RESUMO
Adults are more sensitive to a sound if they know when the sound will occur. In the present experiment, the effects of temporal uncertainty and temporal expectancy on infants' and adults' detection of a 1 kHz tone in a broadband noise were examined. In one experiment, masked sensitivity was measured with an acoustic cue and without an acoustic cue to possible tone presentation times. Adults' sensitivity was greater for the cue than for the no-cue condition, while infants' sensitivity did not differ significantly between the cue and no-cue conditions. In a second experiment, the effect of temporal expectancy was investigated. The detection advantage for sounds occurring at an expected (most frequent) time, over sounds occurring at unexpected (less frequent) times, was examined. Both infants and adults detected a tone better when it occurred before or at an expected time following a cue than when it occurred at a later time. Thus, despite the fact that the auditory cue did not improve infants' sensitivity, it nonetheless provided the basis for temporal expectancies. Infants, like adults, are more sensitive to sounds that are consistent with temporal expectancy.
Assuntos
Vias Auditivas/fisiologia , Percepção Auditiva , Sinais (Psicologia) , Percepção do Tempo , Incerteza , Estimulação Acústica , Adolescente , Adulto , Fatores Etários , Audiometria , Humanos , Lactente , Mascaramento Perceptivo , Detecção de Sinal Psicológico , Adulto JovemRESUMO
Purpose Brainstem auditory evoked response (BAER) testing is often performed under general anesthesia for children unable to complete behavioral audiologic evaluation. Alternatively, acupuncture treatment may be considered appropriate for BAER. Reports of acupuncture treatment in pediatric patients are scarce but are needed to demonstrate effectiveness. This study had 2 main objectives: (a) to examine the feasibility and effectiveness of acupuncture to achieve sleep to perform diagnostic BAER testing in medically complex (Cohort I) and nonmedically complex (Cohort II) children and (b) to assess acceptability to parents and audiologists of acupuncture as an alternative to anesthesia for BAER testing. Method A prospective feasibility study at Seattle Children's Hospital Outpatient Audiology Clinic from August 2015 through December 2018 was performed. A total of 31 pediatric patients were included. The median age for Cohort I was 29 months (interquartile range: 19-37 months), and the median age for Cohort II was 25.5 months (interquartile range: 16-32 months). Variables included number of BAER thresholds obtained, sleep indicators, and acceptability. The cost of BAER with acupuncture and the cost of BAER under anesthesia were compared. Results Acupuncture treatment effectively contributed to an adequate sleep state to obtain BAER results for most patients in both cohorts. Across cohorts, most patients (81%) fell asleep after acupuncture treatment. Complete test results were obtained in 48% of patients. Audiologists and parents reported high satisfaction rates with this procedure (87%). There were no adverse safety effects. Acupuncture treatment was less costly than anesthesia for BAER testing. Conclusions Acupuncture to induce sleep for BAER testing is effective, safe, and cost-efficient in small samples of medically and nonmedically complex pediatric patients. This procedure allowed earlier detection of hearing status and avoided potential adverse effects of anesthesia. Audiologists and parents reported that acupuncture treatment was an acceptable alternative to anesthesia for the BAER procedure.