Feasibility of early activation after cochlear implantation.

OBJECTIVES: The purpose of the study is to investigate feasibility of early activation after cochlear implantation by evaluating long-term impedance change and speech perception. DESIGN: Case-control study SETTING: Between July 2015 and December 2016, we prospectively enrolled 20 subjects for early activation (within 24 hours after cochlear implantation). On the other hand, from November 2013 to July 2015, 20 age- and sex-matched control subjects from the database of cochlear implantees treated with conventional activation schedule (4 weeks after surgery) were retrospectively enrolled. PARTICIPANT: Forty patients who underwent cochlear implantation surgeries. MAIN OUTCOME MEASURES: The series impedance and speech perception score of both groups were compared. RESULTS: No statistical difference in long-term follow-up between the two groups was found using GEEs and multivariate analysis. In the early activation group, impedance reached a steady level by the 2nd postoperative week, and the hearing perception ability significantly improved by the 4th postoperative week. CONCLUSION: This comparative study illustrated sequential impedance data during early activation (24 hours) and conventional activation (4 weeks) after CI surgery. There were no major complications in either group, and the safety of early activation with respect to impedance changes, postoperative residual hearing preservation and speech perception scores were non-inferior to that of the conventional group. Therefore, in this study, we established the feasibility of early activation 24 hours after cochlear implantation.

Estado actual de la atención sanitaria de personas con discapacidad auditiva y visual: una revisión breve / Health care of people with visual or hearing disabilities

Visual or hearing disabilities account for 20% of people reporting some sort of disability. We performed a literature review about the interaction that people with visual or hearing disabilities have with the health care system. We found that these people report a lower quality of life and have a higher frequency of physical and psychological ailments. They also have difficulties to obtain an adequate health care and report a paucity of trained professionals to take care of them.

Deliberate self-harm among children with disabilities in China: a matched case-control study.

BACKGROUND: Study about deliberate self-harm (DSH) in children with different types of disabilities was scarce. This study compared the incidence and patterns of DSH between children with and without disabilities aged 6-17 years using a matched case-control study in Beijing. METHODS: A total of 650 pairs of children with and without disabilities were surveyed. Characteristics of latest episode of self-harm within the 12 months were compared. Associations between disability status, sociodemographic factors, smoking, drinking, sleep problems, and self-harm were examined. RESULTS: Children with disabilities showed significant higher incidence of DSH than children without disabilities. Two groups differed significantly in terms of self-harm methods, body parts injured, premeditation, wishing to be known by others and help-seeking behavior. The adjusted OR for self-harm was 4.76 (2.99-7.55) for children with disabilities compared with children without disabilities. Children who slept fewer than 6 h per night, had difficulty falling asleep at night sometimes/often, and went to sleep after midnight 1 to 3 nights per month or at least once a week were at elevated risk of self-harm. CONCLUSION: This study highlights a strong relationship between disability, sleep problems, and DSH. Interventions to reduce self-harm should target disability and sleep problems as important risk factors.

Negative hearing effects of a single course of IV aminoglycoside therapy in cystic fibrosis patients.

OBJECTIVE: Identify hearing effects of a single course of intravenous (IV) aminoglycoside antibiotics (AGs) therapy in adult cystic fibrosis (CF) patients. Determine whether the change is large enough to enable a proof-of-concept study of a new drug preventing AG-associated hearing loss. DESIGN: Retrospective case review of CF patients with sequential audiograms ± an intervening course of IV AG therapy. STUDY SAMPLE: 84 patients with no intervening IV AG treatment, 38 patients undergoing a single course of IV AGs. RESULTS: Using ASHA ototoxicity metrics, 45% of adult CF patients in the Single-IV group met the criteria for ototoxicity compared to 23% of the No-IV patients. Other hearing metrics including the average maximal threshold shift (TS) and average high frequency TS showed highly significant differences between groups. Testing only participants with mild or greater pre-therapy high frequency hearing loss further increased the differences between the two groups by every metric tested. CONCLUSION: Adult CF patients exposed to a single course of IV AGs have significantly greater TS than patients without IV AG exposure. Patients with mild to moderate hearing loss prior to AG-IVs are at increased risk of developing ototoxicity from subsequent parenteral AG therapy.

