[Guideline: Auditory processing and perception disorders: Proposal for treatment and management of APD : S1 guideline of the German Society of Phoniatrics and Pediatric Audiology]. / Leitlinie "Auditive Verarbeitungs- und Wahrnehmungsstörungen": Vorschlag für Behandlung und Management bei AVWS : S1-Leitlinie der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie.

Despite normal hearing thresholds in pure-tone audiometry, 0.5-1% of children have difficulty understanding what they hear. An auditory processing disorder (APD) can be assumed, which should be clarified and treated. In patients with hearing loss, this must first be compensated or resolved. Only hereafter can a suspected APD be confirmed or excluded. Diagnosis of APD requires that a clear discrepancy between the child's performance in individual auditory functions and other cognitive abilities be demonstrated. Combination of therapeutical modalities is considered particularly more beneficial in APD patients than a single modality. Treatment modalities should consider linguistic and cognitive processes (top-down), e.g., metacognitive knowledge of learning strategies or vocabulary expansion, but also address underlying auditory deficits (bottom-up). Almost 50% of children with APD also have a language development disorder requiring treatment and/or dyslexia. Therefore, each therapeutic intervention for a child with APD must be individually adapted according to the diagnosed impairments. Musical training can improve phonologic and reading abilities. Changes and adaptations in the classroom are helpful to support the weak auditory system of children with APD. Architectural planning of classrooms can be a means of ensuring that direct sound is masked by as little diffuse sound as possible. For example, acoustic ceiling tiles are suitable for reducing reverberant and diffuse sound.

The Effects of Using Hearing Aids and Hearing Assistive Technologies on Programmable Ventriculoperitoneal Shunt.

BACKGROUND: To investigate interaction between behind-the-ear (BTE) hearing aids, hearing assistive technologies, and programmable shunt valve to understand how use of BTE hearing aids in patients who underwent ventriculoperitoneal shunt (VPS) surgery affects the settings of a programmable shunt valve. METHODS: In this study, we investigated the magnetic field (MF) generation of 3 BTE hearing aids made by different companies, 1 frequency modulated system using telecoil technology, and 1 wireless microphone technology and their interactions with 2 programmable shunt valves. All measurements were made in a silent booth using 2 different models. The influence of MF strength in the distance modeling was investigated based on the distance from source auditory prostheses. The measurements were recorded using a Gauss meter. In the anatomical modeling, the change in the settings and interaction of the valve in a bust mannequin were investigated. RESULTS: No MF created by BTE hearing aids was detected in the distance modeling. The highest value measured was 32.67 µT (<90 dB noise) when BTE hearing aids and frequency modulated systems were used, and this value decreased as the distance increased. No MF generation was observed at measurements done for distances >10 mm. In the anatomical modeling, the settings of both programmable valves did not change under all acoustic conditions. CONCLUSIONS: This is the first study to our knowledge examining the MF created by hearing aids and hearing assistive technologies and its impact on programmable valves and variations in their settings. Our findings showed that it is safe to use BTE hearing aids, frequency modulated systems, and wireless microphone technologies in patients with a programmable VPS.

Effects of FM system fitted into the normal hearing ear orcartilage conduction hearing aid fitted into the affected ear on speech-in-noise recognition in Japanese children with unilateral congenital aural atresia.

The effects of FM system fitted into the normal hearing ear (NHE) or a cartilage conduction hearing aid (CCHA) fitted into the affected ear (AE) on the speech recognition ability in noise were examined in children with unilateral congenital aural atresia (UCAA). In children with bilateral normal hearing (BNH), speech recognition score (SRS) was significantly decreased in the noisy environment of -5 dB signal-to-noise ratio (SNR), compared with those in quiet. In children with UCAA, SRS was significantly decreased in noisy environments of 0 and -5 dB SNR, compared with those in quiet. In noisy environments of 0 and -5 dB SNR, SRS in children with UCAA was significantly decreased, compared those in children with BNH. In the noisy environment of -5 dB SNR, SRS in UCAA children aided by FM system fitted into NHE was significantly better than those in unaided children in the same group. In the noisy environment of 0 dB SNR, SRS in UCAA children aided by CCHA into AE tended to be higher than those in unaided children in the same group. FM system and CCHA can be recommended as an audiological management for the improvement of speech recognition in children with UCHL in classrooms. J. Med. Invest. 67 : 134-138, February, 2020.

The relationship between speech recognition in noise and non-speech recognition in noise test performances: Implications for central auditory processing disorders testing.

