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Dissertations |
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1
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THAIS LENHARO SATERS
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Hearing and language monitoring in childhood: analysis of an application for families
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Advisor : ELIENE SILVA ARAUJO
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COMMITTEE MEMBERS :
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ANA MANHANI CACERES ASSENCO
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DORIS RUTHY LEWIS
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ELIENE SILVA ARAUJO
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KÁTIA DE FREITAS ALVARENGA
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Data: Mar 28, 2023
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Show Abstract
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Introduction: The family has an extremely important role in identifying hearing disorders, especially in the first years of the child's life, and the use of technological resources such as Smartphone applications can favor this process. Objective: To analyze family adherence and the usability of an application as a technological solution for auditory and language follow-up in childhood. Methods: This is an observational, descriptive, and cross-sectional study. Families residing in three municipalities in the state of São Paulo and one in Rio Grande do Norte participated, between July and December 2022. Phase 1 consisted of applying a knowledge questionnaire on child hearing health, with 200 families, in order to analyze whether there is influence of prior knowledge on adherence to technology-mediated follow-up. In phase 2, using the System Usability Scale (SUS) and the Net Promoter Score (NPS), the usability and satisfaction of the application “Ei- Escuta Infantil” was analyzed by 10 judges and 18 users. Descriptive and inferential statistical analysis was performed using the Software Statistical Package for the Social Sciences (SPSS), with a significance of 5%. Results: The results were organized into two manuscripts. The level of prior knowledge of families about child hearing health was classified as “little knowledge” for 103 participants (51.5%) and attitudes towards child audiology services were predominantly positive (n= 193; 96.5%). There was no influence of the family income, education level and research participant (mother or father) variables on the level of knowledge in hearing health. Furthermore, 23.5% of the participants installed the app, and there was no association between adherence and the level of prior knowledge or with the mode of delivery of public/private or hospital/outpatient neonatal hearing screening. About usability, all judges evaluated the app with a score higher than the 50th percentile of the SUS, an average total score of 74 points, which demonstrates that the tool did not present major usability problems. In the family members' perception, the SUS median was equivalent to 92.5 points and, following the NPS criteria, 88.8% (n=16) of them would give positive publicity to the product. Conclusion: Families' knowledge about children's hearing health is predominantly restricted, but it does not interfere with adherence to the application. “Ei – Escuta Infantil” showed good usability and can be an auxiliary technological solution to improve parents' knowledge on the subject and maximize auditory and language monitoring in childhood.
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2
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HELLEN TATYANNE DA SILVA BARBOSA
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Hearing and language in early childhood: analysis of the effectiveness of a course for early childhood education professionals
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Advisor : ELIENE SILVA ARAUJO
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COMMITTEE MEMBERS :
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ELIENE SILVA ARAUJO
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ANA MANHANI CACERES ASSENCO
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ISABELLE CAHINO DELGADO
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MARINA LEITE PUGLISI
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Data: Apr 27, 2023
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Show Abstract
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The school environment expands the child's social life, allowing the development of communicative skills in early childhood. The educator is a fundamental agent for the full development of children. Its performance has the potential both to favor communicative skills and to identify possible changes in their development. However, despite the origin of Speech Therapy being associated with Education, there is still little collaboration between these areas in early childhood education. Seeking to fill this gap, this dissertation aimed to analyze the effectiveness of a course on the development of communication in early childhood for training professionals in early childhood education. The longitudinal study was linked to a university extension course aimed at early childhood education professionals. Data collection was based on the application of virtual questionnaires that evaluated the teachers' knowledge about the development of communication in early childhood, decision-making, faced with simulated situations about the development of communication and the opinion about the course. The data collection period extended from September 2021 to December 2022 and consisted of three moments: (1) pre-course; (2) post-immediate - immediately after completion of the course; and (3) post-late - six months after completion of the course. In total, the responses of 92 professionals who participated in the three moments were considered. The casuistry was composed mostly of women, aged up to 39 years, and with specialization as the maximum level of schooling. The results obtained were divided into two articles. The first compared teachers' knowledge about the development of communication in early childhood in the three moments of the study. The comparison of the total number of correct items between the moments revealed that in the post-late period, the participants had more correct answers. In turn, the second article compared the decision-making of professionals in the face of simulated situations in the three moments. This comparison indicated significant differences between performance before and after the course. Thus, it was possible to conclude that the training of early childhood education professionals through a distance course is effective as a tool for expanding knowledge about the development of communication in early childhood.
