Long-term effect of middle ear disease on temporal processing and P300 in two different populations of children.

BACKGROUND/OBJECTIVE: The effects of otitis media on the function of the central auditory nervous system in different populations is unknown. Understanding how the history of otitis media affects children from different nations will guide health professionals worldwide on the importance of adequate auditory stimulus in childhood. For this reason, the aim of the present study was to investigate the long-term auditory effects of middle ear disease on temporal processing and P300 in two different populations of children: Australian and Brazilian. METHODS: Temporal processing tests (Frequency Pattern Tests-FPT and Gaps in noise-GIN) and P300 were measured in 68 Brazilian and Australian children, aged between 8 to 14 years. The Brazilian otitis media group (BrOM) and Australian otitis media group (AusOM) consisted of 20 children each who had a documented history of otitis media. Control groups of 14 children (BrControl and AusControl) were also recruited from each country, all with no documented history of otitis media. RESULTS: The BrOM group showed significantly poorer performance (p<0.001) for FPT and the GIN compared to BrControl. The P300 response showed significantly longer mean latencies (p = 0.02) compared to BrControls. The AusOM group also showed significant delayed latency of P300 (p = 0.04) compared to the AusControl. The FPT showed significantly poorer performance (p = 0.04) compared to AusControls. The two otitis media groups showed no significant differences between each other on P300. Significant differences were seen however in temporal processing tests performance between the two cohorts for the otitis media groups. The BrOM group had significantly poorer responses (p<0.001) for FPT and GIN compared to the AusOM group. CONCLUSIONS: These findings support that although differences exist between BrOM and AusOM groups, otitis media can be demonstrated to affect the underlying mechanisms of the P300 measures and behavioral auditory responses in two different populations of children.

Hearing in Noise Test, HINT-Brazil, in normal-hearing children / Teste de Reconhecimento de Fala no Ruído, HINT-Brasil, em crianças normo-ouvintes

Abstract Introduction: The auditory processing is related to certain skills such as speech recognition in noise. The HINT-Brazil test allows the measurement of the Speech/Noise ratio however there are no studies in the national literature that establish parameters for the child population. Objective: To analyze the performance of normal-hearing subjects aged 8-10 years old in tasks for speech recognition in noise using HINT test. Methods: Sixty schoolchildren were evaluated. They were between 8 and 10 years of age, of both genders, and had no auditory and school complaints, with results ranking within normality for the Basic Audiological Assessment and the Dichotic Digits Test. HINT-Brazil test was applied with headphones, with the Speech/Noise ratio in conditions of frontal noise, noise to the right, and noise to the left being investigated. The software calculated the Composite Noise, which corresponds to the weighted mean of the tested conditions. Results: There was no statistically significant difference between the ears, nor between the genders. There was a statistically significant difference for age ranges of 8 and 10 years, in situations with noise, and for Composite Noise. The age group of 10 years showed better performance than the age group of 8; the age group of 9 years did not show statistically significant difference regarding the other age ranges. We suggest the values of mean and standard deviation of the Speech/Noise ratio, considering the age ranges of: 8 years - Frontal Noise: −2.09 (±1.09); Right Noise: −7.64 (±1.72); Left Noise: −7.53 (±2.80); Composite Noise: −4.86 (±1.31); 9 years - Frontal Noise: −2.82 (±0.74); Right Noise: −8.49 (±2.24); Left Noise: −8.41 (±1.75); Composite Noise: −5.63 (±1.02); 10 years - Frontal Noise: −3.01 (±0.95); Right Noise: −9.47 (±1.43); Left Noise: −9.16 (±1.65); Composite Noise: −6.16 (±0.91). Conclusion: HINT-Brazil test is a simple and fast test, and is not difficult to performed with normal-hearing children. The results confirm that it is an efficient test to be used with the age range evaluated.