In Their Own Words: Caregiver and Patient Perspectives on Stressors, Resources, and Recommendations in Craniofacial Microsomia Care.

This study describes stressors, resources, and recommendations related to craniofacial microsomia (CFM) care from the perspective of caregivers of children with CFM and adults with CFM to inform improved quality of healthcare delivery. A mixed method design was used with fixed-response and open-ended questions from an online survey in English. The survey included demographics, CFM phenotypic information, and items about CFM-related experiences across settings. Themes were identified by qualitative analysis of responses to open-ended questions. Respondents (n = 51) included caregivers (n = 42; 90% mothers) and adults with CFM (n = 9; 78% female), who had a mean age of 45 ±â€Š6 years. Most children were male (71%) with an average age of 7 ±â€Š4 years. Respondents were primarily white (80%), non-Hispanic (89%), from the United States (82%), had a college degree (80%), and had private health insurance (80%). Reflecting the high rate of microtia (84%) in the sample, themes centered on the impact of hearing difficulties across settings with related language concerns. Negative social experiences were frequently described and school needs outlined. Multiple medical stressors were identified and corresponding suggestions included: providers need to be better informed about CFM, treatment coordination among specialists, and preference for a family-centered approach with reassurance, empathy, and clear communication. Advice offered to others with CFM included positive coping strategies. Overall, caregivers' and patients' responses reflected the complexity of CFM treatment. Incorporating these perspectives into routine CFM care has the potential to reduce family distress while improving their healthcare.

Familial misophonia or selective sound sensitivity syndrome: evidence for autosomal dominant inheritance? / Misofonia familiar ou síndrome da sensibilidade seletiva a sons: evidência de herança autossômica dominante?

Abstract Introduction: Misophonia is a recently described, poorly understood and neglected condition. It is characterized by strong negative reactions of hatred, anger or fear when subjects have to face some selective and low level repetitive sounds. The most common ones that trigger such aversive reactions are those elicited by the mouth (chewing gum or food, popping lips) or the nose (breathing, sniffing, and blowing) or by the fingers (typing, kneading paper, clicking pen, drumming on the table). Previous articles have cited that such individuals usually know at least one close relative with similar symptoms, suggesting a possible hereditary component. Objective: We found and described a family with 15 members having misophonia, detailing their common characteristics and the pattern of sounds that trigger such strong discomfort. Methods: All 15 members agreed to give us their epidemiological data, and 12 agreed to answer a specific questionnaire which investigated the symptoms, specific trigger sounds, main feelings evoked and attitudes adopted by each participant. Results: The 15 members belong to three generations of the family. Their age ranged from 9 to 73 years (mean 38.3 years; median 41 years) and 10 were females. Analysis of the 12 questionnaires showed that 10 subjects (83.3%) developed the first symptoms during childhood or adolescence. The mean annoyance score on the Visual Analog Scale from 0 to 10 was 7.3 (median 7.5). Individuals reported hatred/anger, irritability and anxiety in response to sounds, and faced the situation asking to stop the sound, leaving/avoiding the place and even fighting. The self-reported associated symptoms were anxiety (91.3%), tinnitus (50%), obsessive-compulsive disorder (41.6%), depression (33.3%), and hypersensitivity to sounds (25%). Conclusion: The high incidence of misophonia in this particular familial distribution suggests that it might be more common than expected and raises the possibility of having a hereditary etiology.

