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Hearing loss and cognitive impairment are significant health problems, threatening the independent function of older adults. While there appears to be a strong relationship between the two conditions, the mechanisms underlying this association are complex and are not fully elucidated. The purpose of this secondary analysis was to explore the relationship between hearing ability and cognitive performance in older adults. In addition, this study attempted to examine the role of depressive symptoms in the relationship between hearing loss and cognitive performance. Comprehensive measures of peripheral hearing, central auditory processing and cognitive performance were utilized to examine these relationships in a sample (N = 30) of adults aged 60 years and older. The Geriatric Depression Scale (GDS) was used to assess depressive symptoms. Correlational analyses revealed a statistically significant relationship between central auditory processing and executive function. Statistically significant relationships were also observed between speed of processing and peripheral hearing as well as central auditory processing. No significant relationships were noted between depressive symptoms, hearing acuity and cognitive performance. While the correlation coefficients (r) for several of the hearing and cognitive performance measures were not statistically significant, medium effect sizes were detected, suggesting a moderate association may exist between these variables.

Doctor of Philosophy / This study addresses the situation of adults who become deafblind. To date, their everday lives have received little attention in the research literature. Of the few studies conducted many involve surveys, the findings of which present the characteristics of people who are deafblind such as their rates of employment, need for support, or use of equipment. There are also a small number of qualitative studies that have explored the effects of having dual sensory impairment, and particularly in relation to communication and psycho-social wellbeing. Important as these research efforts have been, there is little empirical information available about the everyday lives of people who become deafblind and their concerns, nor any systematic attempt to theorise their experiences. There are however many personal anecdotes typically presented at conferences or through community publications and newsletters. This project aimed to redress the gap in the literature by developing a theoretical framework to explain the everyday experiences of adult who become deafblind. In doing so, it built upon the research and anecdotal literature with an overall purpose of presenting, through rigorous research, the experiences of adults who become deafblind and to do so within the broader discourse on disability and disablism. The study was informed by the social relational understanding of disability developed within the Nordic countries. Grounded theory was the method of choice to examine the lives of adults who become deafblind from their own perspective.Participant observation was employed through direct engagement in shared experiences with adults who have become deafblind both at a social group and via an e-mail list group. Mulitple in-depth interviews were undertaken both face to face and by e-mail with a smaller group of eight participants.The core finding from this study is that people who become deafblind are rendered interactionally powerless in a society predicated on seeing and hearing. The powerlessness that they experience comes from having this dual impairment in a world in which being able to see and hear are expected both in the physical and social environment. The inability of people who become deafblind to 'know and be' in the world in the same way as others results in them feeling, and experienceing, interactional powerlessness. In response, people who become deafblind actively engage in trying to minimise or remove their powerlessness. They do so by working to negotiate a place in this hostile world. They adopt four interrelated strategies, namely, doing things differently, managing support relationships, survivings others' perceptions and presenting sides of self.This study, with its central tenet that interactional powerlessness drives ongoing attempts to negotiate a place makes a theoretical contribution to understanding the experience of becoming deafblind. The findings support the concept of disbaility as social relational. Disability is not the same as the sensory impairment, rather it is expressed in the organisation of personal relations in society which render some more powerful than others and in this case, some less powerful due to their inability to use the natural means of communication of hearing and sight. Moreover, the study findings propose that professionals working with people with this dual sensory impairment must endeavour to reduce their part in the hostile world by providing information about options and support available; recognising the complexity of these adults support requirements; and considering the link between psycho-emotional issues and disablism. Further research is needed to understand empirically and theoretically the relative contribution of personal relationships vis a vis organisational or structural relationships in disabling people who become deafblind.

