The thesis deals with general public's awareness of the issue of hearing impairment. The theoretical part introduces the classification of hearing handicaps; it describes groups of people with hearing disabilities, their means of communication as well as attitudes and prejudice of the public towards such people. It offers an account of how the relationship of the public to the people with hearing impairments changed over time and discusses causes of the prejudice and stereotypes. The thesis similarly presents a number of options for obtaining information on the issue and focuses on the possibilities regarding teaching of sign language. The empirical part investigates the level of public awareness regarding the issue of hearing handicap, whether they are satisfied with the level of understanding, and whether they are interested in receiving information via an educational event in their surrounding or a short informative video providing basic information. KEYWORDS: public's awareness, hearing impairment, prejudice, enlightenment.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2016-08-05T12:13:18Z No. of bitstreams: 1 Nayara Thais de Oliveira Costa.pdf: 1071808 bytes, checksum: f97bb08403576a1534a911329fa2a041 (MD5) / Made available in DSpace on 2016-08-05T12:13:18Z (GMT). No. of bitstreams: 1 Nayara Thais de Oliveira Costa.pdf: 1071808 bytes, checksum: f97bb08403576a1534a911329fa2a041 (MD5) Previous issue date: 2016-03-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Purpose: The main purpose of this study was to establish he relation between audibility for speech sounds and speech recognition in children with neurosensory hearing loss using hearing aid. Method: The subjects of this study were 40 children with moderate to severe hearing loss, of both sexes, with chronological age between tive and 12 years. Initially, the factors that may influence the analyzed subjects' performances in speech recognition tests were assessed. The investigated factors were: audibility for speech, according to Speech intelligibility index (SII); chronological age; audiometric characteristics; information regarding audiologic rehabilitation; means of communication and test material. Finally, groups composed by children with similar SII values were compared in order to identify the individual characteristics of each group and the aspects able to distinguish on group from the other. The studied variables were: audiologic and hearing aid use characteristics (time of sensory deprivation and mean hours of daily use) and performance in recognition of words and consonants. Results: The analysis showed that the SII values had a weak to moderate relation with speech recognition results. Regarding the other variables concerning the child, only the audiometric thresholds were also related to the child's behavior on the test, though this relation ,was always weak. There were statistical differences identified in the performances on the speech material, better for words with greater linguistic content. Finally, children in the group with better audibility - GrSII-1 had better performances in the speech recognition test, however, with more heterogeneous results among its members n compared to the group with lower audibility - GrSII-2. GrSII-1's recognition performance was more susceptible to the influence of other factors, such as time of sensory deprivation. The results of the group with lower audibility was more influenced by ifs audiometric limitations since children in this group had more errors than those in the first group, and these errors were mainly for speech segments with low acoustic energy. Conclusion: Audibility for speech, measured based on SII values is related to the performances of neurosensory hearing impaired children using individual hearing aid in speech recognition tests. However, it must be considered that, although this relation exists, SII represents only the speech signal that is accessible and useful through the hearing aid, and is incapable of expressing adverse factors that may influence the performance of children, such as adequate auditory stimulation deprivation or the test's material characteristic / Objetivo: O objetivo geral desta pesquisa foi estabelecer a relação entre audibilidade para sons de fala e reconhecimento de fala em crianças com deficiência auditiva neurossensorial usuárias de Aparelho de Amplificação Sonora Individual (AASI). Método: Participaram deste estudo 40 crianças com perda auditiva de grau moderado a severo, de ambos os sexos e idade cronológica entre cinco e 12 anos. Inicialmente, foram pesquisados os fatores que poderiam influenciar o desempenho dos sujeitos analisados em teste de reconhecimento de fala, sendo investigados: audibilidade para fala, a partir de valores de Índice de Inteligibilidade de Fala - mais comumente denominado de SII; idade cronológica; características audiométricas; informações relacionadas à reabilitação auditiva; meio de comunicação e material de teste. Por último, grupos formados por crianças que