ANA CLAUDIA MARTINHO DE CARVALHO

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LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina

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  • article 13 Citação(ões) na Scopus
    Cortical maturation in children with cochlear implants: Correlation between electrophysio-logical and behavioral measurement
    (2017) SILVA, Liliane Aparecida Fagundes; COUTO, Maria Ines Vieira; MAGLIARO, Fernanda C. L.; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; CARVALHO, Ana Claudia Martinho de; MATAS, Carla Gentile
    Central auditory pathway maturation in children depends on auditory sensory stimulation. The objective of the present study was to monitor the cortical maturation of children with cochlear implants using electrophysiological and auditory skills measurements. The study was longitudinal and consisted of 30 subjects, 15 (8 girls and 7 boys) of whom had a cochlear implant, with a mean age at activation time of 36.4 months (minimum, 17 months; maximum, 66 months), and 15 of whom were normal-hearing children who were matched based on gender and chronological age. The auditory and speech skills of the children with cochlear implants were evaluated using GASP, IT-MAIS and MUSS measures. Both groups underwent electrophysiological evaluation using long-latency auditory evoked potentials. Each child was evaluated at three and nine months after cochlear implant activation, with the same time interval adopted for the hearing children. The results showed improvements in auditory and speech skills as measured by IT-MAIS and MUSS. Similarly, the long-latency auditory evoked potential evaluation revealed a decrease in P1 component latency; however, the latency remained significantly longer than that of the hearing children, even after nine months of cochlear implant use. It was observed that a shorter P1 latency corresponded to more evident development of auditory skills. Regarding auditory behavior, it was observed that children who could master the auditory skill of discrimination showed better results in other evaluations, both behavioral and electrophysiological, than those who had mastered only the speech-detection skill. Therefore, cochlear implant auditory stimulation facilitated auditory pathway maturation, which decreased the latency of the P1 component and advanced the development of auditory and speech skills. The analysis of the long-latency auditory evoked potentials revealed that the P1 component was an important biomarker of auditory development during the rehabilitation process.
  • article 20 Citação(ões) na Scopus
    Quality of life evaluation in children with cochlear implants
    (2015) ALMEIDA, Renata Paula de; MATAS, Carla Gentile; COUTO, Maria Inês Vieira; CARVALHO, Ana Claudia Martinho de
    PURPOSE: To evaluate the quality of life of children with cochlear implants from the perspective of their parents. METHODS: A clinical and cross-sectional study was conducted with 15 parents of children using cochlear implants of both genders aged between 2 and 12 years old. Parents of these children answered the questionnaire ""Children with Cochlear Implants: Parental Perspective"" (CCIPP). Data related to auditory category and time of cochlear implants use were collected from medical records of the children. The percentages of responses on the CCIPP domains were tabulated and descriptively and inferentially analyzed. RESULTS: The cochlear implants had a positive effect on the quality of life of children in the self-reliance (58.9%) and social relationships (56.7%) domains. No correlation was observed between the time of cochlear implants activation (months) and any of the CCIPP domains. However, children with 24 months or less of cochlear implant use presented higher percentages on the communication domain than those with more than 24 months of cochlear implants use. A negative correlation was observed between the auditory category and the effects of the implant domain. CONCLUSION: From the perspective of parents, the use of cochlear implants improves the quality of life of their children; the shorter the time of cochlear implants use, the higher the improvement in quality of life; and the more developed the auditory skills, the lower the percentage of quality of life improvement with the cochlear implants.
  • article 0 Citação(ões) na Scopus
    Cortical maturation in children with cochlear implants: Correlation between electrophysiological and behavioral measurement (vol 12, e0171177, 2017)
    (2017) SILVA, Liliane Aparecida Fagundes; COUTO, Maria Ines Vieira; MAGLIARO, Fernanda C. L.; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; CARVALHO, Ana Claudia Martinho de; MATAS, Carla Gentile
  • article 6 Citação(ões) na Scopus
    Long latency auditory evoked potentials in children with cochlear implants: systematic review
    (2013) SILVA, Liliane Aparecida Fagundes; COUTO, Maria Ines Vieira; MATAS, Carla Gentile; CARVALHO, Ana Claudia Martinho de
    The aim of this study was to analyze the findings on Cortical Auditory Evoked Potentials in children with cochlear implant through a systematic literature review. After formulation of research question and search of studies in four data bases with the following descriptors: electrophysiology (eletrofisiologia), cochlear implantation (implante coclear), child (criança), neuronal plasticity (plasticidade neuronal) and audiology (audiologia), were selected articles (original and complete) published between 2002 and 2013 in Brazilian Portuguese or English. A total of 208 studies were found; however, only 13 contemplated the established criteria and were further analyzed; was made data extraction for analysis of methodology and content of the studies. The results described suggest rapid changes in P1 component of Cortical Auditory Evoked Potentials in children with cochlear implants. Although there are few studies on the theme, cochlear implant has been shown to produce effective changes in central auditory path ways especially in children implanted before 3 years and 6 months of age.
