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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
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Rythme de parole dans l'interaction langagière : bénéfice d'un entraînement rythmique musical chez l'enfant sourd / Speech rhythm in language interaction : benefit of a musical rhythmic training in deaf children

Hidalgo, Céline 20 December 2018 (has links)
La musique et la parole possèdent toutes deux un degré d’organisation temporelle i.e. de régularité dans le temps. Les stimuli de nature rythmique ont la particularité de pouvoir être anticipés par le cerveau et des études en linguistique et neurosciences ont montré que plus le cerveau est capable d’anticiper les évènements auditifs, meilleure est la qualité du traitement des stimuli. Les enfants sourds, bien que bénéficiant d’un input auditif de plus en plus précis grâce aux implants cochléaires et d’une prise en charge précoce, n’atteignent pas des niveaux de langage homogènes et souffrent de difficultés de perception en milieux bruyants ou lors de conversations. La situation conversationnelle présente un contexte complexe, nécessitant l’activation de la voie audio-motrice pour anticiper et s’adapter aux variations de la parole de son interlocuteur notamment au niveau temporel. Dans ce travail de thèse, nous avons cherché à analyser, grâce à des mesures électrophysiologiques et comportementales, si un entrainement rythmique actif de 30 minutes, pouvait avoir un effet sur les capacités de perception et d’accommodation temporelles de l’enfant sourd dans une tâche de dénomination en alternance avec un partenaire virtuel. Nous avons également testé les capacités rythmiques de ces enfants à différents niveaux de complexités. Les résultats montrent que les enfants sourds souffrent de difficultés à structurer les événements acoustiques selon différent niveaux de hiérarchie mais qu’un entrainement rythmique de 30 minutes versus une stimulation auditive, permet d’améliorer leurs compétences de perception et de production temporelles de la parole dans une situation d’interaction. / Music and speech both possess a certain degree of temporal organization i.e. a certain degree of regularity across time. Studies in linguistics and neuroscience have shown that the brain can extract regularities and use them to anticipate the forthcoming stimuli. It is furthermore established that the better the brain is able to anticipate auditory events, the better the quality of stimulus processing. Deaf children benefit from more and more precise auditory inputs due to advances in cochlear implants development, together with early rehabilitation interventions. However, a great majority of them do not achieve consistent language levels and have strong difficulties in noisy environments or conversations. The conversational situation presents a complex context, requiring the activation of the audio-motor path to anticipate and adapt to the variations of the speech of its interlocutor notably at the temporal level. In this thesis work, we have investigated the temporal perception and accommodation capacities of deaf children in a naming task alternating with a virtual partner, at both behavioral and electrophysiological levels. We have also tested whether an active rhythmic training lasting 30 minutes, could enhance these conversational abilities. Then, we have investigated the rhythmic abilities of these children at different levels complexities. The results show that deaf children suffer from difficulties in structuring acoustic events according to different levels of hierarchy but that a rhythmic training of 30 minutes versus an auditory stimulation, makes it possible to improve their skills of temporal perception and production of speech in a situation of interaction.
32

Experiences from Cochlear Implantation and Auditory Brainstem Implantation in Adults and Children : Electrophysiological Measurements, Hearing Outcomes and Patient Satisfaction

Lundin, Karin January 2016 (has links)
Cochlear implants (CIs) and auditory brainstem implants (ABIs) are prostheses for hearing used in patients with profound hearing impairment. A CI requires an operational cochlear nerve to function in contrast to an ABI. ABIs were initially designed for adult patients with neurofibromatosis type 2 (NF2), suffering from bilateral vestibular schwannomas. Now ABIs are also used for patients, both adults and children, with congenital cochlear malformations, cochlear nerve hypoplasia/aplasia, and cochlear ossification. The aims of this thesis are to evaluate hearing outcome in patients implanted with a CI after long-term deafness. An extended period of deafness has earlier been considered as a contraindication for CI surgery. Further, we analyzed if electrically evoked auditory brainstem responses (eABRs) can predict CI outcome and pinpoint the optimal selection of treatment such as CI or ABI. We also disclose our experiences from ABI surgery in Uppsala, such as implant use, hearing outcome, complications, and satisfaction among the patients. Finally, we evaluated the results and benefits of ABIs in non-NF2 pediatric patients. Results show that patients with an extended deafness period and durations over 20 years can achieve speech understanding and benefit from CIs. Patients with long-term deafness and limited years of hearing before deafness did not perform as well as those with shorter deafness duration and longer hearing experience did. eABR seems to have a definite role in the diagnostic armamentarium, to better consider alternative surgical strategies such as ABI. No eABR waveform predicted a poor CI outcome. There was no correlation between speech perception and eABR waveform latencies or eABR waveform quality. A majority of the ABI patients used their ABIs and benefited from them for at least some period. ABI assisted voice control in a majority of the full-time users and they reported improved understanding of speech with the implant switched on. No severe complications from ABI surgery or ABI stimulation were noted. The patients were generally satisfied, even if their hearing remained very limited. All pediatric patients but one used the implant continuously and benefited from it.
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The impact of cochlear implantation on cognition in older adults: a systematic review of clinical evidence

