Hearing impairment is a chronic health condition that affects increasingly younger age groups. Prevalence rates in the working population are estimated to be between four and nine percent when defined by audiometric loss, and between 30 – 40% when using self-report of hearing problems. Hearing impairment can limit and threaten the social functioning of the affected person. It interferes with oral communication, causing activity limitations and participation restrictions. Additionally, a stigma is attached to hearing loss that can lead to feelings of embarrassment, guilt, anxiety and social exclusion. The stigma also poses a threat to the identity of the hearing impaired person who, in return, manages this threat by concealing or disclosing their hearing impairment depending on the social implications. As a consequence, help–seeking is delayed by a considerable amount of time. Although proven to be an effective intervention, amplification is often rejected by working adults. Another available effective intervention is participating in audiologic rehabilitation (AR) programmes. These programmes focus on stigma reduction and communication strategies. Most existing programmes target an elderly population that had been fitted with hearing aids. No programme for working adults who do not wear amplification is published in the literature. The new AR programme “See it! Hear it! Say it!” had been designed for adults who do not wear amplification and previously trialled in the USA. The purpose of this study was to evaluate the short and mid-term outcomes of a version adapted for the New Zealand context, specifically changes in health related quality of life (HRQoL) and cognitive anxiety. Thirteen participants in two groups participated in the study. The design was a quasi–randomised pre-test/post-test/follow-up test with waitlist design. Outcomes were measured with the International Outcome Inventory – Alternative Interventions (IOI-AI), the Hearing Handicap Inventory for Adults (HHIA), the Cognitive Anxiety Scale (CAS) and a non-standardised online questionnaire. Results demonstrated statistically significant differences between pre-group and follow-up assessment outcomes. Effect sizes ranged between 0.606 and 2.114. Participants reported implementing communication strategies in a number of adverse listening environments. These findings provide evidence that the New Zealand specific version of “See it! Hear it! Say it!” is effective in improving HRQoL and reducing cognitive anxiety.

Thesis (Doctoral)--Uppsala University, 1983. / Includes bibliographical references (p. 33-34).

Made available in DSpace on 2015-07-22T20:50:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-07-30. Added 1 bitstream(s) on 2015-08-11T03:25:48Z : No. of bitstreams: 1 Publico-10872.pdf: 1527877 bytes, checksum: 492c0c2bdca5717f9c37dc7c3eaf9a18 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Contexto: A música sempre fez parte das diversas culturas da humanidade, estabelecendo um link entre o ser humano e as sensações e prazeres sentidos através da melodia e do ritmo. Porém, com o abuso na duração, intensidade e/ou freqüência da música, o ruído pode transformar-se em um problema para a audição. Os profissionais do som constituem o elo entre os músicos e as audiências ou consumidores. Recentemente, vem surgindo uma preocupação geral com a ocorrência de perdas auditivas induzidas por ruído, causadas por atividades sonoras excessivamente amplificadas nos ambientes de lazer e profissional. As atividades dos profissionais do som os expõem a riscos de perdas auditivas expondo, conseqüentemente, sua qualidade de vida, a qualidade do produto musical e a audição dos consumidores. Objetivo: Aferir a prevalência de perda auditiva em profissionais e não-profissionais do som. Método: Estudo transversal comparativo entre dois grupos. O tamanho da amostra compreendeu 177 participantes, sendo 82 profissionais do som e 95 não-profissionais do som. Foi solicitado aos profissionais do som, repouso auditivo de 14 horas. Para ambos grupos, foi aplicado questionário sobre os hábitos auditivos, queixas correlatas, presença de zumbido e levantamento de dados sobre o número de horas de trabalho por dia dos profissionais do som. Foi realizada inspeção visual do meato acústico externo dos participantes mediante uso de otoscópio. Avaliação audiológica foi realizada com o audiômetro portátil AD 229 E digital, financiado pela FAPESP. Resultados: Não houve diferença estatisticamente significante entre os grupos de profissionais e de não-profissionais do som quanto à idade e sexo, tornando a amostra do trabalho homogênea e sem a ocorrência de possíveis vieses em seus resultados. Em relação à perda