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3
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RAYANE MEDEIROS PEREIRA
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Association of audiological and psychoacoustic measures of tinnitus with anxiety symptoms
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Advisor : ERIKA BARIONI MANTELLO
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COMMITTEE MEMBERS :
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ERIKA BARIONI MANTELLO
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FATIMA CRISTINA ALVES BRANCO BARREIRO
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MARINE RAQUEL DINIZ DA ROSA
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Data: May 29, 2023
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Show Abstract
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Introduction: Tinnitus is the perception of a sound generated in the auditory pathways in the absence of an external sound source and can cause different emotional reactions. Objective: (1) To verify whether there is a relationship between the presence of chronic tinnitus and risk factors and comorbidities reported by participants in this research. (2) To verify the relationship and compare the psychoacoustic characteristics, the impact and level of discomfort of tinnitus with symptoms associated with anxiety, in patients with and without hearing loss. Method: Study approved by the Research Ethics Committee, nº 4,880,618. Dissertation structured in two articles. (1) Observational, analytical case-control study, with a sample of 100 participants divided into the Research Group (RG) with chronic tinnitus and the Control Group (CG) without tinnitus. (2) Cross-sectional and analytical study, with a sample of 50 participants divided into two groups, group 1 (G1) without hearing loss and group 2 (G2) with hearing loss. The responses obtained by the visual analogue scale (VAS), Tinnitus Handicap Inventory (THI), acuphenometry and State-Trait Anxiety Inventory (STAI) were analysed. Results: (1) There was influence of diabetes mellitus and hearing loss associated with tinnitus. (2) A significant difference was observed for the variables pitch in the right ear (RE) and total VAS score between the groups. There was a correlation between VAS and loudness and THI with VAS and IDATE-T, in G1. Conclusion: (1) There was an association between the comorbidities diabetes mellitus and hearing loss as risk factors for the presence of tinnitus. (2) There was no difference in the impact of tinnitus on quality of life, the feeling of symptom intensity and signs of anxiety between patients with and without hearing loss. However, there was a difference in the sensation of the frequency of tinnitus in the right ear and the level of discomfort of the symptom, which was greater among patients with hearing loss. It was also identified a relationship between the level of annoyance and the greater sensation of tinnitus intensity, in both ears, in the normal hearing group.
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4
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ANA PAULA SABINO DE MEDEIROS NEVES
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Behavioral organization status and breastfeeding performance of late preterm newborns with hyperbilirubinemia undergoing phototherapy
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Advisor : HIPOLITO VIRGILIO MAGALHAES JUNIOR
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COMMITTEE MEMBERS :
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HIPOLITO VIRGILIO MAGALHAES JUNIOR
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ANDREA MONTEIRO CORREIA MEDEIROS
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GEOVANA DE PAULA BOLZAN
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Data: Sep 21, 2023
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Show Abstract
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Introduction: Prematurity is a risk factor for the occurrence of eating disorders. However, the late preterm newborn, in general, is accompanied in rooming-in without differentiated management. Jaundice is the clinical manifestation of hyperbilirubinemia and is common in the neonatal period. Late preterm infants are at high risk of developing significant hyperbilirubinemia. Bilirubin in high amounts is potentially neurotoxic and phototherapy, a commonly used treatment, can cause adverse events, such as water loss and changes in the circadian cycle. Feeding difficulty is a risk factor for increased serum bilirubin levels. Thus, it is necessary to investigate possible difficulties in breastfeeding, to evaluate the state of behavioral organization and its relationship with latching and sucking responses, in order to provide data that allow adequate management in the face of possible difficulties and guarantee the preterm submitted to phototherapy an effective feeding and adequate intake. Such measures may reduce the risks of increased bilirubin and, as a consequence, the possibility of reducing the duration of phototherapy treatment. Objective: 1) To evaluate the breastfeeding performance of preterm newborns with hyperbilirubinemia undergoing phototherapy. 