MARIA INES VIEIRA COUTO
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- Insertion and performance of Speech-Language Pathology and Audiology in Family Health Support Centers(2014) MOLINI-AVEJONAS, Daniela Regina; ABOBOREIRA, Meiriane Silva; COUTO, Maria Inês Vieira; SAMELLI, Alessandra GiannellaPURPOSE: To analyze the structure of the Centers for Supporting the Family Health (NASF), in 2010, identify the satisfaction degree of speech language pathologists who work in this area and compare the model proposed by the Brazilian Ministry of Health with practice. METHODS: Prospective and descriptive study, with 40 speech language pathologists inserted in NASF type one, from all Brazilian regions, in 2010. It was used a questionnaire with nine questions related to different topics (work infrastructure, NASF team, actions developed by these professionals and satisfaction about the work), sent by electronic mail to the speech language pathologists. Descriptive statistics, χ2, ANOVA and Pearson coefficient of variation were used to analyze variables. Significance level of 5% was adopted. RESULTS: The speech language pathologists reported that, in their working places (NASF), there was an average of 12.2 Health Family Teams, with 8.9 professionals and 1.6 speech language pathologists. Most of them work 40 hours per week. Routine activities cited by speech language pathologists were: promotion and health prevention actions, matricial, therapies, support to health community workers, referrals, home visits, intersectoral actions and administrative tasks. There was variability in the satisfaction score: the majority of interviewees indicated the degree ""Somewhat satisfied"" for work infrastructure and referrals, as well as reported ""Very satisfied"" degree for home visits and support for health community workers. Comparing the model proposed by the Ministry of Health with the speech language pathologists' practices, there was no significant difference. The results show that 40% of speech language pathologists consider that the NASF actions are below the proposed model. CONCLUSION: The NASF structure varied in terms of the number of Family Health Teams, professionals involved and actions performed. There was also significant variability in the satisfaction degree among the subjects studied.
- 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 GentileCentral 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.
- 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 dePURPOSE: 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.
- Longitudinal Analysis of the Absence of Intraoperative Neural Response Telemetry in Children using Cochlear Implants(2014) MOURA, Amanda Christina Gomes de; GOFFI-GOMEZ, Maria Valéria Schmidt; COUTO, Maria Ines Vieira; BRITO, Rubens; TSUJI, Robinson Koji; BEFI-LOPES, Debora Maria; MATAS, Carla Gentile; BENTO, Ricardo FerreiraIntroduction Currently the cochlear implant allows access to sounds in individuals with profound hearing loss. The objective methods used to verify the integrity of the cochlear device and the electrophysiologic response of users have noted these improvements. Objective To establish whether the evoked compound action potential of the auditory nerve can appear after electrical stimulation when it is absent intraoperatively. Methods The clinical records of children implanted with the Nucleus Freedom (Cochlear Ltd., Australia) (CI24RE) cochlear implant between January 2009 and January 2010 with at least 6 months of use were evaluated. The neural response telemetry (NRT) thresholds of electrodes 1, 6, 11, 16, and 22 during surgery and after at least 3 months of implant use were analyzed and correlated with etiology, length of auditory deprivation, and chronological age. These data were compared between a group of children exhibiting responses in all of the tested electrodes and a group of children who had at least one absent response. Results The sample was composed of clinical records of 51 children. From these, 21% (11) showed no NRT in at least one of the tested electrodes. After an average of 4.9 months of stimulation, the number of individuals exhibiting absent responses decreased from 21 to 11% (n = 6). Conclusion It is feasible that absent responses present after a period of electrical stimulation. In our sample, 45% (n = 5) of the patients with intraoperative absence exhibited a positive response after an average of 4.9 months of continued electrical stimulation.