Miller, Gina, Miller, Craig, Marrone, Nicole, Howe, Carol, Fain, Mindy, Jacob, Abraham January 2015 (has links)
BACKGROUND: Hearing loss is the third most prevalent chronic condition faced by older adults and has been linked to difficulties in speech perception, activities of daily living, and social interaction. Recent studies have suggested a correlation between severity of hearing loss and an individual's cognitive function; however, a causative link has yet to be established. One intervention option for management of the most severe to profound hearing loss in older adults is cochlear implantation. We performed a review to determine the status of the literature on the potential influence of cochlear implantation on cognition in the older adult population. METHODS: Over 3800 articles related to cochlear implants, cognition, and older adults were reviewed. Inclusion criteria were as follows: (1) study population including adults > 65 years, (2) intervention with cochlear implantation, and (3) cognition as the primary outcome measure of implantation. RESULTS: Out of 3,886 studies selected, 3 met inclusion criteria for the review. CONCLUSIONS: While many publications have shown that cochlear implants improve speech perception, social functioning, and overall quality of life, we found no studies in the English literature that have prospectively evaluated changes in cognitive function after implantation with modern cochlear implants in older adults. The state of the current literature reveals a need for further clinical research on the impact of cochlear implantation on cognition in older adults.
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Η ακαδημαϊκή και κοινωνική πρόοδος των παιδιών με κοχλιακό εμφύτευμα στην πρωτοβάθμια εκπαίδευση

Σταυροπούλου, Ευγενία 09 January 2014 (has links)
Η παρούσα εργασία μελετά την επίδραση του κοχλιακού εμφυτεύματος στην κοινωνική και ακαδημαϊκή πρόοδο των κωφών μαθητών με κοχλιακό εμφύτευμα πρωτοβάθμιας εκπαίδευσης σύμφωνα με τις απόψεις των εκπαιδευτικών τους. Στην έρευνα συμμετείχαν 24 παιδιά ηλικίας 2 έως 14 ετών με κοχλιακό εμφύτευμα τα οποία φοιτούσαν σε ειδικά σχολεία και αξιολογήθηκαν από τους εκπαιδευτικούς τους στον τομέα της επικοινωνίας, της ακαδημαϊκής και κοινωνικής προόδου συμπληρώνοντας ένα ερωτηματολόγιο για το κάθε παιδί. Τα αποτελέσματα έδειξαν ότι οι μαθητές αυτοί είχαν αναπτύξει ορισμένες επικοινωνιακές δεξιότητες, η κοινωνική τους πρόοδος ήταν κατάλληλη για την ηλικία τους και είχαν διαμορφώσει ταυτότητα κωφού ατόμου, αλλά σε ακαδημαϊκό επίπεδο υπολείπονταν σε σχέση με τους ακούοντες συνομηλίκους τους. Σημαντική επίδραση στους παραπάνω τομείς φάνηκε να έχει η ύπαρξη επιπρόσθετων αναπηριών, η ηλικία εμφύτευσης, ο χρόνος χρήσης του εμφυτεύματος και η μέθοδος επικοινωνίας του σχολείου. Τέλος, γίνεται μια προσπάθεια να αξιοποιηθούν τα αποτελέσματα αυτά και να ληφθούν υπόψη από τους εκπαιδευτικούς για να βελτιωθεί η εκπαίδευση των κωφών μαθητών με κοχλιακό εμφύτευμα. / This paper examines the social and academic outcomes of deaf students with cochlear implants from the perspectives of their teachers. The participants were 24 children aged from 2 to 14 years old who attended special primary schools. Their teachers completed a survey for each child with a cochlear implant about their communication, academic and social outcomes. The results revealed that the students with cochlear implants seemed to show improvements in the area of communication, they also had age-appropriate social skills, while they developed an identity as a deaf person, but they lagged behind their hearing peers in academic achievement. Significant factors influencing the social, and academic progress of these students seemed to be the additional disabilities, the age of implantation, the usage of cochlear implant and the communication approach used in special schools. Finally, implications for teachers working with deaf students with cochlear implants are discussed in order to improve the education of the deaf.
35

