Audição e linguagem em crianças deficientes auditivas implantadas inseridas em ambiente bilíngue: um estudo de casos

O implante coclear (IC) tem sido indicado para crianças deficientes auditivas de grau severo e/ou profundo que não tem benefício com o aparelho de amplificação sonora individual (AASI), e que apresentem família adequada e motivada para o uso do dispositivo, bem como condições adequadas de reabilitação na cidade de origem. Atualmente, a procura pelo IC também ocorre por pais surdos, fluentes na Língua Brasileira de Sinais (LIBRAS), que recorrem a este tratamento para oferecer outra realidade para seus filhos. O ambiente destas crianças é bilíngue, dado pela LIBRAS dos pais e pela linguagem oral dos familiares próximos, do fonoaudiólogo e da escola. Neste sentido, o presente estudo visou acompanhar quatro crianças deficientes auditivas implantadas, sendo duas crianças filhas de pais deficientes auditivos fluentes na LIBRAS (expostas a ambiente bilíngue) e duas crianças filhas de pais sem alterações auditivas (expostas a ambiente oral). Para tanto, as habilidades de audição e de aquisição da linguagem oral foram comparadas nas quatro crianças implantadas. Foi possível observar que as quatro crianças apresentaram habilidades auditivas e de linguagem semelhantes ao longo do primeiro ano de uso do IC. Contudo, a partir disto, as crianças inseridas em ambiente bilíngue apresentaram melhor desempenho auditivo e linguístico, comparado ao desenvolvimento das outras crianças. As crianças inseridas em ambiente bilíngue podem se beneficiar do IC, desenvolvendo habilidades auditivas e de linguagem similares às das crianças inseridas em ambiente oral. Ressalta-se que os benefícios do dispositivo são obtidos a partir de aspectos multifatoriais, e estudos mais aprofundados são necessários.

Idade no diagnóstico e no início da intervenção de crianças deficientes auditivas em um serviço público de saúde auditiva brasileiro

INTRODUÇÃO: Quanto mais precoce o diagnóstico e intervenção da deficiência auditiva, menor será o impacto para o desenvolvimento das habilidades cognitivas, auditivas e de linguagem da criança. OBJETIVO: Caracterizar a idade no diagnóstico e no início da intervenção da perda auditiva e o acompanhamento de crianças atendidas em um serviço público de saúde auditiva brasileiro - Espaço Reouvir do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. MÉTODO: Estudo retrospectivo com informações de 166 prontuários de crianças no que se refere a: gênero; etiologia, tipo, grau e lateralidade da deficiência auditiva; idade do diagnóstico e da adaptação do Aparelho de Amplificação Sonora Individual (AASI) e acompanhamento no serviço. RESULTADOS: A amostra foi composta por 56% homens e 44% mulheres. A etiologia predominante foi a de origem multifatorial. A perda auditiva do tipo neurossensorial ocorreu em 88,6% dos casos. O grau de perda auditiva moderado foi o de maior ocorrência (30,7%), simetria entre as orelhas foi encontrada em 69,9% dos casos e perda auditiva unilateral em 2,4%. A idade média no diagnóstico foi de 5,46 anos e na intervenção de 6,86 anos. Um total de 96,98% das crianças já havia completado o processo de adaptação e 78,32% permaneciam em acompanhamento. CONCLUSÃO: O Programa Reouvir - HCFMUSP ainda recebe crianças, seja para o diagnóstico e/ou para a intervenção, de maneira tardia. Entretanto, ainda assim faz-se possível à realização do acompanhamento de um número significativo de crianças usuárias de AASI, possibilitando um processo de adaptação mais efetivo.

