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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.
71

Význam canisterapie u klienta s naslouchadlem a kochleárním implantátem / The accounte of Animal Assisted Therapy for client with hearing-aid and cochlear implant

FRAŇKOVÁ, Zuzana January 2010 (has links)
The thesis deals with a issue of significance of canistherapy for clients with hearing aid and cochlear implants. Canistherapy, as one of the forms of the zoo-therapy, represents a supporting rehabilitation method based on the contact of the man with the dog and their positive interaction. The theoretical part of the thesis contains the topical terminology of the zoo-rehabilitation and canistherapy, where the author makes the analysis of this topic and deals with influence of the canistherapy on the client with specific defects. Within the theoretical part also the issue of a hearing handicap is defined. The target of the thesis is describing canistherapy as supporting therapeutic method for children with hearing defects. The research is focused on applying the Animal Assisted Therapy method. Based on the qualitative research, four casuistic reports were created describing the importance of the canistherapy for children the hearing defects and their family. For the research, the method of participating observation was applied, method of the analysis of documents (method of the secondary data analysis) and a half-standardized talk. As supplementing method I selected questioning (technology of an questionnaire) with open questions and photo-documentation. The research was made on children of pre-school age after the cochlear implantation coming into the Special Pedagogical Centre for Hearing Handicapped in České Budějovice. The results of the research confirmed that canistherapy influences very positively the total development of the child personality, it contributes to the development of speech as well as communication abilities and psycho-social child development. The thesis may serve as information and study material for beginning and professional canistherapeutical teams, pedagogical, special pedagogical and further professional employees and also the lay public. The information may be disseminated in the form of lectures, by creating publications, leaflets etc..
72

Estudo dos potenciais evocados auditivos de longa latência em crianças pré e pós-adaptação do aparelho em amplificação sonora individual / Study of long latency auditory evoked potentials in children pre and post-fitting individual hearing aid adaptation