Doctor of Philosophy / This study addresses the situation of adults who become deafblind. To date, their everday lives have received little attention in the research literature. Of the few studies conducted many involve surveys, the findings of which present the characteristics of people who are deafblind such as their rates of employment, need for support, or use of equipment. There are also a small number of qualitative studies that have explored the effects of having dual sensory impairment, and particularly in relation to communication and psycho-social wellbeing. Important as these research efforts have been, there is little empirical information available about the everyday lives of people who become deafblind and their concerns, nor any systematic attempt to theorise their experiences. There are however many personal anecdotes typically presented at conferences or through community publications and newsletters. This project aimed to redress the gap in the literature by developing a theoretical framework to explain the everyday experiences of adult who become deafblind. In doing so, it built upon the research and anecdotal literature with an overall purpose of presenting, through rigorous research, the experiences of adults who become deafblind and to do so within the broader discourse on disability and disablism. The study was informed by the social relational understanding of disability developed within the Nordic countries. Grounded theory was the method of choice to examine the lives of adults who become deafblind from their own perspective.Participant observation was employed through direct engagement in shared experiences with adults who have become deafblind both at a social group and via an e-mail list group. Mulitple in-depth interviews were undertaken both face to face and by e-mail with a smaller group of eight participants.The core finding from this study is that people who become deafblind are rendered interactionally powerless in a society predicated on seeing and hearing. The powerlessness that they experience comes from having this dual impairment in a world in which being able to see and hear are expected both in the physical and social environment. The inability of people who become deafblind to 'know and be' in the world in the same way as others results in them feeling, and experienceing, interactional powerlessness. In response, people who become deafblind actively engage in trying to minimise or remove their powerlessness. They do so by working to negotiate a place in this hostile world. They adopt four interrelated strategies, namely, doing things differently, managing support relationships, survivings others' perceptions and presenting sides of self.This study, with its central tenet that interactional powerlessness drives ongoing attempts to negotiate a place makes a theoretical contribution to understanding the experience of becoming deafblind. The findings support the concept of disbaility as social relational. Disability is not the same as the sensory impairment, rather it is expressed in the organisation of personal relations in society which render some more powerful than others and in this case, some less powerful due to their inability to use the natural means of communication of hearing and sight. Moreover, the study findings propose that professionals working with people with this dual sensory impairment must endeavour to reduce their part in the hostile world by providing information about options and support available; recognising the complexity of these adults support requirements; and considering the link between psycho-emotional issues and disablism. Further research is needed to understand empirically and theoretically the relative contribution of personal relationships vis a vis organisational or structural relationships in disabling people who become deafblind.

Title: Theoretical knowledge of first aid of pupils with hearing impairment educated by different communicational approach. Objectives: The purpose of this diploma thesis is to compare the level of theoretical knowledge concerning the first aid at schools for pupils with hearing impairment depending on main communicational approach. The partial goal is to determine if there is a connection between subjective evaluation of first aid knowledge, the ability to provide the first aid and the theoretical knowledge itself. Methods: Questionnaire containing 14 questions was used to determine pupils' knowledge. It was distributed in three elementary schools for hearing impaired children. The aiming group were pupils from the 9th and 10th grade of elementary school. Altogether 18 respondents from 3 elementary schools (X, Y and Z) participated in the research. There were 5 pupils in each class at schools X and Y, and both schools used bilingual communication as the education method, the questionnaire was translated into sign language there. At school Z there were 8 pupils and they were educated by the oral method. Data were converted into electronic form and graphically processed in the program Numbers. Results: Pupils educated at school favoring an oral communication approach achieved 12% better results in...

Background Sensory impairments have been associated with dementia in older adults. However, the contribution of different impairments and how they interact in the development of dementia is not clear. We examined the independent and interaction effects of hearing impairment (HI) and visual impairment (VI) on incident dementia. Design Multi-centric population-based prospective cohort study. Setting Data were taken from the AgeDifferent.de platform, pooling participants aged 75 and older from the German LEILA75+ and AgeCoDe/AgeQualiDe cohorts. Participants Older adults (N = 3497) with mean age 79.8 years, 67.2% female. Measurements Standardized interviews and questionnaires were used to assess self-reported HI and VI at baseline and all-cause dementia in 9 follow-ups, spanning over 20 years. Methods Competing risk regression models were conducted to test the main and interaction effects of HI and VI on dementia incidence, adjusting for established risk factors of dementia and accumulated mortality. Results HI and VI at baseline were reported by 30.3% and 16.6% of individuals, respectively. Adjusting for baseline information on sociodemographics, substance use, cognitive functioning and morbidity, and controlling for accumulated mortality risk, HI (sHR 1.16, 95% CI 1.04–1.30, p = 0.011) but not VI (sHR 1.07, 95% CI 0.90–1.28, p = 0.462) was significantly associated with incident dementia. There was no interaction between HI and VI (sHR 1.09, 95% CI 0.81–1.46, p = 0.567). Conclusions Hearing impairment is associated with an increased incidence of all-cause dementia in older adults. There is no excess risk or risk compensation through the additional presence or absence of visual impairment. Early prevention measures for hearing impairment might help to reduce the long-term risk of dementia.