Fonematický sluch u dětí předškolního věku / Phonemic hearing in preschool-age

Paprskářová, Nikola January 2019 (has links)
The diploma thesis deals with the problem of phonemic differentiation in preschool children. The introductory part is focused on the specifics of preschool age, ontogenesis of speech and characterization of phonemic hearing. The aim of this thesis is to determine the level of phonemic differentiation in children with cochlear implant and children without hearing impairment. The results were obtained using a standardized test battery Evaluation of Phonemic Hearing in Preschool Children by authors Škodová, Mischek and Moravcová from 1995, which is created for this issue. Subsequently, the results of both groups were compared and individual differences in performance between children with cochlear implant and children without hearing impairment were examined. Research has shown that better results in phonemic distinction amounted children without hearing impairment, although the difference in success rate between the two groups was not significant. The main benefit of this work is the fact that the ability of phonemic differentiation is important in children with cochlear implant and its development should be part of rehabilitation care. KEYWORDS phonemic hearing, preschool age, cochlear implant, hearing impairment
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Percepção de fala em adolescentes com surdez pré-lingual usuários de implante coclear / Speech perception in adolescents with pre-lingual hearing impairment with cochlear implants

Souza, Izi Patrícia Souza de 03 October 2012 (has links)
INTRODUÇÃO: A surdez profunda é uma deficiência que afeta a personalidade, o relacionamento e todo o estilo de vida do paciente e quando se trata de adolescentes com surdez profunda pré-lingual, esses conflitos biopsicossociais são exacerbados, necessitando de cautela na avaliação e escolha destes candidatos ao implante coclear. OBJETIVO: Avaliar a percepção de fala em adolescentes portadores de surdez pré-lingual do tipo neurossensorial severa a profunda bilateral com implante coclear. FORMA DE ESTUDO: Prospectivo. CASUÍSTICA E MÉTODO: O estudo foi desenvolvido no Ambulatório de Implante Coclear do grupo de Otologia do Hospital das Clinicas da Faculdade de Medicina da USP. 25 indivíduos com surdez pré-lingual, sensório-neural, de grau severo ou profundo, que foram submetidos ao implante coclear na adolescência, definida entre 10 a 17 anos e 11 meses, passaram por testes de percepção de fala pré-implante coclear e 2 anos após a ativação do dispositivo. Para a comparação e análise utilizamos os resultados dos testes de four choice, reconhecimento de vogais e reconhecimento de sentenças em conjunto fechado e aberto. RESULTADOS: Devido a assimetria na distribuição dos dados, os mesmos estão sumarizados como mediana e intervalo interquartis (percentil 25 percentil 75). Houve variação estatisticamente significante entre as avaliações pré e pós- implante para todos os testes analisados. CONCLUSÃO: Todos os pacientes, embora com resultados heterogêneos, obtiveram melhora estatística em todos os testes de fala que foram aplicados / INTRODUCTION: The profound deafness is a disability that affects personality, relationships and lifestyle of the patient and when it comes to teenagers with profound hearing loss before language, these conflicts are exacerbated biopsychosocial, requiring careful evaluation and choice of candidates implant. OBJECTIVE: To evaluate speech perception in Cochlear Implants for adolescents with severe to profound prelinguistic deafness. STUDY DESIGN: Prospective. MATERIAL AND MÉTHOD: The study was conducted at the Ambulatório de Implante Coclear do grupo de Otologia do Hospital das Clinicas da Faculdade de Medicina da USP. 25 individuals with severe or profound prelinguistic deafness who underwent cochlear implantation in adolescence, set between 10 to 17 years and 11 months, passed tests of speech perception pre-implant and 2 years after activation of the device. For comparison and analysis were used the results of tests of four choice, recognition of vowels and recognition of sentences in closed set and open set. RESULTS: Because of asymmetry in the distribution of data, they are summarized as median and interquartile range (25th percentile - 75th percentile). The results have very significant differences between pre-and post-implant for all tests analyzed. CONCLUSION: All patients, although with mixed results, achieved statistical improvement in all speech tests that were applied
37

