Keywords
deafness - child - evaluation
Palavras-chave
surdez - criança - avaliação
Introduction
The technological advance of the systems of amplification, in specific the device
of individual sonorous amplification (AASI), has brought the necessity to evaluate
the resultant impact of these resources in the auditory abilities of its users as
well as in the services given for the programs of audiologic rehabilitation[1]
[2]. Questionnaires and scales of evaluation of the auditory abilities have been widely
used with this objective, for being of easy application and the same allowing the
accomplishment of longitudinal studies with the use of instrument in different stages
of the therapeutically process[3].
Amongst the methods that consider the perspective of the user in the evaluation of
the benefits of the amplification, auto-evaluation instruments exist, which in its
majority, directed the adult and aged population. The related to the available auditory
difficulties for children and adapted questionnaires of evaluation for the Portuguese
concentrate in the age group of zero the seven years of age and are directed its parents:
The Meaningful Auditory Integration Scale - MORE[4]
[1]; The Infant-Toddler Meaningful Auditory Integration Scale - IT-MAOR[5]
[6]. Related studies the children above of this age group and that they still consider
the perspective of the proper child are scarce[7].
The linguistic development of the deaf child follows the same periods of training
that of a child listener, either in the verbal or visual modality (language of signals).
However, due to interference of the auditory sensorial privation in the acquisition
of the verbal language, the deaf children, children of parents listeners - that they
are not displayed to the language of signals since the birth, as occurs with the deaf
children, children of deaf parents - generally reach the pertaining to school phase
without possessing a systemize language. From there the difficulty in having access
such population by means of questionnaires appears[8]
[9]
[10]
[11].
It is important to stand out that the beneficiaries of the auditory device are not
only the users, but also all those that suffer to limitations in activities and restrictions
from participation in reason of the existence of a involved deaf person in the action
or task. That is, familiar and the too much people who also coexist an user of auditory
device are beneficiary of this product and, as such, they search evidences of that
it will promote an improvement in the auditory abilities as a whole[12]
[13].
In reply to this, the Institute of Audiologic Research developed the LSQ - Listening
Situations Questionnaire[14]. Later, Appleton and Bamford
[15] had used this questionnaire in a research with 16 deaf children with auditory loss
daily pre-linguistic in the age group of 7 to the 11 years, and the respective parents.
The study compared the degree of auditory difficulty told by the children and observed
by the parents. In the majority of the cases, the children had told to minor difficulty
with regard to the auditory abilities of what she was observed by the adults. The
authors had argued if the differences in the answers between parents and children
must to the fact of the parents overestimate the difficulty of the children or the
children not to confer as much importance to the difficulty who feel a time that does
not possess an experience that serves of parameter for the comparison of the degree
of the difficulty. The situations proposals in the LSQ evaluate the auditory abilities
of the child to detect, to discriminate, to recognize and to understand says and some
sonorous signals to it of alert or social conviviality, considering in the distance
of the sonorous source (localization) and the presence or not of noise (figure-deep).
Considering that the auditory difficulty generates restrictions of participation to
the child in diverse activities of the daily one and the LSQ is an instrument that
measures the auditory abilities, is inferred that the use of the auditory device will
be able to promote changes in the auditory abilities of the deaf child[2]
[16].
The objectives of the present study had been: to investigate the benefit supplied
for the amplification in deaf children of 7 to the 11 years that uses the auditory
device, under the perspective of the proper child and the adults with who it more
coexists; e to verify if the time of conviviality of the adults with the child intervene
with its answers.
Method
It is about a clinical, observational and transversal study, approved in August 24th of 2007 for the Commission of Ethics for Analysis of Projects of Research - CAPPesq
of the Clinical Direction of the Hospital of the Clinics and the College of Medicine
of the University of São Paulo (protocol #0601/07).
Casuistry
The research was carried through with 12 families of deaf children in the age group
of 7 to the 11 years. All the children were using auditory device bilaterally and
presented auditory loss of severe degree the deep one. All the citizens were using
of auditory device have three years more than and the average of the time of use of
the device was five years ([Table 1]).