O uso de um software na (re)habilitação de crianças com deficiência auditiva

OBJETIVO: Verificar a aplicabilidade de um software na (re)habilitação de crianças com deficiência auditiva. MÉTODOS: A amostra foi composta por 17 crianças com deficiência auditiva, sendo dez usuárias de Implante Coclear (IC) e sete usuárias de Aparelho de Amplificação Sonora Individual (AASI). Foi utilizado o "Software Auxiliar na Reabilitação de Distúrbios Auditivos (SARDA)". Aplicou-se o protocolo de treinamento durante 30 minutos, duas vezes por semana, pelo tempo necessário para a finalização das estratégias que compõe software. Para mensurar a aplicabilidade do software no treinamento da habilidade de percepção da fala no silêncio e no ruído, foram realizadas avaliações com o Hearing in Noise Test (HINT) pré e pós o treinamento auditivo. Os dados foram analisados estatisticamente. RESULTADOS: O grupo de usuários de IC necessitou em média 12,2 dias para finalizar as estratégias e o grupo de usuários de AASI em média 10,14 dias. Os dois grupos apresentaram diferença entre as avaliações pré e pós no silêncio e no ruído. As crianças mais novas apresentaram maior dificuldade durante a execução das estratégias, porém não houve correlação entre a idade e o desempenho. Não houve influência do tipo do dispositivo eletrônico durante o treinamento. As crianças apresentaram maior dificuldade na estratégia que envolvia estímulos não verbais e na estratégia com estímulos verbais que treina a habilidade de atenção sustentada. A atenção e a motivação da criança durante a estimulação foram fundamentais para o bom rendimento do treinamento auditivo. CONCLUSÃO: O treinamento auditivo com o SARDA foi eficaz, pois propiciou melhora na habilidade de percepção da fala, no silêncio e no ruído, das crianças com deficiência auditiva.

Internet video telephony allows speech reading by deaf individuals and improves speech perception by cochlear implant users

OBJECTIVE To analyze speech reading through Internet video calls by profoundly hearing-impaired individuals and cochlear implant (CI) users. METHODS Speech reading skills of 14 deaf adults and 21 CI users were assessed using the Hochmair Schulz Moser (HSM) sentence test. We presented video simulations using different video resolutions (1280 × 720, 640 × 480, 320 × 240, 160 × 120 px), frame rates (30, 20, 10, 7, 5 frames per second (fps)), speech velocities (three different speakers), webcameras (Logitech Pro9000, C600 and C500) and image/sound delays (0-500 ms). All video simulations were presented with and without sound and in two screen sizes. Additionally, scores for live Skype™ video connection and live face-to-face communication were assessed. RESULTS Higher frame rate (>7 fps), higher camera resolution (>640 × 480 px) and shorter picture/sound delay (<100 ms) were associated with increased speech perception scores. Scores were strongly dependent on the speaker but were not influenced by physical properties of the camera optics or the full screen mode. There is a significant median gain of +8.5%pts (p = 0.009) in speech perception for all 21 CI-users if visual cues are additionally shown. CI users with poor open set speech perception scores (n = 11) showed the greatest benefit under combined audio-visual presentation (median speech perception +11.8%pts, p = 0.032). CONCLUSION Webcameras have the potential to improve telecommunication of hearing-impaired individuals.

Vista general del modelado del sistema auditivo

El objetivo principal del presente proyecto es proporcionar al ingeniero de telecomunicaciones una visión general de las técnicas que se utilizan en el modelado del sistema auditivo. El modelado del sistema auditivo se realiza con los siguientes objetivos: a) Interpretar medidas directas, b)unificar el entendimiento de diferentes fenómenos, c) guiar estrategias de amplificación para suplir pérdidas auditivas y d) tener predicciones experimentalmente comprobables de comportamientos, con diferentes niveles de complejidad. En este trabajo se tratarán y explicarán brevemente las diferentes técnicas utilizadas para modelar las partes del sistema auditivo, desde las analogías electroacústicas, modelos biofísicos, binaurales, hasta la implementación de filtros auditivos mediante procesado de señal. Podemos concluir que el modelado mediante analogías electroacústicas permite una rápida implementación y entendimiento, pero tiene ciertas limitaciones. Las simulaciones mediante análisis numéricos son precisas y de gran utilidad tanto para del oído medio como para el interno. El procesado de señal es el procedimiento más completo y utilizado ya que permite modelar oído externo y medio además de permitir la implementación de filtros cocleares muy precisos y coherentes con la realidad incluyéndolos en modelos perceptivos. ABSTRACT. The main aim of the Project is to provide the Telecommunications Engineer an overview about the approaches for modelling the auditory system. The auditory system modelling is done for the next objectives: a) Interpret direct measures, b) Understand different phenomena c) get strategies of amplification for hearing impaired people and d) Obtain testable predictions experimentally about some behaviors with different complexity levels. Inside this document, several approaches about modeling of the auditory system parts will be explained: analog circuits, biophysics models, binaural models, and auditory filters made through signal processing. In conclusion, analog circuits are made quickly and they are easier to understand but they have many limitations. Simulations through numerical analysis are accurate and useful in middle and inner ear models. Signal processing is the more versatile approach because it lets to make a model of external and middle ear and then it allows to make complex auditory filters. Perceptive models can be made entirely through this method.

