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Avaliação do processamento auditivo central e dificuldades de aprendizagem
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Abstract(s)
Introdução: Desde meados do século XX que o Processamento Auditivo Central tem vindo a despertar o interesse de cada vez mais investigadores. As alterações do processamento auditivo central caracterizam-se por ocorrerem em indivíduos que, apesar de apresentarem limiares auditivos tonais dentro dos valores normais, evidenciam dificuldades de compreensão em algumas situações auditivas mais exigentes, motivando a necessidade de novos testes de avaliação que permitam uma avaliação auditiva central.
Objetivos: O presente trabalho teve como objetivo principal contribuir para a criação de uma bateria de testes para avaliação do processamento auditivo central e para a definição de valores normativos em crianças falantes nativas do Português Europeu dos 5 anos aos 12 anos sem patologia. Um segundo grande objetivo consistiu na exploração da viabilidade de aplicação da bateria à identificação de problemas auditivos centrais em crianças com dificuldades de aprendizagem.
Método: Uma bateria de avaliação, incluindo 6 testes (Teste SSW, Teste de Fala Filtrada, Teste de Fala no Ruído, Teste de Deteção de Intervalo no Ruído, Teste de Padrão de Duração e Teste de Padrão de Frequência) foi criada e aplicada a três amostras: a amostra 1 composta por 217 crianças sem patologia; a amostra 2 integrando 52 crianças com dificuldades de aprendizagem; a amostra 3, um grupo misto, de 15 elementos. A análise dos resultados nos vários testes baseou-se nas métricas da estatística descritiva, tendo-se, também, recorrido a curvas AUROC para estudar a variação da sensibilidade e especificidade de cada um dos testes; para finalizar o estudo, foram aplicadas árvores de decisão com o intuito de determinar os testes com maior potencial para identificação de crianças com dificuldades de aprendizagem.
Principais Resultados: Foi possível concluir que: o conjunto de testes utilizados é aplicável a crianças sem patologia nas faixas etárias estudadas, tendo-se obtido dados normativos; os resultados obtidos corroboram o efeito da maturação no desempenho das tarefas auditivas estudadas; um subgrupo dos testes da bateria, composto pelo Teste SSW, Padrão de Duração e Padrão de Frequência, permite identificar com boa sensibilidade e especificidade crianças com dificuldades de aprendizagem.
Conclusão: A realização deste trabalho permitiu avançar na disponibilização de metodologias de avaliação do processamento auditivo central, algo que trará impacto direto a curto e médio prazo na área. Verificou-se, ainda, que uma pequena parte da bateria possui maior capacidade de identificar o grupo com dificuldades de aprendizagem, abrindo, assim, caminho para a criação de uma mini bateria, que poderá ser empregue em rastreios.
Introduction: Since the mid-twentieth century that Central Auditory Processing has attracted the attention of an increasing number of researchers. The changes in central auditory processing are characterized to occur in individuals who, despite having auditory thresholds within normal values, show comprehension difficulties in more demanding listening situations, prompting the need for new assessment tests that allow a central auditory evaluation. Purpose: This study aimed to contribute to the designing of a battery of tests to evaluate the central auditory processing and to define normative values in European Portuguese native speaking children from 5 to 12 years-old without disease. The second major purpose consisted in exploring the feasibility of applying the battery to identify central auditory problems in children with learning difficulties. Methods: A evaluation battery, including 6 tests (SSW Test, Filtered Speech Test, Speech in Noise Test, Detection of Gap in Noise Test, Duration Pattern Test and Frequency Pattern Test), was developed and applied to three study samples: sample 1 consisted of 217 healthy children; sample 2 integrated 52 children with learning difficulties; sample 3, a mixed group, included 15 elements. The analysis of the results in the various applied tests was based on the metrics of descriptive statistics, and AUROC curves were used to study the variation in the sensitivity and specificity of each test; to complete the study, decision trees were applied to determine the tests with more potential to evaluate children with learning disabilities. Main Results: It was concluded that: the set of tests used is applicable to children without pathology in the age groups studied, and normative data were obtained; the results confirm the effect of maturation in the performance of the assessed auditory tasks; it was determined that a subgroup of the battery of tests, which includes the SSW Test, Duration Pattern Test and Frequency Pattern Test, allows us to more accurately identify children with learning difficulties. Conclusions: This work has enabled progress in providing methodologies to evaluate central auditory processing with the development of a battery of tests, which will bring a direct impact in the area in a short-medium term. It was also determined that a specific set of tests had an increased ability to identify the group with learning difficulties, thus opening the way for the creation of a mini battery, that may be employed in screening evaluations.
Introduction: Since the mid-twentieth century that Central Auditory Processing has attracted the attention of an increasing number of researchers. The changes in central auditory processing are characterized to occur in individuals who, despite having auditory thresholds within normal values, show comprehension difficulties in more demanding listening situations, prompting the need for new assessment tests that allow a central auditory evaluation. Purpose: This study aimed to contribute to the designing of a battery of tests to evaluate the central auditory processing and to define normative values in European Portuguese native speaking children from 5 to 12 years-old without disease. The second major purpose consisted in exploring the feasibility of applying the battery to identify central auditory problems in children with learning difficulties. Methods: A evaluation battery, including 6 tests (SSW Test, Filtered Speech Test, Speech in Noise Test, Detection of Gap in Noise Test, Duration Pattern Test and Frequency Pattern Test), was developed and applied to three study samples: sample 1 consisted of 217 healthy children; sample 2 integrated 52 children with learning difficulties; sample 3, a mixed group, included 15 elements. The analysis of the results in the various applied tests was based on the metrics of descriptive statistics, and AUROC curves were used to study the variation in the sensitivity and specificity of each test; to complete the study, decision trees were applied to determine the tests with more potential to evaluate children with learning disabilities. Main Results: It was concluded that: the set of tests used is applicable to children without pathology in the age groups studied, and normative data were obtained; the results confirm the effect of maturation in the performance of the assessed auditory tasks; it was determined that a subgroup of the battery of tests, which includes the SSW Test, Duration Pattern Test and Frequency Pattern Test, allows us to more accurately identify children with learning difficulties. Conclusions: This work has enabled progress in providing methodologies to evaluate central auditory processing with the development of a battery of tests, which will bring a direct impact in the area in a short-medium term. It was also determined that a specific set of tests had an increased ability to identify the group with learning difficulties, thus opening the way for the creation of a mini battery, that may be employed in screening evaluations.
Description
Keywords
Crianças - Linguagem Linguagem - Aquisição Percepção auditiva na criança Dificuldades de aprendizagem Audiometria Teses de doutoramento - 2017