Le rythme est un aspect important du mouvement et de la perception de l’environnement. Lorsque l’on danse, la pulsation musicale induit une activité neurale oscillatoire qui permet au système nerveux d’anticiper les évènements musicaux à venir. Le système moteur peut alors s’y synchroniser. Cette thèse développe de nouvelles techniques d’investigation des rythmes neuraux non strictement périodiques, tels que ceux qui régulent le tempo naturellement variable de la marche ou la perception rythmes musicaux. Elle étudie des réponses neurales reflétant la discordance entre ce que le système nerveux anticipe et ce qu’il perçoit, et qui sont nécessaire pour adapter la synchronisation de mouvements à un environnement variable. Elle montre aussi comment l’activité neurale évoquée par un rythme musical complexe est renforcée par les mouvements qui y sont synchronisés. Enfin, elle s’intéresse à ces rythmes neuraux chez des patients ayant des troubles de la marche ou de la conscience. / Rhythms are central in human behaviours spanning from locomotion to music performance. In dance, self-sustaining and dynamically adapting neural oscillations entrain to the regular auditory inputs that is the musical beat. This entrainment leads to anticipation of forthcoming sensory events, which in turn allows synchronization of movements to the perceived environment. This dissertation develops novel technical approaches to investigate neural rhythms that are not strictly periodic, such as naturally tempo-varying locomotion movements and rhythms of music. It studies neural responses reflecting the discordance between what the nervous system anticipates and the actual timing of events, and that are critical for synchronizing movements to a changing environment. It also shows how the neural activity elicited by a musical rhythm is shaped by how we move. Finally, it investigates such neural rhythms in patient with gait or consciousness disorders.

Cette thèse a pour objet principal la notion de dissociation élémentielle associée à la spatialisation, principalement en musique instrumentale. Elle inclut quatre compositions accompagnées des partitions et des enregistrements de même qu’un texte écrit comprenant les analyses des quatre œuvres présentées. Dans le chapitre I, le texte expose d’abord la notion de dissociation élémentielle, explique que celle-ci naît de l’autonomie des éléments musicaux les uns par rapport aux autres et traite de l’influence exercée sur ma démarche par le compositeur Charles E. Ives. J’aborde aussi l’importance de la spatialisation musicale et de la notion de paysage sonore composé. Je retrace également quelques exemples de dissociation des éléments dans le répertoire et je fais un parallèle avec la musique électroacoustique. Le chapitre II s’attarde à la dissociation "élémentielle" tant en ce qui a trait aux procédés techniques qu’à l’écriture et à la mise en forme. Le chapitre III traite de la perception auditive en situation "élémentielle" et spatialisée au regard de la psychoacoustique ainsi que des pistes de recherches ultérieures possibles. Les chapitres suivants ont pour objet les analyses des quatre œuvres présentées : 21 courtes pièces sur des textes d’Étienne Lalonde, L’Être et la réminiscence, Les passants et L’autre (le cor étranger). / The primary focus of this thesis is the notion of what I have termed elemential (élémentiel) dissociation associated with spatialization, particularly in instrumental music. It includes four compositions accompanied by scores and recordings, as well as a written text comprising the analyses of the four works presented. In Chapter I, the text presents the notion of elemential (élémentiel) dissociation, explains that it arises from the autonomy of musical elements in relation to each other, and contextualizes the influence of the composer Charles E. Ives' approach upon my own. I also address the importance of musical spatialization and the concept of the complex sound landscape. Additionally, I delineate some examples of the dissociation of elements in the repertoire and draw a parallel to electroacoustic music. Chapter II elaborates upon elemential (élémentiel) dissociation as much in terms of technical processes as of writing and formal structure. Chapter III deals with auditory perception in elemential (élémentiel) and spatialized contexts with regard to psychoacoustics, as well as possible areas for further research. The following chapters are comprised of the analyses of the four works presented: 21 courtes pièces sur des textes d’Étienne Lalonde, L’Être et la réminiscence, Les passants et L’autre (le cor étranger).