auditiva, foi observada uma diferença estatisticamente significante entre os grupos estudados, com prevalência de 50% de perda no grupo de profissionais do som e de apenas 10,5% no outro grupo. Essa diferença pode ter ocorrido em virtude da exposição excessiva a níveis elevados de som. Conclusão: Os profissionais do som apresentam uma maior prevalência de perda auditiva induzida por níveis de pressão sonora elevados quando comparada à população geral (não-profissionais do som), embora a possibilidade de fatores de confusão residuais devido a desfechos não mensurados, como status socioeconômico, não deva ser descartada. / Background: Music is ever present in our daily lives, establishing a link between humans and the arts through the senses and pleasure. Sound technicians are the link between musicians and audiences or consumers. Recently, general concern has arisen regarding occurrences of hearing loss induced by noise from excessively amplified sound-producing activities within leisure and professional environments. Sound technicians’ activities expose them to the risk of hearing loss, and consequently put at risk their quality of life, the quality of the musical product and consumers’ hearing. The aim here was to measure the prevalence of hearing loss induced by elevated sound pressure levels among sound technicians in Brazil and compare this with a control group without occupational noise exposure. Methods: This was a cross-sectional study comparing 177 participants in two groups: 82 sound technicians and 95 controls. A questionnaire on music listening habits and associated complaints was applied, and data were gathered regarding the professionals’ numbers of working hours per day and both groups’ hearing complaint and presence of tinnitus. The participants’ ear canals were visually inspected using an otoscope. Hearing assessments were performed (tonal and speech audiometry) using a portable digital AD 229 E audiometer funded by FAPESP. Results: There was no statistically significant difference between the sound technicians and controls regarding age and gender. Thus, the study sample was homogenous and would be unlikely to lead to bias in the results. A statistically significant difference in hearing loss was observed between the groups: 50% among the professionals and 10.5% among the controls. The difference could be addressed to high sound levels. Conclusion: The sound technicians presented a higher prevalence of high frequency hearing loss consistent with noise exposure than did the general population, although the possibility of residual confounding due to unmeasured factors such as socioeconomic status cannot be ruled out. / FAPESP: 04/10655-5 / TEDE / BV UNIFESP: Teses e dissertações

INTRODUÇÃO: A audição é um dos sentidos mais importantes para o ser humano, e seu funcionamento está interligado à sua produtividade, o que não é diferente aos músicos, já que ela é de suma importância para a qualidade de seu trabalho e permanência na carreira. O desenvolvimento de um programa de prevenção de perdas auditivas tem por objetivo modificar o comportamento dos músicos em relação à sua audição, uma vez que, constantemente, estão expostos a níveis de pressão sonora elevados e ao surgimento de lesões irreversíveis. Contudo, se medidas preventivas não forem realizadas corretamente, as exposições dos músicos frente à intensidade sonora elevada podem trazer prejuízos à saúde e alguns destes, irreversíveis como, a Perda Auditiva Induzida por Níveis de Pressão Sonora Elevados (PAINPSE) ou Perda Auditiva Induzida por Música (PAIM). OBJETIVO GERAL: submeter os músicos ao programa de prevenção de perdas auditivas (PPPA) e verificar sua eficácia. MATERIAL E MÉTODOS: Participaram componentes de quatro bandas musicais, correspondendo a um total de 16 participantes. Esses membros foram submetidos ao Programa de Prevenção de Perdas Auditivas (PPPA) que engloba as seguintes etapas: (1) medição do nível de pressão sonora no ensaio e show; (2) entrevista específica, Audiometria Tonal Liminar e de Altas Frequências, Logoaudiometria, Imitanciometria e Emissões Otoacústicas por estímulo Transientes e Produto de Distorção; (3) orientação sobre a utilização do Equipamento de Proteção Individual (EPI); e (4) a realização de medidas educativas por meio de workshops. RESULTADOS: O Nível de Pressão Sonora (NPS) durante os ensaios e apresentações/shows, encontram-se elevados, sintomas não auditivos estão presentes em 68, 75% da população total da amostra, presença de zumbido após o show em 100% da amostra; maiores dificuldades de compreensão de fala no ruído nos músicos que tocam baixo (75%). Ao traçar o perfil audiológico do músico foram encontrados: maiores médias dos