Jeziela Cristina Raimundo 20 December 2016 (has links)
Introdução: A perda auditiva na infância, mesmo perdas auditivas mínimas, pode dificultar ou atrasar a aquisição de linguagem da criança. Quanto mais tardio for o diagnóstico e o início da intervenção, maiores serão os efeitos da privação sensorial na via auditiva. Em crianças usuárias de aparelho de amplificação sonora individual (AASI), a utilização dos Potenciais Evocados Auditivos de Longa Latência (PEALL) torna-se uma ferramenta de verificação capaz de mensurar a maturação do sistema nervoso auditivo central (SNAC) ao longo do tempo de uso da amplificação. Objetivo: Caracterizar os potenciais evocados auditivos de longa latência (PEALL) em crianças com perda auditiva neurossensorial pré e pós-adaptação do aparelho de amplificação sonora individual (AASI). Metodologia: Estudo longitudinal constituído por 32 sujeitos e dividido em dois grupos: grupo estudo e grupo controle. O grupo estudo foi composto por 18 crianças, sendo cinco do gênero feminino e 13 do gênero masculino, com idade entre sete e 12 anos (média de idade: 9 anos e 2 meses), com perda auditiva neurossensorial bilateral simétrica de grau leve a moderado, sem experiência prévia com qualquer tipo de amplificação. Todas as crianças foram adaptadas com AASI bilateral após a primeira avaliação eletrofisiológica para a captação dos PEALL (componentes P1, N1, P2, N2 e P300) com estímulo de fala e estímulo tone burst, sendo que esta avaliação se repetiu 3 meses e 9 meses após o uso do AASI. O grupo controle foi composto por 14 crianças, sendo seis do gênero feminino e 8 do gênero masculino, com idade entre sete e 12 anos (média de idade: 9 anos e 8 meses). Todas as crianças deste grupo apresentaram audição normal e a avaliação para obtenção dos PEALL foi realizada respeitando o mesmo intervalo de tempo do grupo estudo: M0 - avaliação inicial; M3 e M9 - avaliação após três e nove meses da avaliação inicial. Resultados: Na comparação dos valores de latência e amplitude com o estímulo tone-burst no GE (condição sem AASI), observou-se diferença estatisticamente significante entre os três momentos de avaliação (M0xM3xM9) para a latência do P1 na orelha esquerda (OE) e latência do P300 na orelha direita (OD), com diminuição da latência ao longo do tempo. Na comparação dos momentos de avaliação dois a dois, para o componente P1 a diferença significante deu-se entre os momentos M0xM9 (p-valor=0,022), e para o componente P300 entre M0xM3 (p-valor=0,013). Com relação ao estímulo de fala pode-se observar uma diminuição estatisticamente significante nas latências dos componentes P2 (p-valor=0,010) e N2 (p-valor=0,007) (OE) entre os momentos M3 e M9. Quanto à presença e ausência dos componentes dos PEALL com estímulo de fala, verificou-se ausência dos componentes P1 e N1 no momento M3 assim como para N1, P2 e P300 no momento M9. Com estímulo tone burst observou-se ausência de respostas para os componentes N1 e P2, nos diferentes momentos de avaliação. No que diz respeito à correlação entre o tempo de privação sensorial e os componentes do PEALL obtidos com estímulo tone-burst na OD (condição com AASI) observou-se correlação estatisticamente significante entre tempo de privação sensorial e amplitude do P300 (p-valor=0,006), sendo que quanto maior o tempo de privação sensorial, menor a amplitude do P300 (r=-0,655). Com relação à correlação entre a frequência de uso do AASI e os componentes dos PEALL observou-se correlação estatisticamente significante entre frequência de uso do AASI e amplitude P2-N2 (p-valor=0,033) para o estímulo de fala na condição com AASI na OE. Conclusão: O PEALL demonstrou ser uma ferramenta clínica viável na avaliação de crianças usuárias de AASI, permitindo monitorar e mensurar a plasticidade neuronal do Sistema Nervoso Auditivo Central após um período de