Table 1.
Characterization of the deaf children.
|
Citizens
|
Gender
|
Age
|
Degree of the Auditory Loss
|
Time of use of AASI
|
Linguistic period of training (Pictures, 1997)
|
|
1
|
F
|
11 years
|
severe
|
7 years
|
O: Multiple Combinations
S: Simple Combination
|
|
2
|
M
|
8 years
|
deep
|
5 years
|
O: Pre-linguistic
S: Multiple Combinations
|
|
3
|
F
|
7 years
|
deep
|
4 years
|
O: Pre-linguistic
S: Multiple Combinations
|
|
4
|
F
|
7 years
|
deep
|
6 years
|
O: Stage of 1 word
S: Simple Combination
|
|
5
|
F
|
9 years
|
severe
|
4 years
|
O: Multiple Combinations
S: Pre-linguistic
|
|
6
|
M
|
7 years
|
deep
|
6 years
|
O: Simple Combination
S: Multiple Combinations
|
|
7
|
M
|
8 years
|
severa
|
4 years
|
O: Multiple Combinations
S: Stage of 1 signal
|
|
8
|
M
|
11 years
|
deep
|
7 years
|
O: Stage of 1 word
S: Multiple Combinations
|
|
9
|
M
|
7 years
|
deep
|
5 years
|
O: Simple Combination
S: Simple Combination
|
|
10
|
M
|
9 years
|
deep
|
5 years
|
O: Pre-linguistic
S: Simple Combination
|
|
11
|
M
|
8 years
|
deep
|
4 years
|
O: Stage of 1 word
S: Multiple Combinations
|
|
12
|
M
|
10 years
|
severe
|
5 years
|
O: Multiple Combinations
S: Pre-linguistic
|
Legend: The verbal language; S - language of signals.
The citizens whose preferential communicative modality was the language of signals
totalized seven children, all with auditory losses of deep degree. Between the citizens
whose preferential communicative modality was the verbal language, of a total of five
children, four (80%) presented auditory losses of severe degree, and only one child
(20%) presented loss of deep degree.
48 citizens had participated of the study, which had been divided in four distinct
groups: C1- 12 deaf children; A1- 12 adults with average coexistence of 40 weekly
hours in relation to the deaf child; A2- 12 adults with average coexistence of 20
weekly hours in relation to the deaf child; A3- 12 adults with average coexistence
of 10 weekly hours in relation to the deaf child.
The age group of the adults varied of 19 the 73 years (average of 40 years), of which
24 (66.7%) were of feminine sex and 12 (33.3%) of the masculine sex ([Table 2]).
Table 2.
Characterization of the adults.
|
Citizen
|
Sex
|
Age
|
Degree of kindred/Proximity
|
|
Child 1
|
A1
|
F
|
34
|
Mother
|
|
A2
|
M
|
35
|
Father
|
|
A3
|
F
|
42
|
Aunt
|
|
Child 2
|
A1
|
F
|
29
|
Mother
|
|
A2
|
M
|
37
|
Father
|
|
A3
|
F
|
53
|
Grandfather
|
|
Child 3
|
A1
|
F
|
29
|
Mother
|
|
A2
|
M
|
37
|
Father
|
|
A3
|
F
|
53
|
Grandmother
|
|
Child 4
|
A1
|
F
|
31
|
Mother
|
|
A2
|
M
|
35
|
Father
|
|
A3
|
F
|
60
|
Grandmother
|
|
Child 5
|
A1
|
F
|
43
|
Mother
|
|
A2
|
M
|
56
|
Father
|
|
A3
|
F
|
23
|
Sister
|
|
Child 6
|
A1
|
F
|
41
|
Mother
|
|
A2
|
F
|
30
|
Godmother
|
|
A3
|
F
|
28
|
Phonotherapeutic
|
|
Child 7
|
A1
|
F
|
25
|
Mother
|
|
A2
|
M
|
30
|
Father
|
|
A3
|
F
|
73
|
Grandmother
|
|
Child 8
|
A1
|
F
|
28
|
Mother
|
|
A2
|
M
|
42
|
Father
|
|
A3
|
F
|
34
|
Neighbor
|
|
Child 9
|
A1
|
F
|
44
|
Mother
|
|
A2
|
M
|
44
|
Father
|
|
A3
|
F
|
38
|
Woman Friend
|
|
Child 10
|
A1
|
M
|
45
|
Father
|
|
A2
|
M
|
56
|
Man Friend
|
|
A3
|
F
|
59
|
Woman Friend
|
|
Child 11
|
A1
|
F
|
39
|
Mother
|
|
A2
|
M
|
41
|
Father
|
|
A3
|
F
|
19
|
Cousin
|
|
Child 12
|
A1
|
F
|
45
|
Mother
|
|
A2
|
M
|
43
|
Father
|
|
A3
|
F
|
27
|
Teacher
|
Legend: A1 - adult 1; A2 - adult 2; A3 - adult 3.