Resumo Introdução: O processamento auditivo está relacionado a determinadas habilidades, como o reconhecimento de fala no ruído. O teste HINT-Brasil permite a mensuração da relação Fala/Ruído, porém, não há na literatura nacional estudos que estabeleçam parâmetros para a população infantil. Objetivo: Analisar o desempenho de normo-ouvintes, de 8 a 10 anos, nas tarefas de reconhecimento de fala no ruído, por meio do teste HINT. Método: Avaliados 60 escolares, entre 8 e 10 anos, de ambos os gêneros, sem queixas auditivas e escolares, e com resultados dentro da normalidade para a Avaliação Audiológica Básica e o Teste Dicótico de Dígitos. O teste HINT-Brasil foi aplicado com fones de ouvido, sendo pesquisada a relação Fala/Ruído nas condições Ruído Frontal, Ruído à Direita e Ruído à Esquerda. O software calculou o Ruído Composto, que corresponde à média ponderada das condições testadas. Resultados: Não houve diferença estatisticamente significante entre as orelhas, nem entre os gêneros. Houve diferença estatisticamente significante para as faixas de 8 e 10 anos, nas situações com ruído e para o Ruído Composto. A faixa etária de 10 anos apresentou desempenho melhor do que a faixa etária de 8; a faixa etária de 9 anos não apresentou diferença estatisticamente significante com relação as outras faixas etárias. Sugerimos os valores de Média e Desvio Padrão da relação F/R, considerando as faixas: 8 anos - RF: -2,09 (± 1,09); RD: -7,64 (± 1,72); RE: -7,53 (± 2,80); RC: -4,86 (± 1,31); 9 anos - RF: -2,82 (± 0,74); RD: -8,49 (± 2,24); RE: -8,41 (± 1,75); RC: -5,63 (± 1,02); 10 anos - RF: -3,01 (± 0,95); RD: -9,47 (± 1,43); RE: -9,16 (± 1,65); RC: -6,16 (± 0,91). Conclusão: O teste HINT-Brasil é um teste simples e rápido e não oferece dificuldades em seu uso com crianças normo-ouvintes; os resultados mostram se tratar de um teste eficaz para ser utilizado com a faixa etária avaliada.

An Analysis of The Parameters Used In Speech ABR Assessment Protocols.

The aim of this study was to assess the parameters of choice, such as duration, intensity, rate, polarity, number of sweeps, window length, stimulated ear, fundamental frequency, first formant, and second formant, from previously published speech ABR studies. To identify candidate articles, five databases were assessed using the following keyword descriptors: speech ABR, ABR-speech, speech auditory brainstem response, auditory evoked potential to speech, speech-evoked brainstem response, and complex sounds. The search identified 1288 articles published between 2005 and 2015. After filtering the total number of papers according to the inclusion and exclusion criteria, 21 studies were selected. Analyzing the protocol details used in 21 studies suggested that there is no consensus to date on a speech-ABR protocol and that the parameters of analysis used are quite variable between studies. This inhibits the wider generalization and extrapolation of data across languages and studies.

Hearing in Noise Test, HINT-Brazil, in normal-hearing children.

INTRODUCTION: The auditory processing is related to certain skills such as speech recognition in noise. The HINT-Brazil test allows the measurement of the Speech/Noise ratio however there are no studies in the national literature that establish parameters for the child population. OBJECTIVE: To analyze the performance of normal-hearing subjects aged 8-10 years old in tasks for speech recognition in noise using HINT test. METHODS: Sixty schoolchildren were evaluated. They were between 8 and 10 years of age, of both genders, and had no auditory and school complaints, with results ranking within normality for the Basic Audiological Assessment and the Dichotic Digits Test. HINT-Brazil test was applied with headphones, with the Speech/Noise ratio in conditions of frontal noise, noise to the right, and noise to the left being investigated. The software calculated the Composite Noise, which corresponds to the weighted mean of the tested conditions. RESULTS: There was no statistically significant difference between the ears, nor between the genders. There was a statistically significant difference for age ranges of 8 and 10 years, in situations with noise, and for Composite Noise. The age group of 10 years showed better performance than the age group of 8; the age group of 9 years did not show statistically significant difference regarding the other age ranges. We suggest the values of mean and standard deviation of the Speech/Noise ratio, considering the age ranges of: 8 years - Frontal Noise: -2.09 (±1.09); Right Noise: -7.64 (±1.72); Left Noise: -7.53 (±2.80); Composite Noise: -4.86 (±1.31); 9 years - Frontal Noise: -2.82 (±0.74); Right Noise: -8.49 (±2.24); Left Noise: -8.41 (±1.75); Composite Noise: -5.63 (±1.02); 10 years - Frontal Noise: -3.01 (±0.95); Right Noise: -9.47 (±1.43); Left Noise: -9.16 (±1.65); Composite Noise: -6.16 (±0.91). CONCLUSION: HINT-Brazil test is a simple and fast test, and is not difficult to performed with normal-hearing children. The results confirm that it is an efficient test to be used with the age range evaluated.