Ce mémoire présente une composition d’études et de travaux de recherche orientés autour de trois grandes thématiques : la synthèse, la reproduction et la perception des sons, en considérant à la fois les sons de nature musicale mais aussi environnementale. Il vise en outre un champ d’application, le design sonore, qui implique globalement la création intentionnelle de sons du quotidien. La structure du document est conçu selon un schéma relativement uniforme et comporte, pour chaque partie, une présentation générale de la thématique apportant des éléments théoriques et des données relatives à l’état de l’art, suivie de développements spécifiques permettant de converger vers les sujets d’étude propres à chaque thème – explicitement, formalisme modal dans la synthèse par modélisation physique, pour la partie "Synthèse" ; mesure et contrôle de la directivité des instruments de musique, pour la partie "Reproduction" ; timbre et identification des sources sonores, pour la partie "Perception"– puis d’une présentation détaillée des travaux personnels relatifs à chacun des sujets, le cas échéant, sous la forme d’un article publié. Ces divers éléments de connaissance et d’expérience propose donc une contribution personnelle et originale, volontairement inscrite dans un cadre de recherche élargi, pluridisciplinaire et appliqué. / This dissertation presents a composition of studies and research works articulated around three main topics : synthesis, reproduction and perception of sounds, considering both musical and environmental sounds. Moreover, it focuses on an application field, the sound design, that globally involves the conception of intentional everyday sounds. The document is based on a rather uniform structure and contains, for each part, a general presentation of the topic which brings theoretical elements together with an overview of the state-of-the-art, followed by more precise developments in order to focus on the specific matters related to each topic – in detail, modal formalism in sound synthesis by physical modeling, for the "Synthesis" section ; measurement and control of musical instruments directivity, for the "Reproduction" section ; timbre and sound sources identification, for the "Perception" section – and then followed by a detailed presentation of the personal works related to each matter, in some cases, in the form of published papers. Then, these several elements of knowledge and experience offer a personal and original contribution, deliberately put in a broad, multidisciplinary and applied framework.

Introdução: A atresia congênita de orelha constitui uma deformidade presente ao nascimento, de prevalência unilateral, decorrente da alteração no desenvolvimento das estruturas das orelhas externa e média. Geralmente, provoca perda auditiva condutiva, e pode ser acompanhada por componente sensorioneural. Dentre as formas de tratamento disponíveis, encontra-se o implante de orelha média Vibrant Soundbridge (VSB), que tem se mostrado eficaz no tratamento deste tipo de alteração. A literatura mostra melhora nos limiares tonais e nos resultados dos testes de percepção auditiva da fala, realizados com o uso do processador de fala após a cirurgia. Considerando que os indivíduos com este tipo de malformação podem passar por um período de privação sensorial auditiva anterior à reabilitação, torna-se interessante avaliar o estágio maturacional das estruturas auditivas corticais e o processamento das informações auditivas em nível central, bem como, verificar o benefício da indicação do VSB unilateral em situação de escuta difícil. Não foram encontrados estudos que abordam este aspecto e o emprego dos potenciais evocados auditivos corticais (PEAC) e do P300 em usuários de VSB. Objetivo: Analisar o impacto da perda auditiva condutiva e mista nos PEAC e P300 em usuários de VSB unilateral, com atresia de orelha bilateral, e verificar as habilidades auditivas, em situação de escuta difícil, considerando a indicação do VSB unilateral. Casuística e método: Vinte indivíduos, divididos em dois grupos, pareados em idade, sexo e grau de escolaridade. G1: dez indivíduos com perda auditiva condutiva ou mista bilateral, usuários de VSB unilateral, atendidos na Instituição de realização da pesquisa. Todos fizeram uso de aparelhos auditivos convencionais antes do VSB. G2: Dez indivíduos normo-ouvintes. Realização de audiometria em campo livre com o uso do VSB (apenas o G1), avaliação das habilidades auditivas pelo Hearing in Noise Test, pesquisa dos componentes P1, N1, P2, N2 e P300, em campo calibrado. Resultados: A média dos limiares tonais nas frequências de 500 a 3000 Hz, de 20 a 36 dB NA, mostrou que o VSB possibilitou o acesso aos sons da fala. Não foi observada diferença estatisticamente significante entre os valores de latência dos PEAC e P300 entre os grupos. Foi observada diferença estatisticamente significante entre o limiar de reconhecimento de sentenças e a relação sinal/ruído entre os grupos, sendo os melhores resultados apresentados pelo G2. Conclusão: Indivíduos com atresia de orelha e perda auditiva condutiva ou mista bilateral, quando adequadamente reabilitados, podem atingir a maturação das vias auditivas centrais e o processamento da informação auditiva em nível cortical. As habilidades de reconhecimento auditivo, sem e com ruído competitivo, mostraram-se defasadas quanto à normalidade, apontando para a indicação do VSB bilateral / Introduction: Congenital aural atresia is a