Crianças usuárias de implante coclear com atraso do desenvolvimento da percepção auditiva da fala: análise dos fatores que influenciam o desempenho

Abstract

Factors influencing cochlear implant outcomes analysis in children with auditory speech perception developmental delay There are some pediatric cochlear implant (CI) patients who do not develop open set speech recognition even after a long period of device use, and even without presenting factors in the preoperative stage suggestive of this prognosis. The factors that influence the outcomes of these children act in a complex way also in the intra and postoperative stages and the deep knowledge of them is fundamental to conduct intervetion to achieve a successful auditory habilitation. Regarding audiological postoperative follow up, the use of benchmarkers allows the identification of delayed speech perception and language development. Some factors are already described as negatively influential, but an in-depth analysis studies of their causes are needed. Objectives: a) to describe the auditory skills development of children who did not achieve open set speech recognition at the end of five years of CI use; b) to analyze the factors that influence the auditory speech perception development during the five years of CI use, considering audiological postoperative follow up. Methods: exploratory, retrospective longitudinal study by chart analysis, performed at the CPA/Seção de IC of HRAC-USP. Twenty-one children were analyzed. The development of hearing abilities was described through the Hearing Categories (GEERS, 1994). The factors analyzed were: factors related to the electrodes and problems related to the mapping; use interruption of the device; unsystematical use of the device; missed postoperative follow-up; factors related to the auditory therapy and factors related to neurodevelopment. A qualitative analysis of the results was performed using thematic analysis methodology and quantitative analysis, using descriptive and inferential statistics. Results and Discussion: auditory developmentthere was a discrete trend of increasing curve over the years of use, with oscillations; the performance at the end of the studied period could be represented by the Hearing Category "2"detection of perception patterns. For unilaterally implanted children, who do the activation until 36 months of age and without influential factors in the preoperative stage, it can be expected that they reach category 3 after 5 months of CI use, and it can be considered a red flag if they are not reached it until the 12 months of use .The interruption/unsystematic use were the most frequently observed factors and the causes were related to the functioning of the CI, family behavior and refusal of the child; the interruption time was significantly higher when problems of the external component occurred after the end of its warranty (p=0.001). There was a tendency for individuals living farther from the hospital to miss more returns, however, the association was not significant. Conclusion: it was possible to obtain an auditory developmental pattern of the studied group and the results can be used as benchmarks of performance. The analysis of th...

Percepção da fala, linguagem oral e qualidade de vida em indivíduos com síndromes genéticas usuários de implante coclear

“…Outro aspecto pertinente é que, a maioria dos participantes desse grupo (80%) apresentava DNPM dentro dos padrões esperados para a idade, comprovados a partir de avaliação neuropsicológica realizada na etapa pré-cirúrgica e registrada no prontuário, o que permite supor que haviam condições para a realização de procedimentos comportamentais e, consequentemente, estabelecimento do diagnóstico da perda auditiva de grau acentuado precocemente. , 2007;MEINZEN-DERR et al, 2010;MOOG;GEERS, 2010;COLLETTI et al, 2011;SEDEY, 2011;KONTORINIS et al, 2011;HARRIS et al, 2013;DUNN et al, 2014;TREVISI et al, 2016;VAN NIEROP et al, 2016b;ALZHRANI et al, 2018;SIAGH, 2018). O papel da família, o meio ambiente e a inclusão precoce no meio educacional são fortemente destacados como peças fundamentais no processo de habilitação/reabilitação auditiva em usuários de IC, para o desenvolvimento das habilidades auditivas e da linguagem oral (MOOG;GEERS, 2010;SZAGUN;STUMPER, 2012;ALZHRANI et al, 2018).…”

“…O IC é considerado por vários autores um recurso eficaz, sendo uma excelente opção de habilitação/reabilitação auditiva para adultos e crianças com síndromes genéticas, proporcionando a acessibilidade aos sons ambientais, da fala e ao desenvolvimento da linguagem oral, com impacto positivo na qualidade de vida em geral de seus usuários BRENNER;DAVIDSON, 2003;GEERS, 2004;PENNINGS et al, 2006;RAY et al, 2006;WILSON;DORMAN, 2008;THAI-VAN et al, 2010;WARNER-CZYZ et al, 2011;FORTUNATO-TAVARES et al, 2012;PIETOLA et al, 2012;VAN NIEROP et al, 2016a;ALZHRANI et al, 2018). Deste modo, diversos fatores, intrínsecos e extrínsecos ao indivíduo com deficiência auditiva, podem influenciar os resultados com esse dispositivo, caracterizando-se em um processo multifatorial (MORET, 2002;RAJPUT;BROWN;BAMIOU, 2003;BEVILACQUA;FORMIGONI, 2005;BEVILACQUA;TABANEZ, 2006;DUNN et al, 2014;SIAGH, 2018).…”