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 6 Citação(ões) na Scopus
    Fatores que influenciam na participação dos pais de crianças usuárias de implante coclear na (re)habilitação oral: revisão sistemática
    (2013) COUTO, Maria Inês Vieira; CARVALHO, Ana Claudia Martinho
    PURPOSE: To identify and analyze factors that influence the participation of parents in the rehabilitation process of children with cochlear implants (CI). RESEARCH STRATEGY: Question formulation and articles selection in three databases using the following keywords: cochlear implant (implante coclear) and parents (pais). SELECTION CRITERIA: Complete original articles published in Brazilian Portuguese or English, with direct participation of parents of children with CI. DATA ANALYSIS: Articles were fully read. Data regarding characterization of the centers, research methodology and content were analyzed. RESULTS: Thirteen articles were selected based on the established criteria. The types of studies were cross-sectional and case-control (interview technique). The following influential factors were identified: pre-CI surgery factors (knowledge about CI, quality and quantity of information, specialist's advices, ethical and biomedical aspects, rehabilitation engagement, contact with experienced families, social service support and overall costs); rehabilitation aspects (CI use, oral communication modality, regular school, other disabilities, social and demographic aspects and rehabilitation program's effectiveness); other important influential processes (communication modality, auditory and language development, second oral language learning, as well as parent's behavior and satisfaction). CONCLUSION: The engagement of parents in the rehabilitation process of children with CI depends on several distinct influential factors which audiologists should understand and consider when elaborating a rehabilitation program.
  • 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 30 Citação(ões) na Scopus
    Quality of life and cochlear implant: results in adults with postlingual hearing loss
    (2018) SOUSA, Aline Faria de; COUTO, Maria Ines Vieira; MARTINHO-CARVALHO, Ana Claudia
    Introduction: Considering the variability of results found in the clinical population using a cochlear implant, researchers in the area have been interested in the inclusion of quality of life measures to subjectively assess the benefits of the implantation. Objective: To assess the quality of life of adult users of cochlear implant. Methods: A cross-sectional and clinical study in a group of 26 adults of both genders, with mean duration of cochlear implant use of 6.6 years. The Nijmegen Cochlear Implantation Questionnaire and the generic World Health Organization Quality of Life questionnaire were sent electronically. Results: The best assessed domain in the quality of life assessment for the cochlear implantation questionnaire was the social domain, whereas for the quality of life questionnaire it was the psychological domain. The variables, gender, time of cochlear implant use and auditory modality did not influence the results of both questionnaires. Only the variable level of education was correlated with the environment domain of the quality of life questionnaire. The variable telephone speech comprehension was associated with a better perception of quality of life for all the domains of the specific questionnaire and for the self-assessment of quality of life in general. Conclusion: From the users' perspective, both questionnaires showed that cochlear implant brought benefits to different aspects related to quality of life. (C) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
  • article 7 Citação(ões) na Scopus
    Nijmegen Cochlear Implantation Questionnaire (NCIQ): tradução, adaptação cultural e aplicação em adultos usuários de implante coclear
    (2017) SANTOS, Nathália Porfírio dos; COUTO, Maria Inês Vieira; MARTINHO-CARVALHO, Ana Claudia
    ABSTRACT Purpose Cross-cultural adaptation and translation of the Nijmegen Cochlear Implant Questionnaire (NCIQ) into Brazilian Portuguese and analysis of quality of life (QoL) results in adults with cochlear implant (CI). Methods The NCIQ instrument was translated into Brazilian Portuguese and culturally adapted. After that, a cross-sectional and clinical QoL evaluation was conducted with a group of 24 adults with CI. Results The questionnaire title in Brazilian Portuguese is ‘Questionário Nijmegen de Implantes Cocleares’ (NCIQ-P). The version of the NCIQ questionnaire translated into Brazilian Portuguese presented good internal consistency (0.78). The social and physical domains presented the highest scores, with the basic and advanced sound perception subdomains achieving the highest scores. No correlation between gender and time of device use was found for the questionnaire domains and subdomains. Conclusion The cross-cultural adaptation and translation of the NCIQ into Brazilian Portuguese suggests that this instrument is reliable and useful for clinical and research purposes in Brazilian adults with CI.
  • 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.