his study compared auditory behavioral and physiological measures among three subject groups: 1) Normal control subjects, 2) subjects who were on a prescribed SSRI for depression, and 3) subjects who were prescribed an SSRI for depression, but were not medicated at the time of testing. Test measures included: Standard audiological tests (audiometry and tympanometry), electrophysiological procedures for analysis of auditory- evoked brainstem and late responses, and standardized behavioral speech tests (SCAN-A, SSI, and the low predictability sentence list of the R-SPIN). Analysis of results indicated a statistically significant increase of group mean amplitude of the ABR peak V, from 15dBnSL to 55dBnSL, in the non-medicated group compared to controls. Also, the non-medicated group scored significantly less favorably than controls on the most challenging listening condition (-20 MCR) of the SSI, in the left ear. Although other test measures indicated consistent differences between these two groups, they were not, however, significant.

Background: Binaural hearing improves our ability to understand speech and to localize sounds. Hearing loss can interfere with binaural cues, and despite the success of amplification, ∼25% of people with bilateral hearing loss fit with two hearing aids choose to wear only one (e.g., Brooks and Bulmer, 1981). One explanation is reduced binaural processing, which occurs when the signal presented to one ear interferes with the perception of the signal presented to the other ear (e.g., Jerger et al, 1993). Typical clinical measures, however, are insensitive to binaural processing deficits. Purpose: The purpose of this study was to determine the extent to which behavioral measures of binaural performance were related to electrophysiological measures of binaural processing in subjects with symmetrical pure-tone sensitivity. Research Design: The relationship between middle latency responses (MLRs) and behavioral performance on binaural listening tasks was assessed by Spearman's rho correlation analyses. Separate repeated measures analyses of variance (RMANOVAs) were performed for MLR latency and MLR amplitude. Study Sample: Nineteen subjects were recruited for the present study based on a clinical presentation of symmetrical pure-tone sensitivity with asymmetrical performance on a word-recognition in noise test. This subpopulation of patients included both subjects with and subjects without hearing loss. Data Collection and Analysis: Monaural and binaural auditory processing was measured behaviorally and electrophysiologically in right-handed subjects. The behavioral tests included the Words-in-Noise test (WIN), the dichotic digits test (DDT), and the 500 Hz masking level difference (MLD). Electrophysiologic responses were measured by the binaural interaction component (BIC) of the MLR. The electrophysiological responses were analyzed to examine the effects of peak (Na, Pa, and Nb) and condition (monaural left, monaural right, binaural, and BIC) on MLR amplitude and latency. Results: Significant correlations were found among electrophysiological measures of binaural hearing and behavioral tests of binaural hearing. A strong correlation between the MLD and the binaural Na-Pa amplitude was found (r =.816). Conclusions: The behavioral and electrophysiological measures used in the present study clearly showed evidence of reduced binaural processing in ∼10 of the subjects in the present study who had symmetrical pure-tone sensitivity. These results underscore the importance of understanding binauralauditory processing and how these measures may or may not identify functional auditory problems.

The primary purpose of this investigation was to determine whether temporal coding in the auditory system was the same for younger and older listeners. Temporal coding was assessed by amplitude-modulated auditory steady-state responses (AM ASSRs) as a physiologic measure of phase-locking capability. The secondary purpose of this study was to determine whether AM ASSRs were related to behavioral speech understanding ability. AM ASSRs showed that the ability of the auditory system to phase lock to a temporally altered signal is dependent on modulation rate, carrier frequency, and age of the listener. Specifically, the interaction of frequency and age showed that younger listeners had more phase locking than old listeners at 500 Hz. The number of phase-locked responses for the 500 Hz carrier frequency was significantly correlated to word-recognition performance. In conclusion, the effect of aging on temporal processing, as measured by phase locking with AM ASSRs, was found for low-frequency stimuli where phase locking in the auditory system should be optimal. The exploration, and use, of electrophysiologic responses to measure auditory timing analysis in humans has the potential to facilitate the understanding of speech perception difficulties in older listeners.