congenital deformity. It is unilaterally prevalent due to alterations in the development of the external and middle ear structures. Congenital aural atresia causes conductive hearing loss and can be accompanied by sensorineural component. Among the available forms of treatment is the middle ear implant, Vibrant Soundbridge (VSB), which has been shown to be effective in treating this type of alteration. The literature shows improvement in tonal thresholds and in the results of tests of auditory perception of speech that were performed using the speech processor after surgery. Individuals with this type of malformation often experience a period of auditory sensory deprivation prior to rehabilitation. Hence, it is important to evaluate the maturation stage of the cortical auditory structures, the processing of auditory information at the central level, and to verify the benefit of unilateral VSB in difficult listening situations. There are no previous data on this aspect and with the use of cortical auditory evoked potentials (CAEP) and event-related potential (P300) in users of VSB. Aim: To analyze the impact of conductive and mixed hearing loss on CAEP and P300 in unilateral VSB users with bilateral ear atresia. To verify the auditory abilities in a difficult listening situation considering the indication for unilateral VSB. Materials and methods: Twenty individuals were divided into two groups matched for age, sex, and educational level. G1 comprised ten individuals with bilateral conductive or mixed hearing loss and users of unilateral VSB, who visited the research institution. All subjects used conventional hearing aids prior to VSB. G2 comprised ten normal hearing individuals. Audiometry in the free field was performed with the use of VSB (G1 only) and evaluation of hearing skills by the Hearing in Noise Test was conducted; components P1, N1, P2, N2, and P300 in a calibrated field were recorded. Results: Evaluation of the mean tonal thresholds in the frequencies between 500 and 3000 Hz, from 20 to 36 dB HL, demonstrated that VSB allowed access to speech sounds. There was no statistically significant difference in the CAEP and P300 latency values between the two groups. A statistically significant difference was observed in the sentence recognition threshold and the signal-to-noise ratio between the groups, with best results presented by G2. Conclusion: Individuals with congenital aural atresia and bilateral conductive or mixed hearing loss may reach maturation of the central auditory pathway and achieve adequate processing of auditory information at the cortical level, when rehabilitated. The auditory recognition skills, with and without competitive noise, were shown to be out of phase with normality, indicating the need for a bilateral VSB

INTRODUÇÃO: O termo memória operacional (MO) refere-se a um constructo cognitivo capaz de armazenar e manter a informação acessível para uso determinado por um tempo limitado, possibilitando a manipulação de diversas informações simultâneas e sequenciais como operações matemáticas longas ou complexas, compreensão de palavras pouco frequentes, extensas ou frases complexas. A linguagem está entre as funções cognitivas que dependem do funcionamento da memória operacional e pode estar comprometida em várias condições patológicas, dentre elas o traumatismo cranioencefálico (TCE). Dados da literatura referentes a essa população ainda são restritos ou pouco consistentes. OBJETIVOS: investigar se o teste n-back é uma medida válida para identificar o déficit de memória em pacientes com TCE, estabelecer nota de corte e curva ROC do teste n-back, comparar o desempenho entre os indivíduos saudáveis e aqueles que sofreram TCE, comparar o teste n-back com os testes de linguagem e aspectos da lesão neurológica, tais como gravidade e tempo, tempo de coma e localização hemisférica da lesão nos resultados para verificar o desempenho e a relevância na separação dos casos em pacientes e controles.MÉTODOS: 53 indivíduos brasileiros (26 adultos com TCE e 30 adultos saudáveis) foram avaliados por bateria de estímulos verbais auditivos para verificar diferenças inter-grupos na capacidade de processamento da memória operacional, quanto ao numero de respostas corretas (acurácia), capacidade máxima de processamento na memória operacional (span) e também verificar a relação da memória operacional com habilidades linguísticas, através da comparação de testes. RESULTADOS: na comparação entre os pacientes e os indivíduos do grupo controle observou-se diferença estatisticamente significante entre os grupos tanto para os testes de base quanto para os resultados do n-back. Os grupos foram estatisticamente pareados em relação às variáveis sócio-demográficas (idade, escolaridade e gênero). O modelo estatístico com as variáveis do teste n-back demonstrou ótima separação dos casos em pacientes/ controle com a área sob a curva ROC de 89%. O modelo também mostrou convergência com os testes de linguagem para compreensão auditiva de sentenças, fluência verbal e aspectos discursivos-pragmáticos e com o nível cognitivo. O lado da lesão foi estatisticamente significante para o n-back, fluência verbal e discurso conversacional. CONCLUSÃO: Os resultados mostram que o n-back na maneira como foi desenhado é capaz de diferenciar os indivíduos alterados e os normais na habilidade de memória operacional. No estudo foi possível discriminar o comportamento de indivíduos com lesão encefálica adquirida e indivíduos