possuíam valores de SII similares foram comparados buscando-se identificar as características individuais de cada grupo e os aspectos capazes de distinguir um grupo do outro, sendo pesquisadas como variáveis: as características audiológicas, de uso de AASI (tempo de privação sensorial e média de horas de uso por dia) e desempenho de reconhecimento de palavra e consoantes. Resultados: A análise mostrou que valores de SII tiveram relação fraca a moderada com resultados de reconhecimento de fala. Em relação às demais variáveis relacionadas à criança, foram identificadas que somente os limiares audiométricos também tiveram relação com o comportamento das crianças no teste, porém essa relação foi sempre fraca. Quanto ao material de fala, foram identificadas diferenças estatísticas entre os desempenhos, sendo melhores para palavras com maior conteúdo linguístico. Por último, foi observado que crianças pertencentes ao grupo com melhor audibilidade - GrSII-1, possuíam melhor desempenho em teste de reconhecimento de fala, porém, com resultados mais heterogêneos entre seus membros, se comparado ao grupo com menor audibilidade - GrSII-2. O desempenho de reconhecimento do GrSII-1 se mostrou mais suscetível à influencia de outros fatores, como o tempo de privação sensorial, já os resultados do grupo com menor audibilidade se mostrou mais influenciado por suas limitações audiométricas, sendo que crianças desse grupo tiveram mais erros do que do primeiro grupo, e esses erros foram principalmente para segmentos de fala com baixa energia acústica. Conclusão: A audibilidade para fala, mensurada a partir de valores de SII, tem relação com desempenhos de crianças com deficiência auditiva neurossensorial usuárias de AASI em teste de reconhecimento de fala. No entanto, deve-se levar em consideração que, apesar dessa relação existir, o SII representa apenas que o sinal de fala está acessível e útil por meio do AASI, sendo incapaz de expressar fatores adversos que podem ter influencia sobre o desempenho das crianças, como a privação de estimulação auditiva adequada ou característica do material de teste

A educação em saúde odontológica depende da comunicação, que garanta de fato o conhecimento e adoção das medidas preventivas no cotidiano das crianças, sendo de extrema importância quando se deseja mudar atitudes em relação á doença, priorizando a promoção de saúde. Os programas educativos estão previstos na Política Nacional de Saúde Bucal e devem contemplar o acesso universal a todos os cidadãos. Neste contexto é necessário reconhecer o preparo dos profissionais de odontologia quanto às práticas de comunicação e informação utilizadas para desenvolver hábitos adequados de manutenção da saúde bucal com pacientes com perda de audição.A perda auditiva é um déficit sensorial muito comum e causa grande desvantagem de comunicação. A falta de comunicação leva á desigualdades no acesso á saúde e o desconhecimento sobre cuidados com a saúde bucal representa um fator a ser considerado. Este estudo se propôs a avaliar o conhecimento sobre saúde bucal de pais e professores em escolas especiais de educação para crianças surdas que se comunicam através da Língua Brasileira de Sinais (Libras), e o conhecimento de cirurgiões-dentistas sobre as questões relacionadas ás estratégias de comunicação com pacientes surdos. A conclusão deste estudo enfatiza a necessidade de programas educativos que contemplem ás especificidades de uma criança surda através de parcerias estabelecidas entre a escola, pais e o cirurgião-dentista, para garantir uma comunicação efetiva e a aquisição do conhecimento sobre saúde bucal. / Oral health education depends on communication that can indeed ensure understanding and adoption of preventive measures on the day-to-day of children, and it is extremely important to change attitudes in relation to diseases, prioritizing the promotion of health. Educational programs are included in the National Oral Health Policy and should focus on universal access to all citizens. In this context, it is necessary to recognize how dental professionals are prepared in the practices of communication and information used to develop suitable habits to maintain the oral health of patients with hearing loss. Hearing loss is a very common sensorial deficit and causes major impairment to communication. Lack of communication leads to inequalities in access to health and unawareness about oral health can be a factor to be considered. This study aimed at assessing the knowledge of parents and teachers about oral health in special schools of education for deaf children that communicate in Libras (Brazilian Sign Language), and dentists understanding of issues related to communication strategies with deaf patients. The conclusion of this study emphasizes the need for educational programs that can contemplate the specificities of a deaf child by means of partnerships established between the school, parents and dentists, so as to ensure effective communication and the acquisition of knowledge on oral health.