estimulação auditiva / Introduction: Hearing loss in childhood, even when very small, can hinder or even delay the process of language acquisition. The effects of sensory deprivation in the auditory pathway worsen, as diagnosis and the beginning of intervention are delayed. The use of Long Latency Auditory Evoked Potentials (LLAEP) in children that use individual hearing aids becomes a scanning tool capable of measuring the central auditory nervous system\'s (CANS) maturation throughout the period of use of the hearing aid. Purpose: To characterize the long latency auditory evoked potentials (LLAEP) in children with sensorineural hearing loss before and after fitting of hearing aids. Methodology: Longitudinal study composed of 32 subjects and divided into 2 groups: study group and control group. The study group was composed of 18 children, of these 5 were female and 13 were male, with ages between 7 and 12 years (age average: 9 years and 2 months), with mild to moderate bilateral symmetrical sensorineural hearing loss, with no previous experience using any kind of hearing aid. All of the children were fitted with bilateral hearing aids after the first electrophysiological assessment in order to record the LLAEP (components P1, N1, P2, N2 and P300), with speech and tone-burst stimuli; this assessment was repeated 3 and 9 months after the fitting of the hearing aids. The control group was composed of 14 children, of these 6 were female and 8 were male, with ages between 7 and 12 years (age average 9 years and 8 months). All of the children in this group showed normal hearing and the assessments to record the LLAEP were carried out in the same intervals of time as the study group: A0 - initial assessment; A3 and A9 - assessments 3 and 9 months after the initial assessment. Results: When comparing the latency and amplitude results with the tone-burst stimulus in the study group (SG) (without hearing aids), a statistically significant difference between the 3 assessments (A0xA3xA9) was observed for the P1 latency in the left ear (LE) and the P300 latency in the right ear (RE), with a decrease in latency with the passing of time. When comparing the assessments two by two, for the P1 component, the significant difference was recorded between A0xA9 (p-value=0,022), and for the P300 component, the significant difference was recorded between A0xA3 (p-value=0,013). Regarding the speech stimulus, a statistically significant decrease can be observed in the latency of the components P2 (p-value=0,010) and N2 (p-value=0,007) (LE) between A3 and A9. As for the presence and absence of the LLAEP components with the speech stimulus, an absence of the components P1 and N1 at A3 was observed, as well as for N1, P2 and P300 at A9. An absence of response was observed with the tone-burst stimulus for the N1 and P2 components, at the different times of assessment. As for the correlation between the period of sensory deprivation and the LLAEP components obtained from the tone-burst stimulus in the RE (with hearing aids), a statistically significant correlation was observed between the period of sensory deprivation and the amplitude of the P300 (p-value=0,006) - where there was a higher sensory deprivation time, the amplitude of the P300 was lower (r=-0,655). As for the correlation between the frequency of the use of hearing aids and the components of the LLAEP, a statistically significant relationship was observed between the frequency of use of hearing aids and the P2-N2 amplitude (p-value=0,033) for the speech stimulus when using hearing aids in the LE. Conclusion: The LLAEP proved to be a viable clinical tool in the assessment of children using hearing aids, allowing for the monitoring and measuring of the neural plasticity of the Central Auditory Nervous System after a period of hearing stimulation
73