limiares audiológicos por frequência das bandas estudadas em 500Hz e 3KHz (B1), 3KHz e 4KHz (B2), 3KHz, 4KHz e 6KHz (B3) e em 3KHz (B4); as maiores médias dos limiares audiológicos por frequência dos instrumentos estudados foram em 3KHz, 4KHz e 6KHz (voz), 3KHz e 4KHz (guitarra), 3KHz, 4KHz e 6KHz (baixo) e 3KHz, 4KHz (bateria); presença de entalhe nas frequências de 2KHz, 4KHz, 6KHz e 8KHz na audiometria tonal liminar; já na audiometria de altas frequências em todas as frequências apareceram ao menos um caso, reflexos ausentes em 4KHz (ipsilateral e contralateral); ausência de resposta em 4KHz para todos os baixistas bilateralmente (100%) quando pesquisado EOE por estímulo transiente e na produto de distorção foram encontradas ausência de respostas em 50% da amostra na frequência de 6KHz, sendo assim pesquisada a curva de crescimento (dp growth rate) aparecendo resposta em 75dB em quase 100% dos casos em que houve necessidade de sua realização. Quanto aos achados obtidos da avaliação realizada pelos participantes (músicos) referente ao website, os resultados mostraram que o mesmo atende às necessidades propostas, ou seja, a promoção da saúde auditiva em músicos. CONCLUSÃO: Existe a necessidade de serem tomadas medidas preventivas e a inserção dos músicos em um Programa de Prevenção de Perdas Auditivas (PPPA) a fim de proporcioná-los maiores condições de qualidade de vida e em seu trabalho, já que necessitam da sua audição para desempenhar com eficácia suas atividades e se manter no mercado de trabalho atuando como músico. / INTRODUCTION: Hearing is one of the most important senses for the human being, and its operation is interconnected to its productivity, which is no different to the musicians, since it is of the utmost importance for the quality of their work The development of a hearing loss prevention program, aims to modify the musicians behavior in relation to their hearing, once, constantly, are exposed to high sound pressure levels and the emergence of permanent injury. However, if preventives measures are not performed correctly, the exposures of the musicians facing the high sound intensity can bring losses to health and some of these, irreversible such as, Hearing Loss Induced by High Sound Pressure Levels (HLIHSPL) or Music-induced hearing loss (MIHL) - Noise-Induced Hearing Loss (NIHL). GENERAL OBJECTIVE: submit the musicians to the Hearing Loss Prevention Program (HLPP) and verify its effectiveness. MATERIAL AND METHODS: participated components from four musical bands, corresponding to a total of 16 participants. These members were submitted to the Hearing Loss Prevention Program (PPPA) that include the following steps: (1) measurement of the sound pressure level at the rehearsal and concert; (2) specific interview, Pure Tone Audiometry and High Frequencies, Logoaudiometry, Imitanciometry and Distortion Product Evoked Otoacoustic Emissions (DPEOE); (3) guidance on the use of Personal Protective Equipment (PPE); and (4) the achievement of educational measures through workshops. RESULTS: The Sound Pressure Level (SPL) during the rehearsals and performances/shows are elevated, symptoms not auditory are presents in 68,75% of the total sample population, presence of tinnitus after the show in 100% of the sample; major difficulties of speech comprehension in the noise of the musicians who playing bass (75%). When plotting the audiological profile of the musician were found: highest averages of audiological thresholds by frequency from the studied bands in 500Hz and 3KHz (B1), 3KHz and 4KHz (B2), 3KHz, 4KHz and 6KHz (B3) and in 3KHz (B4); the major averages of audiological frequency thresholds of the studied instruments were in 3KHz, 4KHz and 6KHz (voice), 3KHz and 4KHz (electric guitar), 3KHz, 4KHz and 6KHz (bass) and 3KHz, 4KHz (drums); presence of notch in the frequencies of 2KHz, 4KHz, 6KHz and 8 kHz in the pure tone audiometry; but in the high audiometry frequencies, in all frequencies appeared at least one case, missing reflexes in 4KHz (ipsilateral and contralateral); missing reply in 4KHz for all bassists bilaterally (100%) when researched EOE by transient stimulus and in the distortion product were found missing responses in 50% of the frequency sample of 6KHz, so researched the growth curve (dp growth rate) showing response in 75dB at almost 100% of cases which there was need for its achievement. CONCLUSION: there is a need to take preventive measures and the insertion of the musicians in the Hearing Loss Prevention Program (HLPP) in order to provide them greater conditions of quality of life and in their work, since they need their hearing to play effectively their activities and stay in the labor market working as a musician.