  • article 15 Citação(ões) na Scopus
    Maturação dos potenciais evocados auditivos de longa latência em crianças ouvintes: revisão sistemática
    (2017) SILVA, Liliane Aparecida Fagundes; MAGLIARO, Fernanda Cristina Leite; CARVALHO, Ana Claudia Martinho de; MATAS, Carla Gentile
    ABSTRACT Purpose To analyze how Auditory Long Latency Evoked Potentials (LLAEP) change according to age in children population through a systematic literature review. Research strategies After formulation of the research question, a bibliographic survey was done in five data bases with the following descriptors: Electrophysiology (Eletrofisiologia), Auditory Evoked Potentials (Potenciais Evocados Auditivos), Child (Criança), Neuronal Plasticity (Plasticidade Neuronal) and Audiology (Audiologia). Selection criteria Level 1 evidence articles, published between 1995 and 2015 in Brazilian Portuguese or English language. Data analysis Aspects related to emergence, morphology and latency of P1, N1, P2 and N2 components were analyzed. Results A total of 388 studies were found; however, only 21 studies contemplated the established criteria. P1 component is characterized as the most frequent component in young children, being observed around 100-150 ms, which tends to decrease as chronological age increases. The N2 component was shown to be the second most commonly observed component in children, being observed around 200-250 ms.. The other N1 and P2 components are less frequent and begin to be seen and recorded throughout the maturational process. Conclusion The maturation of LLAEP occurs gradually, and the emergence of P1, N1, P2 and N2 components as well as their latency values are variable in childhood. P1 and N2 components are the most observed and described in pediatric population. The diversity of protocols makes the comparison between studies difficult.
  • article 8 Citação(ões) na Scopus
    Idade no diagnóstico e no início da intervenção de crianças deficientes auditivas em um serviço público de saúde auditiva brasileiro
    (2012) PINTO, Meliane Melina; RAIMUNDO, Jeziela Cristina; SAMELLI, Alessandra Giannella; CARVALHO, Ana Claudia Martinho de; MATAS, Carla Gentile; FERRARI, Gisele Munhoes dos Santos; GARBI, Sérgio; GÂNDARA, Mara; BENTO, Ricardo Ferreira
    INTRODUCTION: The earlier the diagnosis and the intervention from the hearing impairment less will be the impact for the development of cognitive abilities, hearing and of speech from the child. OBJECTIVE: Characterize the age in the diagnosis and the beginning of intervention of the hearing loss and the accompaniment of the assisted children in a public Brazillian hearing health service - Espaço Reouvir from the Clinicas Hospital from the Medical School from the University of São Paulo. METHOD: Retrospective study with information from 166 medical records from children regarding the: gender; etiology, type, degree and laterality of the hearing impairment; age in the diagnosis and adaptation of the Hearing aids (HA) and accompaniment in the service. RESULTS: The sample was composed by 56% men and 44% women. The prevailing etiology was from multifactorial origin. The hearing loss from the neurosensory type occurred in 88,6% of the cases. The degree of moderate hearing loss was the most frequent (30,7%), symmetry in both ears was found in 69,9% of the cases and unilateral hearing loss in 2,4%. The average age in the diagnosis was of 5,46 years and in the intervention was of 6,86 years. A total of 96,98% of children had already completed the process of adaptation and 78,32% still remained in the accompaniment. CONCLUSION: The program Reouvir-HCFMUSP still receives children, both for diagnosis and or intervention in a late manner. However, still is possible the realization of the accompaniment of a significant number of users of the hearing aids, enabling a process of adaptation more effective.
  • article 4 Citação(ões) na Scopus
    Maturação dos potenciais evocados auditivos de longa latência em crianças ouvintes: análise do complexo P1-N1-P2-N2
    (2017) SILVA, Liliane Aparecida Fagundes; MAGLIARO, Fernanda Cristina Leite; CARVALHO, Ana Claudia Martinho de; MATAS, Carla Gentile
    ABSTRACT Purpose The purpose of this study was to monitor the emergence and changes to the components of the Long Latency Auditory Evoked Potentials (LLAEP) in normal hearing children. Methods This longitudinal study included children of both genders: seven aged between 10 and 35 months, and eight children between 37 and 63 months. The electrophysiological hearing evaluation consisted of analysis of LLAEP obtained in a sound field generated with loudspeakers positioned at an azimuth of 90°, through which the syllable /ba/ was played at an intensity of 70 dB HL. Each child underwent an initial evaluation followed by two re-evaluations three and nine months later. Results The emergence of LLAEP components across the nine-month follow-up period was observed. P1 and N2 were the most common components in children of this age range. There was no statistically significant difference regarding the occurrence of P1, N1, P2, and N2 components amongst younger and older children. Regarding latency values, the greatest changes overtime were observed in the P1 component for younger children and in the N2 component for older children. Only the P1 component significantly differed between the groups, with the highest latency values observed in younger children. Conclusion LLAEP maturation occurs gradually and the emergence of complex components appears to be related more to the maturation of the central auditory nervous system than to chronological age.