O objetivo desta dissertação foi o de identificar as orientações e estratégias, utilizadas com as famílias no atendimento em ambiente domiciliar, que ajudaram seus filhos com surdocegueira ou com deficiência múltipla sensorial a alcançarem habilidades em atividades de vida autônoma e social (Avas). A fundamentação teórica refere-se à caracterização da pessoa com surdocegueira e deficiência múltipla sensorial, suas dificuldades de comunicação e participação; às metodologias que orientam a avaliação e organização de programas educacionais; à caracterização e necessidades das famílias; à programas baseados em Avas. Os participantes da pesquisa foram dois alunos e suas mães atendidos no Programa de Atendimento Domiciliar e Famílias Apoiadas (Programa AD & FA), da Ahimsa. Os critérios de seleção dos sujeitos foram: semelhanças nas características devidas à etiologia da deficiência, Síndrome da Rubéola Congênita (SRC) e alterações de comportamentos causados pelas manifestações tardias da (SRC); similaridade da faixa etária, jovens entre 22 e 23 anos. Para a coleta de dados foram realizadas dez visitas domiciliares para cada família no período de fevereiro a setembro de 2009, nas quais foram desenvolvidas atividades em Avas e elaborados relatórios das observações; foram realizadas no final dos atendimentos entrevistas semi-estruturadas com as mães. Foram elencadas as estratégias que efetivaram a participação do aluno e os fatores que constituíram auxílio ou dificuldade para as mães efetivarem ou não as estratégias, por meio da análise dos dados realizada em cinco etapas: 1) elaboração de quadros dos registros dos comportamentos/participação e dos comportamentos comunicativos dos alunos nas atividades no primeiro atendimento; 2) elaboração de quadros dos registros dos comportamentos/participação e dos comportamentos comunicativos dos alunos nas atividades no último atendimento; 3) discussão sobre as diferenças, evolução e outras variações (apresentadas nas participações e na comunicação, assim como na aquisição de autonomia e independência) na execução das atividades, amparado nos quadros da etapa 1 e etapa 2 e nos relatórios das observações das visitas; 4) análise dos relatos e entrevistas das mães assinalando as necessidades e expectativas levantadas, as estratégias que foram efetivadas pelas mães que melhoraram a participação e a comunicação dos alunos e os fatores que levaram as famílias a implementarem ou não as estratégias; 5) reflexões sobre os dados da discussão da etapa 3 e as consonâncias e divergências com a análise da etapa 4. A análise dos dados mostrou os maiores ganhos na comunicação e participação dos alunos nas atividades propostas nas visitas e no dia a dia, também evidenciou as estratégias que trouxeram maiores resultados durante a realização das atividades e ajudaram a melhorar a participação dos alunos, como a adoção e efetivação pelas mães da: implementação de rotina e manutenção de sequências nas atividades, organização das atividades realizadas, organização de utensílios e materiais utilizados, sistematização e implementação de formas de comunicação expressivas e receptivas. A investigação assinalou dificuldades das famílias, para a implementação de algumas orientações e estratégias, devido a questões relacionadas a condições de saúde e a distúrbios de comportamentos de seus filhos. O período bastante exíguo de atendimento, de apenas dez sessões e número de somente dois jovens e suas mães constituíram limites a esta investigação, assinalando a necessidade de dar continuidade aos estudos com mais dados, mais sujeitos e maior tempo para a pesquisa. Apesar disso, a pesquisadora propõe-se a divulgar estes dados por meio de publicações, considerando a inexistência de dados 10 sistematizados e analisados sobre o atendimento domiciliar a pessoas com surdocegueira e com deficiência múltipla sensorial. / The objective of this thesis was to identify the orientations and strategies used with families at home visits that have helped their children with deafblindness or with multiple sensory impairment to develop skills in daily living activities. The theoretical basis refer to the characterization of the person with deafblindness and multiple sensory impaired, their difficulties with communication and participation; to the methodologies that guide the evaluation and organization of educational programs; to the characterization and needs of the families; to programs based on daily living activities. The participants were two students and their mothers enrolled in the Home Visit & Supported Families Program (Program AD & FA), of Ahimsa. The criteria to select the participants were: similarities in the characteristics due to etiology of the disability, Congenital Rubella Syndrome (CRS) and behavior alterations caused by the late manifestations of the CRS; similarity of age group, young adults between 22 and 23 years old. To data collection there were performed 10 home visits to each family in the period of February to September 2009, in which daily living skills activities were developed and observations reports were made; towards the end of the