Comparación de la producción vocal en niños con hipoacusia prelocutiva con adaptación audioprotésica e implante coclear con normooyentes / Vowel production in hearing impaired children: A comparison between normal-hearing, hearing-aided and cochlear-implanted children

Introducción y objetivos: La inadecuada retroalimentación auditiva en los niños con hipoacusia prelocutiva altera la articulación de consonantes y vocales. El propósito de esta investigación es comparar la producción de vocales en niños hipoacúsicos hispanohablantes con implante coclear o adaptación audioprotésica con niños normooyentes por medio del análisis acústico de las frecuencias formánticas y el espacio vocal. Método: Un total de 56 niños con hipoacusia prelocutiva (25 con implante coclear y 31 con audífonos) y 47 niños normooyentes participaron en el estudio. Los 2 primeros formantes (F1 y F2) de las 5 vocales del idioma español se midieron utilizando el programa Praat. Para analizar las diferencias entre los 3 grupos se aplicó el método ANOVA de análisis de la varianza y el test de Scheffé. También se calculó el área del espacio vocal. Resultados: El valor medio del F1 en todas las vocales no mostró diferencias significativas en los 3 grupos de niños. Para las vocales /i/, /o/ y /u/ el valor medio del F2 fue significativamente diferente entre los 2 grupos de niños hipoacúsicos y el grupo de niños normooyentes. Conclusión: Ambos grupos de niños con hipoacusia prelocutiva tienden a presentar sutiles desviaciones en la articulación de las vocales que pueden ser analizadas mediante un programa de análisis acústico

Introduction and objectives: Inadequate auditory feedback in prelingually deaf children alters the articulation of consonants and vowels. The purpose of this investigation was to compare vowel production in Spanish-speaking deaf children with cochlear implantation, and with hearing-aids with normal-hearing children by means of acoustic analysis of formant frequencies and vowel space. Methods: A total of 56 prelingually deaf children (25 with cochlear implants and 31 wearing hearing-aids) and 47 normal-hearing children participated. The first 2 formants (F1 and F2) of the five Spanish vowels were measured using Praat software. One-way analysis of variance (ANOVA) and post hoc Scheffé test were applied to analyze the differences between the 3 groups. The surface area of the vowel space was also calculated. Results: The mean value of F1 in all vowels was not significantly different between the 3 groups. For vowels /i/, /o/ and /u/, the mean value of F2 was significantly different between the 2 groups of deaf children and their normal-hearing peers. Conclusion: Both prelingually hearing-impaired groups tended toward subtle deviations in the articulation of vowels that could be analyzed using an objective acoustic analysis programme

Vowel production in hearing impaired children: A comparison between normal-hearing, hearing-aided and cochlear-implanted children. / Comparación de la producción vocal en niños con hipoacusia prelocutiva con adaptación audioprotésica e implante coclear con normooyentes.

INTRODUCTION AND OBJECTIVES: Inadequate auditory feedback in prelingually deaf children alters the articulation of consonants and vowels. The purpose of this investigation was to compare vowel production in Spanish-speaking deaf children with cochlear implantation, and with hearing-aids with normal-hearing children by means of acoustic analysis of formant frequencies and vowel space. METHODS: A total of 56 prelingually deaf children (25 with cochlear implants and 31 wearing hearing-aids) and 47 normal-hearing children participated. The first 2 formants (F1 and F2) of the five Spanish vowels were measured using Praat software. One-way analysis of variance (ANOVA) and post hoc Scheffé test were applied to analyze the differences between the 3 groups. The surface area of the vowel space was also calculated. RESULTS: The mean value of F1 in all vowels was not significantly different between the 3 groups. For vowels /i/, /o/ and /u/, the mean value of F2 was significantly different between the 2 groups of deaf children and their normal-hearing peers. CONCLUSION: Both prelingually hearing-impaired groups tended toward subtle deviations in the articulation of vowels that could be analyzed using an objective acoustic analysis programme.