- Risk factors identification in children with speech disorders: pilot study(2013) SILVA, Gabriela Martins Duarte; COUTO, Maria Ines Vieira; MOLINI-AVEJONAS, Daniela ReginaPURPOSE: To identify the main risk factors related to children and their parents, associated with speech and language disorders. METHODS: A prospective descriptive study conducted with 170 children and their parents assisted at a school clinic in the period between March 2010 and July 2012. A protocol was developed for this study in order to identify risk factors for language and speech disorders. Data were tabulated and analyzed using descriptive and inferential statistics by the Χ2 and Student' s t-test . RESULTS: The demographic profile is composed of male children aged between 4 and 5 years old, ethnicity declared by parents as being white, residents of the western region of the city of São Paulo, and whose parents had completed high school. The factors related to family and considered as risks for language impairment were being an only child and having a family history of speech and language disorders. As for the children' s health, prematurity, hospitalization for a long period, and the presence of deleterious oral habits were also considered as risk factors. CONCLUSION: The protocol allows establishing the main risk factors related to children with speech and language disorders. It is suggested that children who present with one or more of the aforementioned risk factors should be regularly monitored for speech and language development and, if necessary, referred for early intervention.
- Organization of the referral and counter-referral system in a speech-language pathology and audiology clinic-school(2015) MOLINI-AVEJONAS, Daniela Regina; ESTEVAM, Stephanie Falarara; COUTO, Maria Inês VieiraOBJECTIVE: To analyze the effectiveness of the referral and counter-referral flow in a speech-language pathology and audiology clinic-school and to characterize the patients' profiles. METHODS: Evaluation, retrospective, and prospective study, in which 503 patient records, without age restriction, were selected from a clinic-school and the following variables were analyzed: demographic information, speech and hearing diagnosis, and references. Patients were distributed into two groups according to the referrals made: internal (G1, n=341) and external (G2, n=162) to the clinic-school. RESULTS: A prevalence of male subjects under 12 years of age and with diagnosis of language disorders (primary and secondary) was found. It was observed that 83% patients in G1 were recalled for evaluation and speech therapy after an average of 7 months of waiting; and from the patients in G2 that were contacted (n=101), 13.9% were summoned and are satisfied with the place indicated for therapy after an average of 4 months of waiting. From those who did not receive care, 46% sought another service, and of these, 72.5% were successful. CONCLUSION: The data show the effectiveness and appropriateness of referrals made internally, suggesting that, when the team works together, the network operates more adequately. However, in relation to external referrals, they did not reach the proposed goals, indicating a lack of speech-language pathologists in public services and the low interest of patients in looking for other places of care.
- 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 MartinhoPURPOSE: 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.
- 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
- 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 deThe 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.
- Avaliação do benefício do uso de aparelhos de amplificação sonora individual em crianças(2012) CARVALHO, Luciana Regina de Lima; LICHTIG, Ida; COUTO, Maria Inês VieiraINTRODUCTION: In Brazil, it is rare studies with using deaf children of auditory device above of seven years. OBJECTIVE: To investigate the benefit supplied for the amplification in deaf children to 7 years old to 11 years old using auditory device, under the perspective of the proper child and the adults with who it more coexists, and to verify if the time of conviviality of the adults with the child intervenes with their answers. METHOD: One is about a clinical and experimental study. They had participated of the study 48 citizens, divided in 4 distinct groups: G1- 12 deaf children; G2- 12 adults with average companionship of 40 weekly hours with the deaf child; G312 adults with average companionship of 20 weekly hours with the deaf child; G4- 12 adults with average companionship of 10 weekly hours with the deaf child. All the children were using of device bilaterally and presented auditory loss of severe or deep degree. RESULTS: The results indicate damage in the auditory abilities of the children evaluated had to the difficulties faced for them to listen to elements gifts in situations of its daily one. The time of companionship with the child did not have differences in the results between the different groups in agreement. CONCLUSION: The viability of the evaluation of the proportionate benefit for the auditory device in children was evidenced clinically on the basis of the information of the family. The device of individual sonorous amplification exerted influence in the auditory abilities of the evaluated children, although the proportionate benefit for its use to be lesser of what the waited one.