Contralateral Noise Stimulation Delays P300 Latency in School-Aged Children.

BACKGROUND AND OBJECTIVE: The auditory cortex modulates auditory afferents through the olivocochlear system, which innervates the outer hair cells and the afferent neurons under the inner hair cells in the cochlea. Most of the studies that investigated the efferent activity in humans focused on evaluating the suppression of the otoacoustic emissions by stimulating the contralateral ear with noise, which assesses the activation of the medial olivocochlear bundle. The neurophysiology and the mechanisms involving efferent activity on higher regions of the auditory pathway, however, are still unknown. Also, the lack of studies investigating the effects of noise on human auditory cortex, especially in peadiatric population, points to the need for recording the late auditory potentials in noise conditions. Assessing the auditory efferents in schoolaged children is highly important due to some of its attributed functions such as selective attention and signal detection in noise, which are important abilities related to the development of language and academic skills. For this reason, the aim of the present study was to evaluate the effects of noise on P300 responses of children with normal hearing. METHODS: P300 was recorded in 27 children aged from 8 to 14 years with normal hearing in two conditions: with and whitout contralateral white noise stimulation. RESULTS: P300 latencies were significantly longer at the presence of contralateral noise. No significant changes were observed for the amplitude values. CONCLUSION: Contralateral white noise stimulation delayed P300 latency in a group of school-aged children with normal hearing. These results suggest a possible influence of the medial olivocochlear activation on P300 responses under noise condition.

Sound pressure level generated by individual portable sound equipment.

INTRODUCTION: The use of Personal Digital Audio Players can cause hearing injuries, as the sound is generated directly in the ear canal. It is believed that different types of headphones can cause different amplifications, since they cause changes in the volume and resonance of the ear canal according to their depth. OBJECTIVE: This study aimed to determine the sound pressure to which young individuals are exposed when using Personal Digital Audio Players with two types of headphones: insertion earphones and anatomical insertion earphones. MATERIALS AND METHODS: This was an experimental study. The probe microphone measurements were made with different headphones in 54 ears (27 young individuals). The resonance peaks were also recorded. RESULTS: A statistically significant difference was observed between the evaluated headphones, showing that anatomical insertion earphones had higher levels of sound pressure than insertion earphones for all frequencies measured. There was no correlation between the resonance peak of the closed canal and the frequency where the highest sound pressure level was obtained. There was a significant difference between ears at some frequencies with the different headphones. CONCLUSION: It was concluded that anatomical insertion earphones generate a higher sound pressure level than insertion earphones.