Fiabilidad de los potenciales evocados auditivos de estado estable en la fase diagnóstica del cribado neonatal universal de la hipoacusia / Auditory-steady-state response reliability in the audiological diagnosis after neonatal hearing screening

Introducción y objetivos: La audiometría convencional es el patrón de referencia para cuantificar y describir una hipoacusia. Sin embargo, se precisan métodos alternativos para los pacientes muy jóvenes que no pueden responder con fiabilidad. Los potenciales evocados auditivos de tronco (PEATC) es el método más extendido para determinar de forma objetiva los umbrales auditivos, sin embargo, no informan específicamente en cada frecuencia. La llegada de los potenciales evocados de estado estable (PEAEE) permite conseguir una determinación más específica en frecuencias. El presente trabajo describe y compara los umbrales obtenidos mediante PEATC, PEAEE y audiometría convencional en un grupo de niños que presentan varios grados de pérdida auditiva. Métodos: Se llevó a cabo una comparación entre los umbrales de PEATC, PEAEE y audiométricos obtenidos de 35 niños detectados en el programa de cribado auditivo neonatal. Resultados: La diferencia media (±DE) entre los umbrales de los PEATC y la banda de 4.000Hz de los PEAEE fueron 11,2 dB (±13) para el oído derecho y 10,2 dB (±11) para el izquierdo. Las correlaciones de Pearson entre los umbrales de los PEAEE y audiométricos fue 0,80 y 0,91 (500Hz); 0,84 y 0,82 (1.000Hz); 0,85 y 0,84 (2.000Hz); 0,83 y 0,82 (4.000Hz), respectivamente para oído derecho e izquierdo. Conclusión: La técnica de los PEAEE es una técnica a tener en cuenta para su inclusión en la batería de test que se emplea en el diagnóstico audiológico de los niños con hipoacusia (AU)

Introduction and objectives: Conventional audiometry is the gold standard for quantifying and describing hearing loss. Alternative methods become necessary to assess subjects who are too young to respond reliably. Auditory evoked potentials constitute the most widely used method for determining hearing thresholds objectively; however, this stimulus is not frequency specific. The advent of the auditory steady-state response (ASSR) leads to more specific threshold determination. The current study describes and compares ASSR, auditory brainstem response (ABR) and conventional behavioural tone audiometry thresholds in a group of infants with various degrees of hearing loss. Methods: A comparison was made between ASSR, ABR and behavioural hearing thresholds in 35 infants detected in the neonatal hearing screening program. Results: Mean difference scores (±SD) between ABR and high frequency ABR thresholds were 11.2 dB (±13) and 10.2 dB (±11). Pearson correlations between the ASSR and audiometry thresholds were 0.80 and 0.91 (500Hz); 0.84 and 0.82 (1000Hz); 0.85 and 0.84 (2000Hz); and 0.83 and 0.82 (4000Hz). Conclusion: The ASSR technique is a valuable extension of the clinical test battery for hearing-impaired children (AU)

Auditory-steady-state response reliability in the audiological diagnosis after neonatal hearing screening. / Fiabilidad de los potenciales evocados auditivos de estado estable en la fase diagnóstica del cribado neonatal universal de la hipoacusia.

INTRODUCTION AND OBJECTIVES: Conventional audiometry is the gold standard for quantifying and describing hearing loss. Alternative methods become necessary to assess subjects who are too young to respond reliably. Auditory evoked potentials constitute the most widely used method for determining hearing thresholds objectively; however, this stimulus is not frequency specific. The advent of the auditory steady-state response (ASSR) leads to more specific threshold determination. The current study describes and compares ASSR, auditory brainstem response (ABR) and conventional behavioural tone audiometry thresholds in a group of infants with various degrees of hearing loss. METHODS: A comparison was made between ASSR, ABR and behavioural hearing thresholds in 35 infants detected in the neonatal hearing screening program. RESULTS: Mean difference scores (±SD) between ABR and high frequency ABR thresholds were 11.2 dB (±13) and 10.2 dB (±11). Pearson correlations between the ASSR and audiometry thresholds were 0.80 and 0.91 (500Hz); 0.84 and 0.82 (1000Hz); 0.85 and 0.84 (2000Hz); and 0.83 and 0.82 (4000Hz). CONCLUSION: The ASSR technique is a valuable extension of the clinical test battery for hearing-impaired children.

[Validation of the Spanish parent satisfaction questionnaire with neonatal hearing screening programs]. / Validación del cuestionario de satisfacción de los padres con los programas de cribado auditivo neonatal en español.

INTRODUCTION: Although measuring parent satisfaction has been recommended as one of the important outcome measures in assessing the effectiveness of neonatal hearing screening programs, there are few published studies investigating this issue. OBJECTIVES: To validate the Spanish version of the Parent Satisfaction Questionnaire with Neonatal Hearing Screening Program (PSQ-NHSP). METHODS: 112 parents whose children had received hearing screening participated in this study. RESULTS: High levels of satisfaction were reported with more than 90% of parents satisfied with all aspects of the program. The psychometric properties of the Spanish version of the PSQ-NHSP were analyzed and demonstrated good internal consistency (alpha=0.75). Construct validity was indicated by a significant positive relationship between overall satisfaction and the three specific dimensions in the questionnaire. DISCUSSION: The development of a valid and reliable parent satisfaction questionnaire is important for improving hearing screening programs.