How much to the proximity or degree of kindred, 11 adults of the A1 group were mothers
(91.7%), and only one citizen (8.3%) was father of the deaf child. In the A2 group,
10 adults were parents (83.4%), one was friend of the family (8.3%) and an age godmother
of the child (8.3%). In the A3 group, it had four grandmothers (33.4%), two friends
of the family (16.8%), a sister (8.3%), a neighbor (8.3%), an aunt (8.3%), a cousin
(8.3%), a phonoaudiologic (8.3%) and a teacher (8.3%).
Already how much to the schooling degree, 60% of the adults were of basic level (less
than nine years of study), 20% of average level (the nine to twelve years of study)
and 20% of superior level (above of twelve years of study).
The used criteria of inclusion in this study had been:
-
Pertaining to school children with age group between 7 years to the 11 years and 11
months; inserted in intervention bilingual program; with sensorineural auditory loss
of severe or deep degree; AASI users have one year at least, in order to guarantee
its experience of use; pertaining the families of listeners, therefore in the questionnaire
had been observed situations that used to be part of the routine of families listeners,
as to hear music and to speak to the telephone; minimum time of daily use of the devices
of eight hours.
-
Adults with age group above of 18 years of age; listeners; time of coexistence with
the equal or superior child the ten weekly hours. In the absence of familiar that
they satisfied the criteria demanded for participation in the research, other adults
had been invited who coexisted in agreement child the established criteria.
Had been considered as exclusion criteria:
-
Children with commitments associates - neurological (syndromes, deficiencies or any
another condition that generated a cognitive delay, a time that this would harm the
understanding of the questions), appearance (blindness, low vision or vision subnormal,
what AASI would hinder the correct manipulation it and would make it difficult the
identification of the figures of the questionnaire), emotional (depression/ hyperactivity,
to guarantee the contribution of the child);
-
Children who did not attend school (a time that one of the factors analyzed in the
research was the proportionate benefit for the AASI in the pertaining to school environment).
Material
The Questionnaire of Situations of Hear was used (LSQ) - version for children[14] and version for parents[17]. This questionnaire was translated and adapted for the Brazilian Portuguese as the
norms of the Scientific Advisory Committee of Medical Outcomes Trust[18]
[19] and currently meets in validation phase. It understands ten situations related to
the common auditory difficulties to the majority of the deaf children, namely: to
hear what is said by the professor in a noise classroom; to hear the instructions
of an adult in external environments; to hear the bell or the touch of the telephone
when he is in another one room of the house; to hear the sound of vehicles if approaching;
to talk with some children in a classroom; to hear television with other people; to
hear alone television; to hear music; to hear what it is said in the telephone; to
hear the sound of the buzzer of an ambulance. For each situation, three questions
are made: a) how much this situation is important for the child; b) which the frequency
where it occurs; c) how much difficulty the child presents in this situation (scores
of difficulty).
