Abstract Hearing aid (HA) rehabilitation was studied in northern Finland. The costs of HA fitting were examined at two hospitals, Kainuu Central Hospital and Oulu University Hospital. The patients were visited and interviewed at their home and use of HAs was charted. The benefit of HAs was evaluated using generic and disease-specific questionnaires. The effect of follow-up counselling of HA users on HA use and on the benefit of HAs was studied. The proportion of all HA possessors that are regular users has clearly increased during the past twenty years, and the number of non-users, in particular, has decreased significantly. Only 5.3% of first fitted HAs were not in use in 2001. The costs of HA fitting in 2000 were approximately € 900. There was not much difference in the costs between Kainuu Central Hospital and Oulu University Hospital. The price of a HA accounted for somewhat less than half of the total hospital costs, and the costs of the audiology personnel made up roughly a third of the overall costs. Emotional problems of HA users were significant before HA fitting, but six months after HA fitting the number of patients who felt handicapped by their hearing problems had decreased significantly. This could be seen in the results of both the social and the emotional items of the disease-specific health-related quality-of-life (HRQOL) measure, the short version of the Hearing Handicap Inventory for the Elderly (HHIE-S). The benefit could not, however, be shown with the generic HRQOL instrument, the EuroQol questionnaire (EQ-5D), which apparently lacks sensitivity for measuring changes brought about by audiological intervention. Follow-up counselling of HA users can significantly increase HA use and decrease the number of non-users. It can also significantly increase the users' handling skills. The cost of follow-up counselling is approximately € 83 per fitted HA, which is an 8.7% increment to the calculated cost of fitting a HA.

Made available in DSpace on 2016-04-27T18:12:46Z (GMT). No. of bitstreams: 1 Juliana Habiro de Souza Miguel.pdf: 1525931 bytes, checksum: 8a913eeb0a392601511bc1cec27b49fb (MD5) Previous issue date: 2010-07-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Introduction: Early diagnosis of hearing loss in children, as well as fast intervention, have been shown to be determining factors for hearing and language development, with important implications for the social inclusion process and communicative performance. However, intervention success is directly related to the parents adhesion to the Hearing Care Service, understanding of choices, and potential of their children, in order to adjust their expectations during the treatment. The present study aims to analyze alternatives that guarantee adhesion to use of Hearing Aids, and greater family participation in the initial steps of the intervention. Goal: Discuss family adhesion to the initial part of the intervention, regarding hearing aid usage and participation in the process, as well as its link with hearing and language performance of hearing impaired children. It also aims to examine how adhesion-related issues are problematized in the Family Adhesion Group (GrAF). Method: The study comprehended parents / caregivers of 16 hearing impaired children who attended the ADAPTI (Hearing Aid Fitting and Initial Therapy) in 2009, who had formally applied for the Hearing Care Service (Centro Audição na Criança CeAC). The parents were divided in three groups: Previously Determined (Families that attend both the speech therapy and the GrAF, from the first day set for the beginning of sessions, to the last day); Continuous Flow (Families that started attending the group from the moment they arrived at the CeAC for the ADAPTI); and Control (Families that only attended speech therapy, but not the GrAF). The instruments used included: registering the information from the charts of subjects involved in the research, interviews with the parents (NOVAES, 1986), Family Involvement Scale Evaluation (MOELLER, 2000), MUSS, IT MAIS, cultural awareness activities (NOVAES, 1986) and effective hearing aid usage evaluation. Outcomes: The study verified the effectiveness of parent adhesion to their children s treatment, with over 50% of attendance in the proposed activities (therapeutic intervention and / or GrAF). Regarding the operation and the activities performed at the GrAFs, it was possible to evaluate the differences concerning ties and experience exchanges among the participants. The statistical analysis of children groups, internally homogeneous and heterogeneous among themselves regarding the variables: IT MAIS and MUSS, it was possible to establish three distinct groups regarding datalog usage (hours a day), family participation