Tratamiento de textos para mejorar la comprensión lectora en alumnos con deficiencias auditivas

Proyecto emergente centrado en el tratamiento de textos educativos en castellano con la finalidad de reducir las barreras lingüísticas que dificultan la comprensión lectora a personas con deficiencias auditivas, o incluso a personas aprendiendo una lengua distinta a su lengua materna. Se describe la metodología aplicada para resolver los distintos problemas relacionados con el objetivo a conseguir, la hipótesis de trabajo y las tareas y los objetivos parciales alcanzados.

Half of a yellow sun

A beautiful sweeping story of two sisters caught up in the events of the Nigerian civil war, ending in chilling violence which shocked the entire world.

Access to multimedia technology by people with sensory disabilities /

"March 13, 1998."

The Directory of interpreters for the deaf.

Title from cover.

Technology and handicapped people.

"OTA-BP-H-16 December 1982" - v.2.

Comparison of cognitive screening tasks in an elderly veteran population

Screening measures of cognitive status are traditionally administered face to face. In survey research such screening mcasurcs, while desirable, must he administered by other means. As part of pilot survey research on a New Zealand war veteran population with some degree of hearing impairment, a face-to-face administration of the Mini-Mental State Examination (MMSE; Folstein, Folstein and McHugh, 1975) and a telephoneadministration of the Telephonc Interview for Cognitive Status (TICS; Brandt, Spencer and Folstein. 1988) were compared. Brandt ('/ u/. (1988) reported a very strong linear relationship between scores on the MMSE and the TICS (r=0.94, p < .0001) in an Alzheimer patient population with a mcan MMSE score of 12.06 (6.78). For a sample of 44 mildly to moderately hearing impaired veterans, with a mean MMSE score of 25.52 (2.16) and a mean TICS score of 32.52(5.43), the correlation between the instruments was .39. When veterans who wore hearing aids during the telephone interview ( N = 2 2 ) wcrc separated out from those who did not, the correlation rose to .54. Age was ncgatively correlated with the MMSE ( r = -0.41, / I < .01) and not significantly correlated with the TICS. Education level was unrelated to either measure. The data suggest that the wearing or non-wearing of hearing aids may contribute significantly to the reliability of the TICS. Furthermore, on non-demented populations with a less restricted range of scores. the correlation of the MMSE and TICS may he lower than previously reported.

Auditory training and adult rehabilitation:a critical review of the evidence

Auditory Training (AT) describes a regimen of varied listening exercises designed to improve an individual’s ability to perceive speech. The theory of AT is based on brain plasticity (the capacity of neurones in the central auditory system to alter their structure and function) in response to auditory stimulation. The practice of repeatedly listening to the speech sounds included in AT exercises is believed to drive the development of more efficient neuronal pathways, thereby improving auditory processing and speech discrimination. This critical review aims to assess whether auditory training can improve speech discrimination in adults with mild-moderate SNHL. The majority of patients attending Audiology services are adults with presbyacusis and it is therefore important to evaluate evidence of any treatment effect of AT in aural rehabilitation. Ideally this review would seek to appraise evidence of neurophysiological effects of AT so as to verify whether it does induce change in the CAS. However, due to the absence of such studies on this particular patient group, the outcome measure of speech discrimination, as a behavioural indicator of treatment effect is used instead. A review of available research was used to inform an argument for or against using AT in rehabilitative clinical practice. Six studies were identified and although the preliminary evidence indicates an improvement gained from a range of AT paradigms, the treatment effect size was modest and there remains a lack of large-sample RCTs. Future investigation into the efficacy of AT needs to employ neurophysiological studies using auditory evoked potentials in hearing-impaired adults in order to explore effects of AT on the CAS.