visits semi-structured interviews were carried out with the mothers. The strategies that promoted the participation of the student were listed and the factors that either contributed or made difficult for mothers to promote or not the strategies, through analysis of the data collected in five steps: 1) creation of the tables to record behavior/participation and the communicative behaviors of students in the activities at the first home visit; 2) creation of the tables to record behavior/participation and the communicative behaviors of students in the activities at the last home visit; 3) discussion on the differences, evolution and other variations (presented in the participations and in communication, as well as in the acquisition of independence and autonomy) in the execution of activities, based on the tables of steps 1 and 2 and on the observations reports of the home visits; 4) analysis of reports and interview of the mothers pointing out the needs and expectations raised, the strategies that were used by the mothers that have improved the participation and communication of the students and the factors that led families to implement or not the strategies; 5) reflections on the data of the discussion from step 3 and the similarities and differences with the analysis of step 4. Data analysis showed the benefits in communication and participation of students in the daily living activities proposed during the home visits and day-by-day, in addition, it has showed which strategies brought better results during the performance of the activities and helped improve the participation of the students, as the adoption and use by mothers of: routine implementation and maintenance of sequences in the activities, organization of the activities done, organization of materials used, systematization and implementation of means of expressive and receptive communication. The research pointed out difficulties of families, to implement some orientations and strategies, due to matters related to health conditions and challenging behaviors of their children. The short period of time of the home visits, only 10 sessions, and the number of only two young adults and their mothers were limitations found in this research, pointing out the need to carry on with the studies with more data, more participants and more time for the research. Nevertheless, the researcher proposes to divulge these data through publications, 12 considering the lack of systematized and analyzed data on home visits of people with deafblindness and multiple sensory impairment.

O objetivo desta dissertação foi o de identificar as orientações e estratégias, utilizadas com as famílias no atendimento em ambiente domiciliar, que ajudaram seus filhos com surdocegueira ou com deficiência múltipla sensorial a alcançarem habilidades em atividades de vida autônoma e social (Avas). A fundamentação teórica refere-se à caracterização da pessoa com surdocegueira e deficiência múltipla sensorial, suas dificuldades de comunicação e participação; às metodologias que orientam a avaliação e organização de programas educacionais; à caracterização e necessidades das famílias; à programas baseados em Avas. Os participantes da pesquisa foram dois alunos e suas mães atendidos no Programa de Atendimento Domiciliar e Famílias Apoiadas (Programa AD & FA), da Ahimsa. Os critérios de seleção dos sujeitos foram: semelhanças nas características devidas à etiologia da deficiência, Síndrome da Rubéola Congênita (SRC) e alterações de comportamentos causados pelas manifestações tardias da (SRC); similaridade da faixa etária, jovens entre 22 e 23 anos. Para a coleta de dados foram realizadas dez visitas domiciliares para cada família no período de fevereiro a setembro de 2009, nas quais foram desenvolvidas atividades em Avas e elaborados relatórios das observações; foram realizadas no final dos atendimentos entrevistas semi-estruturadas com as mães. Foram elencadas as estratégias que efetivaram a participação do aluno e os fatores que constituíram auxílio ou dificuldade para as mães efetivarem ou não as estratégias, por meio da análise dos dados realizada em cinco etapas: 1) elaboração de quadros dos registros dos comportamentos/participação e dos comportamentos comunicativos dos alunos nas atividades no primeiro atendimento; 2) elaboração de quadros dos registros dos comportamentos/participação e dos comportamentos comunicativos dos alunos nas atividades no último atendimento; 3) discussão sobre as diferenças, evolução e outras variações (apresentadas nas participações e na comunicação, assim como na aquisição de autonomia e independência) na execução das atividades, amparado nos quadros da etapa 1 e etapa 2 e nos relatórios das observações das visitas; 4) análise dos relatos e entrevistas das mães assinalando as necessidades e expectativas levantadas, as estratégias que foram efetivadas pelas mães que melhoraram a participação e a comunicação dos alunos e os fatores que levaram as famílias a implementarem ou não as estratégias; 5) reflexões sobre os dados da discussão da etapa 3 e as consonâncias e divergências com a análise da etapa 