Pressao sonora gerada por equipamentos sonoros portateis individuais / Sound pressure level generated by individual portable sound equipment

Introdução: O uso de equipamentos portáteis sonoros individuais pode ser um risco auditivo, pois o som é gerado diretamente no meato acústico externo. Acredita-se que fones diferentes proporcionam amplificações diferentes, pois causam variações de volume e de ressonância conforme suas inserções. Objetivos: Verificar a pressão sonora a que jovens estão expostos quando fazem uso de equipamentos sonoros portáteis individuais com dois diferentes fones: de inserção e de inserção anatômico. Materiais e métodos: Trata-se de uma pesquisa experimental. Para tanto, foram feitas medições em 54 orelhas de 27 jovens com idades entre 18 e 30 anos, com os dois tipos de fones. Também foram registrados picos de ressonância da orelha externa com e sem fone. Resultados: Observou-se que o fone de inserção anatômico apresenta aumento do nível de pressão sonora estatisticamente significante em comparação com o fone de inserção para todas as frequências avaliadas. Não há uma correlação entre o novo pico de ressonância do meato fechado e a frequência na qual se obteve os maiores níveis de pressão sonora com o fone. Observou-se diferença estatisticamente significativa entre orelhas para algumas frequências com os diferentes fones. Conclusão: O fone de inserção anatômico gera um maior nível de pressão sonora que o fone de inserção. .

Introduction: The use of Personal Digital Audio Players can cause hearing injuries, as the sound is generated directly in the ear canal. It is believed that different types of headphones can cause different amplifications, since they cause changes in the volume and resonance of the ear canal according to their depth. Objective: This study aimed to determine the sound pressure to which young individuals are exposed when using Personal Digital Audio Players with two types of headphones: insertion earphones and anatomical insertion earphones Materials and methods: This was an experimental study. The probe microphone measurements were made with different headphones in 54 ears (27 young individuals). The resonance peaks were also recorded. Results: A statistically significant difference was observed between the evaluated headphones, showing that anatomical insertion earphones had higher levels of sound pressure than insertion earphones for all frequencies measured. There was no correlation between the resonance peak of the closed canal and the frequency where the highest sound pressure level was obtained. There was a significant difference between ears at some frequencies with the different headphones. Conclusion: It was concluded that anatomical insertion earphones generate a higher sound pressure level than insertion earphones. .

(Central) auditory processing: the impact of otitis media.

OBJECTIVE: To analyze auditory processing test results in children suffering from otitis media in their first five years of age, considering their age. Furthermore, to classify central auditory processing test findings regarding the hearing skills evaluated. METHODS: A total of 109 students between 8 and 12 years old were divided into three groups. The control group consisted of 40 students from public school without a history of otitis media. Experimental group I consisted of 39 students from public schools and experimental group II consisted of 30 students from private schools; students in both groups suffered from secretory otitis media in their first five years of age and underwent surgery for placement of bilateral ventilation tubes. The individuals underwent complete audiological evaluation and assessment by Auditory Processing tests. RESULTS: The left ear showed significantly worse performance when compared to the right ear in the dichotic digits test and pitch pattern sequence test. The students from the experimental groups showed worse performance when compared to the control group in the dichotic digits test and gaps-in-noise. Children from experimental group I had significantly lower results on the dichotic digits and gaps-in-noise tests compared with experimental group II. The hearing skills that were altered were temporal resolution and figure-ground perception. CONCLUSION: Children who suffered from secretory otitis media in their first five years and who underwent surgery for placement of bilateral ventilation tubes showed worse performance in auditory abilities, and children from public schools had worse results on auditory processing tests compared with students from private schools.

(Central) Auditory Processing: the impact of otitis media

OBJECTIVE: To analyze auditory processing test results in children suffering from otitis media in their first five years of age, considering their age. Furthermore, to classify central auditory processing test findings regarding the hearing skills evaluated. METHODS: A total of 109 students between 8 and 12 years old were divided into three groups. The control group consisted of 40 students from public school without a history of otitis media. Experimental group I consisted of 39 students from public schools and experimental group II consisted of 30 students from private schools; students in both groups suffered from secretory otitis media in their first five years of age and underwent surgery for placement of bilateral ventilation tubes. The individuals underwent complete audiological evaluation and assessment by Auditory Processing tests. RESULTS: The left ear showed significantly worse performance when compared to the right ear in the dichotic digits test and pitch pattern sequence test. The students from the experimental groups showed worse performance when compared to the control group in the dichotic digits test and gaps-in-noise. Children from experimental group I had significantly lower results on the dichotic digits and gaps-in-noise tests compared with experimental group II. The hearing skills that were altered were temporal resolution and figure-ground perception. CONCLUSION: Children who suffered from secretory otitis media in their first five years and who underwent surgery for placement of bilateral ventilation tubes showed worse performance in auditory abilities, and children from public schools had worse results on auditory processing tests compared with students from private schools. .