Resumo Introdução: A misofonia é uma condição recentemente descrita, mal compreendida e negligenciada. É caracterizada por fortes reações negativas de ódio, raiva ou medo quando os indivíduos precisam enfrentar alguns sons repetitivos seletivos e de baixa intensidade. Os mais comuns que desencadeiam tais reações aversivas são aqueles provocados pela boca (mascar goma ou mastigar comida, estalar os lábios) ou nariz (respirando, cheirando e soprando) ou pelos dedos (digitando, amassando papel, clicando a caneta, tamborilando na mesa). Artigos anteriores citam que esses indivíduos geralmente conhecem pelo menos um parente próximo com sintomas semelhantes, sugerindo um possível componente hereditário. Objetivo: Encontramos e descrevemos uma família com 15 membros com misofonia, detalhando suas características comuns e o padrão de sons que desencadeiam um desconforto tão forte. Método: Todos os 15 membros concordaram em nos fornecer seus dados epidemiológicos e 12 concordaram em responder a um questionário específico que investigou os sintomas, sons de gatilho específicos, principais sentimentos evocados e atitudes adotadas por cada participante. Resultados: Os 15 membros pertencem a três gerações da família. A idade variou de 9 a 73 anos (média de 38,3 anos, mediana de 41 anos) e 10 eram mulheres. A análise dos 12 questionários mostrou que 10 indivíduos (83,3%) desenvolveram os primeiros sintomas durante a infância ou a adolescência. A média do escore de irritação na Escala Visual Analógica de 0 a 10 foi de 7,3 (mediana 7,5). Os indivíduos relataram sentimentos de ódio/raiva, irritabilidade e ansiedade em resposta a sons, e enfrentaram a situação pedindo para interromper o som, deixando/evitando o lugar e até mesmo discutindo. Os sintomas associados auto-relatados foram ansiedade (91,3%), zumbido (50%), transtorno obsessivo-compulsivo (41,6%), depressão (33,3%) e hipersensibilidade aos sons (25%). Conclusão: A alta incidência de misofonia nessa distribuição familiar em particular sugere que possa ser mais comum do que o esperado e suscita a possibilidade de haver uma etiologia hereditária.

Profile Analysis of Psychological Symptoms Associated With Misophonia: A Community Sample.

Misophonia is characterized by extreme aversive reactions to certain classes of sounds. It has recently been recognized as a condition associated with significant disability. Research has begun to evaluate psychopathological correlates of misophonia. This study sought to identify profiles of psychopathology that characterize misophonia in a large community sample. A total of N = 628 adult participants completed a battery of measures assessing anxiety and anxiety sensitivity, depression, stress responses, anger, dissociative experiences, obsessive-compulsive symptoms and beliefs, distress tolerance, bodily perceptions, as well as misophonia severity. Profile Analysis via Multidimensional Scaling (PAMS) was employed to evaluate profiles associated with elevated misophonia and those without symptoms. Three profiles were extracted. The first two accounted for 70% total variance and did not show distinctions between groups. The third profile accounted for 11% total variance, and showed that misophonia is associated with lower obsessive-compulsive symptoms for neutralizing, obsessions generally, and washing compared to those not endorsing misophonia, and higher levels of obsessive-compulsive symptoms associated with ordering and harm avoidance. This third profile extracted also showed significant differences between those with and without misophonia on the scale assessing physical concerns (that is, sensitivity to interoceptive sensations) as assessed with the ASI-3. Further research is called for involving diagnostic interviewing and experimental methods to clarify these putative mechanisms associated with misophonia.

Use of Adult Patient Focus Groups to Develop the Initial Item Bank for a Cochlear Implant Quality-of-Life Instrument.

Importance: No instrument exists to assess quality of life (QOL) in adult cochlear implant (CI) users that has been developed and validated using accepted scientific standards. Objective: To develop a CI-specific QOL instrument for adults in accordance with the Patient Reported Outcomes Measurement Information System (PROMIS) guidelines. Design, Setting, and Participants: As required in the PROMIS guidelines, patient focus groups participated in creation of the initial item bank. Twenty-three adult CI users were divided into 1 of 3 focus groups stratified by word recognition ability. Three moderator-led focus groups were conducted based on grounded theory on December 3, 2016. Two reviewers independently analyzed focus group recordings and transcripts, with a third reviewer available to resolve discrepancies. All data were reviewed and reported according to the Consolidated Criteria for Reporting Qualitative Research. The setting was a tertiary referral center. Main Outcomes and Measures: Coded focus group data. Results: The 23 focus group participants (10 [43%] female; mean [range] age, 68.1 [46.2-84.2] years) represented a wide range of income levels, education levels, listening modalities, CI device manufacturers, duration of CI use, and age at implantation. Data saturation was determined to be reached before the conclusion of each of the focus groups. After analysis of the transcripts, the central themes identified were communication, emotion, environmental sounds, independence and work function, listening effort, social isolation and ability to socialize, and sound clarity. Cognitive interviews were carried out on 20 adult CI patients who did not participate in the focus groups to ensure item clarity. Based on these results, the initial QOL item bank and prototype were developed. Conclusions and Relevance: Patient focus groups drawn from the target population are the preferred method of identifying content areas and domains for developing the item bank for a CI-specific QOL instrument. Compared with previously used methods, the use of patient-centered item development for a CI-specific QOL instrument will more accurately reflect patient experience and increase our understanding of how CI use affects QOL.