saudáveis quanto à medida de acurácia e capacidade máxima de manipulação da informação na memória operacional. Esse comportamento reflete o funcionamento linguístico e cognitivo que se correlaciona com o mecanismo de memória operacional / INTRODUCTION: The term working memory (WM) refers to a construct cognitive capability of storing and keeping information on line to a determined use for a limited time, enabling the manipulation of diverse simultaneous and sequential information such as long or complex mathematical operations, comprehension of less frequent words, extensive or complex sentences. The language is among the cognitive functions which depends on the operational memory behavior and may be engaged in many pathological conditions, among them the TBI (traumatic brain injury). Literature dada relative to such population are still restrict or weak. AIM: investigate whether the n -back task is a valid measure for identifying memory deficits in patients with TBI; establish cutoff and ROC curve of n-back task; to compare performance between normals individuals and those who have suffered TBI; to compare n-back task with tests of language and aspects of neurological injury, such as severity, coma and hemispheric laterality of the lesion to verify the performance and relevance in the separation of cases. METHODOS: 53 individuals Brazilians (26 adults with TBI and 30 healthy adults) were assessed by a battery of auditory verbal stimuli for detecting differences between groups in the processing capacity of working memory, as the accuracy and span also check the relationship of working memory to language skills, through the comparison tests. RESULTS: in the comparison between patients and control subjects was observed statistically significant differences between groups thus to the tests as the basis tests as to results of the n -back. The groups were statistically matched in relation to socio-demographic variables (age, education and gender). The statistical model with variables of the n -back test showed good separation of cases where patients / control with the area under the ROC curve of 89 % . The model also showed convergence with language tests for auditory comprehension of sentences, verbal fluency and pragmatic - discursive aspects and the cognitive level. The side of the lesion was statistically significant for the n -back, verbal fluency and conversational discourse. CONCLUSION: the results demonstrated that the n-back on the way it was designed is able to distinguish the changed individuals and the normal on the working memory ability. On the study it was possible to discriminate the behaviors of individuals with acquired brain injury and healthy individuals regarding the accuracy and maximum capacity of manipulating information on the working memory. Such behavior reflects the linguistic and cognitive function which correlates with the working memory mechanism

Ce mémoire présente une composition d’études et de travaux de recherche orientés autour de trois grandes thématiques : la synthèse, la reproduction et la perception des sons, en considérant à la fois les sons de nature musicale mais aussi environnementale. Il vise en outre un champ d’application, le design sonore, qui implique globalement la création intentionnelle de sons du quotidien. La structure du document est conçu selon un schéma relativement uniforme et comporte, pour chaque partie, une présentation générale de la thématique apportant des éléments théoriques et des données relatives à l’état de l’art, suivie de développements spécifiques permettant de converger vers les sujets d’étude propres à chaque thème – explicitement, formalisme modal dans la synthèse par modélisation physique, pour la partie "Synthèse" ; mesure et contrôle de la directivité des instruments de musique, pour la partie "Reproduction" ; timbre et identification des sources sonores, pour la partie "Perception"– puis d’une présentation détaillée des travaux personnels relatifs à chacun des sujets, le cas échéant, sous la forme d’un article publié. Ces divers éléments de connaissance et d’expérience propose donc une contribution personnelle et originale, volontairement inscrite dans un cadre de recherche élargi, pluridisciplinaire et appliqué. / This dissertation presents a composition of studies and research works articulated around three main topics : synthesis, reproduction and perception of sounds, considering both musical and environmental sounds. Moreover, it focuses on an application field, the sound design, that globally involves the conception of intentional everyday sounds. The document is based on a rather uniform structure and contains, for each part, a general presentation of the topic which brings theoretical elements together with an overview of the state-of-the-art, followed by more precise developments in order to focus on the specific matters related to each topic – in detail, modal formalism in sound synthesis by physical modeling, for the "Synthesis" section ; measurement and control of musical instruments directivity, for the "Reproduction" section ; timbre and sound sources identification, for the "Perception" section – and then followed by a detailed presentation of the personal works related to each matter, in some cases, in the form of published papers. Then, these several elements of knowledge and experience offer a personal and original contribution, deliberately put in a broad, multidisciplinary and applied framework.