Part-based recognition of 3-D objects with application to shape modeling in hearing aid manufacturing

Zouhar, Alexander 14 August 2015 (has links)
In order to meet the needs of people with hearing loss today hearing aids are custom designed. Increasingly accurate 3-D scanning technology has contributed to the transition from conventional production scenarios to software based processes. Nonetheless, there is a tremendous amount of manual work involved to transform an input 3-D surface mesh of the outer ear into a final hearing aid shape. This manual work is often cumbersome and requires lots of experience which is why automatic solutions are of high practical relevance. This work is concerned with the recognition of 3-D surface meshes of ear implants. In particular we present a semantic part-labeling framework which significantly outperforms existing approaches for this task. We make at least three contributions which may also be found useful for other classes of 3-D meshes. Firstly, we validate the discriminative performance of several local descriptors and show that the majority of them performs poorly on our data except for 3-D shape contexts. The reason for this is that many local descriptor schemas are not rich enough to capture subtle variations in form of bends which is typical for organic shapes. Secondly, based on the observation that the left and the right outer ear of an individual look very similar we raised the question how similar the ear shapes among arbitrary individuals are? In this work, we define a notion of distance between ear shapes as building block of a non-parametric shape model of the ear to better handle the anatomical variability in ear implant labeling. Thirdly, we introduce a conditional random field model with a variety of label priors to facilitate the semantic part-labeling of 3-D meshes of ear implants. In particular we introduce the concept of a global parametric transition prior to enforce transition boundaries between adjacent object parts with an a priori known parametric form. In this way we were able to overcome the issue of inadequate geometric cues (e.g., ridges, bumps, concavities) as natural indicators for the presence of part boundaries. The last part of this work offers an outlook to possible extensions of our methods, in particular the development of 3-D descriptors that are fast to compute whilst at the same time rich enough to capture the characteristic differences between objects residing in the same class.
74

En forskningssammanställning och prototypframtagning för taktilt hörhjälpmedel : Ett konceptvalideringsprojekt / A research compilation and prototyping for a tactile hearing aid : A concept validation project

