Re (habilitação) por meio do uso do sistema FM e do treinamento auditivo acusticamente controlado em distúrbio do processamento auditivo
Arquivos
Data
2015-01-28
Autores
Perez, Ana Paula 
Orientadores
Pereira, Liliane Desgualdo
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Verificar a variação comportamental e eletrofisiológica (P300) do processamento auditivo, antes e após diferentes abordagens em adultos, com e sem distúrbio do processamento auditivo. Métodos. Participaram do estudo 21 jovens adultos, com idades entre 18 e 27 anos, sendo 10 sem distúrbio do processamento auditivo (Grupo Comparação) e 11 indivíduos com este distúrbio (Grupo Estudo). Os indivíduos do grupo estudo foram reunidos em três subgrupos segundo a abordagem e denominados GE1, GE2 e GE3. Os indivíduos do GE1 também foram submetidos a uma intervenção placebo e denominados nesse momento GE4. Todos os indivíduos foram submetidos, em dois momentos, à avaliação comportamental do processamento auditivo que avaliaram as habilidades de localização, fechamento, figura-fundo, ordenação e resolução temporal, e avaliação eletrofisiológica, por meio do potencial evocado auditivo de longa latência (P300). Um subgrupo com distúrbio foi selecionado aleatoriamente para a abordagem denominada sem intervenção, grupo estudo 1 (GE1). O GC e o GE1 foram orientados a aguardar em torno de um mês para serem reavaliados. Outro subgrupo com o distúrbio foi selecionado para participar do programa de treinamento auditivo acusticamente controlado (TAAC) durante oito sessões, grupo estudo 2 (GE2). Outro subgrupo com distúrbio foi adaptado com o sistema FM dinâmico, para uso em sala de aula de 4 a 10 semanas, grupo estudo 3 (GE3). Os mesmos indivíduos do GE1, em um segundo momento, participaram de uma abordagem de escuta passiva por um período de quatro semanas, grupo estudo 4 (GE4). Resultados. Na avaliação inicial as piores respostas para os testes comportamentais foram verificadas no grupo estudo. Na segunda avaliação as piores respostas para os testes comportamentais, com diferenças estatisticamente significantes, foram mantidas nos grupos sem intervenção (GE1) e com uso do sistema FM (GE3), enquanto que o grupo que fez o TAAC (GE2) apresentou respostas similares às do grupo comparação, demonstrando melhora e normalização das habilidades auditivas. Quando comparadas as habilidades auditivas no mesmo grupo, avaliadas em dois momentos, foram verificadas: melhora na habilidade de resolução temporal do grupo comparação (GC); melhora nas habilidades de ordenação temporal para uma sequência de sons com diferentes frequências e resolução temporal no grupo que não sofreu intervenção (GE1); melhoras nas habilidades de fechamento, figura-fundo, ordenação e resolução temporal, bem como na diminuição da latência da onda P300 com estímulo de fala, indicativo de aprimoramento na velocidade do processamento de fala, no grupo que fez o TAAC (GE2); melhora em figura-fundo para sons verbais e resolução temporal, com piora em fechamento, houve variação importante com diminuição da latência, para estímulo não verbal e o para estímulo verbal, em dois indivíduos que utilizaram o FM (GE3); o efeito placebo não apresentou respostas positivas em seus resultados (GE4). Conclusão. O programa de TAAC foi eficaz na melhora significativa das habilidades auditivas e da integridade funcional da via auditiva através da medida eletrofisiológica com estímulo de fala. A utilização do sistema FM interferiu em mudanças neurais positivas, com menores respostas de latência em dois indivíduos, sugerindo um processamento cogntitivo mais rápido.