Percepção da fala em crianças usuárias de implante coclear com duas estratégias de processamento do sinal do sistema HiResolution / Speech perception in children with cochlear implants with two sound processing strategy of the HiResolution system

Melo, Tatiana Mendes de 22 October 2012 (has links)
A melhora na percepção da fala dos usuários de implante coclear (IC) ao longo do tempo está relacionada, entre outros fatores, ao avanço tecnológico das estratégias de processamento do sinal. Deste modo, o objetivo deste trabalho foi avaliar o desempenho de percepção da fala em crianças usuárias de IC, utilizando duas diferentes estratégias de processamento do sinal do sistema HiResolution da Advanced Bionics. Para tanto, participaram deste estudo 11 crianças com deficiência auditiva pré-lingual, usuárias do componente interno HiRes 90K e processador de fala modelo platinum, e que apresentavam habilidade auditiva de reconhecimento em conjunto aberto. Foi realizada a avaliação intra-sujeito em três momentos, de acordo com a estratégia de fala utilizada. O desempenho da linha de base foi avaliado com a estratégia HiResolution 120 (HiRes 120) e posteriormente, foi realizada a conversão da estratégia para a HiResolution (HiRes). Após três meses de uso da estratégia HiRes, os participantes foram avaliados e realizada a conversão da estratégia para a HiRes 120. Após três meses de uso da HiRes 120, os participantes foram reavaliados. Em todas as avaliações, os participantes foram submetidos à pesquisa dos limiares audiométricos em campo livre, avaliação da percepção da fala por meio do teste Hearing in Noise (HINT), no silêncio e na presença de ruído competitivo e, avaliação dos benefícios proporcionados pelo uso do IC em situações cotidianas, por meio do questionário Parents\' Evaluation of Aural/oral Performance of Children (PEACH). Os resultados demonstraram que não houve diferença dos limiares audiométricos em campo livre, do desempenho auditivo no silêncio e do benefício do IC em situações de vida diária, em função da estratégia de processamento de sinal utilizada. Houve tendência de melhor desempenho auditivo na situação de ruído com o uso da estratégia de processamento de sinal HiRes 120, embora, tal resultado não tenha sido estatisticamente significante. Essa tendência indica que a representação espectral do sinal acústico de forma mais detalhada proporcionada pela HiRes 120 pode auxiliar no desempenho auditivo de crianças usuárias de IC em situações de ruído, contudo, essa característica da estratégia de processamento de sinal não influenciou o desempenho auditivo nas situações de silêncio. Reforça-se a importância da observação clínica e avaliação de percepção de fala com ruído na seleção da estratégia de processamento de sinal, a fim de otimizar o desempenho auditivo dos usuários de IC. / Improvements in speech perception with cochlear implant (CI) over the years is related, among others factors, to the technological advance of the sound processing strategy. The purpose of the present study was to investigate speech perception performance in CI children, with two different Advanced Bionics sound processing strategy. Subjects were 11 prelingually deafened children implanted with the HiRes 90K cochlear implant and used a bodyworn platinum sound processor. All subjects showed evidence of open-set speech recognition. A within-subjects design was used to compare performance with standard HiRes and HiRes 120. Baseline performance was assessed with HiResolution 120 (HiRes 120). Subjects then were fitted with HiResolution (HiRes) and returned for re-evaluation after three months of use. After three months of HiRes experience, subjects were refitted with HiRes 120 and returned three months later for reassessment. During test sessions, subject\'s performance was evaluated by warble-tone sound-field thresholds, the Brazilian Hearing in Noise test (HINT) in quiet and in noise and Parents\' Evaluation of Aural/oral Performance of Children questionnaire (PEACH). The detection thresholds, the speech perception in quiet and the CI benefit in daily life were similar for both sound processing strategy. There was a trend toward better hearing performance in noise with HiRes 120, although this result was not statistically significant. This trend indicates that more precise spectral representation of the acoustic signal provided by the HiRes 120 can result in an improvement in the speech perception in noise by CI children. However, this characteristic did not influence the auditory performance in quiet. It reinforces the importance of clinical observation and speech perception in noise assessment in the sound processing strategy selection, in order to optimize the auditory performance of CI users.
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Avaliação da percepção da fala com ruído competitivo em crianças portadoras de deficiência auditiva neurossensorial com espectro da neuropatia auditiva usuárias de implante coclear / Assessment of speech perception with competitive noise in children with sensorineural hearing loss with auditory neuropathy spectrum disorder and cochlear implants users