  • article
    Aquisição de vocábulos em crianças usuárias de implante coclear
    (2014) SOUSA, Aline Faria; COUTO, Maria Inês Vieira; CARVALHO, Ana Claudia Martinho de; MATAS, Carla Gentile; BEFI-LOPES, Débora Maria
    PURPOSE: to analyze word acquisition in early oral language development of a group of children with cochlear implants. METHODS: this consisted on a clinical, prospective and longitudinal study. Five mothers of children with cochlear implants participated. The mothers reported the words that were spontaneously produced by their children. The Language Development Survey adapted to Brazilian Portuguese was administered once a month, totaling six moments per child. The paired t-test was used on the longitudinal data analysis. RESULTS: the mean number of words spontaneously produced by the group of children gradually increased from the first to the sixth month: 38 to 58.8 words. There were significant differences in the number of words produced on Moment 1 and Moment 5 (p = 0.016) and between Moment 1 and Moment 6 (p = 0.010). The categories with the greatest number of words produced by children were other, people, modifiers and actions. The categories with the greatest increase were modifiers, body parts and other. CONCLUSIONS: the group of children with cochlear implants showed a gradual increase in the number of words spontaneously (mainly other, modifiers, people and actions) produced over a period of six months, being significant after the fifth month of Speech-Language therapy. The number of words produced increased with higher significance with longer intervention periods. It is suggested that Speech-Language Pathologists apply the formulary on a six-month interval as this is an ideal period to evidence lexical acquisition.
  • article 6 Citação(ões) na Scopus
    Telephone Usage and Cochlear Implant: Auditory Training Benefits
    (2015) SOUSA, Aline Faria de; CARVALHO, Ana Claudia Martinho de; COUTO, Maria Ines Vieira; TSUJI, Robinson Koji; GOFFI-GOMEZ, Maria Valéria Schmidt; BENTO, Ricardo Ferreira; MATAS, Carla Gentile; BEFI-LOPES, Debora Maria
    Introduction: Difficulties with telephone use by adult users of cochlear implants (CIs) are reported as a limitation in daily life. Studies to improve the speech understanding of CI users on the telephone are scarce in the Brazilian scientific literature. Objective To develop and evaluate the effectiveness of a training program of auditory abilities on the telephone for an adult CI user. Resumed Report The subject was a 55-year-old woman with a degree in accounting who used a CI for 24 months. The program consisted of three stages: pretraining evaluation, eight sessions of advanced auditory abilities training, and post-training evaluation. Auditory abilities with CI were evaluated before and after training in three conditions: sound field, telephone with the speech processor in the microphone function, and telephone with the speech processor in the telecoil function. Speech recognition was assessed by three different lists: one with monosyllabic and dissyllabic words, another with nonsense syllables, and another one with sentences. The Client Oriented Scale of Improvement (COSI) was used to assess whether the needs established by the CI user in everyday telephone use situations improved after training. The auditory abilities training resulted in a relevant improvement in the percentage of correct answers in speech tests both in the telephone use conditions and in the sound field condition. Conclusion The results obtained with the COSI inventory indicated a performance improvement in all situations presented at the beginning of the program.
  • article
    Auditory Cortical Maturation in a Child with Cochlear Implant: Analysis of Electrophysiological and Behavioral Measures
    (2015) SILVA, Liliane Aparecida Fagundes; COUTO, Maria Ines Vieira; TSUJI, Robinson Koji; BENTO, Ricardo Ferreira; CARVALHO, Ana Claudia Martinho de; MATAS, Carla Gentile
    The purpose of this study was to longitudinally assess the behavioral and electrophysiological hearing changes of a girl inserted in a CI program, who had bilateral profound sensorineural hearing loss and underwent surgery of cochlear implantation with electrode activation at 21 months of age. She was evaluated using the P1 component of Long Latency Auditory Evoked Potential (LLAEP); speech perception tests of the Glendonald Auditory Screening Procedure (GASP); Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS); and Meaningful Use of Speech Scales (MUSS). The study was conducted prior to activation and after three, nine, and 18 months of cochlear implant activation. The results of the LLAEP were compared with data from a hearing child matched by gender and chronological age. The results of the LLAEP of the child with cochlear implant showed gradual decrease in latency of the P1 component after auditory stimulation (172 ms-134 ms). In the GASP, IT-MAIS, and MUSS, gradual development of listening skills and oral language was observed. The values of the LLAEP of the hearing child were expected for chronological age (132ms128ms). The use of different clinical instruments allow a better understanding of the auditory habilitation and rehabilitation process via CI.