For each one of the three items of the LSQ had four possibilities of reply, which
varied of 1 to 4 points, in accordance with the importance/frequency/degree of difficulty
of the ten presented situations. The maximum total score for this questionnaire was
of 120 points, and the minimum, 30 points. How much bigger is the score, greater the
difficulty faced for the child and, consequently, less its auditory abilities[15].
The score of difficulty was determined by the addition of the punctuations gotten
in item C of each question. The maximum score was of 40 points, and minimum ten. In
the cases where the child did not use the auditory device in definitive situation,
she asked herself if the child did not use it for presenting much difficulty in this
situation (4 points), or for it not to have difficulty (1 point).
By the Appleton and Bamford
[15], superior total scores to 100 points indicate the necessity of revision of the device
and score of difficulty above of 22 demands the analysis of the situations where the
child presents more difficulty, associated with a detailed revision of the functioning
of the device. Scores of difficulty is closely on to the benefit offered for the auditory
device, being that high scores disclose the existence of obstacles in the execution
of activities considered excellent in the daily one of a child.
It is considered, therefore, that the benefit supplied for the amplification is adjusted
when there is total score below of 100 points and props up of inferior difficulty
the 22 in the LSQ ([Table 3]).
Tabela 3.
Pontuações do LSQ segundo Appleton e Bamford (2006).
|
Minimum
|
Maximum
|
Waited
|
|
Total Score
|
30
|
120
|
Under than 100
|
|
Score of Difficulty
|
10
|
40
|
below of 22
|
After the signature of the assent term ([Annex 1]), the questionnaire was managed with deaf child and, in the sequence, with three
adults whom the child coexisted. In the cases of the deaf children whose preferential
communicative modality was the language of signals, the application of the questionnaire
was made in Brazilian Language of Signals (LIBRAS). For in such a way, the researcher
received the training from a deaf professor. For the children who found in the initial
periods of training of the verbal language, one used the figures of the questionnaire
to facilitate to its understanding, requesting itself it the child who pointed the
chosen option.
Annex 1.
|
HOSPITAL OF THE CLINICS OF THE COLLEGE OF MEDICINE OF THE UNIVERSITY OF SÃO PAULO
TERM OF FREE AND CLARIFIED ASSENT
(Instructions for fulfilling in the verse)
|
|
I - DATA OF IDENTIFICATION OF THE CITIZEN OF THE RESEARCH OR THE LEGAL RESPONSIBLE.
NAME OF THE PATIENT.: ...............................................................................................
DOCUMENT OF IDENTITY: ........................................ SEX: M ( ) F ( )
BIRTHDAY: ......../......../......
ADDRESS ...........................................................................
N° ...................... APT: .............
QUARTER: ........................................................ CITY ..........................................................
CEP: ......................................... TELEPHONE: DDD (............) ...............................................
2. LEGAL RESPONSIBLE .......................................................................................................
NATURE (degree of kindred, tutor, custodian etc.) ....................................................................
IDENTITY DOCUMENT: .................................... SEX: M ( ) F ( )
BIRTHDAY.: ....../......./......
ADDRESS: .............................................. N° ................... APT:
.............................
QUARTER: .......................................................... CITY: .....................................................
CEP: .............................................. TELEPHONE: DDD (............)
.........................................
_____________________________________________________________________________________________
II - DATA ON THE SCIENTIFIC RESEARCH
1. HEADING OF THE RESEARCH PROTOCOL QUALITY OF LIFE OF THE DEAF CHILD OF 7 THE 12
YEARS: THE PAPER OF THE DEVICE OF INDIVIDUAL SONOROUS AMPLIFICATION
2. RESEARCHER: Luciana Regina de Lima Carvalho
FUNCTION/EMPLOYEE: Studying Master of Phonoaudiology
REGISTRATION REGIONAL ADVICE N° 15898
UNIT of the HCFMUSP: Department of Physiotherapy, Speech Therapy and Occupational
Therapy of the College of Medicine of the University of São Paulo
3. EVALUATION OF THE RISK OF THE RESEARCH:
WITHOUT RISK OF DANGER • MINIMUM RISK •* AVERAGE RISK •
RISK LOW • RISK BIGGER •
(Probability from that the individual suffers some damage as immediate or delayed
consequence of the study)
* is about an evaluation of not invasive speech therapist nature.