BACKGROUND: According to the American Academy of Audiology, a recommendation for frequency-modulation systems may be based upon performances on speech perception tests that do not include background noise. PURPOSE: The primary purpose of this study was to evaluate the presumption that non-speech recognition in noise test results are related to speech recognition in noise ability for a group of young adults. RESEARCH DESIGN: Performances on the non-speech recognition in noise tests included in the SCAN-3:A test battery were compared to speech recognition in noise performances as measured with the auditory figure ground subtest of the SCAN-3:A and the Hearing in Noise Test. STUDY SAMPLE: Fifty-four young, native speakers of American English with normal pure-tone thresholds participated in the study. DATA COLLECTION AND ANALYSIS: For the purposes of this study, the SCAN-3:A raw scores were used. The Hearing in Noise Test was administered in a simulated soundfield environment under headphones. The Spearman rho statistic was used to determine the relationships between non-speech recognition in noise vs. speech recognition in noise test results. RESULTS: No significant relationships were found between the auditory figure-ground results and any of the non-speech recognition in noise subtest performances. Modest but statistically significant relationships were found between the Hearing in Noise Test Composite scores vs. the competing words-directed ear and the time compressed sentences subtests of the SCAN-3:A. CONCLUSION: Of the four non-speech recognition in noise subtests that were evaluated, only the competing words-directed ear and the time-compressed sentences performances were significantly correlated to the Composite scores of the Hearing in Noise Test. The results demonstrated a limited external validity for two of the four non-SRN tests for the determination of SRN ability.

Effects of FM system fitted into normal hearing ear on speech-in-noise recognition in Japanese school-aged children with unilateral severe-to-profound hearing loss.

OBJECTIVES: We examined speech recognition ability of elementary school-aged Japanese children with unilateral hearing loss under noisy environments and then examined the effects of the FM system fitted into their normal hearing ear on their speech recognition ability. METHODS: Twelve children with severe-to-profound sensorineural hearing loss and ten age-matched children with bilateral normal hearing received speech recognition test in quiet and noisy environments. Other nine children with severe-to-profound sensorineural hearing loss received speech recognition test with or without the FM receiver fitted to the normal hearing ear in quiet and noisy environments. RESULTS: Signal-to-noise ratio (SNR) in Japanese elementary school classrooms was estimated to be -6.9 dB at a preferential seat. In noisy environment of -5 dB SNR similar to working classrooms, the correct rates of speech recognition test in children with unilateral hearing loss were significantly lower, compared with those in children with bilateral normal hearing. In the noisy environment, the correct rates in children aided by the FM system with unilateral hearing loss were significantly better, compared with unaided ones. CONCLUSION: The results suggested that the FM system is recommended as an audiological management for improvement of speech recognition of children with unilateral hearing loss in noisy classrooms. J. Med. Invest. 65:216-220, August, 2018.

Uso do Sistema FM em implante coclear / Use of FM System in cochlear implant

RESUMO Objetivo Verificar o uso do Sistema de Frequência Modulada (FM) e o benefício deste dispositivo em usuários de implante coclear. Método Análise de prontuários dos 113 usuários de Implante Coclear (IC), adaptados com kits de Sistema FM, entre setembro de 2013 e 2015, após publicação da Portaria 1.274 de 25/6/2013, referentes aos resultados dos testes de percepção de fala (TPF) e dos questionários Listening Inventory For Education – Revised (LIFE-R) e Classroom Participation Questionnaire (CPQ). Resultados O uso do Sistema FM em sala de aula foi efetivo por 47,15% dos pacientes, enquanto 21,42% não o utilizaram. Não houve correlação entre o uso do Sistema FM e a faixa etária dos pacientes. Os resultados nos TPF no ruído foram estatisticamente melhores com o uso do FM. Em relação aos questionários, a pontuação obtida na situação “após uso do Sistema FM”, no questionário LIFE-R, foi estatisticamente melhor para o item “situações de escuta em sala de aula” e, no questionário CPQ, para os itens “compreensão dos professores e aspectos positivos”, quando comparada a da situação “sem uso do Sistema FM”. Conclusão Os pacientes beneficiados com a concessão do Sistema FM fizeram uso do dispositivo em sala de aula e mostraram melhora tanto na percepção da fala no ruído quanto na impressão subjetiva da compreensão da fala do professor em sala de aula, após o uso do Sistema FM.