Orientadores: Edi Lúcia Sartorato, Arthur Menino Castilho / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-20T16:24:36Z (GMT). No. of bitstreams: 1 Ramos_PriscilaZonzini_M.pdf: 3611007 bytes, checksum: 2be9b03e75155e4bfaecc2357fec2c70 (MD5) Previous issue date: 2012 / Resumo: A surdez é considerada a doença sensorial mais prevalente em humanos, causada por uma variedade de fatores ambientais e genéticos. No Brasil, não há dados oficiais referentes à prevalência e à etiologia das deficiências auditivas, mas sabe-se que os fatores ambientais ainda superam os de origem genética. No diagnóstico etiológico da surdez, a realização concomitante de exames laboratoriais, de imagem e genéticos, embora amplie a chance diagnóstica, onera o Sistema de Saúde, devido ao alto custo. Deste modo, o objetivo do presente estudo foi avaliar a eficácia dos exames de imagem e genéticos e seu impacto em Saúde Pública, bem como estabelecer um protocolo diagnóstico, visando maior eficiência e redução de custos na determinação da etiologia das perdas auditivas. Foi realizada a análise de 100 indivíduos com perda auditiva neurossensorial, atendidos no Ambulatório de Otorrinolaringologia do Hospital das Clínicas da UNICAMP, no período de 2002 a 2010, e que foram submetidos ao implante coclear. Uma investigação detalhada foi realizada nos pacientes, incluindo exames de imagem, genéticos e laboratoriais (em casos específicos). Após a realização dos exames específicos, o número de casos com a etiologia não esclarecida foi reduzido de 72 para 42, representando redução de 42%. Alterações radiológicas foram identificadas em 29 pacientes, enquanto alterações moleculares foram encontradas em 31 indivíduos, incluindo a c.35delG, p.V27I, p.M34T, p.V37I, p.E47X, p.L90P, p.V95M, p.K168R, p.W172X no gene GJB2, a del(GJB6-D13S1830) no gene GJB6 e a m.1555A>G no gene mitocondrial MTRNR1. Os exames de imagem e genéticos contribuíram, respectivamente, para o diagnóstico etiológico de 20% e 19% dos casos analisados. A etiologia não foi esclarecida em 42% dos pacientes, em 25% foi de origem ambiental, 19% genética, e em 14% dos casos decorrente de malformações ou outros problemas na orelha interna. Pôde-se concluir que tanto os exames de imagem quanto os genéticos foram importantes para a identificação da etiologia das perdas auditivas, no entanto, os testes moleculares contribuíram principalmente para o diagnóstico dos pacientes com surdez congênita, enquanto os exames radiológicos tiveram maior contribuição para os casos com perda progressiva ou abrupta. A alta prevalência de mutações no gene GJB2 foi confirmada, especialmente da mutação c.35delG, nos casos de perda auditiva neurossensorial severa a profunda bilateral. A pesquisa molecular teve importante contribuição no diagnóstico etiológico da surdez, além de possibilitar o aconselhamento genético e sugerir melhor prognóstico para o implante coclear, como observado em estudos prévios. O TaqMan® OpenArray® Genotyping é uma técnica promissora para o diagnóstico molecular da perda auditiva, pois permite a análise de diversas mutações em vários pacientes de uma só vez, o que implica em um diagnóstico mais rápido a um custo mais baixo. O protocolo sequencial permite a otimização do diagnóstico etiológico e redução dos custos, ao contrário da realização concomitante de exames de imagem, laboratoriais e genéticos. Por fim, mesmo com uma investigação detalhada, a etiologia desconhecida continuou prevalecendo, o que aponta para a necessidade de estudos moleculares mais aprofundados, para que a real causa possa ser esclarecida / Abstract: Deafness is considered the most prevalent sensory disorder in humans, caused by a variety of environmental and genetics factors. In Brazil, there are no official data regarding the prevalence and etiology of hearing impairment, but it is known that environmental factors are among the major causes. Although a simultaneous testing approach, including clinical exams, audiological, laboratorial, imaging and genetic expands the etiological diagnosis, overloads the healthcare system due to high costs. Thus, the goal of the present study is to evaluate the effectiveness of imaging and genetics tests and their impact on public health, aiming to increase efficiency and reduce costs of the etiological diagnosis of hearing loss. It was conducted an analysis of 100 patients with sensorineural hearing loss, from Department of Otorhinolaryngology of the State University of Campinas (UNICAMP), submitted to cochlear implantation between 2002 and 2010. A detailed investigation was performed in patients, including imaging and genetics analysis. After specific tests, the