Speech Recognition Outcomes After Cochlear Reimplantation Surgery.

This study compares speech recognition outcomes before and after cochlear reimplantation surgery, in relation to clinical factors known before and at time of surgery. Between 2006 and 2015, 2,055 adult cochlear implant surgeries were conducted at this center, of which 87 were reimplantation surgeries (4.2%). Speech recognition scores (SRS) assessed before and after reimplantation were available for 54 adults. Overall, SRS measured after reimplantation were similar to the best SRS obtained by the patient and greater than the last SRS measured before surgery. Additional complications were noted in the clinical files of all patients for which reimplantation was considered unsuccessful (16%).

Barriers to early cochlear implantation.

OBJECTIVE: Identify variables associated with paediatric access to cochlear implants (CIs). DESIGN: Part 1. Trends over time for age at CI surgery (N = 802) and age at hearing aid (HA) fitting (n = 487) were examined with regard to periods before, during, and after newborn hearing screening (NHS). Part 2. Demographic factors were explored for 417 children implanted under 3 years of age. Part 3. Pre-implant steps for the first 20 children to receive CIs under 12 months were examined. RESULTS: Part 1. Age at HA fitting and CI surgery reduced over time, and were associated with NHS implementation. Part 2. For children implanted under 3 years, earlier age at HA fitting and higher family socio-economic status were associated with earlier CI. Progressive hearing loss was associated with later CIs. Children with a Connexin 26 diagnosis received CIs earlier than children with a premature / low birth weight history. Part 3. The longest pre-CI steps were Step 1: Birth to diagnosis/identification of hearing loss (mean 16.43 weeks), and Step 11: MRI scans to implant surgery (mean 15.05 weeks) for the first 20 infants with CIs under 12 months. CONCLUSION: NHS implementation was associated with reductions in age at device intervention in this cohort.

Communication changes following non-glottic head and neck cancer management: The perspectives of survivors and carers.

PURPOSE: Head and neck cancer (HNC) survivors may experience functional changes to their voice, speech and hearing following curative chemoradiotherapy. However, few studies have explored the impact of living with such changes from the perspective of the HNC survivor and their carer. The current study employed a person-centred approach to explore the lived experience of communication changes following chemoradiotherapy treatment for HNC from the perspective of survivors and carers. METHOD: Participants included 14 survivors with non-glottic HNC and nine carers. All participants took part in in-depth interviews where they were encouraged to describe their experiences of living with and adjusting to communication changes following treatment. Interviews were analysed as a single data set. RESULT: Four themes emerged including: (1) impairments in communication sub-systems; (2) the challenges of communicating in everyday life; (3) broad ranging effects of communication changes; and (4) adaptations as a result of communication changes. CONCLUSION: These data confirm that communication changes following chemoradiotherapy have potentially negative psychosocial impacts on both the HNC survivor and their carer. Clinicians should consider the impact of communication changes on the life of the HNC survivor and their carer and provide adequate and timely education and management to address the needs of this population.

Problemas de la audición en el adulto mayor, factores asociados y calidad de vida: estudio SABE, Bogotá, Colombia / Hearing disorders in elderly people, associated factors and quality of life: SABE Study, Bogotá, Colombia