ABSTRACT Purpose To verify the use of the Frequency Modulation System (FM) and its benefit for cochlear implant users. Methods Analysis of medical records of 113 users of Cochlear Implants (CI) adapted with FM System kits between September 2013 and September 2015 after publication of the Administrative Rule 1.274 of 6/25/2013, regarding the results of the speech perception tests (SPT) and the Listening Inventory For Education - Revised (LIFE-R) and Classroom Participation Questionnaire (CPQ). Results The use of the FM System in the classroom was effective for 47.15% of the patients, while 21.42% did not use it. There was no correlation between the use of the FM System and the age group of patients. The results of the SPT regarding noise were statistically better with the use of FM System. Regarding the questionnaires, the score obtained in the LIFE-R in the situation “after use of the FM System” was statistically better for the item “listening situations in the classroom” and in the CPQ, for the items “teacher understanding” and “positive aspects”, when compared to the situation “without using the FM System”. Conclusion Patients benefitting from the concession of the FM System made use of the device in the classroom and improvement in both speech perception in noisy environments and subjective impression of the understanding of teachers’ speech in the classroom was observed after the use of the FM System.

FM listening evaluation for children: adaptação para a língua portuguesa / FM listening evaluation for children

INTRODUÇÃO: A inclusão do deficiente auditivo na escola é assegurada pelo poder público no Brasil por documentos oficiais e o sistema FM é um instrumento da tecnologia assistiva que o professor deve ter acesso. OBJETIVO: traduzir e adaptar para a Língua Portuguesa o questionário FM Listening Evaluation for children. MÉTODOS: A tradução e adaptação do questionário FM Listening Evaluation incluíram a tradução para o idioma português, adaptação lingüística e revisão das equivalências gramatical e idiomática e adaptação; também foi avaliada a reprodutibilidade intra-pesquisadores. O questionário foi aplicado nos professores e na fonoaudióloga de 12 crianças de sete a treze anos deficientes auditivas, usuárias de Aparelho de Amplificação Sonora Individual e adaptadas com sistema FM. RESULTADOS: A tradução e adaptação do questionário resultaram no novo inventário:AVALIAÇÃO DO SISTEMA FM, apresentando diferença significativa entre os resultados de ruído e: via auditiva e silêncio; - distância e: via auditiva e silêncio; - via auditiva e: ruído, distância e silêncio; - silêncio e: ruído, distância e via auditiva. Houve diferença significativa sem e com o Sistema FM, sendo que neste a pontuação foi sempre maior. Na comparação intrapesquisadores evidenciou-se diferença significativa entre: pontuação total com FM; via auditiva sem FM e ruído com FM. CONCLUSÃO: O questionário Avaliação do Sistema FM foi considerado um instrumento confiável para verificação e acompanhamento dos benefícios do Sistema FM podendo favorecer assim o processo de inclusão escolar do aluno deficiente auditivo.

INTRODUCTION: The inclusion of children with hearing impairments in schools is guaranteed by the Brazilian government by means of official legislation. The FM system is an assistive technology instrument to which regular teachers should have access. OBJECTIVE: To translate and adapt to Portuguese the FM Listening Evaluation questionnaire for children and assess its reliability. METHODS: The translation and adaptation to the FM Listening Evaluation included translation into Portuguese, linguistic adaptation and revision of the grammatical and idiomatic equivalences and adaptation; inter-researcher reproducibility was also evaluated. The questionnaire was administered to the teachers and speech-language pathologists of 12 children aged seven to thirteen years with hearing impairment; the children used hearing aids and had been adapted to the FM system. RESULTS: The translation and adaptation of the questionnaire resulted in new inventory: FM EVALUATION SYSTEM, presenting a significant difference between the results of noise and: hearing pathways and silence; - distance and: hearing pathways and silence; - hearing pathways and: noise, distance and silence; - silence and: noise, distance and hearing pathways. There was significant difference with and without the FM system, in which the score was always higher. Intra-examiner comparison revealed a significant difference between the total score with FM, via FM and hearing no noise with FM. CONCLUSION: The questionnaire Rating System FM was considered a reliable instrument for verifying and monitoring the benefits of FM system, in order to promote the process of educational inclusion for students with hearing impairments.

Effect of Severe-to-profound Hearin-impaired Children Using FM/HA Combination System / 听力学及言语疾病杂志

Objective To compare the speech recognition by severe - to - profound hearing - impaired children using digital hearing aids and microlink FM system.Methods Hearing - impaired children were given respectively bilateral 100% omnidirection digital hearing aids, bilateral 100% omnidirection digital hearing aids and lateral FM system, bilateral 100% omnidirection digital hearing aids and bilateral FM system in noise and quiet environment. Speech recognition of these children was tested using different intensity.Results There was significant difference between children using microlink FM system and none FM system ( P