Ce mémoire présente une composition d’études et de travaux de recherche orientés autour de trois grandes thématiques : la synthèse, la reproduction et la perception des sons, en considérant à la fois les sons de nature musicale mais aussi environnementale. Il vise en outre un champ d’application, le design sonore, qui implique globalement la création intentionnelle de sons du quotidien. La structure du document est conçu selon un schéma relativement uniforme et comporte, pour chaque partie, une présentation générale de la thématique apportant des éléments théoriques et des données relatives à l’état de l’art, suivie de développements spécifiques permettant de converger vers les sujets d’étude propres à chaque thème – explicitement, formalisme modal dans la synthèse par modélisation physique, pour la partie "Synthèse" ; mesure et contrôle de la directivité des instruments de musique, pour la partie "Reproduction" ; timbre et identification des sources sonores, pour la partie "Perception"– puis d’une présentation détaillée des travaux personnels relatifs à chacun des sujets, le cas échéant, sous la forme d’un article publié. Ces divers éléments de connaissance et d’expérience propose donc une contribution personnelle et originale, volontairement inscrite dans un cadre de recherche élargi, pluridisciplinaire et appliqué. / This dissertation presents a composition of studies and research works articulated around three main topics : synthesis, reproduction and perception of sounds, considering both musical and environmental sounds. Moreover, it focuses on an application field, the sound design, that globally involves the conception of intentional everyday sounds. The document is based on a rather uniform structure and contains, for each part, a general presentation of the topic which brings theoretical elements together with an overview of the state-of-the-art, followed by more precise developments in order to focus on the specific matters related to each topic – in detail, modal formalism in sound synthesis by physical modeling, for the "Synthesis" section ; measurement and control of musical instruments directivity, for the "Reproduction" section ; timbre and sound sources identification, for the "Perception" section – and then followed by a detailed presentation of the personal works related to each matter, in some cases, in the form of published papers. Then, these several elements of knowledge and experience offer a personal and original contribution, deliberately put in a broad, multidisciplinary and applied framework.