number of individuals with unknown cause was reduced from 72 to 42 (42% of reduction). Radiologic abnormalities were identified in 29 of the patients, while molecular alterations were found in 31 individuals, including c.35delG, p.V27I, p.M34T, p.V37I, p.E47X, p.L90P, p.V95M, p.K168R, p.W172X in the GJB2 gene, del(GJB6-D13S1830) in the GJB6 gene and m.1555A>G in the MTRNR1 mitochondrial gene. Genetic and imaging results contributed to the etiological diagnosis of 19% and 20% of the cases, respectively. The etiology remained unknown in 42% of the patients, was due to environmental factors in 25%, genetics in 19% and inner ear malformations or other defects in 14% of the cases. It was concluded that both imaging and genetic analysis were important to identify the etiology of hearing loss, however, molecular tests contributed mainly for diagnosis of patients with congenital deafness, while radiologic exams had greater contribution for diagnosis of cases with progressive or sudden hearing loss. The high prevalence of mutations in the GJB2 gene was confirmed, especially the c.35delG mutation, in cases of sensorineural severe to profound bilateral hearing loss. The molecular research had an important contribution to the etiology of deafness, besides providing genetic counseling and a better prognosis for cochlear implantation, as suggested by previous studies. The TaqMan® OpenArray® Genotyping is a promising technique for molecular diagnostic of hearing loss, because it allows the analisys of many mutations in several patients at once, which implies in a faster diagnosis at a lower cost. The sequential protocol enables an optimization of the etiological diagnosis and cost reduction, as opposed to simultaneously holding imaging, laboratory and genetic tests. Finally, even with a careful investigation, the unknown etiology prevailed as main cause which points to the need of carrying out detailed genetic studies in those cases with idiopathic hearing loss in order to elucidate the diagnosis / Mestrado / Genetica Animal e Evolução / Mestre em Genética e Biologia Molecular

For children with hearing loss, spoken language development often requires the use of hearing aids. Young children often have to rely on their parents or other adults to confirm that their hearing aids are functioning correctly; however, less than 50% of parents check their child’s hearing aids every day. Because of the significant likelihood that a hearing aid malfunction could go unnoticed, it is recommended that children learn hearing aid self-management skills in elementary school and become independent with these skills by middle school. Using the ICF Model of disability, self-management skills should include more than just hearing aid skills, but also skills such as self-advocacy; these can be grouped under one umbrella as “hearing loss self-management skills”. Pediatric self-management skills are associated with improved outcomes for other complex health conditions and have been shown to be responsive to pediatric-focused interventions. While there have been studies to design engaging ways of increasing these hearing loss self-management skills in adults, few have involved children. This study seeks to answer the following two research questions: the first, “What are the baseline hearing loss self-management skills in middle school-aged children?”; the second, “Are educational videos an effective way to increase hearing loss self-management skills in middle school-aged children?”. To answer the first question, children between the ages of 11 and 14 who use at least one hearing aid were asked to answer questions based on the Audiology Self-Advocacy Checklist – Middle School (ASAC-MS) on a scale of “Never/Rarely/Sometimes/Almost all the Time”, to observe their baseline self-reported skills. To answer the second question, a playlist of seven narrated videos with subtitles and visible faces for lipreading was created to address the different topics of the ASAC-MS. The participants were asked to watch these videos and answer the ASAC-MS again. While data collection is not complete, the research team anticipates that most participants will rate their skills in the Rarely or Sometimes categories in the pre-intervention ASAC-MS, and anticipates that the post-intervention ASAC-MS scores will be higher than the pre-intervention ASAC-MS scores. Answering these two research questions is an important step in identifying the needs of current young hearing aid users and identifying ways to meet these needs. Improved hearing loss self-management skills may result in improved speech and language for children with hearing loss in the future.