4. DURATION OF the RESEARCH: 2 years
_____________________________________________________________________________________________
III - REGISTER OF THE EXPLANATIONS OF THE RESEARCHER TO THE PATIENT OR ITS LEGAL REPRESENTATIVE
ON THE RESEARCH CONSIGNING:
Your son was invited to participate of a work whose objective is to investigate the
quality of life of deaf children in the age group of 7 the 12 years of age, under
the point of view of different people who coexist it and taking as base the paper
of the use of the auditory device. That is, the objective of this research is to verify
if the adequate use of the auditory device can increase the quality of life of the
deaf child. For this, information of different people will be collected who coexist
the child.
The following materials and procedures will be used: questionnaire with questions
on the behavior of the child in different situations (to be answered by the proper
child and the people that coexists it), comment of the manuscript of the device (carried
through for the responsible child or), and examinations of hearing (audiometry and
tests of speak, with and without the device). The application of the questionnaires
and the comment of the manuscript of the device will be filmed. The total duration
will be of approximately two hours and stocking, however, so that the participants
are not very tired, the hearing examinations will not be carried through in the same
day of the application of the questionnaires and comment of the manuscript of the
device.
The research presents minimum risk, since it is not of invasive nature. As discomfort,
the participant could be tired, since she will remain in evaluation for a period of
about eighty minutes in each one of the days of evaluation. It will be able to still
have a light bother due to rank of the phones in the ears for accomplishment of the
hearing examinations.
The result of the evaluation will be given to each one of the participants. Children
who present problems will be directed for specialized professional evaluation. It
does not have restriction of participation in any other procedures of any nature.
_____________________________________________________________________________________________
IV - CLARIFICATIONS GIVEN FOR THE RESEARCHER ON GUARANTEES OF THE CITIZEN OF THE RESEARCH
CONSIGNING:
The participant will have access to any time to the information on procedures, risks
and benefits related to the research, also to nullify eventual doubts.
The participant will have freedom to remove its assent at any time and to leave to
participate of the study, without this brings damage to the continuity of the assistance.
The data of this research will be kept, after the ending of the same one (2009) per
more 5 years (up to 2014).
The research does not present risk to provoke damages to the health, for not being
invasive.
_____________________________________________________________________________________________
V. INFORMATION OF NAMES, ADDRESSES AND TELEPHONES OF THE RESPONSIBLE ONES FOR THE
ACCOMPANIMENT OF THE RESEARCH, FOR CONTACT IN CASE OF CLINICAL INTERCORRÊNCIAS AND
ADVERSE REACTIONS.
LUCIANA REGINA DE LIMA CARVALHO. OLGA BENÁRIO STREET, 53, TEL. 3989-8686 / 7242-3823
IDA LICHTIG. CIPOTÂNEA STREET, 51, TEL. 3091-8418
_____________________________________________________________________________________________
VII - ASSENT AFTER-CLARIFIED
I declare that, after conveniently clarified for the researcher and to have understood
what was explained me, I assent in participating of the present Protocol of São Paulo
Research, June 20th of 2007.
_____________________________________________________________________________________________
Signature of the citizen of the responsible research or legal signature of the researcher
(Stamp or Legible name)
|
It was opted to managing the protocol in the residences of the citizens in order to
offer to greater comfort to the families and to uninhibited the child, a time that
being outside of the therapeutically environment this would hold in more natural way,
propitiating the comment of same in situations daily it and the familiar dynamics[20].