Temporal resolution: assessment procedures and parameters for school-aged children.

UNLABELLED: Temporal resolution enables the identification of fine differences in speech segmental aspects. Random Gap Detection Test (RGDT) and Gaps-In-Noise Test (GIN) evaluate such skills, by using different acoustic parameters. OBJECTIVE: To compare the performance of normal school aged children without learning disabilities and/or hearing complaints in the GIN and RGDT, and analyze potential performance differences in these two procedures. METHOD: Cross sectional contemporary cohort study. 28 children, aged 8-10 years were evaluated. After peripheral audiological evaluation, RGDT and GIN were performed. RESULTS: There were no statistical differences in performance between gender and age on the RGDT and GIN tests, between the right and left ears on the GIN test, and between frequencies on the RGDT test. The mean detection threshold gap for RGDT was 9.25 ± 3.67 ms, and for GIN was 4.32 ± 0.61 ms (right ear) and 4.43 ± 0.79 ms (left ear). The results of the GIN Test were statistically lower than those from the RGDT (p < 0.001). CONCLUSION: Both tests indicated normal temporal resolution for all 28 children. GIN test presents advantages regarding the ease of application, task variable, stimuli and presentations form. However, the RGDT has advantages concerning the time required for administration and scoring.

Resolução temporal: procedimentos e parâmetros de avaliação em escolares / Temporal resolution: assessment procedures and parameters for school-aged children

A resolução temporal permite identificação de pequenas diferenças acústicas nos aspectos segmentais da fala e pode ser avaliada por meio do Random Gap Detection Test (RGDT) e Gaps-In-Noise Test (GIN), os quais possuem diferentes parâmetros acústicos. OBJETIVO: Comparar o desempenho de escolares sem dificuldades de aprendizagem e/ou queixas auditivas, na aplicação do GIN e RGDT, e analisar diferenças de desempenho entre os procedimentos. MÉTODO: Estudo de coorte contemporânea com corte transversal. Avaliaram-se 28 crianças, de 8 a 10 anos, as quais foram submetidas ao RGDT e GIN após avaliação audiológica periférica prévia. RESULTADOS: Não foram encontradas diferenças estatísticas em relação ao gênero e faixa etária, frequências no RGDT e orelhas no GIN. A média do limiar de detecção de gap do RGDT foi de 9,25 ms ± 3,67, e no GIN foi de 4,32 ms ± 0,61 (orelha direita) e 4,43 ms ± 0,79 (orelha esquerda). Os resultados do GIN foram estatisticamente menores do que no RGDT (p < 0,001). CONCLUSÃO: Ambos os testes demonstraram resolução temporal normal nas 28 crianças. O GIN apresenta vantagens em relação à facilidade de aplicação, natureza da tarefa solicitada, estímulo empregado e forma de apresentação. Porém, o RGDT apresenta vantagens no tempo necessário para a aplicação e registro de pontuação.

Temporal resolution enables the identification of fine differences in speech segmental aspects. Random Gap Detection Test (RGDT) and Gaps-In-Noise Test (GIN) evaluate such skills, by using different acoustic parameters. OBJECTIVE: To compare the performance of normal school aged children without learning disabilities and/or hearing complaints in the GIN and RGDT, and analyze potential performance differences in these two procedures. METHOD: Cross sectional contemporary cohort study. 28 children, aged 8-10 years were evaluated. After peripheral audiological evaluation, RGDT and GIN were performed. RESULTS: There were no statistical differences in performance between gender and age on the RGDT and GIN tests, between the right and left ears on the GIN test, and between frequencies on the RGDT test. The mean detection threshold gap for RGDT was 9.25 ± 3.67 ms, and for GIN was 4.32 ± 0.61 ms (right ear) and 4.43 ± 0.79 ms (left ear). The results of the GIN Test were statistically lower than those from the RGDT (p < 0.001). CONCLUSION: Both tests indicated normal temporal resolution for all 28 children. GIN test presents advantages regarding the ease of application, task variable, stimuli and presentations form. However, the RGDT has advantages concerning the time required for administration and scoring.