No description available.

Introdução: A desnutrição energético-protéica é um dos maiores problemas de saúde pública no Brasil, ocorrendo mais frequentemente em pré-escolares e determinando o comprometimento do crescimento. A desnutrição pode provocar alterações no sistema nervoso central, dependendo da intensidade, da época de incidência e da duração da doença, comprometendo irreversivelmente as funções intelectuais. Levando-se em consideração a importância da integridade do Sistema Auditivo Periférico e Central na aquisição e desenvolvimento de fala, linguagem e aprendizado, torna-se imprescindível que anormalidades auditivas tanto periféricas como centrais sejam identificadas e tratadas precocemente nesta população. Objetivo: Caracterizar os achados das avaliações comportamentais, eletroacústicas e eletrofisiológicas da audição em crianças com desnutrição, bem como compará-los aos obtidos em crianças saudáveis da mesma faixa etária. Métodos: Foram realizados exames de audiometria tonal, logoaudiometria, teste dicótico de dígitos, imitanciometria, potencial evocado auditivo de tronco encefálico (PEATE) e potencial evocado auditivo de longa latência (PEALL) em 31 crianças desnutridas (grupo estudo) e 34 crianças saudáveis (grupo controle), com idade entre 7 e 12 anos, de ambos os gêneros. Resultados: Na análise dos dados quantitativos da audiometria tonal foi observada uma diferença estatisticamente significante entre os grupos para os limiares auditivos nas frequências de 250 e 8000 Hz, tendo o grupo estudo apresentado limiares auditivos mais elevados. Na análise qualitativa, não houve diferença estatisticamente significante entre os grupos, apesar de duas crianças do grupo estudo apresentarem perda auditiva discreta. Na análise dos dados qualitativos, não foram encontradas alterações na logoaudiometria para os dois grupos. No teste dicótico de dígitos, houve diferença estatisticamente significante entre os grupos, sendo observada uma maior proporção de crianças com alteração no grupo estudo. Ambos os grupos apresentaram resultados alterados na imitanciometria, não havendo diferença estatisticamente significante entre os grupos. Ambos os grupos apresentaram resultados normais do PEATE. Na análise dos dados quantitativos dos PEALL, verificou-se diferença estatisticamente significante entre os grupos para as latências dos componentes P1, N1 e P300, sendo que o grupo estudo apresentou latências maiores para todos os componentes. Na avaliação da amplitude do P300, houve diferença estatisticamente significante entre as orelhas direita e esquerda do grupo controle, sendo a amplitude do P300 maior na orelha direita. Por sua vez, no grupo estudo, não houve diferença significativa entre as orelhas direita e esquerda. Tanto o grupo controle quanto o grupo estudo apresentaram alterações nos resultados do PEALL, havendo diferença estatisticamente significante entre os grupos para os componentes P1, N1 e P300, sendo que o grupo estudo apresentou maior ocorrência de alterações. O tipo de alteração predominante nos componentes P1 e P300 foi o aumento de latência e, para o componente N1, foi a ausência de resposta no grupo estudo; para o grupo controle, o tipo de alteração predominante nos componentes P1, N1 e P300 foi o aumento de latência. Devido ao predomínio de crianças desnutridas de grau leve (58,1%), não foi possível estabelecer uma correlação entre o grau da desnutrição e a alteração dos PEALL. Conclusão: Crianças com desnutrição apresentaram mais alterações na avaliação comportamental da audição (audiometria tonal e teste dicótico de dígitos) e nos PEALL do que as crianças saudáveis, sugerindo déficit na via auditiva central e alteração no processamento da informação acústica. Há a necessidade de mais estudos para melhor caracterizar as alterações fonoaudiológicas e audiológicas desta população. / Introduction: Protein-energy malnutrition is a major public health problem in Brazil. It is more frequent among pre-school aged children and it compromises growth. Malnutrition may cause changes to the central nervous system depending on its intensity, time of incidence and duration, irreversibly compromising intellectual functions. Considering the importance of Peripheral and Central Auditory System integrity to the acquisition and development of speech, language and learning, it is crucial that both peripheral and central auditory abnormalities are identified and treated early in this population. Objective: To describe the findings of behavioral, electroacoustic and electrophysiological auditory assessments of malnourished children, as well as comparing them with findings from healthy children within the same age group. Methods: The following tests were performed in 31 malnourished children (study group) and 34 healthy children (control group), aged 7 to 12, from both genders: pure tone audiometry, speech audiometry, dichotic digit test, immittance measures, brainstem