Fransson, Hilda January 2021 (has links)
Det här är ett examensarbete för högskoleingenjörsexamen i innovationsteknik och design. Fokus på projektet är att validera det fortsatta arbetet inom ett pågående produktutvecklingsprojekt av ett taktilt hörhjälpmedel. Projektets syfte är att undersöka forskning och teknik kopplat till taktil stimulering för att uppfatta ljud, och använda det som grund för beslutsfattning gällande den fortsatta inriktningen på utvecklingsprojektet. Målen för projektet är att leverera en sammanställning av aktuell forskning; en funktionsprototyp för testning av det senaste konceptet; samt resultat och analys av genomförda tester av det senaste konceptet gjorda med prototypen. Relevant och aktuell forskning och teknik kring sensorisk substitution för ljud-till-känsel-system har sammanställts. Forskningssammanställningen visar att sensorisk substitution för överföring av ljudinformation via hudens känselsinne är möjligt om tekniken fungerar och anpassas för ändamålet. Utifrån sammanställningen togs beslutet att fortsätta arbetet med att testa det senast framtagna konceptet inom utvecklingsprojektet. Detta koncept består av elektromagnetiska aktuatorer där spolarna fungerar som rörlig del, och aktuatorerna är satta i matrisformation. En funktionsprotototyp tillverkades för att testa hur spel mellan aktuatorerna påverkas av att ha spolen som rörlig del, och om aktuatorerna kan röra sig utan att påverkas av närliggande aktuatorer. Resultaten från testerna visar att den rörliga spolen löser tidigare problem med spel mellan aktuatorerna. Analysen av testresultaten har sammanställts i en FMEA och visar att även om grundpremissen för konceptet fungerar, finns det många risker som behöver hanteras i det framtida arbetet av produktutvecklingen. / This is a bachelor thesis in innovation and design engineering. The focus of this thesis is to validate the continuing work of an ongoing product development project developing a tactile hearing aid.  The purpose is to investigate research and technical solutions regarding tactile stimulation for sound perception and to use this as a basis for decision making for the continuing work of the product development project. The goal of this thesis is to deliver a compilation of state-of-the-art research; a works-like prototype for testing of the latest concept; and the results and analysis of tests performed with the prototype. A compilation was made of relevant research and technical solutions regarding sensory substitution for sound-to-touch systems. The compilation shows that sensory substitution for sound information transfer via the sense of touch is possible if the technical aspects work and are adapted for this purpose. Based on the results from the compilation a decision was made to continue the work by testing the development project’s latest actuator concept. The concept is based on solenoid actuators where the coils work as moving parts, and the actuators are set in a matrix formation. A works-like prototype of the actuators was made to test how play between the actuators is affected by having the coil as the moving part and whether the actuators can move without being affected by the actuators around them. The test results show that the moving coil solves the earlier problems regarding play between the actuators. The analysis of the test results has been compiled in a FMEA and shows that even though the basic premise of the concept works, there are a lot of risks which must be addressed during the continuing work on the product development.
75

Style Preference Survey: A Report on the Psychometric Properties and a Cross-Validation Experiment

Smith, Sherri L., Todd, Ricketts, McArdle, Rachel A., Chisolm, Theresa H., Alexander, Genevieve, Bratt, Gene 01 February 2013 (has links)
Background: Several self-report measures exist that target different aspects of outcomes for hearing aid use. Currently, no comprehensive questionnaire specifically assesses factors that may be important for differentiating outcomes pertaining to hearing aid style. Purpose: The goal of this work was to develop the Style Preference Survey (SPS), a questionnaire aimed at outcomes associated with hearing aid style differences. Two experiments were conducted. After initial item development, Experiment 1 was conducted to refine the items and to determine its psychometric properties. Experiment 2 was designed to cross-validate the findings from the initial experiment. Research Design: An observational design was used in both experiments. Study Sample: Participants who wore traditional, custom-fitted (TC) or open-canal (OC) style hearing aids from 3 mo to 3 yr completed the initial experiment. One-hundred and eighty-four binaural hearing aid users (120 of whom wore TC hearing aids and 64 of whom wore OC hearing aids) participated. A new sample of TC and OC users (n 5 185) participated in the cross-validation experiment. Data Collection and Analysis: Currently available self-report measures were reviewed to identify items that might differentiate between hearing aid styles, particularly preference for OC versus TC hearing aid styles. A total of 15 items were selected and modified from available self-report measures. An additional 55 items were developed through consensus of six audiologists for the initial version of the SPS. In the first experiment, the initial SPS version was mailed to 550 veterans who met the inclusion criteria. A total of 184 completed the SPS. Approximately three weeks later, a subset of participants (n 5 83) completed the SPS a second time. Basic analyses were conducted to evaluate the psychometric properties of the SPS including subscale structure, internal consistency, test-retest reliability, and responsiveness. Based on the results of Experiment 1, the SPS was revised. A cross-validation experiment was then conducted using the revised version of the SPS to confirm the subscale structure, internal consistency, and responsiveness of the questionnaire in a new sample of participants Results: The final factor analysis led to the ultimate version of the SPS, which had a total of 35 items encompassing five subscales: (1) Feedback, (2) Occlusion/Own Voice Effects, (3) Localization, (4) Fit, Comfort, and Cosmetics, and (5) Ease of Use. The internal consistency of the total SPS (Cronbach'sa5 .92) and of the subscales (each Cronbach'sa..75) was high. Intraclass correlations (ICCs) showed that the test-retest reliability of the total SPS (ICC5.93) and of the subscales (each ICC..80) also was high. TC hearing aid users had significantly poorer outcomes than OC hearing aid users on 4 of the 5 subscales, suggesting that the SPS largely is responsive to factors related to style-specific differences. Conclusions: The results suggest that the SPS has good psychometric properties and is a valid and reliable measure of outcomes related to style-specific, hearing aid preference.
76

