Efetividade do treinamento auditivo sobre as respostas comportamentais e eletrofisiológicas em crianças e adolescentes com transtorno do processamento auditivo

Abstract

Introduction: Auditory Processing Disorder (APD) is complex and affects not only patients auditory behavior. Auditory training (AT) promotes neuroplasticity and is widely used to remediate APD by improving auditory skills. It is important to integrate behavioral and electrophysiological findings in APD diagnosis and in AT effectiveness verification. Purpose: To review the national literature on Middle Latency Response (MLR) and to verify the effectiveness of AT on APD in children and adolescents. Methods: From 1315 indexed articles founded, eight matched inclusion criterion and were analyzed using STROBE initiative. For AT effectiveness analysis it was conducted a quasi-experimental prospective study with 50 eight to 16 years old APD individuals by using Staggered Spondaic Words test (SSW), Pitch Pattern Sequence (PPS), Speech in Noise and Masking Level Difference (MLD) tests and Auditory Brainstem Response (ABR), MLR and P300 measures. G1 (n=25) underwent eight AT sessions and stimulation at home. Control group was not stimulated until the reassessment. The statistical analysis considered confidence intervals of 95% and significance level of 5% (p<0.05). Results: Cross-sectional studies (75%); clicks stimuli (100%) of 11/s (100%) and 70 dBHL (88%); 10Hz (50%) and 200 Hz (75%) filters; C3/C4/A1/A2/Fpz (88%) electrodes array; Na-Pa amplitude as normality criteria; and ANOVA (63%) for statistics were predominant among the reviewed articles. In normal hearing individuals the average latency was Pa=32ms and amplitude was Na-Pa=1,57uV. There was association between auditory training and behavioral and electrophysiological responses enhancement. The improvement was more significant and in more tests and skills at training group. MLR, P300, SSW and PPS were more sensitive to the AT which had greater impact on boys (p=0.004), right-handed (p=0.001), with learning (p=0.004) and hear in noise (p=0.016) complaints, 10 comorbidities (p=0.009) and previous speech therapy (p=0.007). AT adherence (72%) correlate to greater improvement, whose perception was related to better electrophysiological responses and their significant occurrence in behavioral tests as well. Conclusion: There is no consensus on MLR recording. AT was effective to auditory skills improvement and adherence was crucial for its outcomes in children and adolescents with APD.