auditory processing and pitch-matching, through which accurate pitch-matching individuals perform better in the Pitch Pattern Sequence Test. Inaccurate pitch-matching individuals may be skilled at discriminating pitch, despite their poor performance in the Pitch-Matching Test.

RESUMO Objetivo Analisar o impacto da exposição à música na audição e na qualidade de vida de músicos de uma orquestra sinfônica brasileira. Métodos Trata-se de um estudo quantitativo transversal, descritivo, sobre os aspectos da saúde auditiva de 30 músicos da orquestra sinfônica do Paraná, com idade entre 33 e 54 anos. Foram medidos os níveis de pressão sonora a que os músicos estão expostos durante um ensaio da orquestra e os participantes responderam a um questionário sobre a prática musical e o questionário SF-36, que investiga a qualidade de vida. Foi realizada audiometria convencional e de altas frequências. Resultados Durante o ensaio da orquestra, foram observados níveis de pressão sonora que colocam a audição dos músicos em risco. Os sintomas auditivos mais relatados foram zumbido e intolerância a sons intensos. Na audiometria convencional, mais da metade dos músicos apresentou perda auditiva neurossensorial, com piores resultados nas frequências mais altas. Na audiometria de altas frequências, também foram encontrados limiares auditivos mais elevados nas frequências mais altas. Quanto à qualidade de vida, houve correlação significativa para os músicos com perda auditiva no domínio “limitação por aspectos emocionais”. Conclusão Os níveis de pressão sonora a que os músicos estão expostos são excessivos, colocando em risco a sua audição. A perda auditiva, juntamente com outros sintomas auditivos, pode interferir na qualidade de vida, uma vez que a audição é fundamental para essa categoria profissional.

ABSTRACT Purpose To analyze the impact of exposure to music in the hearing process and quality of life in musicians of a symphony orchestra. Methods This is a descriptive, cross-cut, quantitative study on the aspects of hearing health in 30 musicians of the symphony orchestra of Paraná, ages between 33 and 54 years. The sound pressure levels that musicians are exposed to were measured during the orchestra rehearsal, and participants answered a questionnaire about the musical practice as well as the SF-36 questionnaire, which investigates the quality of life. Conventional audiometry and high-frequency audiometry were applied. Results During the orchestra rehearsal, hazardous sound pressure levels to musicians’ hearing health were observed. The commonest symptoms reported were tinnitus and intolerance to intense sounds. In the conventional audiometry test, more than half of the musicians featured sensorineural hearing loss, and the worst results were found in high frequencies. In the high -frequency audiometry test, higher auditory thresholds were also found in higher frequencies. As for quality of life, there was significant correlation for musicians with hearing loss in the domain “limitation due to emotional aspects”. Conclusion the sound pressure levels that musicians are exposed to are excessive and represent a risk to hearing health. Hearing loss and other auditory symptoms can interfere in their quality of life, once hearing is essential to this professional category.

OBJETIVO: avaliar e comparar a percepção de trabalhadores sobre aspectos de conforto e uso de dois tipos de protetores auriculares (tipo concha e inserção) em três unidades de uma empresa madeireira com tempos diferentes de implantação de Programas de Preservação Auditiva (PPA).MÉTODOS: trata-se de um estudo transversal, que comparou a percepção de 440 trabalhadores de três unidades de empresa do estado do Paraná, com tempos diferentes de Programa de Preservação Auditiva, sobre protetores auriculares. Foram aplicados dois questionários fechados (9 e 10 questões) com escala de respostas de 1 a 5 (escala Likert) sobre percepção de conforto de protetores auriculares e analisadas as audiometrias.RESULTADOS: 17,5% apresentaram audiogramas alterados. Em relação ao questionário de percepção de conforto, a importância da atenuação do ruído (média 4,25) foi o aspecto mais relevante, seguido da possibilidade de comunicação (média 4,15). Na avaliação do protetor utilizado, a Unidade A com mais tempo de PPA apresentou pontuações melhores tanto para a percepção dos aspectos importantes do protetor auricular pelos trabalhadores quanto na avaliação do protetor auricular utilizado. Houve diferença significativa sobre a dificuldade de comunicação com o uso de protetor auricular entre trabalhadores com audiogramas normais e alterados (p=0,0371). Quanto ao conforto global na comparação dos trabalhadores usuários do protetor auricular do tipo concha com os do tipo inserção, não houve diferença (p=0,2264) independente da Unidade.CONCLUSÃO: Em geral, os trabalhadores das unidades apresentaram uma boa percepção de aspectos importantes da proteção auditiva para a utilização de ambos os tipos de protetores auriculares.