INTRODUÇÃO: O termo memória operacional (MO) refere-se a um constructo cognitivo capaz de armazenar e manter a informação acessível para uso determinado por um tempo limitado, possibilitando a manipulação de diversas informações simultâneas e sequenciais como operações matemáticas longas ou complexas, compreensão de palavras pouco frequentes, extensas ou frases complexas. A linguagem está entre as funções cognitivas que dependem do funcionamento da memória operacional e pode estar comprometida em várias condições patológicas, dentre elas o traumatismo cranioencefálico (TCE). Dados da literatura referentes a essa população ainda são restritos ou pouco consistentes. OBJETIVOS: investigar se o teste n-back é uma medida válida para identificar o déficit de memória em pacientes com TCE, estabelecer nota de corte e curva ROC do teste n-back, comparar o desempenho entre os indivíduos saudáveis e aqueles que sofreram TCE, comparar o teste n-back com os testes de linguagem e aspectos da lesão neurológica, tais como gravidade e tempo, tempo de coma e localização hemisférica da lesão nos resultados para verificar o desempenho e a relevância na separação dos casos em pacientes e controles.MÉTODOS: 53 indivíduos brasileiros (26 adultos com TCE e 30 adultos saudáveis) foram avaliados por bateria de estímulos verbais auditivos para verificar diferenças inter-grupos na capacidade de processamento da memória operacional, quanto ao numero de respostas corretas (acurácia), capacidade máxima de processamento na memória operacional (span) e também verificar a relação da memória operacional com habilidades linguísticas, através da comparação de testes. RESULTADOS: na comparação entre os pacientes e os indivíduos do grupo controle observou-se diferença estatisticamente significante entre os grupos tanto para os testes de base quanto para os resultados do n-back. Os grupos foram estatisticamente pareados em relação às variáveis sócio-demográficas (idade, escolaridade e gênero). O modelo estatístico com as variáveis do teste n-back demonstrou ótima separação dos casos em pacientes/ controle com a área sob a curva ROC de 89%. O modelo também mostrou convergência com os testes de linguagem para compreensão auditiva de sentenças, fluência verbal e aspectos discursivos-pragmáticos e com o nível cognitivo. O lado da lesão foi estatisticamente significante para o n-back, fluência verbal e discurso conversacional. CONCLUSÃO: Os resultados mostram que o n-back na maneira como foi desenhado é capaz de diferenciar os indivíduos alterados e os normais na habilidade de memória operacional. No estudo foi possível discriminar o comportamento de indivíduos com lesão encefálica adquirida e indivíduos saudáveis quanto à medida de acurácia e capacidade máxima de manipulação da informação na memória operacional. Esse comportamento reflete o funcionamento linguístico e cognitivo que se correlaciona com o mecanismo de memória operacional / INTRODUCTION: The term working memory (WM) refers to a construct cognitive capability of storing and keeping information on line to a determined use for a limited time, enabling the manipulation of diverse simultaneous and sequential information such as long or complex mathematical operations, comprehension of less frequent words, extensive or complex sentences. The language is among the cognitive functions which depends on the operational memory behavior and may be engaged in many pathological conditions, among them the TBI (traumatic brain injury). Literature dada relative to such population are still restrict or weak. AIM: investigate whether the n -back task is a valid measure for identifying memory deficits in patients with TBI; establish cutoff and ROC curve of n-back task; to compare performance between normals individuals and those who have suffered TBI; to compare n-back task with tests of language and aspects of neurological injury, such as severity, coma and hemispheric laterality of the lesion to verify the performance and relevance in the separation of cases. METHODOS: 53 individuals Brazilians (26 adults with TBI and 30 healthy adults) were assessed by a battery of auditory verbal stimuli for detecting differences between groups in the processing capacity of working memory, as the accuracy and span also check the relationship of working memory to language skills, through the comparison tests. RESULTS: in the comparison between patients and control subjects was observed statistically significant differences between groups thus to the tests as the basis tests as to results of the n -back. The groups were statistically matched in relation to socio-demographic variables (age, education and gender). The statistical model with variables of the n -back test showed good separation of cases where patients / control with the area under the ROC curve of 89 % . The model also showed convergence with language tests for auditory comprehension of sentences, verbal fluency and pragmatic - discursive aspects and the cognitive level. The side of the lesion was statistically significant for the n -back, verbal fluency and conversational discourse. CONCLUSION: the results demonstrated that the n-back on the way it was designed is able to distinguish the changed individuals and the normal on the working memory ability. On the study it was possible to discriminate the behaviors of individuals with acquired brain injury and healthy individuals regarding the accuracy and maximum capacity of manipulating information on the working memory. Such behavior reflects the linguistic and cognitive function which correlates with the working memory mechanism