4. A análise dos dados mostrou os maiores ganhos na comunicação e participação dos alunos nas atividades propostas nas visitas e no dia a dia, também evidenciou as estratégias que trouxeram maiores resultados durante a realização das atividades e ajudaram a melhorar a participação dos alunos, como a adoção e efetivação pelas mães da: implementação de rotina e manutenção de sequências nas atividades, organização das atividades realizadas, organização de utensílios e materiais utilizados, sistematização e implementação de formas de comunicação expressivas e receptivas. A investigação assinalou dificuldades das famílias, para a implementação de algumas orientações e estratégias, devido a questões relacionadas a condições de saúde e a distúrbios de comportamentos de seus filhos. O período bastante exíguo de atendimento, de apenas dez sessões e número de somente dois jovens e suas mães constituíram limites a esta investigação, assinalando a necessidade de dar continuidade aos estudos com mais dados, mais sujeitos e maior tempo para a pesquisa. Apesar disso, a pesquisadora propõe-se a divulgar estes dados por meio de publicações, considerando a inexistência de dados 10 sistematizados e analisados sobre o atendimento domiciliar a pessoas com surdocegueira e com deficiência múltipla sensorial. / The objective of this thesis was to identify the orientations and strategies used with families at home visits that have helped their children with deafblindness or with multiple sensory impairment to develop skills in daily living activities. The theoretical basis refer to the characterization of the person with deafblindness and multiple sensory impaired, their difficulties with communication and participation; to the methodologies that guide the evaluation and organization of educational programs; to the characterization and needs of the families; to programs based on daily living activities. The participants were two students and their mothers enrolled in the Home Visit & Supported Families Program (Program AD & FA), of Ahimsa. The criteria to select the participants were: similarities in the characteristics due to etiology of the disability, Congenital Rubella Syndrome (CRS) and behavior alterations caused by the late manifestations of the CRS; similarity of age group, young adults between 22 and 23 years old. To data collection there were performed 10 home visits to each family in the period of February to September 2009, in which daily living skills activities were developed and observations reports were made; towards the end of the visits semi-structured interviews were carried out with the mothers. The strategies that promoted the participation of the student were listed and the factors that either contributed or made difficult for mothers to promote or not the strategies, through analysis of the data collected in five steps: 1) creation of the tables to record behavior/participation and the communicative behaviors of students in the activities at the first home visit; 2) creation of the tables to record behavior/participation and the communicative behaviors of students in the activities at the last home visit; 3) discussion on the differences, evolution and other variations (presented in the participations and in communication, as well as in the acquisition of independence and autonomy) in the execution of activities, based on the tables of steps 1 and 2 and on the observations reports of the home visits; 4) analysis of reports and interview of the mothers pointing out the needs and expectations raised, the strategies that were used by the mothers that have improved the participation and communication of the students and the factors that led families to implement or not the strategies; 5) reflections on the data of the discussion from step 3 and the similarities and differences with the analysis of step 4. Data analysis showed the benefits in communication and participation of students in the daily living activities proposed during the home visits and day-by-day, in addition, it has showed which strategies brought better results during the performance of the activities and helped improve the participation of the students, as the adoption and use by mothers of: routine implementation and maintenance of sequences in the activities, organization of the activities done, organization of materials used, systematization and implementation of means of expressive and receptive communication. The research pointed out difficulties of families, to implement some orientations and strategies, due to matters related to health conditions and challenging behaviors of their children. The short period of time of the home visits, only 10 sessions, and the number of only two young adults and their mothers were limitations found in this research, pointing out the need to carry on with the studies with more data, more participants and more time for the research. Nevertheless, the researcher proposes to divulge these data through publications, 12 considering the lack of systematized and analyzed data on home visits of people with deafblindness and multiple sensory impairment.