Validación del cuestionario de satisfacción de los padres con los programas de cribado auditivo neonatal en español / Validation of the Spanish parent satisfaction questionnaire with neonatal hearing screening programs

Introducción: Aunque se recomienda tener en cuenta la satisfacción de los padres como una de las valoraciones importantes para la evaluación de la efectividad de los programas de cribado auditivo neonatal, hay pocos estudios publicados que investiguen este tema. Objetivos: Validación de la versión en español del Cuestionario de Satisfacción de los Padres con el Programa de Cribado Neonatal de la Hipoacusia (PSQ-HNSP). Métodos: Participaron 112 padres de niños cribados para la hipoacusia. Resultados: Se encontraron unos grados de satisfacción importantes, más del 90 % de los padres mostraron su satisfacción con todos los aspectos del programa. Se analizaron las propiedades psicométricas de la versión en español del PSQ-HNSP, que demostraron una buena consistencia interna (α = 0,75). La validez de su construcción queda demostrada por la correlación significativa hallada entre la satisfacción general y las tres dimensiones específicas del cuestionario. Discusión: Es importante el desarrollo de un cuestionario válido y fiable que valore la satisfacción de los padres con el fin de usar este dato para mejorar los programas de cribado de la hipoacusia(AU)

Introduction: Although measuring parent satisfaction has been recommended as one of the important outcome measures in assessing the effectiveness of neonatal hearing screening programs, there are few published studies investigating this issue. Objectives: To validate the Spanish version of the Parent Satisfaction Questionnaire with Neonatal Hearing Screening Program (PSQ-NHSP). Methods: 112 parents whose children had received hearing screening participated in this study. Results: High levels of satisfaction were reported with more than 90 % of parents satisfied with all aspects of the program. The psychometric properties of the Spanish version of the PSQ-NHSP were analyzed and demonstrated good internal consistency (α = 0.75). Construct validity was indicated by a significant positive relationship between overall satisfaction and the three specific dimensions in the questionnaire. Discussion: The development of a valid and reliable parent satisfaction questionnaire is important for improving hearing screening programs(AU)

[Incidence of hypoacusia secondary to hyperbilirubinaemia in a universal neonatal auditory screening programme based on otoacoustic emissions and evoked auditory potentials]. / Incidencia de hipoacusia secundaria a hiperbilirrubinemia en un programa de cribado auditivo neonatal universal basado en otoemisiones acústicas y potenciales evocados auditivos.

INTRODUCTION: Hyperbilirubinaemia is a neonatal risk factor that has been proved to be associated with sensorineural hearing loss. A high concentration of unconjugated bilirubin place newborn children at risk of suffering toxic effects, including hypoacusia. OBJECTIVES: Review of the newborn screening results with a diagnosis of pathological hyperbilirubinaemia as part of a hearing-loss early detection protocol in the general population based on otoemissions and evoked potentials. MATERIAL AND METHOD: Retrospective study of 21 590 newborn children screened between 2002 and 2006. The selection criteria for defining pathological hyperbilirubinaemia were bilirubin concentrations in excess of 14 mg/dL in pre-term infants and 20 mg/dL in full-term babies. The Universal Neonatal Hearing Screening Programme is a two-phase protocol in which all children are initially subjected to a transient otoacoustic emissions test (TOAE). Children presenting risk factors associated with auditory neuropathy were always given brainstem auditory evoked potentials (BAEP). RESULTS: The patients identified as having severe hyperbilirubinaemia in the neonatal period numbered 109 (0.5 %) and 96 of these (88.07 %) passed the otoacoustic emissions test at the first attempt and 13 (11.93 %) did not; 11 of the 13 children in whom the otoacoustic emissions test was repeated passed it successfully. The 2 children who failed to pass the otoacoustic emissions test has normal BAEP results; 3 (2.75 %) of the newborn infants who passed the TOAE test did not pass the BAEP. DISCUSSION: Hyperbilirubinaemia values previously considered safe may harm the hearing system and give rise to isolated problems in auditory processing without being associated with other signs of classical kernicterus. Our results show that hyperbilirubinaemia-related auditory neuropathy reveals changes over time in the audiometric outcomes.