Introdução: A atresia congênita de orelha constitui uma deformidade presente ao nascimento, de prevalência unilateral, decorrente da alteração no desenvolvimento das estruturas das orelhas externa e média. Geralmente, provoca perda auditiva condutiva, e pode ser acompanhada por componente sensorioneural. Dentre as formas de tratamento disponíveis, encontra-se o implante de orelha média Vibrant Soundbridge (VSB), que tem se mostrado eficaz no tratamento deste tipo de alteração. A literatura mostra melhora nos limiares tonais e nos resultados dos testes de percepção auditiva da fala, realizados com o uso do processador de fala após a cirurgia. Considerando que os indivíduos com este tipo de malformação podem passar por um período de privação sensorial auditiva anterior à reabilitação, torna-se interessante avaliar o estágio maturacional das estruturas auditivas corticais e o processamento das informações auditivas em nível central, bem como, verificar o benefício da indicação do VSB unilateral em situação de escuta difícil. Não foram encontrados estudos que abordam este aspecto e o emprego dos potenciais evocados auditivos corticais (PEAC) e do P300 em usuários de VSB. Objetivo: Analisar o impacto da perda auditiva condutiva e mista nos PEAC e P300 em usuários de VSB unilateral, com atresia de orelha bilateral, e verificar as habilidades auditivas, em situação de escuta difícil, considerando a indicação do VSB unilateral. Casuística e método: Vinte indivíduos, divididos em dois grupos, pareados em idade, sexo e grau de escolaridade. G1: dez indivíduos com perda auditiva condutiva ou mista bilateral, usuários de VSB unilateral, atendidos na Instituição de realização da pesquisa. Todos fizeram uso de aparelhos auditivos convencionais antes do VSB. G2: Dez indivíduos normo-ouvintes. Realização de audiometria em campo livre com o uso do VSB (apenas o G1), avaliação das habilidades auditivas pelo Hearing in Noise Test, pesquisa dos componentes P1, N1, P2, N2 e P300, em campo calibrado. Resultados: A média dos limiares tonais nas frequências de 500 a 3000 Hz, de 20 a 36 dB NA, mostrou que o VSB possibilitou o acesso aos sons da fala. Não foi observada diferença estatisticamente significante entre os valores de latência dos PEAC e P300 entre os grupos. Foi observada diferença estatisticamente significante entre o limiar de reconhecimento de sentenças e a relação sinal/ruído entre os grupos, sendo os melhores resultados apresentados pelo G2. Conclusão: Indivíduos com atresia de orelha e perda auditiva condutiva ou mista bilateral, quando adequadamente reabilitados, podem atingir a maturação das vias auditivas centrais e o processamento da informação auditiva em nível cortical. As habilidades de reconhecimento auditivo, sem e com ruído competitivo, mostraram-se defasadas quanto à normalidade, apontando para a indicação do VSB bilateral / Introduction: Congenital aural atresia is a congenital deformity. It is unilaterally prevalent due to alterations in the development of the external and middle ear structures. Congenital aural atresia causes conductive hearing loss and can be accompanied by sensorineural component. Among the available forms of treatment is the middle ear implant, Vibrant Soundbridge (VSB), which has been shown to be effective in treating this type of alteration. The literature shows improvement in tonal thresholds and in the results of tests of auditory perception of speech that were performed using the speech processor after surgery. Individuals with this type of malformation often experience a period of auditory sensory deprivation prior to rehabilitation. Hence, it is important to evaluate the maturation stage of the cortical auditory structures, the processing of auditory information at the central level, and to verify the benefit of unilateral VSB in difficult listening situations. There are no previous data on this aspect and with the use of cortical auditory evoked potentials (CAEP) and event-related potential (P300) in users of VSB. Aim: To analyze the impact of conductive and mixed hearing loss on CAEP and P300 in unilateral VSB users with bilateral ear atresia. To verify the auditory abilities in a difficult listening situation considering the indication for unilateral VSB. Materials and methods: Twenty individuals were divided into two groups matched for age, sex, and educational level. G1 comprised ten individuals with bilateral conductive or mixed hearing loss and users of unilateral VSB, who visited the research institution. All subjects used conventional hearing aids prior to VSB. G2 comprised