Percepção da equipe de saúde, discentes e usuários sobre a comunicação com indivíduos surdos na atenção primária

The study aimed to identify in the professionals and students of health courses that work in a health Basic Unit in the city of Natal/RN their perceptions of the care of deaf patients, and with the population's needs with hearing loss in relation to health care. This is a cross-sectional, exploratory, descriptive study, conducted between April to July 2014, with a population composed of 21 health professionals, 17 students and 8 deaf users. For data collection, we used a structured questionnaire with open and closed questions applied to groups composed of health professionals (doctors, dentists, nurses and health workers) and students of medical schools, nursing, physical education, nutrition and social service. The professionals/students answered a semi-structured questionnaire with open and closed questions concerning the possible difficulties the care of the deaf and hearing impaired. Data collection with deaf users was conducted through filmed interview for the Brazilian Sign Language (Libras) could be interpreted as to the Portuguese by the researcher. With the latter it was conducted a survey of their reactions when looking for a care in the health service. Regarding the profile of identification of the subjects, it was analyzed by simple descriptive statistics (absolute and relative frequencies). The open questions were analyzed through the content analysis technique which allowed the categorization process preserving all the points raised in the discussion so that the lines were representative of the whole. When asked about the professionals and students attitude used to communicate with deaf patients possible the following categories emerged: the "writing", the "gestures" and the "third party assistance". With regard of the deaf, when asked about their experiences in seeking care in health, the elucidated categories were: "quality of care to the hearing impaired", "communication with the hearing impaired adequacy" and "dependence on third parties." The closed questions were measured and adapted to the 5 degrees of variation Likert Scale, which comprised three of these issues: degree of difficulty in communication to meet a patient with hearing loss (minimum to great difficulty); feeling of comfort while using sign language (minimum to severe discomfort); and knowledge of the Law 10.436, which provides for the Brazilian Sign Language (Libras) (low knowledge to entirely clear). The data collected with professionals and students revealed some misunderstanding and discomfort in health care for deaf patients, reality also evidenced in the opinion of the deaf participants. This study revealed problems in communication, resulting in negative consequences in serving this population. This diagnosis may be relevant to public policy development and curriculum guidelines essential to the training of health professionals, inclusion and improving assistance to deaf.

Educação bilíngue para surdos : um estudo acerca de práticas de letramento crítico com alunos surdos usuários da Língua Brasileira de Sinais

At a time when the issue of the inclusion of hearing-impaired students in regular schools has been discussed, it becomes necessary to reflect upon the relevance of a recurrent educational process in schools specialized in education for the hearing-impaired: the bilingual schools. Such institutions, still scarce in Brazil, offer an oriented and specialized education to hearing-impaired children and adolescents, since they have the Brazilian Sign Language as a language of instruction in all subjects, and the Portuguese written language as an additional language, which gives them the bilingual status. This research aims to investigate how the practices developed in my Portuguese classes in a bilingual school have contributed to the development of student‟s literacy, specifically the Critical Literacy (STREET, 1985, 1990, 1998), in two classes of hearing-impaired students enrolled in the final grades of elementary school. It is a qualitative, ethnographic research, which uses the triangulation system for analyzing data: (i) the pedagogical sequences; (ii) the students‟ activities and (iii) the teacher‟s and students‟ written accounts registered as field notes. Through the intersection of the data, this work evaluates whether students have achieved some level of Critical Literacy, and what kind of collaboration and/or activity is relevant during this process. This research is justified by the need to evaluate practices at bilingual schools that, although supported by current law in Brazil, are still a minority whose work is still not acknowledged or valued. The results show that activities using real texts of different genres can contribute to the development of Critical Literacy, and also to dynamic classes, with discussions about relevant topics to society in Sign Language. Also, activities that encourage students to do research and that provide to the hearing-impaired student, the understanding of the real usefulness of Portuguese as an instrument for the social inclusion of the hearing-impaired providing opportunities for them to change their social position can collaborate to this process.

O desenvolvimento da competência comunicativa intercultural de surdos aprendizes de inglês : a internet como meio

Dissertação (mestrado)—Universidade de Brasília, Instituto de Letras, Departamento de Línguas Estrangeiras e Tradução, Programa de Pós-Graduação em Linguística Aplicada, 2015.