auditory evoked potential (BAEP) and long-latency auditory evoked potential (LLAEP). Results: While analyzing quantitative data from pure tone audiometry we observed statistically significant differences between groups for hearing thresholds at frequencies of 250 and 8000 Hz; the study group had higher hearing thresholds. As for quantitative analysis, there was no statistically significant difference between groups, although two children in the study group showed slight hearing loss. While analyzing qualitative data we did not find any changes in speech audiometry in any of the groups. As for the dichotic digit test, there was a statistically significant difference between groups, with a higher proportion of abnormal children in the study group. Both groups showed abnormal immittance measures results, although there was no statistically significant difference between the groups. Both showed normal BAEP results. When analyzing quantitative LLAEP data we observed a statistically significant difference between groups in terms of latency of components P1, N1 and P300; the study group had higher latencies for all components. When analyzing P300 amplitudes, there was a statistically significant difference between the right and left ears in the control group; P300 amplitudes was wider for the right ear. On the other hand, the study group did not show any statistically significant difference between the right and left ears. Both the control and study group shoed abnormal LLAEP results. There was a statistically significant difference between groups for components P1, N1 and P300; abnormalities were more frequent in the study group. The type of predominant abnormality in components P1 and P300 was increased latency and for component N1 it was lack of response in the study group; for the control group the type of predominant abnormality in components P1, N1 and P300 was increased latency. Because most children were only slightly malnourished (58.1%), it was not possible to establish a correlation between the level of malnutrition and LLAEP abnormalities. Conclusion: Malnourished children showed more abnormalities in auditory behavioral assessment (pure tone audiometry and dichotic digit test) and LLAEP than healthy children. This suggests a deficit in central auditory pathways and abnormalities in the processing of acoustic information. Further studies are necessary to better describe speech and language and hearing abnormalities in this population.

Introdução: A desnutrição energético-protéica é um dos maiores problemas de saúde pública no Brasil, ocorrendo mais frequentemente em pré-escolares e determinando o comprometimento do crescimento. A desnutrição pode provocar alterações no sistema nervoso central, dependendo da intensidade, da época de incidência e da duração da doença, comprometendo irreversivelmente as funções intelectuais. Levando-se em consideração a importância da integridade do Sistema Auditivo Periférico e Central na aquisição e desenvolvimento de fala, linguagem e aprendizado, torna-se imprescindível que anormalidades auditivas tanto periféricas como centrais sejam identificadas e tratadas precocemente nesta população. Objetivo: Caracterizar os achados das avaliações comportamentais, eletroacústicas e eletrofisiológicas da audição em crianças com desnutrição, bem como compará-los aos obtidos em crianças saudáveis da mesma faixa etária. Métodos: Foram realizados exames de audiometria tonal, logoaudiometria, teste dicótico de dígitos, imitanciometria, potencial evocado auditivo de tronco encefálico (PEATE) e potencial evocado auditivo de longa latência (PEALL) em 31 crianças desnutridas (grupo estudo) e 34 crianças saudáveis (grupo controle), com idade entre 7 e 12 anos, de ambos os gêneros. Resultados: Na análise dos dados quantitativos da audiometria tonal foi observada uma diferença estatisticamente significante entre os grupos para os limiares auditivos nas frequências de 250 e 8000 Hz, tendo o grupo estudo apresentado limiares auditivos mais elevados. Na análise qualitativa, não houve diferença estatisticamente significante entre os grupos, apesar de duas crianças do grupo estudo apresentarem perda auditiva discreta. Na análise dos dados qualitativos, não foram encontradas alterações na logoaudiometria para os dois grupos. No teste dicótico de dígitos, houve diferença estatisticamente significante entre os grupos, sendo observada uma maior proporção de crianças com alteração no grupo estudo. Ambos os grupos apresentaram resultados alterados na imitanciometria, não havendo diferença estatisticamente significante entre os grupos. Ambos os grupos apresentaram resultados normais do PEATE. Na análise dos dados quantitativos dos PEALL, verificou-se diferença estatisticamente significante entre os grupos para as latências dos componentes P1, N1 e P300, sendo que o grupo estudo apresentou latências maiores para todos os componentes. Na avaliação da