A summary of the results shows that with 5 of the 9 subjects the high-frequency consonant scores indicated the same aid for the patient that the NU-6 scores indicated. In 2 cases the NU-6 indicated amplification was appropriate whereas the high-frequency consonant scores indicated amplification was not appropriate. Obviously, the high-frequency consonant scores should be considered supplemental to the NU-6 scores and not as a replacement for the NU-6. The combination of the NU-6 and the high-frequency consonant results for Subject 1 may indicate that the patient should have received further counseling and should have been taught how to communicate more effectively without an aid. The high-frequency consonant scores obtained by 2 of the subjects indicated different aids than the ones indicated by the NU-6 test and the patient preference. Perhaps the reason the patient chose an aid other than the one that would most benefit him was that he was most comfortable with the aid that allowed him to hear in the manner to which he was accustomed, even if he did not do as well with it. If a person had become accustomed to not hearing the high-frequency sounds, an aid that suddenly allowed him to hear those sounds might disturb him. The addition of high-frequency amplification might have made speech sound foreign to him. It would have been much easier for him to choose the aid that he was most comfortable with.(ABSTRACT TRUNCATED AT 250 WORDS)

The entire context of South African education is undergoing a slow, yet definite metamorphosis, and inclusion is now nationally both a constitutional imperative and an unequivocal reality. Teachers are the key role-players in determining the quality of implementation of this new policy. They are expected to embrace the new philosophy, to think and to work in a new frame of reference. Unfortunately, too often change in education has failed because insufficient attention has been paid to the challenges posed to those who are expected to put the change into effect. Against this background the aim of this study is to determine the challenges posed to the teacher of the child with a hearing loss in inclusive education. In order to attain this aim, the study was divided into two sections: a literature study and an empirical study. The literature study offers a review of the development of the inclusive philosophy, with specific reference to the educational inclusion of the child with a hearing loss. The knowledge and attitude of teachers towards inclusive education as well the responsibilities of the teachers of a child with a hearing loss within the South African education system are critically discussed. During the empirical research a descriptive design was followed comprising of questionnaire surveys followed by focus group discussions. The questionnaire surveys explored the knowledge, attitudes and training needs of 220 teachers and 81 student teachers. Focus group discussions were conducted with four parents, five speech therapist/audiologist and four teachers (all actively involved in inclusion programmes) and these results were used to substantiate findings from the questionnaire survey. The results of this study indicate that the teachers in regular education as well as the student teachers had sufficient knowledge about the theoretical aspects of inclusion but they lack knowledge regarding the child with a hearing loss. Aspects that were significantly related to the teachers’ lack of knowledge were their unwillingness to include a child with hearing loss and to a lesser extent their years of teaching experience. It was clear that both the teachers and student teachers appear to have negative attitudes towards the inclusion of children with hearing loss. The negative attitudes of the teachers were, as in the case of knowledge, significantly related to their unwillingness to include a child with a hearing loss and their years of teaching experience, but also to their personal experience with hearing loss. The teachers and student teachers indicated specific needs in terms of further training and the content of training. A wide variety of demands that are posed to teachers with regard to the unique South African context were identified, for example lack of support, lack of training, high teacher/child ratios etc. The implications of this study, which amongst other factors include the motivation for the promotion of educational audiology in order to support and train the teachers of children with a hearing loss in inclusive education, are discussed. The education system is challenged to address the needs of teachers in order to ensure the successful implementation of inclusive education for children with hearing loss. / Thesis (DPhil (Communication Pathology))--University of Pretoria, 2004. / Speech-Language Pathology and Audiology / unrestricted

Made available in DSpace on 2016-04-27T18:11:56Z (GMT). No. of bitstreams: 1 Gabriela Ribeiro Ivo Rodrigues.pdf: 4015764 bytes, checksum: 07311235963cd8c282288b7d688c3e0f (MD5) Previous issue date: 2012-05-24 / Fundação de Amparo a Pesquisa do Estado de São Paulo / The auditory steady-state response (ASSR) has been suggested as an alternative to the auditory brainstem response (ABR) to estimate the hearing threshold in children who are unable to carry out the tests with conditioned behavioral hearing procedures. The purpose of this study was to verify the applicability of ASSR to estimate the hearing thresholds in children with sensorineural hearing loss, comparing them to other procedures available for this assessment. The study included 15 children ages between 2 months and 3 years old, with sensorineural hearing loss. The ASSR obtained in 1, 2 and 4 kHz were compared with click ABR; the ASSR at 0.5, 1, 2 and 4 kHz were compared with the tone-ABR and with the visual