Results
Auditory abilities in the perception of the children
There was great variability of answers for the item (how much the situation is important
for the child). Perhaps this explains due to the character most personal of this question,
generating bigger divergence between the answers given for the citizens. In item B
(which the frequency where the situation occurs), had some divergences between the
answers due the differences in the routine and familiar dynamics of the analyzed citizens.
Already item C (difficulty presented for the child in the situation) had little divergence
between the answers, what it is justified for the raised degree of auditory difficulty
related by all the citizens ([Table 4]).
Table 4.
Results of the group of deaf children how much to the answers for question.
|
Question
|
Medium
|
Shunting line-standard
|
|
1A – how much is important to hear what it is said by the professor in a noise room
|
2,93
|
1,398
|
|
1B – The frequency that occurs to have to hear what is said by the professor in a
noise room
|
2,27
|
1,335
|
|
1C – how much difficulty feels to hear what it is said by the professor in a noise
room
|
2,67
|
1,125
|
|
2A – how much is important to hear the instructions of an adult in external environments
|
2,73
|
1,223
|
|
2B – The frequency that occurs to have to hear the instructions of an adult in external
environments
|
2,93
|
1,016
|
|
2C – how much difficulty feels to hear the instructions of an adult in external environments
|
3,13
|
,915
|
|
3A – how much important is to hear the touch of the telephone in another room of the
house
|
3,13
|
1,125
|
|
3B – The frequency that occurs to have to hear the touch of the telephone in another
room of the house
|
2,53
|
,915
|
|
3C – how much difficulty feels to hear the touch of the telephone in another one room
of the house
|
2,80
|
1,163
|
|
4A – how much is important to hear the sound of vehicles approaching
|
2,87
|
1,125
|
|
4B – the frequency that occurs to have to hear the sound of vehicles approaching
|
2,73
|
1,100
|
|
4C – how much difficulty feels when hearing the sound of vehicles approaching
|
2,80
|
,941
|
|
5A – how much it is important to talk with some children in the classroom
|
3,27
|
,961
|
|
5B – the frequency that occurs to talk with some children in the classroom
|
2,27
|
,834
|
|
5C – how much difficulty feels when talking with some children in the classroom
|
3,33
|
,915
|
|
6A – how much it is important to hear the television with other people
|
3,00
|
1,104
|
|
6B – The frequency that occurs to have to hear the television with other people
|
3,33
|
,900
|
|
6C – how much difficulty feels to hear the television with other people
|
3,00
|
,816
|
|
7A – how much it is important to hear the television alone
|
3,13
|
,915
|
|
7B – the frequency that occurs to hear the television alone
|
2,67
|
,816
|
|
7C – how much difficulty feels to hear the television alone
|
3, 47
|
,915
|
|
8A – how much it is important to listen to music
|
3,00
|
1,163
|
|
8B – the frequency that occurs to listen to music
|
2,67
|
1,060
|
|
8C – how much difficulty feels when listen to music
|
3,13
|
,915
|
|
9A - how much it is important to hear what it is said in the telephone
|
3,13
|
1,060
|
|
9B – the frequency that occurs to have to hear what is said in the telephone
|
2,27
|
1,104
|
|
9C – how much difficulty feels to hear what it is said in the telephone
|
3,47
|
,743
|
|
10A – how much it is important to hear the sound of the buzzer of an ambulance
|
3,13
|
,816
|
|
10B – the frequency that occurs to hear the sound of the buzzer of an ambulance
|
2,27
|
1,163
|
|
10C – how much difficulty feels to hear the sound of the buzzer of an ambulance
|
2,67
|
1,163
|
Two citizens (16.7%) had presented total scores above of the waited one in the LSQ.
Already how much to score of difficulty, 11 citizens (91.7%) had gotten inadequate
performance ([Table 5]).
Table 5.