amplitude do P300, houve diferença estatisticamente significante entre as orelhas direita e esquerda do grupo controle, sendo a amplitude do P300 maior na orelha direita. Por sua vez, no grupo estudo, não houve diferença significativa entre as orelhas direita e esquerda. Tanto o grupo controle quanto o grupo estudo apresentaram alterações nos resultados do PEALL, havendo diferença estatisticamente significante entre os grupos para os componentes P1, N1 e P300, sendo que o grupo estudo apresentou maior ocorrência de alterações. O tipo de alteração predominante nos componentes P1 e P300 foi o aumento de latência e, para o componente N1, foi a ausência de resposta no grupo estudo; para o grupo controle, o tipo de alteração predominante nos componentes P1, N1 e P300 foi o aumento de latência. Devido ao predomínio de crianças desnutridas de grau leve (58,1%), não foi possível estabelecer uma correlação entre o grau da desnutrição e a alteração dos PEALL. Conclusão: Crianças com desnutrição apresentaram mais alterações na avaliação comportamental da audição (audiometria tonal e teste dicótico de dígitos) e nos PEALL do que as crianças saudáveis, sugerindo déficit na via auditiva central e alteração no processamento da informação acústica. Há a necessidade de mais estudos para melhor caracterizar as alterações fonoaudiológicas e audiológicas desta população. / Introduction: Protein-energy malnutrition is a major public health problem in Brazil. It is more frequent among pre-school aged children and it compromises growth. Malnutrition may cause changes to the central nervous system depending on its intensity, time of incidence and duration, irreversibly compromising intellectual functions. Considering the importance of Peripheral and Central Auditory System integrity to the acquisition and development of speech, language and learning, it is crucial that both peripheral and central auditory abnormalities are identified and treated early in this population. Objective: To describe the findings of behavioral, electroacoustic and electrophysiological auditory assessments of malnourished children, as well as comparing them with findings from healthy children within the same age group. Methods: The following tests were performed in 31 malnourished children (study group) and 34 healthy children (control group), aged 7 to 12, from both genders: pure tone audiometry, speech audiometry, dichotic digit test, immittance measures, brainstem auditory evoked potential (BAEP) and long-latency auditory evoked potential (LLAEP). Results: While analyzing quantitative data from pure tone audiometry we observed statistically significant differences between groups for hearing thresholds at frequencies of 250 and 8000 Hz; the study group had higher hearing thresholds. As for quantitative analysis, there was no statistically significant difference between groups, although two children in the study group showed slight hearing loss. While analyzing qualitative data we did not find any changes in speech audiometry in any of the groups. As for the dichotic digit test, there was a statistically significant difference between groups, with a higher proportion of abnormal children in the study group. Both groups showed abnormal immittance measures results, although there was no statistically significant difference between the groups. Both showed normal BAEP results. When analyzing quantitative LLAEP data we observed a statistically significant difference between groups in terms of latency of components P1, N1 and P300; the study group had higher latencies for all components. When analyzing P300 amplitudes, there was a statistically significant difference between the right and left ears in the control group; P300 amplitudes was wider for the right ear. On the other hand, the study group did not show any statistically significant difference between the right and left ears. Both the control and study group shoed abnormal LLAEP results. There was a statistically significant difference between groups for components P1, N1 and P300; abnormalities were more frequent in the study group. The type of predominant abnormality in components P1 and P300 was increased latency and for component N1 it was lack of response in the study group; for the control group the type of predominant abnormality in components P1, N1 and P300 was increased latency. Because most children were only slightly malnourished (58.1%), it was not possible to establish a correlation between the level of malnutrition and LLAEP abnormalities. Conclusion: Malnourished children showed more abnormalities in auditory behavioral assessment (pure tone audiometry and dichotic digit test) and LLAEP than healthy children. This suggests a deficit in central auditory pathways and abnormalities in the processing of acoustic information. Further studies are necessary to better describe speech and language and hearing abnormalities in this population.