ten normal hearing individuals. Audiometry in the free field was performed with the use of VSB (G1 only) and evaluation of hearing skills by the Hearing in Noise Test was conducted; components P1, N1, P2, N2, and P300 in a calibrated field were recorded. Results: Evaluation of the mean tonal thresholds in the frequencies between 500 and 3000 Hz, from 20 to 36 dB HL, demonstrated that VSB allowed access to speech sounds. There was no statistically significant difference in the CAEP and P300 latency values between the two groups. A statistically significant difference was observed in the sentence recognition threshold and the signal-to-noise ratio between the groups, with best results presented by G2. Conclusion: Individuals with congenital aural atresia and bilateral conductive or mixed hearing loss may reach maturation of the central auditory pathway and achieve adequate processing of auditory information at the cortical level, when rehabilitated. The auditory recognition skills, with and without competitive noise, were shown to be out of phase with normality, indicating the need for a bilateral VSB

Children with pronunciation difficulties are at risk of consequences later on, such as reading and writing difficulties. Problems with pronunciation could make a child less intelligible and affect their ability to discriminate between different speech sounds. To facilitate the assessment of pronunciation difficulties it is necessary to use appropriate and updated assessment tools suitable to analyze the children’s phonological development. The Swedish pronunciation test, Bedömning Av Fonologi (B.A.F.), has therefore been developed. This new test can be used by professionals to evaluate the phonological realisations of children. The purpose of this study was to gather normative data of 4 and 5 year olds for B.A.F. and to investigate if girls and boys performed differently concerning the pronunciation of the words in B.A.F. Furthermore, the intention was to investigate if there was any correlation in the performance of the words in B.A.F. with oral motor precision (by oral motor movements tasks), oral motor speed (by repeating syllables) as well as auditory perception (by repetition of nonwords). 63 children (36 girls and 27 boys) in the ages of 48 to 71 months participated in the study. The results showed that by using B.A.F. it is possible to see that the number of correctly pronounced words increases with age. Further, the results indicated that children in the ages of four and five had established /p, t, k, d, f, v, j, h, l, m, n/ and /ŋ/ and all the vocals except /y:/ and /Y/. The only speech sound that did not prove to be established was /r/. Neither the 4 nor the 5 year olds had established consonant clusters containing /r/. A significant correlation was found between oral motor speed and correctly pronounced words in B.A.F. The children’s auditory perception also correlated with the number of correctly pronounced words in B.A.F. This study suggests that skills concerning auditory perception and oral motor speed have more effect on pronunciation skills than oral motor precision. The results gave no indication of a difference in pronunciation between girls and boys. / Barn med uttalssvårigheter löper risk för senare konsekvenser, som exempelvis läs- och skrivsvårigheter. Problem med uttal kan göra ett barn svårförståeligt för omgivningen och kan påverka förmågan att särskilja mellan språkljud. För att underlätta bedömningen av uttalssvårigheter behövs uttalstest som är aktuella och anpassade efter barns utveckling. Därför har det nya uttalstestet Bedömning Av Fonologi (B.A.F.) producerats. Med hjälp av B.A.F. kan barns fonologi undersökas genom uttal av språkljud i ord. Denna studie syftade till att ta fram normativa data för testet hos 4- och 5-åringar. Studien syftade även till att undersöka om några skillnader mellan könen gällande prestationen på B.A.F. fanns samt om något samband mellan uttal av orden i B.A.F. och ett antal uppgifter som mätte oralmotorisk precision (oralmotoriska rörelser) och snabbhet (upprepning av stavelser), samt auditiv perception (repetition av nonord) kunde påvisas. I studien deltog 63 barn (36 flickor och 27 pojkar) i åldrarna 4;0 år till 5;11 år. Under analysen delades barnen in i grupper av halvårsintervall. Resultaten visade att man i B.A.F. kan se att antal korrekt uttalade ord ökar i linje med stigande ålder. Det påvisades även att barn i fyra- och fem årsåldern etablerat /p, t, k, d, f, v, j, h, l, m, n/ och /ŋ/ samt alla vokaler utom /y:/ och /Y/. Det enda konsonantfonem som ej visade sig vara etablerat i dessa åldrar var /r/. Ingen av åldersgrupperna hade heller etablerat kluster innehållandes /r/. Ett signifikant samband kunde påvisas mellan oralmotorisk snabbhet och antal korrekt uttalade ord i B.A.F. Även barnens auditiva perception korrelerade signifikant med antal korrekt uttalade ord i B.A.F. Föreliggande studie tyder på att auditiv perception och oralmotorisk snabbhet har ett större samband med uttalet än oralmotorisk precision. Inga uttalsskillnader mellan könen framkom.