Yamaguti, Elisabete Honda 28 February 2013 (has links)
Nos últimos anos houve um grande avanço na tecnologia de processamento de sinal do Implante Coclear (IC), mas ainda há uma limitação a ser superada que é a percepção de fala no ruído. Este dispositivo passou a ser indicado para habilitação e reabilitação de um grupo com características audiológicas e eletrofisiológica específica, denominada de Desordem do Espectro da Neuropatia Auditiva (DENA). As características inerentes a este tipo de alteração auditiva podem determinar dificuldades adicionais para o desenvolvimento de habilidades auditivas mais complexas, tal como a percepção dos sons da fala na presença de ruído. Deste modo, este estudo tem como objetivo investigar a percepção de fala na presença de ruído em crianças portadoras de deficiência auditiva neurossensorial com DENA e usuárias de IC e comparar com um grupo de crianças portadoras de deficiência auditiva sensorial usuárias de IC. Trata-se de um estudo realizado no Centro de Pesquisas Audiológicas (CPA) do Hospital de Anomalias Craniofaciais da Universidade de São Paulo na cidade de Bauru (HRAC/ USP). Para a realização da avaliação da percepção de fala no ruído foi utilizado o Teste HINT / BRASIL (Hearing in Noise Test versão em português do Brasil), proposto por NILSSON et al. (1994) e adaptado para a língua portuguesa por BEVILACQUA et al. (2008). A amostra inicial foi formada por 48 crianças com DENA, após os critérios de inclusão 14 crianças com DENA fizeram para do grupo experimental e 12 crianças com deficiência auditiva neurossensorial do grupo controle. Não foram observados resultados estatisticamente significantes para os dois grupos com relação aos testes de percepção de fala no ruído, com relação às habilidades auditivas e de linguagem foi possível observar evolução das habilidades com o tempo de uso para os dois grupos. Pode-se concluir que o IC é indicado para o tratamento das crianças com DENA e estas se comportam de modo bem similar às crianças com deficiência auditiva neurossensorial. / In recent years, there has been a major breakthrough in signal processing technology of cochlear implant (CI), but there is a limitation to be overcome, which is the perception of speech in noise. This device is now indicated for habilitation and rehabilitation of a group with specific electrophysiological and audiological features, called Auditory Neuropathy Spectrum Disorder (ANSD). The characteristics inherent to this type of hearing impairment may determine additional difficulties for developing more complex listening skills, such as the perception of speech sounds in noise. Thus, this study aims to investigate the speech perception in noise in children with sensorineural hearing loss with ANSD and users of CI, and compare with a group of children with sensorineural hearing loss CI users. It is a study in Centro de Pesquisas Audiológicas (CPA), at the Hospital de Anomalias Craniofaciais da Universidade de São Paulo - Bauru (HRAC/ USP). To perform the evaluation of the speech perception in noise test was used HINT / BRAZIL (Hearing in Noise Test - Portuguese version of Brazil), proposed by Nilsson et al. (1994) and adapted into Portuguese by BEVILACQUA et al. (2008). The initial sample was formed consisting of 48 children with ANSD, after the inclusion criteria, 14 children with ANSD made for the experimental group and 12 children with sensorineural hearing loss in the control group. There was no statistically significant results for the two groups with respect to test speech perception in noise, compared with auditory and language skills was possible to observe the evolution of skills with time of use for both groups. It can be concluded that the CI is indicated for the treatment of children with ANSD, and they behave very similarly to children with sensorineural hearing loss.
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Linguagem oral em crianças com cinco anos de uso do implante coclear / Oral language of children with five years of experience using coclear implant