The chirp stimulus was designed seeking to compensate the delay of the sound wave through the cochlea, enabling simultaneous stimulation of nerve fibers along the auditory pathway, providing better neural synchrony and consequently higher amplitude responses. This study aims to analyze and compare the results of brainstem auditory evoked potential in newborns born at term, using the click and iChirp stimuli at different intensities, analyzing latency and amplitude of the V wave, tested ear and genre. The study analyzed 30 newborns at terms, and the protocol for BAEP registry with click and iChirp stimulus was: rarified polarity, 2048 scans, presentation rate of 27.7 stimuli/s, bandpass filter from 100 to 3,000 Hz, 100k gain, 12 ms window for the click and 24 ms for iChirp. Intensities researched with the two stimuli were 60, 40 and 20 dB nHL. When results with the two stimuli used in the study were compared regarding the values for the latency of the V wave, increased values with iChirp were observed in the three levels of performance. In regards to the magnitude of this component, the three researched intensities also revealed that the iChirp stimulus was able to generate statistically significant larger amplitudes when compared to the click stimulus. Additionally, subtle differences were observed between the ears and between the genres for the latency values and V wave amplitude with the different stimuli used, although with little clinical relevance. In conclusion, the use of iChirp stimulus may be interesting in the field of audiological diagnosis in children, since it evokes responses with larger amplitudes in the three intensity levels studied, facilitating the identification of the V wave. It is worth noting that when the iChirp was used, the latency of the V wave was higher when compared to research with the click. The variables ear tested and gender exhibited slight differences that were not considered clinically relavant. / O estímulo chirp foi projetado buscando compensar o atraso da onda sonora em sua viagem pela cóclea, possibilitando uma estimulação simultânea das fibras nervosas ao longo da via auditiva proporcionando uma melhor sincronia neural e consequentemente o registro de respostas com maiores amplitudes. Este estudo visa analisar e comparar os resultados do Potencial Evocado Auditivo de Tronco Encefálico em neonatos nascidos a termo, utilizando os estímulos clique e iChirp, em diferentes intensidades de apresentação, analisando latência e amplitude da onda V, orelha testada e gênero. A casuística do estudo foi de 30 neonatos a termos, e o protocolo para registro do PEATE com estímulo clique e iChirp foi: polaridade rarefeita, 2048 varreduras, taxa de apresentação de 27,7 estímulos/s, filtro passa banda de 100 a 3000 Hz, ganho de 100k, janela de 12 ms para o clique e 24 ms para o iChirp. As intensidades pesquisadas com os dois estímulos foi de 60, 40 e 20 dB nHL. Na comparação dos resultados obtidos com os dois estímulos utilizados no estudo, em relação aos valores para a latência da onda V, observou-se que valores aumentados com o iChirp, nos três níveis de apresentação. Em relação a amplitude deste componente, observou-se que o estímulo iChirp foi capaz de gerar amplitudes maiores estatisticamente significantes quando comparado ao clique, também nas três intensidades pesquisadas. Houve discretas diferenças entre as orelhas e entre os gêneros para os valores de latência e amplitude da onda V com os diferentes estímulos utilizados, entretanto com pouca relevância clínica. Conclui-se que a utlização do estímulo iChirp pode ser interessante no campo do diagnóstico audiológico infantil, por evocar respostas com maiores amplitudes, nos três níveis de intensidade pesquisadas, desta maneira faciliando a identificação da onda V. Cabe ressaltar que quando utilizou-se o iChirp a latência da onda V apresentou-se maior quando comparada a pesquisa com o clique. As variáveis orelha testada e gênero apresentaram discretas diferenças que não foram consideras relavantes clinicamente.