Introducción. El envejecimiento de la población es un fenómeno epidemiológico universal que conlleva un acentuado aumento de la expectativa de vida y al cual no somos ajenos. Las enfermedades concomitantes dependientes de la edad, entre ellas los problemas auditivos, son cada día más prevalentes e inciden notoriamente en la calidad de vida. Objetivo. Estimar la prevalencia de los problemas de audición, así como de los factores asociados y su efecto en la calidad de vida de los adultos mayores en Bogotá. Materiales y métodos. Se analizaron los datos del estudio SABE, Bogotá, en el curso del cual se entrevistó a 2.000 personas de 60 años o más en una muestra transversal probabilística por conglomerados (cobertura de 81,9 %). Se utilizó la variable "problemas en la audición" y se relacionó con los factores sociodemográficos, el uso de dispositivos auriculares, la percepción de la propia salud, las enfermedades concomitantes, la funcionalidad, la cognición y la calidad de vida, medida esta con la escala visual analógica del grupo EuroQOL ( EuroQoL-Visual Analogue Scale , EQ-VAS). Resultados. Se encontró una prevalencia de problemas de audición en 267 personas (13,5 %), de las cuales el 15 % utilizaba audífonos; dicha prevalencia fue mayor en aquellas de 75 o más años (46,1 %), en el nivel socioeconómico bajo (20,2 %) y entre analfabetas (19,3 %, p<0,05). Se encontró mayor prevalencia en las personas con depresión (20,2 %, p<0,001) y con hipertensión arterial (15 %, p<0,01). En aquellas con problemas de audición se encontró peor calidad de vida medida por la EQ-VAS (60,93±1,38 Vs . 71,75±0,45, p<0,0001). Cuando las personas usaban los audífonos, su calidad de vida mejoraba en comparación con la de quienes no los utilizaban (59,59±1,52, p<0,01). Conclusiones. Los problemas auditivos son relevantes en los adultos mayores e inciden notoriamente en su percepción de la calidad de vida, asociándose con otras situaciones clínicas, funcionales y cognoscitivas; sin embargo, el uso de audífonos revierte esta percepción.

Introduction: The aging of the population is a universal epidemiological phenomenon which is not unfamiliar to us and is accompanied by a marked increase of life expectancy. Age-dependent comorbidities, such as hearing disorders, are more prevalent and affect the quality of life in a noticeable manner. Objective: To estimate the prevalence of hearing disorders, of the associated factors and their impact on the quality of life of older adults in Bogota. Materials and methods: Data was taken from the Bogotá SABE Study, which included 2,000 individuals aged =60 years in a probabilistic cross-sectional study sampled by clusters (with 81.9% coverage). We used the "hearing disorders" variable relating it to socio-demographic variables, as well as to the use of hearing aids, the self-perceived health, the comorbidities, the functionality, the cognition and the quality of life as measured with the Visual Analog Scale of the EuroQol Group (EQ-VAS). Results: We found a prevalence of hearing disorders in 267 individuals (13.5%), of whom 15% used hearing aids. The frequency was higher in individuals aged =75 years (46.1%), in the low socioeconomic level (20.2%) and among illiterate people (19.3%, p<0.05). Regarding comorbidities, we found a higher prevalence in individuals suffering from depression (20.2%, p<0.001), and high blood pressure (15%, p<0.01). The quality of life was worse in individuals with hearing disorders, as measured with the EuroQol EQ-VAS (60.93 ± 1.38 vs. 71.75 ± 0.45, p< 0.0001), but it improved among those who used hearing aids as compared to those who did not use them (59.59 ± 1.52, p<0.01). Conclusions: Hearing disorders are relevant in elderly individuals and they affect their perceived quality of life in a noticeable manner. In addition, they are associated with other clinical, functional and cognitive problems. Nevertheless, the intervention with hearing aids reverses that perception.

Scalar position in cochlear implant surgery and outcome in residual hearing and the vestibular system.

OBJECTIVE: To evaluate the effect of the intracochlear electrode position on the residual hearing and VNG- and cVEMP responses. DESIGN: Prospective pilot study. STUDY SAMPLE: Thirteen adult patients who underwent unilateral cochlear implant surgery were examined with high-resolution rotational tomography after cochlear implantation. All subjects were also tested with VNG, and 12 of the subjects were tested with cVEMP and audiometry before and after surgery. RESULTS: We found that although the electrode was originally planned to be positioned inside the scala tympani, only 8 of 13 had full insertion into the scala tympani. Loss of cVEMP response occurred to the same extent in the group with full scala tympani positioning and the group with scala vestibuli involvement. There was a non-significant difference in the loss of caloric response and residual hearing between the two groups. Interscalar dislocation of the electrode inside the cochlea was observed in two patients. A higher loss of residual hearing could be seen in the group with electrode dislocation between the scalae. CONCLUSIONS: Our findings indicate that intracochlear electrode dislocation is a possible cause to loss of residual hearing during cochlear implantation but cannot be the sole cause of postoperative vestibular loss.