and degree of hearing loss. Conclusion: The systematic use of hearing aids was the only variable closely related to hearing and language skills. Degree of hearing loss and age at the beginning of amplification, have not explained the development of the children in the study. Establishing routines and procedures at the Hearing Care Services to evaluate adhesion of hearing impaired children s families to the treatment, at the beginning of the intervention are essential, especially concerning the use of hearing aids and participation in the hearing rehabilitation process / Introdução: Diagnóstico precoce da deficiência auditiva em crianças, bem como início da intervenção o mais cedo possível têm sido apontados como determinantes no desenvolvimento auditivo e de linguagem, com importantes implicações no processo de inclusão social e desempenho comunicativo. No entanto, o sucesso da intervenção está diretamente relacionado à adesão dos pais ao Serviço de Saúde Auditiva, à compreensão das escolhas e do potencial de seus filhos, de modo que possam ajustar suas expectativas no decorrer do tratamento. O presente estudo busca analisar alternativas que garantam a adesão ao uso do Aparelho de Amplificação Sonora Individual (AASI) e maior envolvimento da família nas etapas iniciais da intervenção. Objetivo: discutir a adesão das famílias na fase inicial de intervenção quanto ao uso do AASI e participação no processo, bem como sua relação com desempenho auditivo e de linguagem das crianças com deficiência auditiva. Visa ainda analisar como questões relativas à adesão são problematizadas no Grupo de Adesão Familiar (GrAF). Método: Participaram do estudo pais e/ou responsáveis de 16 crianças deficientes auditivas que frequentavam o ADAPTI (Adaptação de AASI e Terapia Inicial) no ano de 2009 e que estavam regularmente inscritas no Serviço de Saúde Auditiva - Centro Audição na Criança CeAC. Os pais foram divididos em três grupos: PRÉ DETERMINADO - PD (Famílias participantes tanto da terapia fonoaudiológica quanto do GrAF, desde o primeiro dia estabelecido para o início dos atendimentos até o último dia), FLUXO CONTÍNUO - FC (Famílias que iniciavam a participação no grupo a partir do momento em que chegavam ao CeAC para o ADAPTI) e CONTROLE - C (Famílias que participaram somente da terapia fonoaudiológica, mas não do GrAF). Os instrumentos utilizados foram: registro das informações dos prontuários dos sujeitos da pesquisa, entrevista com os pais (NOVAES, 1986), Escala de Avaliação de Envolvimento Familiar (MOELLER, 2000), MUSS, IT MAIS, atividades de sensibilização cultural (NOVAES, 1986) e Avaliação do uso efetivo do AASI. Resultados: Foi constatada a efetividade da adesão dos pais ao tratamento dos filhos, sendo registrado comparecimento em mais de 50% dos atendimentos propostos (intervenção terapêutica e/ou GrAF). No que se refere ao funcionamento e às dinâmicas realizadas nos GrAF, foi possível avaliar diferenças quanto aos vínculos e troca de experiências entre os participantes. Na análise estatística dos agrupamentos de crianças, homogêneos internamente e heterogêneos entre si quanto às variáveis: IT MAIS e MUSS, foi possível a formação de três diferentes grupos no que se refere ao uso do datalog (horas/dia), envolvimento familiar e grau de perda auditiva. Conclusão: O uso sistemático de AASI foi a única variável com forte relação com habilidades auditivas e de linguagem. Grau de perda auditiva e idade de início de amplificação não explicaram o desenvolvimento das crianças do estudo. Estabelecimento de rotinas e procedimentos nos Serviços de Saúde Auditiva para avaliar a adesão das famílias de crianças com deficiência auditiva ao tratamento, na fase inicial de intervenção são necessários, em especial no que se refere ao uso do AASI e participação no processo de reabilitação auditiva

In an effort to improve the auditory brainstem implant, a prosthesis in which user outcomesare modest, infrared neural stimulation (INS) was applied to the cochlear nucleus in a ratanimal model. Pulsed INS, delivered to the surface of the cochlear nucleus via an opticalfibre, evoked auditory brainstem responses (ABR) and generated broad neural activation inthe inferior Colliculus (IC). Varying the parameters of the laser stimulation revealed laserpeak power to be the dominating parameter for both ABR and IC responses. Strongestresponses were recorded when the fibre was placed at lateral positions on the cochlearnucleus, close to the temporal bone. After deafening by auditory nerve section, ABR andIC responses to INS disappeared, consistent with a reported "optophonic" effect, a laser-inducedacoustic artifact. Thus, for deaf individuals who use the auditory brainstemimplant, INS alone does not appear promising as a new approach.