Punctuation of the citizens for test.
|
Citizen
|
LSQ Total Punctuation
|
LSQ Score of Difficulty
|
|
1
|
84
|
19
|
|
2
|
75
|
29
|
|
3
|
90
|
34
|
|
4
|
103
|
32
|
|
5
|
83
|
32
|
|
6
|
95
|
30
|
|
7
|
96
|
27
|
|
8
|
72
|
24
|
|
9
|
79
|
29
|
|
10
|
98
|
39
|
|
11
|
108
|
40
|
|
12
|
91
|
30
|
*The data in boldface meet outside of the waited one.
Citizens 3, 10 and 11 had presented scores difficulty higher. But citizen 1 had score
of adequate difficulty.
Considering that total scores raised in the LSQ they disclose a reduction of the auditory
abilities, it can be said that it had improvement of the auditory abilities in the
majority of the analyzed deaf children, however still persists one high degree of
difficulty in the different presented situations of listening.
Auditory abilities in the perception of the adults
In the comparative degrees between the members how much to the answers for question,
test ANOVA with repeated measures was used, and it did not have statistical significant
differences in none of the comparative degrees ([Table 6]).
Table 6.
Average of the comparative degrees between the members how much to scores of difficulty
(ANOVA).
|
Question
|
C1
|
A1
|
A2
|
A3
|
p
|
|
1C – difficulty to hear the professor in a noise classroom
|
2,67
|
3,13
|
3,27
|
3,27
|
0,696
|
|
2C - difficulty to hear instructions of adults in external environments
|
3,13
|
3,40
|
3,07
|
3,13
|
0,820
|
|
3C - difficulty to hear the telephone in another one room of the house
|
2,80
|
2,67
|
3,13
|
2,87
|
0,845
|
|
4C - difficulty to hear the sound of vehicles if approaching
|
2,80
|
2,87
|
2,73
|
3,13
|
0,795
|
|
5C - difficulty when talking with some children in the classroom
|
3,33
|
3,33
|
2,87
|
2,80
|
0,376
|
|
6C - difficulty to hear the television with other people
|
3,00
|
3,33
|
2,80
|
2,87
|
0,435
|
|
7C - difficulty to hear the alone television
|
3,47
|
2,87
|
2,27
|
3,00
|
0,116
|
|
8C - difficulty to hear music
|
3,13
|
3,53
|
3,00
|
2,87
|
0,125
|
|
9C - difficulty to hear what it is said in the telephone
|
3,47
|
2,73
|
3,40
|
3,53
|
0,754
|
|
10C - difficulty to hear the sound of the buzzer of an ambulance
|
2,67
|
2,53
|
2,67
|
2,87
|
0,820
|
Also it did not have statistical significant differences between the answers of the
children and the adults and enters the three groups of adults ([Table 7]).
Table 7.
Value p of the comparative degree enters the groups how much scores of difficulty
(Tukey).
|
Groups
|
A1
|
A2
|
A3
|
|
C1
|
0,913
|
0,851
|
0,878
|
|
A1
|
|
0,669
|
0,982
|
|
A2
|
|
|
0,993
|
* level of significance of 5% (p = 0,05).
Discussion
The majority of the citizens presented inside total scores of the waited one in the
LSQ, however a deaf child only got score of adequate difficulty. This perhaps if must
to the fact of it props up total to encompass other aspects (importance and frequency
of the situations), which can have masked the difficulties faced for the children.
Situations related for the children as of big difficulty had been understood in item
8 (to hear music) and 9 (to hear what it is said in the telephone), both situations
that involves more advanced abilities auditory (understanding of speaks without visual
track). The situations of lesser difficulty had been to hear the buzzer of an ambulance
and to hear the touch of the telephone in another room of the house (item 10 and 3,
respectively), due to raised intensity of these sonorous signals.
The majority of the citizens presented damage in auditory abilities due to auditory
loss, exactly making device use. A possible explanation for such fact is the delayed
identification of the deafness of the pertaining children to the study[11]. But a citizen (subject 4) received the diagnosis before the six months from life,
being diagnosised to the rising (mother had rubella in the gestation). The average
age of the diagnosis for the too much citizens was of 25,3 months, age very above
of the recommended one for the Brazilian Committee On Auditory Losses of childhood
(CBPAI). According to committee, all the children must be tested to the birth or in
the maximum until the three months of age, and, in case of confirmed auditory deficiency,
to receive educational intervention until the six months from life[8].