Style Preference Survey: A Report on the Psychometric Properties and a Cross-Validation Experiment

Smith, Sherri L., Todd, Ricketts, McArdle, Rachel A., Chisolm, Theresa H., Alexander, Genevieve, Bratt, Gene 01 February 2013 (has links)
Background: Several self-report measures exist that target different aspects of outcomes for hearing aid use. Currently, no comprehensive questionnaire specifically assesses factors that may be important for differentiating outcomes pertaining to hearing aid style. Purpose: The goal of this work was to develop the Style Preference Survey (SPS), a questionnaire aimed at outcomes associated with hearing aid style differences. Two experiments were conducted. After initial item development, Experiment 1 was conducted to refine the items and to determine its psychometric properties. Experiment 2 was designed to cross-validate the findings from the initial experiment. Research Design: An observational design was used in both experiments. Study Sample: Participants who wore traditional, custom-fitted (TC) or open-canal (OC) style hearing aids from 3 mo to 3 yr completed the initial experiment. One-hundred and eighty-four binaural hearing aid users (120 of whom wore TC hearing aids and 64 of whom wore OC hearing aids) participated. A new sample of TC and OC users (n 5 185) participated in the cross-validation experiment. Data Collection and Analysis: Currently available self-report measures were reviewed to identify items that might differentiate between hearing aid styles, particularly preference for OC versus TC hearing aid styles. A total of 15 items were selected and modified from available self-report measures. An additional 55 items were developed through consensus of six audiologists for the initial version of the SPS. In the first experiment, the initial SPS version was mailed to 550 veterans who met the inclusion criteria. A total of 184 completed the SPS. Approximately three weeks later, a subset of participants (n 5 83) completed the SPS a second time. Basic analyses were conducted to evaluate the psychometric properties of the SPS including subscale structure, internal consistency, test-retest reliability, and responsiveness. Based on the results of Experiment 1, the SPS was revised. A cross-validation experiment was then conducted using the revised version of the SPS to confirm the subscale structure, internal consistency, and responsiveness of the questionnaire in a new sample of participants Results: The final factor analysis led to the ultimate version of the SPS, which had a total of 35 items encompassing five subscales: (1) Feedback, (2) Occlusion/Own Voice Effects, (3) Localization, (4) Fit, Comfort, and Cosmetics, and (5) Ease of Use. The internal consistency of the total SPS (Cronbach'sa5 .92) and of the subscales (each Cronbach'sa..75) was high. Intraclass correlations (ICCs) showed that the test-retest reliability of the total SPS (ICC5.93) and of the subscales (each ICC..80) also was high. TC hearing aid users had significantly poorer outcomes than OC hearing aid users on 4 of the 5 subscales, suggesting that the SPS largely is responsive to factors related to style-specific differences. Conclusions: The results suggest that the SPS has good psychometric properties and is a valid and reliable measure of outcomes related to style-specific, hearing aid preference.
77

