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      Auditory processing in children and adolescents in situations of risk and vulnerability Translated title: Processamento auditivo em crianças e adolescentes em situação de risco e vulnerabilidade

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          ABSTRACT

          CONTEXT AND OBJECTIVE:

          Children and adolescents who live in situations of social vulnerability present a series of health problems. Nonetheless, affirmations that sensory and cognitive abnormalities are present are a matter of controversy. The aim of this study was to investigate aspects to auditory processing, through applying the brainstem auditory evoked potential (BAEP) and behavioral auditory processing tests to children living on the streets, and comparison with a control group.

          DESIGN AND SETTING:

          Cross-sectional study in the Laboratory of Auditory Processing, School of Medicine, Universidade de São Paulo.

          METHODS:

          The auditory processing tests were applied to a group of 27 individuals, subdivided into 11 children (7 to 10 years old) and 16 adolescents (11 to 16 years old), of both sexes, in situations of social vulnerability, compared with an age-matched control group of 10 children and 11 adolescents without complaints. The BAEP test was also applied to investigate the integrity of the auditory pathway.

          RESULTS:

          For both children and adolescents, there were significant differences between the study and control groups in most of the tests applied, with significantly worse performance in the study group, except in the pediatric speech intelligibility test. Only one child had an abnormal result in the BAEP test.

          CONCLUSIONS:

          The results showed that the study group (children and adolescents) presented poor performance in the behavioral auditory processing tests, despite their unaltered auditory brainstem pathways, as shown by their normal results in the BAEP test.

          RESUMO

          CONTEXTO E OBJETIVO:

          Crianças e adolescentes que vivem em situação de vulnerabilidade social apresentam uma série de problemas de saúde. Apesar disso, ainda é controversa a afirmação sobre a existência de alterações cognitivas e/ou sensoriais. O objetivo deste estudo foi investigar aspectos relacionados ao processamento auditivo, através da aplicação de testes de potencial evocado auditivo de tronco encefálico (PEATE) e avaliação comportamental do processamento auditivo em crianças em situação de rua, comparando a um grupo controle.

          TIPO DE ESTUDO E LOCAL:

          Estudo transversal no Laboratório de Processamento Auditivo, Faculdade de Medicina da Universidade de São Paulo.

          MÉTODOS:

          Os testes de processamento auditivo foram aplicados em um grupo de 27 indivíduos, subdivididos em grupos de 11 crianças (7 a 10 anos) e 16 adolescentes (11 a 16 anos) de ambos os sexos, em situação de vulnerabilidade social, e comparado a um grupo controle, formado por 21 crianças, subdivididas em grupos de 10 crianças e 11 adolescentes, pareados por idade, sem queixas. Também se aplicou os PEATE para investigação da integridade da via auditiva.

          RESULTADOS:

          Para ambas as faixas etárias, foram encontradas diferenças significantes entre grupos estudo e controle para a maioria dos testes aplicados, sendo que o grupo estudo apresentou desempenho estatisticamente pior do que o controle para todos os testes, exceto para o teste pediatric speech intelligibility. Apenas uma criança apresentou resultado alterado para os PEATE.

          CONCLUSÕES:

          Os resultados demonstraram pior desempenho do grupo estudo (crianças e adolescentes) para os testes comportamentais de processamento auditivo, apesar de estes apresentarem integridade da via auditiva em nível de tronco encefálico, demonstrada pela normalidade nos resultados do PEATE.

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          Most cited references72

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          Action sets and decisions in the medial frontal cortex.

          Activations in human dorsomedial frontal and cingulate cortices are often present in neuroimaging studies of decision making and action selection. Interpretations have emphasized executive control, movement sequencing, error detection and conflict monitoring. Recently, however, experimental approaches, using lesions, inactivation, and cell recording, have suggested that these are just components of the areas' functions. Here we review these results and integrate them with those from neuroimaging. A medial superior frontal gyrus (SFG) region centred on the pre-supplementary motor area (pre-SMA) is involved in the selection of action sets whereas the anterior cingulate cortex (ACC) has a fundamental role in relating actions to their consequences, both positive reinforcement outcomes and errors, and in guiding decisions about which actions are worth making.
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            Neurobiological basis of speech: a case for the preeminence of temporal processing.

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              Childhood neglect is associated with reduced corpus callosum area.

              Childhood abuse has been associated with abnormalities in brain development, particularly corpus callosum (CC) morphology. The impact of neglect has not been assessed, though it is the most prevalent form of childhood maltreatment. Regional CC area was measured from magnetic resonance imaging scans in 26 boys and 25 girls admitted for psychiatric evaluation (28 with abuse or neglect) and compared with CC area in 115 healthy control subjects. Data were analyzed by multivariate analysis of covariance, with age and midsagittal area as covariates. Total CC area of the abused/neglected patients was 17% smaller than in control subjects (p =.0001) and 11% smaller than in psychiatric patients who had not been abused or neglected (contrast group; p =.01). Control subjects and the contrast group did not differ in total CC area. Neglect was the strongest experiential factor and was associated with a 15%-18% reduction in CC regions 3, 4, 5, and 7 (all p <.02). In contrast, sexual abuse seemed to be the strongest factor associated with reduced CC size in girls. These data are consistent with animal research that demonstrated reduced CC size in nursery-reared compared with semi-naturally reared primates. Early experience might also affect the development of the human CC.
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                Author and article information

                Journal
                Sao Paulo Med J
                Sao Paulo Med J
                Sao Paulo Med J
                São Paulo Medical Journal
                Associação Paulista de Medicina - APM
                1516-3180
                1806-9460
                12 July 2012
                2012
                : 130
                : 3
                : 151-158
                Affiliations
                [I ] originalMD, PhD. Speech Therapist and Postdoctoral Researcher in the field of auditory processing at Universidade de São Paulo (USP), São Paulo, Brazil.
                [II ] originalMD. Speech Therapist, Department of Physical Therapy, Speech Therapy and Occupational Therapy, Universidade Estadual Paulista Julio de Mesquita Filho (Unesp), Botucatu, São Paulo, Brazil.
                [III ] originalMD. Speech Therapist and Postgraduate Student in Rehabilitation Science, Universidade de São Paulo (USP), São Paulo, Brazil.
                [IV ] originalMD, PhD. Associate Professor, Department of Physical Therapy, Speech Therapy and Occupational Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
                Author notes
                [Address for correspondence: ] Cristina Ferraz Borges Murphy. Alameda Grajau, 473 - apto 2001, Alphaville - Barueri (SP) - Brasil. CEP 06454-050. Tel. (+55 11) 4195-4329. E-mail: crist78@ 123456yahoo.com

                Conflict of interest: None

                Article
                10.1590/S1516-31802012000300004
                10876193
                22790547
                79f5df56-8279-4828-9a16-c4aa718df851

                This is an open access article distributed under the terms of the Creative Commons license.

                History
                : 12 May 2011
                : 28 September 2011
                : 29 September 2011
                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 41, Pages: 08
                Categories
                Original Article

                homeless youth,social problems,evoked potentials, auditory, brain stem,auditory perceptual disorders,cognition,menores de rua,problemas sociais,potenciais evocados auditivos do tronco encefálico,transtornos da percepção auditiva,cognição

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