The three citizens with the worse scores of difficulty had auditory losses of deep
degree, in such a way, can be said that the degree of the auditory loss intervened
with the auditory abilities of the evaluated deaf children.
All the children with auditory loss of severe degree had preferred to use the verbal
language to the one of signals. Already it enters the children with deep loss; only
one (12.5%) preferred to use the verbal language. Such data suggest that the degree
of audibility with the use of the auditory device can also intervene with the choice
of the linguistic modality.
It is interesting to notice despite the only citizen with score of difficulty adjusted
in the LSQ was also the only one in such a way to present satisfactory linguistic
performance in the verbal language how much of signals, presenting auditory loss of
severe degree and making device use in a long period.
The children of the study had been capable to answer to the LSQ in satisfactory way,
a time that none of the citizens presented difficulty to answer to the questions of
the questionnaire. It is treated, therefore, of an instrument adjusted for use with
Brazilian deaf children above of seven years, therefore the simple language and proportionate
the visual support for the figures allows the understanding of the same content for
children in initial periods of training of the linguistic, independent development
of its modality (verbal or language of signals). It is standed out that the phonoaudiology
must have basic slight knowledge of POUNDS to manage the questionnaire with using
children of language of signals[9]
[10].
The results demonstrated the viability of the evaluation of the auditory abilities
in using deaf children of auditory device the information of the family, a time that
the difference differently between the data offered for the groups that had participated
of this research were not statistical significant, of the found results in the study
of Appleton and Bamford
[15].
Independent of the time of weekly conviviality with the child, the adults of the different
groups had had similar visions on the exploitation, the difficulties and the frequency
of each situation presented in the questionnaire. However, it is interesting to observe
that, amongst adults who had made suggestions or commentaries in the LSQ, five they
belonged to the A1 group, three were of the A2 group and only one belonged to the
A3 group. This leads to the conclusion of that the adults whose copes with the child
is bigger, tend to have ampler visions of their behavior, being more intent to their
reactions and preferences, although the results not to have statistical been significant
in this aspect. It is interesting to observe also that it had a trend of the groups
C1 and A1 to present more similar answers in the LSQ, pointing out that how much bigger
the conviviality with the child, greater can be equivalence between the answers.
Thinking about forms to reduce the difficulties faced for the using deaf children
of auditory device, in order to improve the quality of life of these children and
their families, an available resource is the use of systems of frequency modulated
(FM) in environments where it has sonorous competition (classrooms, for example),
use that, unhappily, still little is spread in Brazil due to the raised financial
cost[2].
Future studies become necessary to also validate the use of the LSQ in children listeners,
a time that the questionnaire is capable to supply important information concerning
the auditory behavior of this population by means of situations of sonorous competition,
being able to be an instrument of great utility for the evaluation of children with
problems of auditory processing. Using children of implantation to also cochlear can
benefit themselves of such use.
Conclusion
The results supplied for the studied groups 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 the daily one. Such damage, however, suffers sensible reduction
with the use from the auditory device, a time that the majority of the children benefited
of the amplification supplied for the device, getting props up totals adjusted in
the LSQ.
The device of individual sonorous amplification exerted influence in the auditory
abilities of the evaluated children and the adults which they coexist, although the
proportionate benefit for their use to be lesser of what the waited one.
The viability of the administration of the LSQ with deaf children above of seven years
using of auditory device and with the adults was evidenced clinically whose coexistence
with these children is superior the ten weekly hours, indicating the effectiveness
of this instrument for evaluation of such population. It is standed out, however,
that the LSQ does not have to be the only instrument of evaluation of the auditory
abilities of this population, but a complement to the structuralized procedures.
More studies are necessary to corroborate the data found in this research and to clarify
the differences between the available data in international literature and the results
gotten in the present study.