Speech Signals Used to Evaluate Functional Status of the Auditory System

Wilson, Richard H., McArdle, Rachel 01 July 2005 (has links)
This review presents a brief history of the evolution of speech audiometry from the 1800s to present day. The two-component aspect of hearing loss (audibility and distortion), which was formalized into a framework in past literature, is presented in the context of speech recognition. The differences between speech recognition in quiet and in background noise are discussed as they relate to listeners with normal hearing and listeners with hearing loss. A discussion of the use of sentence materials versus word materials for clinical use is included as is a discussion of the effects of presentation level on recognition performance in quiet and noise. Finally, the effects of age and hearing loss on speech recognition are considered.
78

Examining the Interaction Effects of Fluid Intelligence, Visual Cue Reliance, and Hearing Aid Usage on Speech-in-Noise Recognition Abilities : An investigative study in hearing aid users

Ghebregziabiher, Tnbit Isayas January 2023 (has links)
Research within cognitive hearing science has throughout the years examined the relationship between speech recognition and cognitive functioning. The purpose of this study was to examine the effects of hearing aid experience, fluid intelligence, and visual cues on speech-in-noise recognition. Data from the n200 database by Rönnberg et al. (2016) was analyzed to address two research problems: (1) whether the number of years of hearing aid use influence reliance on visual cues in speech-in-noise recognition and (2) how the relationship between fluid intelligence and reliance on visual cues changes depending on hearing aid use experience. Data from 214 participants with hearing impairment was analyzed using linear mixed effects models. No statistically significant interactions were observed in the results for both research questions. However, the results indicated that increased hearing aid experience, as well as the presence of visual cues resulted in better speech-in-noise recognition ability.
79

Neural and Cognitive Effects of Hearing Loss on Speech Processing / Neurala och kognitiva effekter av hörselnedsättning vid bearbetning av talsignaler

Petersen, Eline Borch January 2017 (has links)
Understanding speech in the presence of noise can be difficult, especially when suffering from a hearing loss. This thesis examined behavioural and electrophysiological measures of speech processing with the aim of establishing how they were influenced by hearing loss (internal degradation) and listening condition (external degradation). The hypothesis that more internal and external degradation of a speech signal would result in higher working memory (WM) involvement was investigated in four studies. The behavioural measure of speech recognition consistently decreased with worse hearing, whereas lower WM capacity only resulted in poorer speech recognition when sound were spatially co-located. Electrophysiological data (EEG) recorded during speech processing, revealed that worse hearing was associated with an increase in inhibitory alpha activity (~10 Hz). This indicates that listeners with worse hearing experienced a higher degree of WM involvement during the listening task. When increasing the level of background noise, listeners with poorer hearing exhibited a breakdown in alpha activity, suggesting that these listeners reached a ceiling at which no more WM resources could be released through neural inhibition. Worse hearing was also associated with a reduced ability to selectively attend to one of two simultaneous talkers, brought on by a reduced neural inhibition of the to-be-ignored speech. Increasing the level of background noise reduced the ability to neurally track the to-be-attended speech. That internal and external degradation affected the tracking of ignored and attended speech, respectively, indicates that the two speech streams were neurally processed as independent objects. This thesis demonstrates for the first time that hearing loss causes changes in the induced neural activity during speech processing. In the last paper of the thesis, it is tentatively suggested that neural activity can be utilized from electrodes positioned in the ear canal (EarEEG) for adapting hearing-aid processing to suite the individual listeners and situation. / Att förstå tal i brus kan vara svårt, speciellt när man lider av en hörselnedsättning. Denna avhandling undersöker beteende- och elektrofysiologiska data med föremålet att bestämma hur de påverkas av hörselskada (intern försämring) och lyssningssituation (extern försämring). Hypotesen att båda intern och extern försämring av talsignalen resulterar i mer aktivering av arbetsminnet under bearbetning av talsignaler har undersökts i fyra studier. Beteendedata visade att talförståelse försämrades med större hörselnedsättning, medan lägre arbetsminneskapacitet endast resulterade i sämre talförståelse när ljudkällorna inte var rumsligt sammanfallande. Elektrofysiologiska mätningar (EEG) gjorda under bearbetning av tal, visade at sämre hörsel associerades med högre inhibitorisk alfa-aktivitet (~10 Hz). Detta indikerar att personer med sämre hörsel upplevde en högre involvering av arbetsminnet under lyssningsuppgiften. Då nivån av bakgrundsljud höjdes, visade personer med sämre hörsel ett sammanbrott av alfaaktiviteten, vilket tyder på att de nådde ett tak där ytterligare arbetsminnes-resurser inte kunde frigöras genom neural inhibition. Sämre hörsel var också förknippat med en reducerad förmåga till at fokusera uppmärksamheten på en av två samtidiga talare, förorsakat av en reducerad förmåga till neuralt att undertrycka den störande talsignalen. En ökning av nivån av bakgrundsljud minskade förmågan att inkoda den relevante talsignalen. Att intern och extern försämring påverkade respektive inkodning av störande och relevant tal, indikerar att de två tal-strömma är neuralt behandlas som oavhängiga objekt. Denna avhandling demonstrerar för första gången att hörselskada förorsakar ändringar i den inducerade neurale aktiviteten under bearbetningen av talsignaler. I avhandlingens sista artikel förslås det preliminärt att neural aktivitet kan upptas från elektroder placerade i hörselgången som kan användas till att kontrollera hörapparat signalbehandling. / <p>Funded by the Oticon Foundation. Project number: 11-2757.</p>
80

