DEBORA MARIA BEFI LOPES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina - Docente
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
5 resultados
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- Investigation of auditory processing disorder and language impairment using the speech-evoked auditory brainstem response(2012) ROCHA-MUNIZ, Caroline N.; BEFI-LOPES, Debora M.; SCHOCHAT, ElianeThis study investigated whether there are differences in the Speech-Evoked Auditory Brainstem Response among children with Typical Development (TD), (Central) Auditory Processing Disorder (C) APD, and Language Impairment (LI). The speech-evoked Auditory Brainstem Response was tested in 57 children (ages 6-12). The children were placed into three groups: TD (n = 18), (C)APD (n = 18) and LI (n = 21). Speech-evoked ABR were elicited using the five-formant syllable/da/. Three dimensions were defined for analysis, including timing, harmonics, and pitch. A comparative analysis of the responses between the typical development children and children with (C)APD and LI revealed abnormal encoding of the speech acoustic features that are characteristics of speech perception in children with (C)APD and LI, although the two groups differed in their abnormalities. While the children with (C)APD might had a greater difficulty distinguishing stimuli based on timing cues, the children with LI had the additional difficulty of distinguishing speech harmonics, which are important to the identification of speech sounds. These data suggested that an inefficient representation of crucial components of speech sounds may contribute to the difficulties with language processing found in children with LI. Furthermore, these findings may indicate that the neural processes mediated by the auditory brainstem differ among children with auditory processing and speech-language disorders.
- Association between language development and auditory processing disorders(2014) ROCHA-MUNIZ, Caroline Nunes; ZACHI, Elaine Cristina; TEIXEIRA, Rosani Aparecida Antunes; VENTURA, Dora Fix; BEFI-LOPES, Debora Maria; SCHOCHAT, ElianeIntroduction: It is crucial to understand the complex processing of acoustic stimuli along the auditory pathway;comprehension of this complex processing can facilitate our understanding of the processes that underlie normal and altered human communication. Aim: To investigate the performance and lateralization effects on auditory processing assessment in children with specific language impairment (SLI), relating these findings to those obtained in children with auditory processing disorder (APD) and typical development (TD). Material and methods: Prospective study. Seventy-five children, aged 6-12 years, were separated in three groups: 25 children with SLI, 25 children with APD, and 25 children with TD. All went through the following tests: speech-in-noise test, Dichotic Digit test and Pitch Pattern Sequencing test. Results: The effects of lateralization were observed only in the SLI group, with the left ear presenting much lower scores than those presented to the right ear. The inter-group analysis has shown that in all tests children from APD and SLI groups had significantly poorer performance compared to TD group. Moreover, SLI group presented worse results than APD group. Conclusion: This study has shown, in children with SLI, an inefficient processing of essential sound components and an effect of lateralization. These findings may indicate that neural processes (required for auditory processing) are different between auditory processing and speech disorders.
- Efficacy of Auditory Training Using the Auditory Brainstem Response to Complex Sounds: Auditory Processing Disorder and Specific Language Impairment(2012) FILIPPINI, R.; BEFI-LOPES, D. M.; SCHOCHAT, E.Objectives: This study verified the efficacy of a formal auditory training (AT) program in children with hearing and language disorders using the auditory brainstem response to complex sounds (c-ABR) with and without background noise. Patients and Methods: Thirty children (7-13 years) were distributed into four groups: typical development (TD: n = 7), auditory processing disorder (APD: n = 9) and specific language disorder (SLIa: n = 6, and SLIb: n = 8). All children underwent behavioral assessment of auditory processing and c-ABR with and without background noise. The APD and SLIa groups underwent 8 weeks of formal AT, but all children were reevaluated 12 weeks after the initial assessment. Results: The TD group presented better behavioral performance than the other groups. For c-ABR in silence, no significant differences were observed among groups or assessments, except regarding VA complex measures, which were altered in the APD group. For c-ABR with background noise, however, the APD, SLIa and SLIb groups presented delayed latencies. Groups that underwent formal AT improved behavioral performance and decreased latencies to c-ABR in background noise at final assessment. Conclusions: These data suggest that efficacy of formal AT can be demonstrated by c-ABR with background noise.
- Sensitivity, specificity and efficiency of speech-evoked ABR(2014) ROCHA-MUNIZ, Caroline Nunes; BEFI-LOPES, Debora Maria; SCHOCHAT, ElianeWe determined the sensitivity, specificity and efficiency of speech-evoked Auditory Brainstem Response (ABR) as a diagnostic support for Auditory Processing Disorder (APD) and specific language impairment (SLI). Speech-evoked ABRs were elicited using the five-formant syllable/da/. The waveforms V. A. C, D, E, F. and 0 of all groups were analyzed. The sensitivity and specificity were calculated, and receiver operating characteristic analyses were performed to determine the optimum cut-off. Seventy-five children who were native speakers of Brazilian-Portuguese participated. The participants included 25 children with APD, 25 children with SLI and 25 with typical development. Statistical analysis demonstrated a cut-off for latency values of 6.48, 7.51, 17.82, 22.33, 30.79, 39.54 and 48.00 for V. A, C, D, E, F, and 0 waves, respectively. The A wave exhibited superior balance for the APD group. For the SLI group, the A, D and 0 waves exhibited the best balance. Furthermore, when analyzing the APD and SLI groups separately, better sensitivity values were observed for the SLI group than the APD group. Speech-evoked ABR is a useful test to identify auditory processing disorders and language impairment. Furthermore, this study represented an important step forward in establishing the clinical utility of speech-evoked ABR in Brazilian Portuguese-speaking children.
- Mismatch negativity in children with specific language impairment and auditory processing disorder(2015) ROCHA-MUNIZ, Caroline Nunes; BEFI-LOPES, Debora Maria; SCHOCHAT, ElianeIntroduction: Mismatch negativity, an electrophysiological measure, evaluates the brain's capacity to discriminate sounds, regardless of attentional and behavioral capacity. Thus, this auditory event-related potential is promising in the study of the neurophysiological basis underlying auditory processing. Objective: To investigate complex acoustic signals (speech) encoded in the auditory nervous system of children with specific language impairment and compare with children with auditory processing disorders and typical development through the mismatch negativity paradigm. Methods: It was a prospective study. 75 children (6-12 years) participated in this study: 25 children with specific language impairment, 25 with auditory processing disorders, and 25 with typical development. Mismatch negativity was obtained by subtracting from the waves obtained by the stimuli /ga/ (frequent) and /da/ (rare). Measures of mismatch negativity latency and two amplitude measures were analyzed. Results: It was possible to verify an absence of mismatch negativity in 16% children with specific language impairment and 24% children with auditory processing disorders. In the comparative analysis, auditory processing disorders and specific language impairment showed higher latency values and lower amplitude values compared to typical development. Conclusion: These data demonstrate changes in the automatic discrimination of crucial acoustic components of speech sounds in children with specific language impairment and auditory processing disorders. It could indicate problems in physiological processes responsible for ensuring the discrimination of acoustic contrasts in pre-attentional and pre-conscious levels, contributing to poor perception.