PURPOSE: To evaluate and compare the workers' perception of comfort and use aspects regarding two types of hearing protectors (shell and earplug), in three units from a lumbering company, with different implantation times for Hearing Preservation Programs.METHODS: This is a cross-sectional study comparing 440 workers' perception of hearing protectors, from three companies in Paraná State (Brazil), with different times for Hearing Preservation Programs. Two closed questionnaires were applied (9 and 10 questions, respectively), with a scale of answers varying from 1 to 5 (Likert's scale) regarding the perception of the comfort of hearing protectors. Then, audiometry results were analyzed.RESULTS: About 17.5% presented audiogram examinations with alterations. With regard to the questionnaire about the comfort perception, the importance of noise attenuation (mean of 4.25) was the most relevant aspect, followed by communication possibility (mean of 4.15). In the protector assessment, Unit A with more Hearing Preservation Program time presented better scores for both the worker's perception of important aspects regarding hearing protector and for the assessment of the used hearing protector. There was a significant difference on communication difficulty with the use of a hearing protector among workers with normal and altered audiograms (p=0.0371). With regard to the global comfort in the comparison of workers using the shell-type hearing protector with those using insert-type hearing protectors, there was no difference (p=0.2264), irrespective of the type of the unit.CONCLUSION: In general, the unit workers presented a good perception of the important aspects about the hearing protection use of both types of hearing protectors.

INTRODUÇÃO: Pesquisas comprovam que a perda auditiva em músicos pode gerar dificuldade no reconhecimento de timbres e na afinação dos instrumentos. OBJETIVO: Analisar os limiares auditivos de 250 Hz a 16.000 Hz de um grupo de estudantes de música e compará-los a um grupo de não músicos para determinar se a audiometria de altas frequências é um recurso útil na detecção precoce da deficiência auditiva. MÉTODO: Forma de estudo: observacional, de coorte, retrospectivo. Realizou-se audiometria convencional e de altas frequências em 42 estudantes de música (audiômetro Madsen Itera II, fones TDH39P para a audiometria convencional e HDA 200 para audiometria de altas frequências). RESULTADOS: Dos 42 estudantes, 38,10% eram do gênero feminino e 61,9% do gênero masculino, com média de 26 anos; na audiometria convencional 92,85% apresentaram limiares auditivos dentro dos padrões de normalidade; mesmo dentro da normalidade, piores resultados ocorreram na orelha esquerda para todas as frequências, excetuando-se 4000 Hz; quando comparado ao grupo de não músicos os piores resultados ocorreram em 500 Hz na orelha esquerda e 250 Hz, 6000 Hz, 9000 Hz, 10.000 Hz e 11.200 Hz em ambas as orelhas. CONCLUSÃO: A avaliação dos limiares de altas frequências de forma periódica pode ser útil na detecção precoce da deficiência auditiva em músicos.

INTRODUCTION: Research has shown that hearing loss in musicians may cause difficulty in timbre recognition and tuning of instruments. AIM: To analyze the hearing thresholds from 250 Hz to 16,000 Hz in a group of music students and compare them to a non-musician group in order to determine whether high-frequency audiometry is a useful tool in the early detection of hearing impairment. METHODS: Study design was a retrospective observational cohort. Conventional and high-frequency audiometry was performed in 42 music students (Madsen Itera II audiometer and TDH39P headphones for conventional audiometry, and HDA 200 headphones for high-frequency audiometry). RESULTS: Of the 42 students, 38.1% were female students and 61.9% were male students, with a mean age of 26 years. At conventional audiometry, 92.85% had hearing thresholds within normal limits; but even within the normal limits, the worst results were observed in the left ear for all frequencies, except for 4000 Hz; compared to the non-musician group, the worst results occurred at 500 Hz in the left ear, and at 250 Hz, 6000 Hz, 9000 Hz, 10,000 Hz, and 11,200 Hz in both the ears. CONCLUSION: The periodic evaluation of high-frequency thresholds may be useful in the early detection of hearing loss in musicians.