Temporal resolution: performance of school-aged children in the GIN - Gaps-in-noise test.

UNLABELLED: Time resolution hearing skill is the minimum time necessary to solve acoustic events, which is fundamental for speech understanding, and which may be assessed by gap-detection tests, such as the Gaps-in-noise test (GIN). AIM: the purpose of this study was to verify the performance of time processing ability in children with no hearing and/or education difficulties by applying the GIN test in both genders and ages from 8 to 10 years. STUDY DESIGN: a prospective cross-sectional contemporary cohort. MATERIAL AND METHOD: The GIN test was applied to 75 school-aged children separated into three groups by age. RESULTS: The findings showed no statistical differences among age groups or ears. Males had slightly better responses than females on the percentage of correct responses only. CONCLUSION: The gap threshold and percentage of correct responses were calculated regardless of the ear, gender or age, and were respectively 4.7ms and 73.6%. Based on a 95% confidence interval, the cut-off criterion for normal and abnormal performance was 6.1ms for the mean gap detection threshold and 60% for the percentage of correct responses.

Resolução temporal: desempenho de escolares no teste GIN - Gaps-in-noise / Temporal resolution: performance of school-aged children in the GIN - Gaps-in-noise test

A habilidade auditiva denominada resolução temporal consiste no tempo mínimo necessário para resolver eventos acústicos, sendo fundamental para a compreensão de fala, e pode ser avaliada por testes de detecção de gaps, dentre eles o teste GIN - Gaps In Noise. OBJETIVO: Verificar o desempenho da resolução temporal em crianças sem queixas auditivas e/ou dificuldades escolares, no teste GIN, considerando-se o gênero masculino e feminino e a faixa etária de 8, 9 e 10 anos. FORMA DO ESTUDO: Coorte contemporânea com corte transversal prospectivo. MATERIAL E MÉTODO: O teste GIN foi aplicado em 75 escolares, reunidos em três grupos por faixa etária. RESULTADOS: Não foram encontradas diferenças significantes em relação às variáveis orelha e faixa etária. O gênero masculino obteve desempenho levemente melhor do que o feminino em relação apenas à porcentagem de acertos. CONCLUSÃO: A média do limiar de detecção de gaps e porcentagem de acertos foram calculados independente das variáveis orelha, gênero e faixa etária, sendo encontrados os valores de 4,7ms e 73,6 por cento. Baseado no critério de intervalo de confiança 95 por cento como corte para normalidade, os valores do limiar de detecção de gap e porcentagem de acertos foram 6,1ms e 60 por cento, respectivamente.

Time resolution hearing skill is the minimum time necessary to solve acoustic events, which is fundamental for speech understanding, and which may be assessed by gap-detection tests, such as the Gaps-in-noise test (GIN). AIM: the purpose of this study was to verify the performance of time processing ability in children with no hearing and/or education difficulties by applying the GIN test in both genders and ages from 8 to 10 years. STUDY DESIGN: a prospective cross-sectional contemporary cohort. MATERIAL AND METHOD: The GIN test was applied to 75 school-aged children separated into three groups by age. RESULTS: The findings showed no statistical differences among age groups or ears. Males had slightly better responses than females on the percentage of correct responses only. CONCLUSION: The gap threshold and percentage of correct responses were calculated regardless of the ear, gender or age, and were respectively 4.7ms and 73.6 percent. Based on a 95 percent confidence interval, the cut-off criterion for normal and abnormal performance was 6.1ms for the mean gap detection threshold and 60 percent for the percentage of correct responses.