Audiometric screening of a population with intellectual disability.

OBJECTIVE: Evaluation of pure-tone audiometry (PTA) in hearing screening of a population with mild to profound intellectual disability (ID). DESIGN: PTA was performed at six frequencies at the screening level 20 dB HL. Referral criteria were threshold levels ≥ 25 dB HL at two or more frequencies for one ear or both. STUDY SAMPLE: 1478 participants aged 7-91 years were included. RESULTS: 1470 (99.5%) people cooperated in screening of which 1325 (90%) could be tested on both ears at all six frequencies. A majority, 987 (66.8%), performed ordinary PTA, 234 (15.8%) conditioned play audiometry, and 249 (16.9%) behavioural observation audiometry. Six hundred and sixty-nine (45%) passed and 809 (55%) failed according to referral criteria. Of those failing, 441 (54.5%) accepted referral to clinical evaluation. CONCLUSIONS: PTA with slight modifications is applicable for screening of a population with mild to profound intellectual disability. The most challenging and time-consuming activity is to introduce the test procedure in a way that reduces anxiety and establishes trust.

Patients perceive tonsil cancer as a strike at psycho-socially "vital organs".

INTRODUCTION: Tonsil cancer (TC) is a type of head and neck cancer (HNC) that is predominantly associated with infection with human papilloma virus (HPV). In Denmark, the incidence of HPV-related HNC has increased fivefold over the past three decades. HNC more often affects men than women, and HPV-related HNC tends to affect younger age groups than other HNCs. The present study examined the long-term health-related quality of life (QoL) in patients with TC. MATERIAL AND METHODS: A medical anthropological approach was applied using individual qualitative interviews with seven former TC patients. The participants included men and women who had undergone various treatments, i.e. radiation therapy, chemotherapy and operation. Data were analyzed using a narrative methodology. RESULTS: Treatment sequelae peaked within the first three months and included severe pain in the radiated area, nausea and fatigue. Within this period, patients were unable to eat solid food and often had difficulty speaking. Half of the participants lost some of their hearing due to radiation. Even two years after treatment, most participants had persisting sequelae, mainly xerostomia, porous teeth and reduced mobility of the tongue and jaw. Fatigue and difficulties eating and communicating, in particular, had a very negative effect on the participants' psycho-social QoL. CONCLUSION: This study allowed for a deeper understanding of the negative effects of HNC on patients' QoL. These QoL effects ought to be included in future considerations of HPV vaccination of boys as well as girls. FUNDING: The study was funded by an unrestricted research grant from Sanofi Pasteur MSD. TRIAL REGISTRATION: not relevant.

Health-related quality of life before and after management in adults referred to otolaryngology: a prospective national study.

OBJECTIVE: An assessment of the effect of otolaryngological management on the health-related quality of life of patients. DESIGN: Application of the Health Utilities Index mark 3 (HUI-3) before and after treatment; application of the Glasgow Benefit Inventory (GBI) after treatment. SETTING: Six otolaryngological departments around Scotland. PARTICIPANTS: A 9005 adult patients referred to outpatient clinics. MAIN OUTCOME MEASURES: Complete HUI-3 data was collected from 4422 patients; complete GBI data from 4235; complete HUI-3 and GBI data from 3884. RESULTS: The overall change in health related quality of life from before to after management was just +0.02. In the majority of subgroups of data (classified by type of management) there was essentially no change in HUI-3 score. The major exceptions were those patients provided with a hearing aid (mean change 0.08) and those whose problem was managed surgically (mean change 0.04). The mean GBI score was 5.3 which is low. Those managed surgically reported a higher GBI score of 13.0. CONCLUSION: We found that patients treated surgically or given a hearing aid reported a significant improvement in their health related quality of life after treatment in otolaryngology departments. In general, patients treated in other ways reported no significant improvement. We argue that future research should look carefully at patient groups where there is unexpectedly little benefit from current treatment methods and consider more effective methods of management.