In individuals claiming compensation for occupational noise induced hearing loss, a population with a high incidence of nonorganic hearing loss, a reliable and valid behavioural pure tone (PT) threshold is not always achievable. Recent studies have compared the accuracy of behavioural PT threshold estimation using the slow cortical auditory evoked potentials (SCAEP) and auditory steady-state responses (ASSR) but there is no consensus regarding recommended technique. A review of the literature indicated that no comparison has been completed on the use of SCAEP and a single frequency ASSR technique. A research project was therefore initiated with the aim of comparing the clinical effectiveness (accuracy) and clinical efficiency (time required) of SCAEP and ASSR for behavioural PT threshold estimation in adults exposed to occupational noise. Adult participants were divided into a group with normal hearing (behavioural PT thresholds < 20 dBHL; n = 15) and a group of participants with hearing loss (n = 16 adults), the latter of which were recruited from individuals referred for audiometric screening, as part of hearing conservation programs, and who were, therefore, exposed to occupational noise. The GSI Audera electrophysiological system was used for both SCAEP and ASSR threshold measurement at 0.5, 1, 2 and 4 kHz. Use was made of tone burst stimuli for the SCAEP (rise and fall of 10 ms with 80 ms plateau), while amplitude and frequency modulated (AM/FM) stimuli was used during ASSR testing. The system’s 40 Hz protocol was chosen for use during ASSR recording while participants slept because this led to lparticipants. ASSR thresholds could not be measured in two of the three sleeping participants in the preliminary study using an 80 Hz modulation rate due to excessive noise. The mean SCAEP difference scores (SCAEP threshold minus behavioural PT threshold) for both participant groups were -0.2+10.2, 2.8+10.1,5.8+9.7, 0.5+10.4 at 0.5, 1, 2, and 4 kHz respectively, while ASSR difference scores were 25.3+12.8, 21.7+11.3,32.3+12.2, 27.1+13.8. The SCAEP correlations with behavioural PT thresholds across frequencies (r = 0.85) were also stronger than ASSR correlations (r = 0.75). Therefore, with regard to proximity of auditory evoked potentials (AEP) to behavioural PT thresholds and consistency of this relationship, the SCAEP, rather than ASSR, is the AEP of choice. However, the SCAEP took on average 10.1 minutes longer to complete than the ASSR. Clinical effectiveness was given comparably more weight than the clinical efficiency of the AEP technique to estimate behavioural PT thresholds due to the impact on overcompensation for occupational noise induced hearing loss. As such, the study acknowledged the SCAEP as the AEP of choice for the purpose of behavioural PT thresholds in adults exposed to occupational noise. It is important to note that the conclusion reached in the current study arose from the comparison of the SCAEP with a specific ASSR technique. Accuracy of ASSR estimation of behavioural PT thresholds is strongly influenced by stimulus and recording parameters of the system used, and by the participant variables. Copyright / Dissertation (MCommunication Pathology)--University of Pretoria, 2010. / Speech-Language Pathology and Audiology / Unrestricted