Objective: Verify the behavioral and electrophysiological variation of auditory processing, before and after different approaches in adults with and without auditory processing disorder. Methods: 10 individuals without auditory processing disorder (APD) (comparison group) and 11 individuals with auditory processing disorder (APD) (study group), ranging in age from 18 to 27 years old. Subjects in the study group were gathered into three groups according to the approach and called: GE1, GE2, GE3. The GE1 individuals were also subjected an intervention sham for four weeks and named GE4 in this time. All of them underwent, on two moments, the behavioral auditory processing evaluation that assessed the abilities of location, auditory closure, figure-ground, ordering and temporal resolution, and electrophysiological evaluation, with long latency auditory evoked potential (P300). A subgroup with auditory processing disorder was randomly selected for the approach without intervention, study group 1 (GE1). The GC and GE1 were instructed to wait to be reassessed. Another subgroup with disorder was selected to participate in the auditory training program for eight sessions, study group 2 (GE2). Another subgroup with disorder use the dynamic FM system in classroom over a period of 4-10 weeks, study group 3 (GE3). The same individuals of GE1, in a second stage, participated in a passive listening approach for a four-week period, study group 4 (GE4). Results: In the first evaluation the worst responses to the behavioral tests were observed in the study group. In the second evaluation the worst responses to behavioral tests remained, with statistically significant differences in the groups without intervention (GE1) and FM system (GE3), while the group that performed the auditory training (GE2) showed responses similar, with an improvement and normalization of auditory skills. When compared the auditory abilities in the same group, evaluated in two stages were verified: the improvement in the ability of temporal resolution in the comparison group (GC); improvement in the temporal organization skill for a sequence of sounds with different frequencies and temporal resolution in the group without intervention (GE1); improvements in closing skills, figure-ground, ordering and temporal resolution as well as in reducing the latency of the P300 wave with speech stimuli, indicating an improvement in processing speed of speech, in the group made the TAAC (GE2); improvement in the verbal figure-ground and temporal resolution, with deterioration in auditory closure, there was a significant variation with lower latency for non-verbal and verbal stimuli, two subjects using the FM (GE3); the sham intervention showed no positive responses in their results (GE4). Conclusion: The auditory training program was effective in significantly improving listening skills and functional integrity of the auditory pathway through the electrophysiological measure with speech stimuli. The FM system interfered with positive neural changes, with lower latency response in two individuals, suggesting a faster cognitive processing.
Objective: Verify the behavioral and electrophysiological variation of auditory processing, before and after different approaches in adults with and without auditory processing disorder. Methods: 10 individuals without auditory processing disorder (APD) (comparison group) and 11 individuals with auditory processing disorder (APD) (study group), ranging in age from 18 to 27 years old. Subjects in the study group were gathered into three groups according to the approach and called: GE1, GE2, GE3. The GE1 individuals were also subjected an intervention sham for four weeks and named GE4 in this time. All of them underwent, on two moments, the behavioral auditory processing evaluation that assessed the abilities of location, auditory closure, figure-ground, ordering and temporal resolution, and electrophysiological evaluation, with long latency auditory evoked potential (P300). A subgroup with auditory processing disorder was randomly selected for the approach without intervention, study group 1 (GE1). The GC and GE1 were instructed to wait to be reassessed. Another subgroup with disorder was selected to participate in the auditory training program for eight sessions, study group 2 (GE2). Another subgroup with disorder use the dynamic FM system in classroom over a period of 4-10 weeks, study group 3 (GE3). The same individuals of GE1, in a second stage, participated in a passive listening approach for a four-week period, study group 4 (GE4). Results: In the first evaluation the worst responses to the behavioral tests were observed in the study group. In the second evaluation the worst responses to behavioral tests remained, with statistically significant differences in the groups without intervention (GE1) and FM system (GE3), while the group that performed the auditory training (GE2) showed responses similar, with an improvement and normalization of auditory skills. When compared the auditory abilities in the same group, evaluated in two stages were verified: the improvement in the ability of temporal resolution in the comparison group (GC); improvement in the temporal organization skill for a sequence of sounds with different frequencies and temporal resolution in the group without intervention (GE1); improvements in closing skills, figure-ground, ordering and temporal resolution as well as in reducing the latency of the P300 wave with speech stimuli, indicating an improvement in processing speed of speech, in the group made the TAAC (GE2); improvement in the verbal figure-ground and temporal resolution, with deterioration in auditory closure, there was a significant variation with lower latency for non-verbal and verbal stimuli, two subjects using the FM (GE3); the sham intervention showed no positive responses in their results (GE4). Conclusion: The auditory training program was effective in significantly improving listening skills and functional integrity of the auditory pathway through the electrophysiological measure with speech stimuli. The FM system interfered with positive neural changes, with lower latency response in two individuals, suggesting a faster cognitive processing.
Descrição
Citação
PEREZ, Ana Paula Perez. Re (habilitação) por meio do uso do sistema FM e do treinamento auditivo acusticamente controlado em distúrbio do processamento auditivo. 2015. 175 f. Tese (Doutorado em Fonoaudiologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2015.