Stuchi, Raquel Franco 07 April 2009 (has links)
INTRODUÇÃO. A linguagem oral é a forma mais efetiva de comunicação em nossa sociedade. A audição é fundamental para o desenvolvimento da linguagem oral. A partir da década de 90 o implante coclear (IC), apesar de não substituir a função coclear, vêm trazendo resultados expressivamente benéficos para o desenvolvimento da linguagem oral de crianças deficientes auditivas sensórioneural severa/profunda pré-lingual. Os estudos atuais têm se preocupado em identificar os fatores que levam algumas crianças com deficiência pré-lingual usuárias de IC a alcançar um desempenho de linguagem oral melhor do que as outras. Entre outros fatores, sabe-se que quanto antes a criança recebe o implante e conforme vai aumentando o tempo de uso do implante o desempenho melhora.Poucos estudos se voltam para a caracterização da linguagem oral dessas crianças. Objetivos: 1. Avaliar a linguagem oral, tanto a compreensão quanto a expressão, das crianças usuárias de IC há 5 anos; 2. Avaliar a relação entre o desempenho de compreensão oral com o desempenho de expressão oral das crianças usuárias de IC há 5 anos; 3. Avaliar a relação entre o desempenho de linguagem oral e o índice reconhecimento de fala dessas crianças; Método: 27 crianças deficientes auditivas pré-linguais usuárias de IC com tempo de uso do IC variando de 5a a 5a11m foram avaliadas por meio da Reynell Developmental Scales II (RDLS) composta pela Escala de Compreensão (C) e Escala de Expressão (E). Foi realizada a análise quantitativa descritiva das pontuações nas seções de C e E. Foi realizada calculado o coeficiente de correlação de Pearson entre as medianas das pontuações totais na Escala de Compreensão e de Expressão de cada indivíduo. Foi calculado o coeficiente de correlação de Spearman entre a pontuação na C e índice de reconhecimento de fonemas; pontuação na E e índice de reconhecimento de fonemas; pontuação RDLS total e índice de reconhecimento de fonemas. RESULTADOS: As medianas das pontuações indicaram que tanto em C como em E houve maior dificuldade em relação às sentenças com maior extensão, palavras de sentido gramatical, palavras e sentenças mais independentes do contexto imediato e mais facilidade em relação à palavras de sentido lexical e mais dependentes do conexto; houve correlação positiva e estatisticamente significante entre C e E. Houve relação estatisticamente significante entre o índice de reconhecimento de fonemas de C, E e pontuação total da RDLS. CONCLUSÕES:Apesar da variabilidade encontrada, as crianças implantadas há cinco anos apresentam dificuldade em relação ás palavras de sentido gramatical e frases com maiores extensões, bem como palavras e frases que não dependem do contexto imediato. A linguagem oral das crianças implantadas há cinco anos está aquém da esperada para a idade cronológica das mesmas. Não houve discrepância entre compreensão e expressão, entretanto mais estudos são necessários para que se determine a superioridade de uma ou de outra. A correlação entre o índice de reconhecimento de fonemas e o desempenho de linguagem comprova a importância da audição para a linguagem oral / INTRODUCTION. The oral language is the most effective form of communication in our society. Hearing is the primary method for the oral language development. Even though the Cochlear Implant (CI) does not replace the Cochlear Function, since the 90´s it has bringing results that are significant beneficial to the oral language development of children with prelingual severe to profound hearing loss. Current researches have been concerned identifying the factors that make some children users of IC with pre-lingual hearing loss to achieve better oral language performance than the others. Besides that, it is known that if the child is implanted soon and the time of use increases, the performance will improve. Few studies turn to the characterization of these children oral language, which is a deviant process in relation to normality, but still needs more research. OBJECTIVES: 1. Evaluate both the comprehensive and expressive language of children that have been Cochlear Implanted for 5 years. 2. Assess the relationship between the comprehensive and expressive language performances of this population. 3. Assess the relationship between the oral language performance and their speech perception. METHOD: 27 children with pre lingual hearing loss that have been implanted for 5 to 5 years and 11 months were evaluated by the Reynell Developmental Scales II ( RDLS) composed by the Comprehensive Scale (C) and Expression Scale (E). The quantitative description of the scores in the sections C and E was performed and the Pearson correlation coefficient between the median scores in the total scale of comprehension and expression of each individual was calculated. In addition, the Spearman correlation coefficient between the score in the C index and phonemes recognition, the score on section E and the score for phonemes recognition, RDLS total score index and phonemes recognition were also calculated. RESULTS: The median scores demonstrated that both on C and E there were greater difficulty with longer sentences, the grammatical meaning of words, words and sentences that were more independent of immediate context. The lexical meaning of words with more context were more straightforward. There were a positive statistically correlation between C and E. There was a significant statistically relationship between the rate of phonemes recognition of C, E and the total score of RDLS. CONCLUSIONS: Despite the established variability, the children that were implanted five years ago have found difficulties with the grammatical meaning of words, longer phrases, and words and phrases that do not depend on the immediate context. The oral language of children implanted five years ago is inferior if compared with children with the same chronological age. There was similarity between expression and comprehension, however, more studies are required to determine whether the superiority of one or other. The correlation between the speech perception and the language performance demonstrates the importance of hearing for oral language development
40