Objetivo: Realizar uma investigação do sistema auditivo em indivíduos com displasia frontonasal quanto à acuidade e quanto à condução do estímulo sonoro até o nível do tronco encefálico, correlacionando com as características clínicas. Modelo: Análise prospectiva descrevendo os achados da avaliação audiológica em indivíduos com sinais clínicos de displasia frontonasal. Local de Execução: Setor de Genética, HRAC-USP. Participantes: 21 pacientes, na faixa etária de 7 a 42 anos, sendo 14 do sexo feminino e 7 do sexo masculino. Variáveis: Limiares audiométricos em decibels nas frequências de 0,25 a 8 kHz nas duas orelhas, tipo de curva timpanométrica nas duas orelhas, latências absolutas das ondas I, III e V; latências interpicos I-V, III-V e I-III e diferença interaural da onda V do PEATE, em milissegundos, para cada orelha. Resultados: Limiares audiométricos normais em 15 (70%) indivíduos e alterados em 5 (25%), a maior parte dos casos compatíveis com perda auditiva condutiva. Na timpanometria, 30 orelhas (72%) apresentaram curva tipo A, 5 (12%) tipo C, 4 (9%) tipo Ar e 3 (7%) tipo B. Os valores médios em milissegundos das latências absolutas e interpicos nas orelhas direita e esquerda respectivamente foram os seguintes. Onda I: 1,92 e 1,91; onda III: 3,97 e 3,97; onda V: 5,88 e 5,88; interpicos I-V: 3,96 e 3,97; interpicos III-V: 1,91 e 1,92; interpicos I-III: 2,05 e 2,03 e diferença interaural da onda V: 0,04. Conclusões: Os indivíduos com DFN estudados não apresentaram alterações na via auditiva desde sua porção periférica até o tronco encefálico. As alterações condutivas encontradas são provavelmente relacionadas às patologias de orelha média decorrentes da fissura de palato, presente nesses casos. Sugerimos a avaliação de níveis mais altos dentro do sistema auditivo. / Objective: To evaluate the auditory system in patients with frontonasal dysplasia (FND) considering hearing sensitivity and sound stimulus conduction from cochlea to brainstem. Model: A prospective analysis describing audiological evaluation results in patients with clinical signs of FND. Setting: Genetics Department, HRAC-USP. Participants: 21 patients, aged from 7 to 42 years, 14 females and 7 males. Variables: Audiometric thresholds, in decibels, obtained by testing frequencies from 0,25 to 8 kHz, both ears; type of tympanometric curve in both ears; waves I, III and V absolute latencies; interpeak intervals I-V, III-V and I-III and wave V interear difference of ABR, in milisseconds, considering both right and left ears. Results: Hearing thresholds were normal in 15 (70%) patients and abnormal in 5 (25%), most with conductive hearing loss. Tympanometric curve was type A in 30 (72%) ears, type C in 5 (12%), type Ar in 4 (9%) and type B in 3 (7%). Mean values, in milisseconds, of absolute latencies and interpeaks recorded from right and left ears, respectivelly, were: wave I= 1,92 and 1,91; wave III= 3,97 and 3,97; wave V= 5,88 and 5,88; interpeak I-V= 3,96 and 3,97; interpeak III-V= 1,91 and 1,92; interpeak I-III= 2,05 and 2,03 and wave V interear difference= 0,04. Conclusions: Patients with FND showed no abnormalities in the auditory system from cochlea to brainstem in our study. Mild conductive hearing loss found in some of them is probably related to cleft palate, occurring in these cases. We suggest further evaluation of hearing pathways in higher levels.