reinforcement audiometry (VRA). The results showed good concordance between the ASSR at high frequencies with the responses of click ABR (0.63 - 0.70), being the best correlation for 1 kHz (0.70). When compared to tone-ABR it could be seen good concordance between the techniques, with coefficients of 0.77, 0.60, 0.66 and 0.50 for the frequencies of 0.5, 1, 2 and 4 kHz. However, the best coefficients were comparing the ASSR with the VRA (0.89 - 0.93), indicating strong correlation between the techniques. The results showed that when compared to other procedures available to estimate the hearing, the ASSR provided similar findings, proving to be a viable technique in order to estimate the hearing thresholds in a child when the VRA may not be possible / Os Potencias Evocados Auditivos de Estado Estável (PEAEE) têm sido apontados como uma alternativa aos Potenciais Evocados Auditivos de Tronco Encefálico (PEATE) para estimar os limiares auditivos em crianças que não conseguem realizar a avaliação auditiva comportamental com procedimentos condicionados. O objetivo deste estudo foi verificar a aplicabilidade dos PEAEE para estimar os limiares auditivos em crianças com perda auditiva neurossensorial, comparando-os os outros procedimentos disponíveis para esta avaliação. Participaram deste estudo 15 crianças com idades entre 2 meses e 3 anos, todas com perda auditiva neurossensorial. As respostas obtidas nos PEAEE nas freqüências de 1, 2 e 4 kHz foram comparadas com as do PEATE-clique; as respostas dos PEAEE nas freqüências de 0.5, 1, 2 e 4 kHz foram comparadas com as dos PEATE por freqüência específica (PEATE-FE) e com a audiometria de reforço visual (VRA). Os resultados encontrados mostraram boas concordâncias entre as respostas dos PEAEE nas altas freqüências e as respostas dos PEATE-clique (0.63 - 0.70), sendo a melhor correlação para a freqüência de 1 kHz (0.70). Quando os PEAEE foram comparados aos PEATE-FE também foram observadas boas concordâncias, com coeficientes de 0.77, 0.60, 0.66 e 0.50 para as freqüências de 0.5, 1, 2 e 4 kHz. Todavia, os melhores coeficientes obtidos foram da comparação dos PEAEE com a VRA (0.89 0.93), indicando forte concordância entre as técnicas. Os resultados mostraram que, quando comparados aos outros procedimentos eletrofisiológicos disponíveis para estimar a audição, os PEAEE forneceram medidas bem semelhantes, assim como quando comparados a VRA; demonstrando ser uma técnica viável para estimar os limiares auditivos de forma objetiva quando a VRA pode não ser possível

Children frequently experience fluctuating conductive hearing loss during and following episodes of otitis media with effusion. With the prevalence of the disease increasing in the non-Aboriginal population in Australia, many children may be at risk of long-term learning and behavioural problems. There are conflicting findings in the research literature regarding the effects of this type of hearing loss. Although it is expected that the insertion of tympanostomy tubes (grommets) will reduce the duration and prevalence of both the disease and the conductive hearing loss, this does not always happen. For some primary school aged children it appears that experience with otitis media with effusion with or without grommet insertion is associated with various education problems including poor academic achievement and inappropriate behaviour. A current concern is whether or not these possible effects would continue to influence the learning and behaviour of children as they continue into their high school years. A review of the literature suggests that multiple factors including interrelationships between experience of otitis media with effusion, family and childcare environments may be involved in explaining why some students do not achieve as expected at school (Roberts et al., 2000). The literature further suggests there may be a cumulative effect in these factors, which introduces both quantitative and qualitative aspects to the discussion. A study was undertaken to identify the impact of otitis media with effusion and its associated sequelae on the learning and behaviour of high school students. Information from parents of high school students in Years 8 and 9 was used to identify students for inclusion in the study and to provide information on their medical and educational history as well as the parents' perceptions of various aspects of the students' learning and behaviour (including social skills). Three groups were formed: a Non-OME/Non-Grommet Group (n = 28), an OME/Grommet Group (n = 17) and an OME/Non-Grommet Group (n = 32). The TORCH, WRAT 3 and the Test of Syntactic Abilities (Screening Test) were administered to the students who also provided their own perceptions of specific aspects of their own learning and behaviour on a survey form. Teachers' perceptions on these areas were also collected. School academic records as well as data from school behavioural records were used. Analysis of the results revealed a range of mild effects. These included poorer academic results particularly for girls with a history of grommets, who also exhibited a lack of confidence in their social skills. An increase in behaviour problems for boys with a history of the disease (with or without grommets) was also found. The study identifies a number of associated teaching and learning issues including noise levels in childcare environments and school classrooms, current teaching and learning methodology and the training of new teachers. It recommends a number of areas for future research including more in-depth questioning of parents regarding their awareness of hearing problems in their children, the use of more fine-grained measures to assess learning outcomes and the identification of possible gender differences associated with the disease and experiences with grommets.