Análise da voz de deficientes auditivos pré e pós uso de implante coclear / Voice analysis of deaf before and after cochlear implantation

Zancanella, Maysa Tibério Ubrig 17 March 2010 (has links)
OBJETIVO: Verificar se ocorrem modificações nos parâmetros vocais (perceptivos e acústicos) em adultos com deficiência auditiva pós-lingual, após o uso de implante coclear (IC), sem reabilitação vocal específica. MÉTODO: Participaram 40 indivíduos com deficiência auditiva pós-lingual, seqüencialmente implantados no período de abril de 2006 a abril de 2009, composto por 20 adultos do gênero masculino e 20 do feminino (grupo estudo). Os pacientes apresentavam idades de 23 a 60 anos, perda auditiva sensorioneural de severa a profunda bilateral, uso de linguagem oral para comunicação, alfabetizados, exame laringológico normal e limiares auditivos com IC, em campo livre melhores que 40 dBHL, para todas as freqüências de fala. Foi realizada gravação da voz antes e após 6 a 9 meses de uso do IC. No intuito de evitar que mudanças nas características vocais fossem atribuídas a gravações das vozes em dias e momentos diferentes, optou-se pela formação de um grupo controle. O grupo controle foi formado por 12 indivíduos adultos deficientes auditivos pós-linguais, sendo 6 do gênero masculino e 6 do gênero feminino, que não receberam o IC. Para as sessões de gravações da voz utilizamos leitura das frases do protocolo CAPE-V, leitura de texto e emissão da vogal sustentada /a/. Foi realizada avaliação perceptivo-auditiva das vozes por 3 juízes e análise acústica por meio do programa PRAAT. RESULTADOS: Observou-se no grupo estudo redução estatisticamente significante no grau geral da voz, tensão, loudness, instabilidade vocal, valores de frequência fundamental (F0) do sexo masculino e de sua variabilidade em ambos os sexos, ao compararmos as vozes pré e pós IC. O grupo controle não apresentou modificações estatisticamente significantes na maioria dos parâmetros vocais estudados, com exceção do pitch e F0 no sexo feminino. Ao compararmos a variação de resultados do grupo estudo e controle não foi possível comprovar estatisticamente que os indivíduos com IC se diferenciaram dos indivíduos sem o uso do dispositivo, com exceção dos valores de variabilidade da F0 no sexo masculino. CONCLUSÃO: Os implantados apresentaram discretas modificações no grau geral da voz, tensão, loudness e instabilidade, assim como reduções nos valores de F0 e sua variabilidade. / OBJECTIVE: To ascertain whether cochlear implantation (CI), without specific vocal rehabilitation, is associated with changes in perceptual and acoustic vocal parameters in adults with severe to profound postlingual deafness. METHODS: The study group comprised 40 postlingually deaf adults (twenty males and twenty females), between 23 and 60 years of age, with severe-to-profound and/or profound bilateral sensorineural hearing loss, who: made use of oral communication; had a literacy level adequate for collection of speech samples; a normal laryngeal examination; and post-CI auditory thresholds of 40 dBHL or better for all speech frequencies on sound field audiometry. Patients with laryngeal or lip/palate abnormalities, a history of laryngeal surgery or prior tracheotomy were excluded. Participants voices were recorded prior to CI and 6 and 9 months post-CI. In order to check for chance modifications between two evaluations, a control group of 12 postlingually deaf adults, 6 male and 6 female, without CI was also evaluated. All sessions comprised the recording of read sentences from CAPE-V, text and sustained vowel /a/. Perceptual evaluation of voice and acoustic analysis were then conducted. RESULTS: We found a statistically significant reduction in overall severity, strain, loudness, instability, vocal fundamental frequency (F0) values (in male participants) and F0 variability (in both genders). The control group showed no statistically significant changes in most vocal parameters assessed, apart from pitch and F0 (in female participants only). Upon comparing the variation of results between the study and control groups, we found no statistically significant difference in vocal parameters between CI recipients and non-recipients, with the exception of F0 variability in male participants. CONCLUSIONS: Implant recipients showed modest changes in overall severity, strain, loudness and instability, as well as reductions in F0 and F0 variability.

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