2) To investigate the responses of the state of behavioral organization of late preterm newborns with hyperbilirubinemia submitted to phototherapy and its association with the latch responses, nutritive and non-nutritive sucking. Method: Controlled cross-sectional study. It was carried out in a public teaching maternity hospital whose sample consisted of 60 mother/newborn dyads, divided into two groups. A group composed of 30 newborns who presented significant hyperbilirubinemia, therefore, in need of phototherapy (case group), and another group with 30 newborns without the need for phototherapy (control group). The characterization data of the sample were obtained through anamnesis and collection from medical records. Performance assessment in breastfeeding was carried out using the Breastfeeding Observation Form protocol proposed by UNICEF, the assessment of the state of behavioral organization and non-nutritive sucking using the Preterm Oral Feeding Readiness Scale instrument. Indirect bilirubin levels were checked on the day of the assessment by the pediatrician. For statistical analysis, the Mann-Whitney U test was used in order to analyze the differences between the groups in sample characterization, breastfeeding performance, behavioral organization and aspects of non-nutritive sucking, Kendall's Tau-B test was used. used to verify the association between the variables state of behavioral organization, attachment, nutritive and non-nutritive sucking. A significance level of 5% was adopted for all analyses. Results: In the assessment of breastfeeding performance, there was a significant difference in the general observation of the newborn, position of the newborn, latching and sucking sections. There was a significant difference in the state of behavioral organization and non-nutritive sucking. It was also verified, the association between the state of behavioral organization and the handling responses, nutritive and non-nutritive sucking. Conclusion: Newborns undergoing phototherapy have more breastfeeding difficulties, lower scores in the state of behavioral organization and in non-nutritive sucking. The speech-language evaluation can contribute to identify feeding difficulties and enable assertive behaviors in the care of these newborns.
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5
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BIANCA STEPHANY BARBOSA VITAL
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REMOTE MICROPHONE SYSTEMS IN CHILDREN AND ADOLESCENTS WITH AUTISMO SPECTRUM DISORDER
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Advisor : SHEILA ANDREOLI BALEN
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COMMITTEE MEMBERS :
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ARYELLY DAYANE DA SILVA NUNES ARAÚJO
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JOSELI SOARES BRAZOROTTO
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REGINA TANGERINO DE SOUZA JACOB
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SHEILA ANDREOLI BALEN
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Data: Sep 28, 2023
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Show Abstract
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Introduction: Autism Spectrum Disorder (ASD) has a prevalence of 1/36 diagnosed children and may present social, behavioral and language difficulties.Sensory and perceptual changes, including auditory changes, can also be observed. The Remote Microphone (MR) is an assistive technology that allows for a better signal-to-noise ratio and can promote improvements in auditory perception, attention and reduced listening effort. Objective: Map studies on the use of remote microphone in children and adolescents with ASD. Methodology: This is a Scope Review study that follows the methodological guidelines of the Joanna Briggs Institute (JBI) and recommendations from the PRISMA-ScR checklist. A search was carried out in the following databases: Embase, Scopus, Web of Science, Lilacs and Google Scholar and ProQuest gray literature, in addition to reference lists of included studies and consultation with experts. The search strategy was adapted to each database using specific units. Intervention studies were included, with children and adolescents with ASD who used MR, without restrictions on gender, language, age, time of publication, ethnicity or geographic location. Results: 709 studies were identified in the databases and gray literature. Of these, seven articles were included for inclusion and data analysis. Of the publications identified in the list of references and indicated by experts, only one was included in the exclusion and data analysis. The 08 studies were heterogeneous regarding the model of the MR system (individual or in the field), the tests applied, the intervention period and the location of the intervention. In seven studies, it was possible to verify an improvement in participants' speech perception after the MR intervention period. As well as, improvements in verbal response time, social interaction, classroom behavior, auditory attention, auditory memory, noise tolerance and stress reduction and changes in neural activity with electrophysiological assessment after a period were also observed among the studies. of intervention. Conclusion: Children and adolescents who used MR showed benefits in speech perception, social interaction and behavior. This assistive technology shows promise for this population, however more field studies are needed to define more specific protocols and parameters of use describing the variables that exist depending on the different conditions and levels of ASD.