Incidencia de hipoacusia secundaria a hiperbilirrubinemia en un programa de cribado auditivo neonatal universal basado en otoemisiones acústicas y potenciales evocados auditivos / Incidence of hypoacusia secondary to hyperbilirubinaemia in a universal neonatal auditory screening programme based on otoacoustic emissions and evoked auditory potentials

Introducción: La hiperbilirrubinemia es un factor de riesgo neonatal que tiene probada asociación con la hipoacusia neurosensorial. Una concentración elevada de bilirrubina no conjugada pone al neonato en situación de riesgo de efectos tóxicos, entre los que se encuentra la hipoacusia. Objetivos: Revisión de los resultados del cribado de neonatos con diagnóstico de hiperbilirrubinemia patológica dentro de un protocolo de detección precoz de la hipoacusia en la población basado en otoemisiones y potenciales evocados. Material y método: Estudio retrospectivo de 21.590 neonatos cribados entre 2002 y 2006. Los criterios de selección para definir hiperbilirrubinemia patológica fueron las concentraciones de bilirrubina mayor de 14 mg/dl en el pretérmino y 20 mg/dl en el neonato a término. El Programa de Cribado Auditivo Neonatal Universal es un protocolo de dos fases en el que inicialmente todos los niños se someten a un test de otoemisiones acústicas transitorias (OEAT). A los niños que presentan factores de riesgo asociados a la neuropatía auditiva siempre se les realiza potenciales evocados auditivos de tronco cerebral (PEATC). Resultados: Se identificó a 109 (0,5 %) pacientes con hiperbilirrubinemia severa en el período neonatal, 96 (88,07 %) de ellos superaron la prueba de otoemisiones en el primer intento y 13 (11,93 %) no pasaron; 11 de los 13 niños a quienes se repitió la prueba de otoemisiones la superaron. En los 2 niños que no superaron las otoemisiones acústicas los PEATC fueron normales; 3 (2,75 %) neonatos que pasaron la prueba de OEAT no superaron los PEATC. Discusión: Los valores de hiperbilirrubinemia previamente considerados seguros pueden dañar el sistema auditivo y ocasionar problemas aislados en el procesamiento auditivo sin asociarse a otros signos del kernicterus clásico. Nuestros resultados indican que la neuropatía auditiva en relación con la hiperbilirrubinemia muestra cambios en los resultados audiométricos con el tiempo

Introduction: Hyperbilirubinaemia is a neonatal risk factor that has been proved to be associated with sensorineural hearing loss. A high concentration of unconjugated bilirubin place newborn children at risk of suffering toxic effects, including hypoacusia. Objectives: Review of the newborn screening results with a diagnosis of pathological hyperbilirubinaemia as part of a hearing-loss early detection protocol in the general population based on otoemissions and evoked potentials. Material and method: Retrospective study of 21 590 newborn children screened between 2002 and 2006. The selection criteria for defining pathological hyperbilirubinaemia were bilirubin concentrations in excess of 14 mg/dL in pre-term infants and 20 mg/dL in full-term babies. The Universal Neonatal Hearing Screening Programme is a two-phase protocol in which all children are initially subjected to a transient otoacoustic emissions test (TOAE). Children presenting risk factors associated with auditory neuropathy were always given brainstem auditory evoked potentials (BAEP). Results: The patients identified as having severe hyperbilirubinaemia in the neonatal period numbered 109 (0.5 %) and 96 of these (88.07 %) passed the otoacoustic emissions test at the first attempt and 13 (11.93 %) did not; 11 of the 13 children in whom the otoacoustic emissions test was repeated passed it successfully. The 2 children who failed to pass the otoacoustic emissions test has normal BAEP results; 3 (2.75 %) of the newborn infants who passed the TOAE test did not pass the BAEP. Discussion: Hyperbilirubinaemia values previously considered safe may harm the hearing system and give rise to isolated problems in auditory processing without being associated with other signs of classical kernicterus. Our results show that hyperbilirubinaemia-related auditory neuropathy reveals changes over time in the audiometric outcomes

Hipoacusia: Tu hijo y tú, una guía para familias con niños hipoacúsicos

En el momento en que se detecta hipoacusia en el niño y se valora, los padres reciben mucha información hablada sobre un problema que resulta desconocido, complejo y difícil de entender. Esta guía os permitirá revisar y consultar dudas en momentos de mayor tranquilidad, hablarlo y comentarlo entre vosotros y con otras personas cercanas. Es un complemento a la información que iréis recibiendo en el futuro.