The effect of cochlear implantation on nasalance of speech in postlingually hearing-impaired adults.

OBJECTIVES/HYPOTHESIS: Hypernasality is considered a prevalent speech abnormality that could significantly contribute to the unintelligibility of the hearing-impaired speakers. The aim of this study was to evaluate the effect of cochlear implantation and the duration of hearing loss on nasalance of speech of a postlingually impaired group of Saudi adult patients. STUDY DESIGN: Retrospective study. METHODS: This study included 25 postlingually hearing-impaired patients who underwent cochlear implantation and 25 age-matched control subjects. Patients were divided into three groups according to the duration of hearing loss. The nasometric data of the hearing-impaired group were compared with the control group. Also, the preoperative values were compared with the postoperative values 6, 12, and 24 months after surgery. RESULTS: Significant differences were demonstrated between the preimplantation nasalance scores of the three subgroups and between the patients and control groups. There were statistically significant differences demonstrated between the pre- and the postimplantation nasalance values for the three groups of patients. CONCLUSION: Cochlear implantation appears to have significant effects on improving the nasalance of the speech of postlingually hearing-impaired adult patients. However, the degree of improvement might vary according to the duration of hearing loss the patients had preimplantation.

Social cognitive performance and different communication settings in groups of children with different disorders / Desempenho sócio-cognitivo e diferentes situações comunicativas em grupos de crianças com diagnósticos distintos

PURPOSE: To investigate the social-cognitive performance of children with diagnostics of autism spectrum disorder (ASD), mental disability (MD) and hearing impairment (HI) in two different communicative situations. METHODS: Participated in this study 30 children ages between 3 and 12 years starting speech language therapy processes, divided in three groups: Group 1 - ten children with diagnoses included in the Autism Spectrum Disorders (ASD); Group 2: ten children diagnosed with mental disabilities (MD) and Group 3: ten children diagnosed with hearing impairment (HI). The subjects were assessed in two different communicative situations (group and individual therapy situation) for 12 months. RESULTS: Data regarding the performance of the three groups in the two situations show that G3 had better absolute performance when compared with other groups, with the variable symbolic play as an important differential criterion for the three groups. CONCLUSION: We conclude that the social-cognitive performance can be used as an auxiliary tool for intervention, helping the identification of variables that could interfere in the communicative performance.

OBJETIVO: Verificar o desempenho sócio-cognitivo de crianças com diagnósticos inseridos nos distúrbios do espectro do autismo (DEA), deficiência mental (DM) e deficiência auditiva (DA) em duas diferentes situações comunicativas. MÉTODOS: Participaram desta pesquisa 30 crianças, entre 3 e 12 anos de idade, em início de atendimento fonoaudiológico, que foram divididas em três grupos: Grupo 1: dez crianças com diagnóstico inserido nos distúrbios do espectro do autismo (DEA); Grupo 2: dez crianças com diagnóstico de deficiência mental (DM); Grupo 3: dez crianças com diagnóstico dentro do grupo de deficiência auditiva (DA). Os sujeitos foram analisados em duas situações comunicativas distintas (situação em grupo e situação individual de terapia), durante 12 meses. RESULTADOS: O grupo composto por crianças e adolescentes com diagnóstico de deficiência auditiva apresentou melhor desempenho absoluto quando comparado com os outros grupos, sendo a variável jogo simbólico um importante critério diferencial nos três grupos. CONCLUSÃO: O desempenho sócio-cognitivo pode ser utilizado como instrumento auxiliar no planejamento terapêutico, facilitando a identificação de variáveis que possam interferir no desempenho comunicativo.

Investigation of the actions taken by adults who failed a telephone-based hearing screen.