Objective: To examine the effectiveness of the Listening and Communication Enhancement (LACE) program as a supplement to standard-of-care hearing aid intervention in a Veteran population. Design: A multisite randomized controlled trial was conducted to compare outcomes following standard-of-care hearing aid intervention supplemented with (1) LACE training using the 10-session DVD format, (2) LACE training using the 20-session computer-based format, (3) placebo auditory training (AT) consisting of actively listening to 10 hr of digitized books on a computer, and (4) educational counseling - the control group. The study involved 3 VA sites and enrolled 279 veterans. Both new and experienced hearing aid users participated to determine if outcomes differed as a function of hearing aid user status. Data for five behavioral and two self-report measures were collected during three research visits: baseline, immediately following the intervention period, and at 6 months postintervention. The five behavioral measures were selected to determine whether the perceptual and cognitive skills targeted in LACE training generalized to untrained tasks that required similar underlying skills. The two self-report measures were completed to determine whether the training resulted in a lessening of activity limitations and participation restrictions. Outcomes were obtained from 263 participants immediately following the intervention period and from 243 participants 6 months postintervention. Analyses of covariance comparing performance on each outcome measure separately were conducted using intervention and hearing aid user status as between-subject factors, visit as a within-subject factor, and baseline performance as a covariate. Results: No statistically significant main effects or interactions were found for the use of LACE on any outcome measure. Conclusions: Findings from this randomized controlled trial show that LACE training does not result in improved outcomes over standard-of-care hearing aid intervention alone. Potential benefits of AT may be different than those assessed by the performance and self-report measures utilized here. Individual differences not assessed in this study should be examined to evaluate whether AT with LACE has any benefits for particular individuals. Clinically, these findings suggest that audiologists may want to temper the expectations of their patients who embark on LACE training.

Made available in DSpace on 2016-04-27T18:12:40Z (GMT). No. of bitstreams: 1 Christiane Mara Lombardi.pdf: 1385912 bytes, checksum: 328011c61fba9727cf9df90c8404a529 (MD5) Previous issue date: 2009-02-27 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Theme: The majority of the elderly people with presbycusis can benefit from group hearing rehabilitation. The literature on this subject evaluated those programs as effective. Therefore, the literature does not point the origin of this effectiveness. Based on the information collected from these literature, a private hospital located in São Paulo created the Hearing Aid User Support Group GAUAA, which consists of four monthly meetings. Purpose: To find out the effectivness of a group hearing rehabilitation program for the elderly through shifting from quantitative data to qualitative data. Method: Thirty subjects, hearing aid users with monoaural adaptation, showing moderate to severe hearing loss with ages between seventy and ninety-two years old have participated in this research. This study provided two situations: on situation I, the International Outcome Inventory for Hearing Aids questionnaire (IOI-HÁ) was applied before and after the program. The objetive was to evaluate the user degree of satisfaction. The collected data were submeted to the Wilcoxon test method analysis and analysed through the Spearman correlation method. The situation II was divided in two phases: on phase I, the subjects statements were collected and analysed after the program. At phase II, the subjects statements were analysed during the GAUAA meetings. These data were analysed by the french line of the speech analysis proposed by Orlandi(1996). Results: The data found at situation I were statistically significant, but they could not indicate what would be the reason for the positive effectiveness responses from the clinical perpective. Thus, the situation II through the qualitative analysis, made possible to observe the subjects singularities, which suggested that the effectiveness of a hearing rehabilitation program is due to the identification among the participants and by transference, sustained by the coordinator´s position. The GAUAA effectiveness derives from the ludical speech dominance, which its effects promote the effectiveness of the hearing aid use / Tema: possíveis benefícios de um grupo de apoio voltado a idosos com presbiacusia e usuários de auxiliar auditivo. Objetivo: por meio da articulação entre dados quantitativos e dados qualitativos, localizar a origem da eficácia de