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This review of scientific literature was performed in Brazillan and North American studies about the prevalence and assessment procedures of Infant Hearing Loss. Fourteen Brazilian articles and 12 American publications of prevalence between 2000 and 2012 were reviewed. The prvalence of infant hearing loss in Brazilian papers was between 0.2% and 10.2% and American papers from 0.22% to 3.61%. As or the procedures used for diagnosis there was a high similarity in the choice of methods.

The purpose of this research is to investigate the relationship between early intervention providers’ backgrounds, and their perceptions of caregiver coaching and auditory skill development, to develop professional development programs. An explanatory sequential design was used with participants of varying backgrounds and experience. In the first phase of the study, participants responded to a survey regarding their educational background, and their comfort with caregiver coaching and auditory skill development. Survey results were analyzed using Spearman’s Ranked Correlational Coefficient (Spearman’s rs) to form groups of participants from extreme cases. The second phase of the study consisted of participant interviews from each of the groups. Interviews were coded to identify themes present within and between groups. The information from both phases were analyzed to generate how professional preparation and certifications influence service delivery. Results were subsequently analyzed to determine potential improvements in the EI system, professional development, and policy.

Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment on communication means that not only does the person with hearing impairment experience the consequences but also his or her frequent communication partners. This thesis investigates the impact of hearing impairment on spouses and uses the World Health Organization’s term “third-party disability.” Third-party disability is defined as the impairments, activity limitations, and participation restrictions experienced by the family due to the health condition of their significant other, and was identified by the World Health Organization as an area for future development and application of the International Classification of Functioning, Disability and Health (ICF). Despite a number of studies previously published on the effect of hearing impairment on family members, including younger couples and carers, there remain substantial gaps in knowledge and understanding of the difficulties specifically relating to older people and factors associated with third-party hearing disability. This thesis focuses on the third-party disability experienced by normally hearing spouses (termed the “spouses” in this thesis) of older people with hearing impairment (termed the “partners” in this thesis). To add empirical data to the body of research, this series of studies first explored the lived experience of spouses of older people with hearing impairment in a qualitative study, then identified the ICF domains and categories that described third-party hearing disability, described the extent of third-party hearing disability in this population, modelled the contribution of factors to third-party hearing disability, and developed and psychometrically tested a scale to measure the third-party disability of spouses of older people with hearing impairment. Studies conducted within this thesis were therefore completed in two phases. Ten spouses of older people with hearing impairment participated in the first qualitative phase, consisting of semi-structured in-depth interviews. Results of this study showed that spouses experience a number of effects as a result of their partners’ hearing impairment including: (1) the broad ranging effects of the hearing impairment on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ hearing impairment; (3) the effect of acceptance of the hearing impairment on the spouse; and (4) the impact of ageing and retirement. Findings were then linked to the ICF to identify the most typical and relevant domains and categories of the ICF for spouses of older people with hearing impairment. The majority of themes were able to be linked to the ICF, with most linking to codes in the activities and participation component. A number of contextual factors were also identified that influenced the spouses’ third-party disability. In the second phase, a further 100 older couples affected by hearing impairment participated in a quantitative face-to-face survey to describe the nature and degree of third-party disability in spouses, and to examine factors associated with third-party hearing disability. Concepts identified in the first qualitative study were used to formulate a 36-item tool for measuring spouses’ third-party hearing disability, namely the Significant Other Scale for Hearing Disability (SOS-HEAR). The majority of spouses in this study (98%) reported some degree of third-party hearing disability on at least one item of the SOS-HEAR. Communication difficulties between the couple were the central source of stress reported by spouses, followed by emotional problems in the spouse. Three factors were found to be significantly associated with greater third-party hearing disability: (1) lower relationship satisfaction as described by spouses; (2) a larger spouse-partner age difference; and (3) greater hearing disability in the hearing impaired partner as perceived by the spouse. The scaling properties of the SOS-HEAR were then examined, with a revised 27-item questionnaire found to be a reliable means of measuring older spouses’ third-party hearing disability. Use of the SOS-HEAR is proposed as a means of identifying spouses of older people with hearing impairment in need of intervention. If spouses are identified as experiencing third-party hearing disability, health professionals are then in a position to facilitate discussions with the couple about the impact of the hearing loss on their daily functioning. The inclusion of spouses in rehabilitation takes into account the needs of both members of the couple such that they become partners in rehabilitation. In summary, this research has shown that hearing impairment in older people has an effect on the spouse, as they too experience situations of communication activity limitations and participation restrictions. It is clear that the lives of participants in this study were considerably affected as a result of their partners’ hearing impairment, with spouses reporting a wide variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. This series of studies has highlighted the potentially important role of family-centred intervention in rehabilitation for older adults with hearing impairment, and strongly suggests the need for increased inclusion of spouses and significant others in the rehabilitation process.