O objetivo deste trabalho é empreender uma análise de um campo discursivo das práticas que conferem à surdez o estatuto de particularidade linguística e cultural. Para tanto, foi realizada pesquisa etnográfica em espaços caracterizados pela presença de sistemas de comunicação gestuais-visuais normatizados sob a forma da Língua Brasileira de Sinais (LIBRAS). Atentou-se também a aspectos históricos relativos à surdez e a formas disciplinares constitutivas da LIBRAS. Acompanhar o percurso de líderes surdos em espaços variados foi fundamental para revelar uma normatividade na qual a surdez é afirmada e performatizada em termos de língua e cultura. Ao mesmo tempo são constituídas tensões, disputas e lutas em torno dessa normatividade. Categorias identitárias, tais como cultura surda e comunidade surda, são constantemente mobilizadas por profissionais que atuam em defesa da libras e são referidas sobretudo a sujeitos classificados como surdos . Constatou-se, enfim, que líderes surdos ocupam posição de destaque ao atuarem como porta-vozes da coletividade linguística falante de libras. / The objective of this work is to analyze a discursive field of practices that grants deafness a status of linguistic and cultural particularity. For this purpose, ethnographic research was conducted in spaces characterized by the presence of gestural-visual communication systems normalized in the form of the Brazilian Sign Language (LIBRAS). Research on historical aspects regarding deafness and integral disciplinary forms of LIBRAS was also undertaken. Following the course of deaf leaders in varied spaces was crucial in revealing a normativity in which deafness is affirmed and performed in terms of language and culture. At the same time, tensions, disputes and struggles are formed around this normativity. Identifying categories, such as deaf culture and deaf community, are constantly mobilized by professionals that act in defense of LIBRAS and are referenced primarily in terms of subjects classified as deaf. Ultimately, it was determined that deaf leaders occupy a prominent position in acting as spokespeople for the linguistic collective of LIBRAS speakers.

O objetivo deste trabalho é empreender uma análise de um campo discursivo das práticas que conferem à surdez o estatuto de particularidade linguística e cultural. Para tanto, foi realizada pesquisa etnográfica em espaços caracterizados pela presença de sistemas de comunicação gestuais-visuais normatizados sob a forma da Língua Brasileira de Sinais (LIBRAS). Atentou-se também a aspectos históricos relativos à surdez e a formas disciplinares constitutivas da LIBRAS. Acompanhar o percurso de líderes surdos em espaços variados foi fundamental para revelar uma normatividade na qual a surdez é afirmada e performatizada em termos de língua e cultura. Ao mesmo tempo são constituídas tensões, disputas e lutas em torno dessa normatividade. Categorias identitárias, tais como cultura surda e comunidade surda, são constantemente mobilizadas por profissionais que atuam em defesa da libras e são referidas sobretudo a sujeitos classificados como surdos . Constatou-se, enfim, que líderes surdos ocupam posição de destaque ao atuarem como porta-vozes da coletividade linguística falante de libras. / The objective of this work is to analyze a discursive field of practices that grants deafness a status of linguistic and cultural particularity. For this purpose, ethnographic research was conducted in spaces characterized by the presence of gestural-visual communication systems normalized in the form of the Brazilian Sign Language (LIBRAS). Research on historical aspects regarding deafness and integral disciplinary forms of LIBRAS was also undertaken. Following the course of deaf leaders in varied spaces was crucial in revealing a normativity in which deafness is affirmed and performed in terms of language and culture. At the same time, tensions, disputes and struggles are formed around this normativity. Identifying categories, such as deaf culture and deaf community, are constantly mobilized by professionals that act in defense of LIBRAS and are referenced primarily in terms of subjects classified as deaf. Ultimately, it was determined that deaf leaders occupy a prominent position in acting as spokespeople for the linguistic collective of LIBRAS speakers.