um programa de reabilitação auditiva em grupo de idosos. No geral, embora a literatura sobre o tema aborde esse aspecto, não há ainda estudos que propõem parâmetros de atuação e estratégias que levem ao uso sistemático do auxiliar auditivo por parte dessa população. Método: participaram deste estudo 30 sujeitos com perda auditiva de grau moderado a severo, na faixa etária de 70 a 92 anos, usuários de auxiliar auditivo com adaptação monoaural e participantes do Grupo de Apoio ao Usuário de Auxiliar Auditivo GAUAA, criado em um hospital privado de São Paulo, sendo o trabalho desenvolvido em quatro encontros mensais. Foram analisadas duas situações: a Situação I, em que foi aplicado o questionário QI-AASI (Questionário Internacional-Aparelho De Amplificação Sonora Individual), antes e depois do programa, para avaliar o grau de satisfação do usuário. Os achados foram submetidos ao método de análise dos Testes dos Postos Sinalizados de Wilcoxon. A situação II foi dividida em duas etapas: na 1ª etapa procedeu-se à coleta e análise de depoimentos dos usuários após o programa, e na 2ª etapa, à análise dos dizeres dos participantes durante as reuniões do GAUAA. Esses dados foram analisados à luz da metodologia de Análise de Discurso de linha francesa, articulada à tipologia do discurso proposta por Orlandi(1996). Resultados: Os achados da situação I mostraram-se estatisticamente significantes, mas, clinicamente, não indicaram o que provocava as respostas positivas sobre a participação no GAUAA. Já a situação II, em que foi utilizada a metodologia qualitativa, possibilitou observar a singularidade dos sujeitos, sugerindo que a eficácia de um programa de reabilitação auditiva se dá pela identificação entre os participantes e pela transferência sustentada pela posição do coordenador. Concluiu-se que a eficácia do GAUAA deriva da dominância do discurso lúdico, cujos efeitos promovem a efetividade do uso do auxiliar auditivo

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

Analizuojant kochlearinio implanto reikšmę žymiai neprigirdinčių ir kurčių vaikų santykių su aplinka pokyčiams, nors kochlearinė implantacija yra labai efektyvus klausos protezavimo metodas, integruojant ir reabilituojant žymiai neprigirdinčius ir kurčius vaikus visuomenėje, tačiau tai palyginti nauja sritis ir mes neaptikom kitų mokslinių tyrimų, nagrinėjančių šią temą Lietuvoje. Klausa žmogui yra vienas iš pagrindinių komunikacijos būdų tarp aplinkinių ir pasaulio, kuriame jis gyvena. Statistikos duomenimis, per metus maždaug 35 vaikams nustatomas įgimtas kurtumas. Vienas iš būdų padėti klausos negalią turintiems asmenims reabilituotis ir integruotis į visuomenę - tai kochlearinės implantacijos. Pirmoji kochlearinė implantacija ne tik Lietuvoje, bet ir Baltijos šalyse atlikta 1999 metais. Šiuo metu Lietuvoje yra operuoti, 75 vaikai. Mūsų darbo naujumą sudaro tai, kad šis darbas vienas pirmųjų tokio pobūdžio darbų Lietuvoje. Darbo tikslas – išanalizuoti kochlearinio implanto reikšmę žymiai neprigirdinčių ir kurčių vaikų santykių su aplinka pokyčiams. Tyrimo tikslui įgyvendinti sprendžiami šie pagrindiniai uždaviniai: 1. Išsiaiškinti ar tiriami vaikai naudojosi individualiais klausos aparatais iki implantacijos. 2. Išanalizuoti ugdymo įstaigos pasirinkimą priklausomai nuo to, kada buvo atlikta implantacija, iki šešerių metų ir jau sulaukus šešerių metų amžiaus. 3. Ištirti vaikų santykių su aplinkiniais ir bendraamžiais pokyčius iki ir po kochlearinės... [toliau žr. visą tekstą] / Though the Cochlear implantation is an extremely effective prosthetic appliance for the treatment of hard of hearing people, the analysis of the impact of Cochlear implant to the changes of considerably hard of hearing and deaf children relationship with environment required lots of efforts, because this kind of children integration to society is rather new in Lithuania and there is a lack of investigations. Hearing is among the main people communication means which they use for acquiring the world they live in. According to statistics, approximately 35 children are born per annum with the diagnosis of deafness. Thus, Cochlear implantation is one of the ways to help people with hearing disability to rehabilitate and integrate into society. In 1999 the first Cochlear implantation has been performed not only in Lithuania but also in Baltic states. Up till now 75 children have been operated. The novelty of our work is composed since it is one of the first works of this kind in Lithuania. The objective of this paper is to analyze the significance of Cochlear implant to the changes of considerably hard of hearing and deaf children relationship with environment. For the implementation of the objective, the paper has been solving the following exercises: 1. To discover whether the inquiring children have been using their individual hearing-aids till implantation. 2. To analyze the choice of educational institution without reference to the time the implantation has been... [to full text]