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6
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CLAYDIANNE DOS SANTOS FREITAS
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Professional development of literacy teachers in the context of reading science
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Advisor : CINTIA ALVES SALGADO AZONI
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COMMITTEE MEMBERS :
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CINTIA ALVES SALGADO AZONI
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ANGELA MARIA CHUVAS NASCHOLD
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RENAN DE ALMEIDA SARGIANI
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Data: Sep 29, 2023
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Show Abstract
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Studies show that teacher training based on scientific evidence impacts the theoretical and practical understanding of these professionals. The moments of professional improvement in initial or continuing education enrich the teaching practice by providing contributions that support an effective and structured pedagogical intervention focused on the educational needs of students. Current scientific evidence on literacy, the result of highly methodologically rigorous research in the field of Cognitive Sciences of reading, has helped teachers in the practice of teaching children with persistent difficulties in the development of reading through approaches that consider the effectiveness of explicit and systematized teaching of reading and writing. However, there are few intervention studies with teacher training that address content about the neurobiological process of reading and persistent difficulties in the development of written language, which motivated the application of this study, which aims to identify the knowledge of Brazilian professionals who work in the public education network of municipalities in Rio Grande do Norte on literacy and verify the impact of the Professional Development Program for Literacy Teachers in the Context of the Science of Reading. The study is descriptive of an exploratory nature with data analysis based on the Bardin model. For its design, literature reviews, Likert evaluation questionnaires and intervention with professional training were used. With this, it was possible to identify that the participants did not have confidence in relation to knowledge about evidence-based literacy and about teaching students with persistent difficulties in the development of reading. The research findings support future professional training in evidence-based literacy that supports the strengthening of educational actions aimed at inclusive teaching of reading and writing that meets the educational needs of students who have greater difficulties in the learning process.
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7
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INGRID RAFAELLA DANTAS DOS SANTOS
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TELEINTERVENTION GUIDED BY VIDEOFEEDBACK FOR FAMILIES OF HARD OF HEARING CHILDREN
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Advisor : JOSELI SOARES BRAZOROTTO
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COMMITTEE MEMBERS :
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JOSELI SOARES BRAZOROTTO
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SHEILA ANDREOLI BALEN
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LUCIANA PIMENTEL FERNANDES DE MELO
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Data: Sep 29, 2023
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Show Abstract
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Therapeutic protocols that optimize development results in the hearing-impaired child population still lack evidence. Videofeedback is a low-cost, easily accessible technology procedure that can improve communication between family and child, with impacts on their development. Its use through telepractice can transform the provision of specialized therapies for this population. Therefore, the present study aimed to analyze the effectiveness of a remote intervention program with videofeedback to improve interaction between families and hard of hearing children. This is, therefore, a quasi-experimental intervention study, with a convenience sample based on the availability of families to participate in teleconsultation sessions, consisting of 12 families using a hearing health service, divided into control and experimental groups, evaluated pre- and post-intervention by researchers blind to the study. Families and children were characterized using secondary data from medical records and questionnaires and clinical assessments. The variables analyzed in the pre and post moments were those referring to the evaluation of the interaction between the family and their child, recorded on video. The intervention program through telepractice consisted of 10 intensive, sequential sessions. Prior to the main study, a single-case pilot study was carried out to calibrate the research procedures, presented as Article 1.In the pilot study (Article 1), reliable change and clinical significance were observed for the mother's behaviors and reliable change for the child's receptive and expressive language behaviors, indicating the potential of the proposed model. In the intervention study (Article 2), a statistically significant difference was found between the control and experimental groups in the pre- and post-intervention moments (p <0.01). Among the variables highlighted in family-child interaction (general assessment of the caregiver's communicative competence, tuned interaction, intrusiveness, solution of breaks in communication and syntactic expansion) it was observed that both in the EG and in the CG some families behaved as outliers, however, reliable clinical change was found in the families in the experimental group in relation to the control group and clinical significance for some of the families in the EG. It is concluded that the intervention guided by videofeedback mediated by telepractice is effective, highlighting the improvement of interactions between families and their hard of hearing children and the potential of this tool for optimizing results in clinical pediatric auditory rehabilitation programs.