Hearing impairment is the most common communication disability in older people. The wide-ranging impact of hearing impairment on communication means that not only does the person with hearing impairment experience the consequences but also his or her frequent communication partners. This thesis investigates the impact of hearing impairment on spouses and uses the World Health Organization’s term “third-party disability.” Third-party disability is defined as the impairments, activity limitations, and participation restrictions experienced by the family due to the health condition of their significant other, and was identified by the World Health Organization as an area for future development and application of the International Classification of Functioning, Disability and Health (ICF). Despite a number of studies previously published on the effect of hearing impairment on family members, including younger couples and carers, there remain substantial gaps in knowledge and understanding of the difficulties specifically relating to older people and factors associated with third-party hearing disability. This thesis focuses on the third-party disability experienced by normally hearing spouses (termed the “spouses” in this thesis) of older people with hearing impairment (termed the “partners” in this thesis). To add empirical data to the body of research, this series of studies first explored the lived experience of spouses of older people with hearing impairment in a qualitative study, then identified the ICF domains and categories that described third-party hearing disability, described the extent of third-party hearing disability in this population, modelled the contribution of factors to third-party hearing disability, and developed and psychometrically tested a scale to measure the third-party disability of spouses of older people with hearing impairment. Studies conducted within this thesis were therefore completed in two phases. Ten spouses of older people with hearing impairment participated in the first qualitative phase, consisting of semi-structured in-depth interviews. Results of this study showed that spouses experience a number of effects as a result of their partners’ hearing impairment including: (1) the broad ranging effects of the hearing impairment on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ hearing impairment; (3) the effect of acceptance of the hearing impairment on the spouse; and (4) the impact of ageing and retirement. Findings were then linked to the ICF to identify the most typical and relevant domains and categories of the ICF for spouses of older people with hearing impairment. The majority of themes were able to be linked to the ICF, with most linking to codes in the activities and participation component. A number of contextual factors were also identified that influenced the spouses’ third-party disability. In the second phase, a further 100 older couples affected by hearing impairment participated in a quantitative face-to-face survey to describe the nature and degree of third-party disability in spouses, and to examine factors associated with third-party hearing disability. Concepts identified in the first qualitative study were used to formulate a 36-item tool for measuring spouses’ third-party hearing disability, namely the Significant Other Scale for Hearing Disability (SOS-HEAR). The majority of spouses in this study (98%) reported some degree of third-party hearing disability on at least one item of the SOS-HEAR. Communication difficulties between the couple were the central source of stress reported by spouses, followed by emotional problems in the spouse. Three factors were found to be significantly associated with greater third-party hearing disability: (1) lower relationship satisfaction as described by spouses; (2) a larger spouse-partner age difference; and (3) greater hearing disability in the hearing impaired partner as perceived by the spouse. The scaling properties of the SOS-HEAR were then examined, with a revised 27-item questionnaire found to be a reliable means of measuring older spouses’ third-party hearing disability. Use of the SOS-HEAR is proposed as a means of identifying spouses of older people with hearing impairment in need of intervention. If spouses are identified as experiencing third-party hearing disability, health professionals are then in a position to facilitate discussions with the couple about the impact of the hearing loss on their daily functioning. The inclusion of spouses in rehabilitation takes into account the needs of both members of the couple such that they become partners in rehabilitation. In summary, this research has shown that hearing impairment in older people has an effect on the spouse, as they too experience situations of communication activity limitations and participation restrictions. It is clear that the lives of participants in this study were considerably affected as a result of their partners’ hearing impairment, with spouses reporting a wide variety of stresses involving lifestyle changes, communication difficulties, and emotional consequences. This series of studies has highlighted the potentially important role of family-centred intervention in rehabilitation for older adults with hearing impairment, and strongly suggests the need for increased inclusion of spouses and significant others in the rehabilitation process.