OBJECTIVES: Hearing impairment constitutes a highly prevalent chronic health condition among older adults worldwide which negatively impacts on communication and health-related quality of life. Irrespective of this, the majority of older adults do not seek professional help for hearing impairment and/or do not obtain hearing aids. Therefore, a new approach for detecting and promoting help-seeking for hearing impairment is needed. The purpose of this study was to investigate the actions taken by those who failed Telscreen, a telephone-based screening tool for hearing loss, and to increase our understanding of factors that influence taking action. DESIGN: A cohort of 193 participants (112 females, 81 males; age range 24-93 yr) who had failed Telscreen participated in a follow-up telephone interview 4 to 5 mo later. Participants were asked why they called Telscreen, about their hearing ability, their Telscreen result, and what action they had taken toward hearing rehabilitation. One outcome measure was identified: decision to seek professional help for hearing impairment (yes/no). Given that the outcome measure was dichotomized, a logistic regression model for binary outcomes was fitted to the data. RESULTS: Of the 193 participants who failed Telscreen, only 36% sought help from a range of sources (e.g., audiologist, hearing service or hearing aid provider, and family doctor). Results of the logistic regression analysis indicated that individuals who had considered hearing aids before calling Telscreen and/or who recalled their Telscreen result were significantly more likely to seek professional help for their hearing impairment. Nineteen participants who sought help for their hearing impairment had hearing aid fitting recommended to them. Eight participants had aid/s fitted, and of these, six reported a successful outcome. CONCLUSIONS: For every 100 individuals who fail a hearing screening, only 36 seek help. Of these 36 individuals who take some action, 13 are recommended hearing aids, approximately half of whom follow this advice and obtain hearing aids. Approximately three-quarters of these individuals use and value their hearing aids. Provided that the screening is automated and low cost, hearing screening via telephone has proven to change the lives of 5% of individuals who decided to seek professional help for hearing impairment at little cost to the other 95% of individuals. Suggestions for future research based on the present research findings are discussed.

Avaliação da restrição de participação e de processos cognitivos em idosos antes e após intervenção fonoaudiológica / Evaluation of participation restriction and cognitive processes in the elderly before and after the audiologic rehabilitation

OBJETIVO: Avaliar a restrição de participação em atividades de vida diária e de processos cognitivos em idosos, de acordo com gênero e faixa etária, antes e após intervenção fonoaudiológica. MÉTODOS: Participaram 50 idosos, 23 do gênero feminino e 27 do gênero masculino. Os idosos foram distribuídos em dois grupos etários: Grupo 1 - 24 idosos, com idade entre 60 e 74 anos (11 do gênero feminino e 13 do gênero masculino); Grupo 2 - 26 idosos com idade igual ou superior a 75 anos (12 do gênero feminino e 14 do gênero masculino). Os idosos foram avaliados antes após um ano de adaptação da prótese auditiva, por meio do questionário HHIE e o teste MEEM. Foram realizados acompanhamentos bimestrais totalizando sete reuniões, a fim de garantir a utilização efetiva da prótese. Quanto à estatística, foram realizadas análises descritivas e análise de variância. RESULTADOS: Houve redução da restrição de participação nas escalas emocional e social do HHIE no período pós-intervenção, nos dois grupos, em indivíduos de ambos os gêneros. Os resultados do teste MEEM foram melhores no período pós-intervenção, independentemente do gênero e idade do participante. CONCLUSÃO: Há menor autopercepção das restrições de participação em atividades de vida diária após intervenção fonoaudiológica. Além disso, idosos de diferentes idades e de ambos os gêneros referem diminuição de restrições cognitivas após adaptação de prótese auditiva.

OBJECTIVE: To evaluate the restriction of participation in activities of daily living and cognitive processes in older adults, according to gender and age, before and after rehabilitation. METHODS: The study included 50 individuals, 23 females and 27 males. The elderly were divided into two groups: Group 1 to 24 individuals aged between 60 and 74 years (11 females and 13 males), Group 2 - 26 elderly aged above 75 years (12 of female and 14 male). The elderly were evaluated before one year after the adaptation of hearing aids through the HHIE test and MMSE. Bimonthly follow-ups were conducted a total of seven meetings, to ensure the effective use of the prosthesis. As for the statistical analysis were performed descriptive and statistical analysis. RESULTS: There was a reduction of the restriction of participation in social and emotional scales HHIE post-intervention in both groups, individuals of both genders. The MMSE test results were better in the post-intervention, regardless of gender and age of the participant. CONCLUSION: There is little perception of the restrictions on participation in activities of daily living after rehabilitation. Moreover, the elderly of different ages and both genders decreased cognitive constraints refer after hearing aid fitting.