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8
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ISABELLE COSTA DE VASCONCELOS
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Functional near-infrared spectroscopy (fNIRS) in infants with congenital syphilis.
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Advisor : SHEILA ANDREOLI BALEN
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COMMITTEE MEMBERS :
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GABRIELA CINTRA JANUÁRIO
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PEDRO DE LEMOS MENEZES
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SHEILA ANDREOLI BALEN
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Data: Sep 29, 2023
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Show Abstract
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Introduction: Neurosyphilis is an infection of the central nervous system caused by Treponema pallidum and can be symptomatic or asymptomatic in children with congenital syphilis. Syphilis infection can cause different alterations, including hearing loss as a possible late manifestation of congenital syphilis, and is a globally recognized risk indicator for hearing loss. However, there is little information on the consequences for cerebral hemodynamics. Research combining near-infrared spectroscopy (fNIRS) and auditory stimuli in infants plays a significant and multifaceted role in science and society. One of the main contributions of this research is to provide information on how babies' brains develop in response to auditory stimuli.
Objective: To identify the acquisition parameters of functional near-infrared spectroscopy (fNIRS) with speech stimulation in infants up to two years of age, through a systematic review. To describe the cortical activation pattern of a four-month-old infant with neurosyphilis using fNIRS with speech stimulation.
Method: Two studies were carried out. Study 1 was a systematic review of fNIRS parameters (Prospero n. CRD42022311267). The search was carried out in PubMed, Embase, Scopus, Web of Science, LILACS, PsycINFO, Livivo, Google Scholar and ProQuest. We included cross-sectional studies of normal-hearing infants aged 0-24 months using fNIRS with monosyllabic speech stimuli. Study 2 is a clinical case study (CEP/HUOL n. 5.323.957). The clinical case is of a four-month-old infant referred by an infectious disease specialist for audiological assessment. The audiological assessment included the following procedures: Tympanometry, Evoked Otoacoustic Emissions, Brainstem Evoked Response Audiometry with click stimulus and fNIRS with speech stimulus.
Results: A total of 932 articles were identified in the database (DB) and 770 in the gray literature (LC). After removing duplicates, 409 remained in the DB and 499 in the LC. The titles and abstracts were then read in phase 1, when 64 articles in the DB and 25 articles in the LC were selected for full reading, of which four remained for final analysis and data extraction. From the articles included, the conformity of only three parameters involved in the experimental designs was evidenced: the presentation of stimuli bilaterally as well as the bilateral capture of response in the temporal lobes and the use of natural sleep. In study 2, a similar tetha was observed between the conditions and channels evaluated in both cerebral hemispheres, with greater oxyhemoglobin (HbO) amplitude being observed in the frontal position when compared to the posterior region.
Final Considerations: In study 1, there was a lack of uniformity in the parameters adopted by the various studies, which shows the absence of a standardized procedure. Study 2 showed development within the expected range for hearing, with cortical responses to speech stimuli.
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9
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THAYSA FLORÊNCIO BARBOSA FELIPE
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TELEPRACTICE IN WRITTEN LANGUAGE: PARENT GUIDANCE PROGRAM OF CHILDREN AND ADOLESCENTS WITH DYSLEXIA.