O distúrbio de aprendizagem (DA) é um transtorno de origem neurobiológica caracterizado por falhas no processamento cognitivo-linguístico, auditivo e visual que prejudicam, principalmente, as habilidades de leitura, escrita e raciocínio matemático. Estudos reforçam a necessidade da intervenção fonoaudiológica dirigida à população com DA. Como alternativa para o tratamento do DA são adotados os programas de remediação fonológica que visam o treino de habilidades metalinguísticas e o ensino da relação letra-som necessários para a aprendizagem do sistema de escrita. A literatura ainda reforça o uso de estratégias não somente fonológicas, mas que envolvam diretamente a leitura e a escrita. Considerando o exposto, o objetivo do presente trabalho foi verificar os efeitos de um programa de remediação fonológica associado à leitura e escrita em escolares com DA e verificar a aplicabilidade dos Potenciais Evocados Auditivos Corticais (PEAC-P1-N1-P2) como indicadores de evolução terapêutica. Foram selecionados 20 escolares na faixa etária de 8 a 14 anos, de ambos os gêneros, diagnosticados com DA por equipe interdisciplinar da FOB-USP. Os participantes foram divididos em 2 grupos: Grupo Experimental (10 escolares) e Grupo Controle (10 escolares). O GE foi submetido ao programa de remediação para comparação com escolares do GC que inicialmente não receberam a intervenção. Foram realizadas avaliações pré e pós a aplicação do programa de remediação para verificar o desempenho cognitivo-linguístico dos participantes nas habilidades do processamento fonológico, leitura (velocidade e compreensão), escrita (palavras, pseudopalavras e produção textual), memória auditiva e visual. As atividades do programa de remediação foram aplicadas em 24 sessões. Os atendimentos foram individuais, realizados 2 vezes por semana, com duração de 50 minutos. Os resultados revelaram que o desempenho cognitivo-linguístico do grupo submetido à intervenção foi estatisticamente superior (p<0,05) ao do grupo não remediado em todas as habilidades avaliadas, exceto na memória visual, cujo grupo não remediado também apresentou evolução. Portanto, observou-se que a remediação fonológica associada à leitura e escrita promoveu resultados significantes nas habilidades do processamento fonológico, memória auditiva, leitura (velocidade e compreensão) e escrita (palavras, pseudopalavras e produção textual). Com relação aos PEAC, constatou-se diferença significante entre os grupos nos valores de latência do componente P1. Considerando que as mudanças no P1 foram observadas somente no grupo submetido à intervenção, pode-se inferir que as mudanças nos valores de latência desse componente foram influenciadas pela remediação. Portanto, verifica-se que o programa de remediação, empregado no presente estudo, promoveu melhoras significantes nas habilidades cognitivo-linguísticas dos escolares com DA, as quais puderam ser monitoradas por meio do componente P1 dos PEAC. / The learning disability (LD) is a neurological disorder characterized by deficits on cognitive-linguistic processing that impair the learning of reading, writing and mathematical reasoning. Studies reinforce the necessity of speech therapy aimed to LD population. The phonological remediation programs are adopted as an alternative for the treatment of LD. These programs focus on metalinguistic skills and the instruction of letter-sound relationship, essential to learning the writing system. It´s also recommended the association between phonological strategies with reading and writing skills. Considering the above, the main objective of this work was to verify the effects of a phonological remediation program associated with reading and writing strategies in children with LD. It was also evaluated the applicability of Cortical Auditory Evoked Potentials (CAEP) P1-N1-2 complex as indicators of therapeutic progress. There were selected 20 students in the age of 8-14 years, both genders, diagnosed with LD by an interdisciplinary team of FOB-USP. The students were divided into 2 groups: experimental group (10 students) and control group (10 students). The EG was submitted to the remediation program to be compared with GC which initially did not receive the intervention. The groups were evaluated pre and post the remediation program to verify their performances. The activities of the remediation program were implemented in 24 sessions (individual sessions, performed 2 times per week, lasting 50 minutes). The results revealed that cognitive-linguistic performance of the intervention group was statistically superior (p<0.05) compared with the group not submitted to remediation program in all abilities assessed, except in visual memory, whose CG also showed progress. Therefore, it was observed that phonological remediation program associated with reading and writing was able to promote significant results in phonological processing, visual memory, reading (speed and comprehension) and writing (words, invented words and text production). With respect to CAEP, there was significant difference between the groups just for the latency value of P1 component. Considering that changes in P1 were observed just in the intervention group it is noted that latency values of this component were influenced by the remediation program. Therefore, it appears that remediation program, conducted in the present study, promoted significant improvements on cognitive-linguistic skills of students with LD, which can be monitored through the P1 component of CAEP.