Relações entre audibilidade de sons de fala, uso de amplificação sonora e habilidades auditivas em crianças / Relationship between audibility of speech, use of sound amplification and hearing abilities in children

Costa, Eliane Carvalho da 19 March 2015 (has links)
Made available in DSpace on 2016-04-27T18:12:08Z (GMT). No. of bitstreams: 1 Eliane Carvalho da Costa.pdf: 5578176 bytes, checksum: ccfa56eaac90ee496ec24f3f922bbfc2 (MD5) Previous issue date: 2015-03-19 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / Objective: This research focuses on the relationship between audibility of speech, recurrent usage of sound amplification devices and the development of auditory abilities in hearing impaired children. Method: The research was submitted to Ethics Committee for Research at the Pontifícia Universidade Católica de São Paulo was approved on report 731.690. 35 infants and children diagnosed by 3 years of age were selected, with chronological age corrected from 2 to 50 months. The study was conducted at the Centro de Audição na Criança (CeAC/Derdic) on PUCSP. The analysis was based on measurements of audibility (Speech Intelligibility Index SII), use of hearing aid (HA) in an average percentage of daily hours of use in comparison with the time in which the child is awake and reports from parents in HA use situations in everyday life, conducted from structured interviews and scripted interviews. There was also an analysis of medical reports of subjects, the LittlEars® application to evaluate the development of auditory abilities and socio-economic aspects as well as family demographics. Interviews with open-ended questions were recorded and transcribed to exemplify the data that was collected. Children were divided in two groups according to age: those who were chronologically up to 12 months (Group A) when they started using HA and those older than 13 months (Group B). In each group (A and B), children were also subdivided according to audibility classification, that is, in three SII intervals: Gr1 SII below 35%; Gr2 36 to 55% and Gr3 equal or above 56%. Results: We observed that 74% of the subjects were diagnosed with hearing loss before their first year of being born and 37% by 6 months. Children from Gr2 (moderate to severe audibility) are more affected by distance from the speaker, becoming more vulnerable to multiple factors. Findings demonstrate that Gr1 (significant losses) had the lowest average of usage time when compared to other groups and in comparison to the hearing abilities measured in LittlEars®, 51% of children were below the minimum expected when compared to their hearing peers. As for daily use, 70% of mothers of infants up to 12 months said that they use HAs in the car, and children above 13 months reach 78%. 73% pf Group A use products whenever they are with an employed caretaker, compared to only 37% from Group B. As to external environments and going out, 82% (A) and 72% (B) say they always wear the product. 53% and 44% of interviewees, respectively from groups A and B, said they never have to keep adjusting their children s HAs due to feedback. 100% of interviewees check their children's devices every day before being worn. Conclusion: Gr1 children (mostly profound losses), were the least consistent in using hearing aids in daily routine in both age groups. There were no differences between groups when socioeconomic level was considered. Mother referred not to use the hearing aids in unsupervised situations such as car rides, or playing outside. They were unsure about the consistency of HA use during nursery end school hours. Several parents have a hard time noticing hearing changes in babies and children in response to amplification and this seems to affect constant usage / Objetivo: Esta pesquisa visa estabelecer relações entre audibilidade de sons de fala, rotina no uso de aparelho de amplificação sonora e desenvolvimento de habilidades auditivas em crianças diagnosticadas com deficiência auditiva. Método: A pesquisa foi submetida ao Comitê de Ética em Pesquisa da Pontifícia Universidade Católica de São Paulo e Plataforma Brasil e aprovada com o parecer número 731.690. Foram selecionados 35 bebês e crianças pequenas diagnosticadas até 3 anos de idade e idade cronológica corrigida de 2 a 50 meses. O estudo foi realizado no Centro de Audição na Criança (CeAC/Derdic) da PUCSP. A análise foi realizada a partir de medidas de audibilidade (Speech Intelligibility Index SII), uso de aparelho de amplificação sonora individual (AASI) e relatos dos pais de situações de uso do AASI no cotidiano, a partir da entrevista estruturada e roteiro de entrevista. Foi realizada análise dos prontuários, aplicação do LittlEars® para avaliar o desenvolvimento das habilidades auditivas e caracterização socioeconômica e demográfica das famílias. As entrevistas com perguntas abertas foram filmadas e transcritas. As crianças foram divididas em dois grupos segundo a faixa etária: as que tinham idade cronológica de até 12 meses (Grupo A) quando iniciaram o uso de AASI e as que tinham idade cronológica de 13 meses ou mais (Grupo B). Em cada grupo, as crianças foram subdivididas quanto a classificação de audibilidade, segundo valores de SII: Gr1 com SII abaixo de 35%; Gr2 - de 36-55% e Gr3 igual ou maior que 56%. Resultados: Observamos que 74% dos sujeitos receberam o diagnóstico da perda auditiva antes do 1º ano de vida e 37% até os 6 meses. Pesquisa reforça que está crescendo o número de crianças diagnosticadas abaixo de 18 meses e tendo início no processo de seleção e adaptação de aparelhos de amplificação sonora (AASI). Verificamos que as crianças do GR2 (de audibilidade moderada/severa) são mais afetadas pela distância entre o falante e o microfone do AASI sendo, portanto mais vulneráveis a interferência de outros fatores. Achados demonstram que o Gr1 (perdas profundas) teve a menor média de tempo de uso em relação aos outros grupos e com relação às habilidades auditivas verificadas no LittlEars®, 51% das crianças estão abaixo do mínimo esperado em comparação aos seus pares ouvintes. Quanto ao uso no cotidiano, 70% das mães até 12 meses disseram que elas usam sempre os AASIs no carro, e as crianças acima de 13 meses, usam 78%. 73% do grupo A usam os aparelho sempre que estão com uma cuidadora e o grupo B, 37% apenas. Quanto a ambientes externos e passeios, 82% (A) e 72% (B) afirmam usarem sempre os aparelhos. 100% das entrevistadas referiram verificar os aparelhos de seus filhos todos os dias. Conclusão: Crianças do Gr1, a maioria com perda profunda utilizaram os AASI no cotidiano com menor frequência que os outros grupos nas duas faixas etárias. Não houve diferença na consistência de uso quando comparado nível socioeconômico das famílias. Em situações em que as mães não podem supervisionar (no carro, ao ar livre), preferem não colocar os AASI. Não tem certeza se os AASI são utilizados consistentemente na creche ou na escola. Muitos pais têm dificuldade de perceber mudanças auditivas dos bebês e crianças em resposta a amplificação e isto parece afetar o uso consistente

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