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Advisor : CINTIA ALVES SALGADO AZONI
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COMMITTEE MEMBERS :
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CINTIA ALVES SALGADO AZONI
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ISABELLE CAHINO DELGADO
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IVONALDO LEIDSON BARBOSA LIMA
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PATRICIA ABREU PINHEIRO CRENITTE
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Data: Sep 29, 2023
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Show Abstract
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INTRODUCTION: The family is the child's first interactive subject with the world, which plays a fundamental role in child development, and can contribute to the acquisition of written language from the first years of life, so those responsible need information and tools to assist in this participation. of learning.
OBJECTIVE: To analyze the impact of a parental guidance program for children and adolescents with dyslexia, using telephonoaudiology.
METHOD: the study was divided into two articles: 1) Integrative review study and; 2) Quantitative and qualitative, longitudinal, prospective study, in which a parental guidance program was applied to children and adolescents with dyslexia via telephonoaudiology, in order to provide information on how the family can contribute to the development of reading and writing. The sample consisted of 12 mothers, who answered 2 Google forms questionnaires, pre and post application of the program, and participated in 8 remote meetings.
EXPECTED RESULTS: 1) Integrative review study: important findings pointed out how beneficial the participation and help of the family in the acquisition of reading and writing is, but the number of international research on this topic overlaps with national research, requiring more national studies that encourage and present the population about the importance of parental involvement in written language. 2) Study 2: Brought contributions in the acquisition of knowledge to families of children with dyslexia, on how they can contribute to such development and also expanding research and actions in the field of Telephonoaudiology.
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10
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VANESSA BARBOSA DA SILVA SOUSA
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VALIDATION OF EDUCATIONAL GAMES FOR PARENTAL COACHING OF HARD OF HEARING CHILDREN FAMILIES
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Advisor : JOSELI SOARES BRAZOROTTO
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COMMITTEE MEMBERS :
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JOSELI SOARES BRAZOROTTO
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LUCIANA FIGUEIREDO DE OLIVEIRA
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LUCIANA PIMENTEL FERNANDES DE MELO
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Data: Sep 29, 2023
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Show Abstract
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The daily activities of the family of children with hearing impairment are a strong factor in their development, as they are the most effective agents in continuously supporting the child's development. There is, however, a lack of evidence on specific intervention models for parental training for families, especially those aimed at validating specific intervention materials. Therefore, the objective of this study was to develop and validate games for parental training for families of children with hearing impairment. This is a mixed method, documentary, methodological study (through the development of educational games and their validation). For the development of the games, an integrative review was carried out to systematize the evidence on parental training programs for families of children with disabilities, which is presented as Article 1. After studying the programs and research in the area, a set of of games and a guide consisting of multipurpose cards, a route game and a guide for families on aspects related to the development of children with hearing impairment and the role of the family with facilitating strategies. Such games were evaluated by 6 experienced judges in auditory rehabilitation, as well as by 2 families of children with hearing impairment who have already been discharged from rehabilitation, using the Health Educational Content Validation Instruments (HECVI) and Educational Games Validation, adapted for the purpose of this research. After the content and appearance validation stage of the materials by the judges, with 95% agreement on the adequacy of the material, it was used in a short-term pilot intervention, consisting of 5 sessions, 1 in a group setting and 4 individual sessions, pre- and post-intervention design, for 4 families of hearing-impaired children from a hearing health service, in which pre- and post-interaction and their satisfaction with the intervention were evaluated, presented as Article 2. The results showed that the games were validated and comprise a kit with manual and rules for the 2 games, 21 multipurpose cards and a route game with 25 situational cards to reflect on how to optimize communication with children with hearing impairment. Although no reliable change or clinical significance was found in the inferential analysis of the interactions, in the qualitative analysis an improvement was observed for 3 of the four families, in particular, in the variables: responds to the child's communication, enthusiasm in the interaction, tuned interaction and first uses the voice to attract the child's attention. All families participating in the intervention using the games were satisfied. It was concluded that the game package was developed and validated, called: “Game of Tuning”, which proved to be a promising auxiliary tool for parental coaching in pediatric auditory rehabilitation services.
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