Speech perception and spoken language of children with auditory neuropathy spectrum disorder: a systematic literature review

Santos, Flávia Rodrigues dos; Fernandes, Júlia Speranza Zabeu; Delgado-Pinheiro, Eliane Maria Carrit

doi:10.1590/1982-0216/20232539522

Flávia Rodrigues dos Santos

Conception and design of the study

Data collection

Analysis

Interpretation of data and writing of the article

Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais - HRAC/USP, Bauru, São Paulo, Brasil.

https://orcid.org/0000-0002-5539-9501

Júlia Speranza Zabeu Fernandes

Conception and design of the study

Data collection

Analysis

Interpretation of data

Critical review of the article for relevant intellectual content

Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais - HRAC/USP, Bauru, São Paulo, Brasil.

https://orcid.org/0000-0003-4254-9299

Eliane Maria Carrit Delgado-Pinheiro

Conception and design of the study

Data collection

Analysis

Data interpretation

Critical review of the article for relevant intellectual content

Final approval of the version to be published

Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Filosofia e Ciências - FFC/UNESP, Departamento de Fonoaudiologia, Marília, São Paulo, Brasil.

https://orcid.org/0000-0002-7589-2125

Corresponding author: Eliane Maria Carrit Delgado-Pinheiro, Departamento de Fonoaudiologia, Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Avenida Hygino Muzzi Filho, 737, Mirante, CEP: 17.525-900 - Marília, São Paulo, Brasil, E-mail: eliane.delgado@unesp.br

Conflict of interests: Nonexistent.

Author contributions: FRS: conception and design of the study, data collection, analysis, interpretation of data and writing of the article; JSZF: conception and design of the study, data collection, analysis, interpretation of data and critical review of the article for relevant intellectual content;EMCD-P: conception and design of the study, data collection, analysis, data interpretation, critical review of the article for relevant intellectual content and final approval of the version to be published.

Search strategy
English	((Hearing Aids) OR (“Hearing Aids”) OR (Hearing Aid) OR (“Hearing Aid”) OR (Cochlear Implants) OR (“Cochlear Implants”) OR (Cochlear Implant) OR (“Cochlear Implant“) OR (Cochlear Implantation) OR (“Cochlear Implantation”)) AND ((Auditory Neuropathy) OR (“Auditory Neuropathy”) OR (Auditory Neuropathies) OR ("Auditory Neuropathies") OR (Auditory Dyssynchrony) OR (“Auditory Dyssynchrony”) OR (Auditory Dys synchrony) OR (“Auditory Dys synchrony”) OR (Auditory Dys-synchrony) OR (“Auditory Dys-synchrony”) OR (Auditory Neuropathy Spectrum Disorder) OR (“Auditory Neuropathy Spectrum Disorder”)) AND ((Speech Perception) OR (“Speech Perception”) OR (Auditory Perception) OR (“Auditory Perception”) OR (Child Language) OR (“Child Language”) OR (Language Development) OR (“Language Development”) OR (Verbal Learning) OR (“Verbal Learning”) OR (Language Development Disorders) OR (“Language Development Disorders”) OR (Language Disorders) OR (“Language Disorders”) OR (Rehabilitation of Speech and Language Disorders) OR (“Rehabilitation of Speech and Language Disorders”))
Portuguese	((Auxiliares de Audição) OR (“Auxiliares de Audição”) OR (Implantes Cocleares) OR (“Implantes Cocleares”) OR (Implante Coclear) OR (“Implante Coclear“)) AND ((Neuropatia Auditiva) OR (“Neuropatia Auditiva”) OR (Neuropatias Auditivas) OR ("Neuropatias Auditivas") OR (Dessincronia Auditiva) OR (“Dessincronia Auditiva”) OR (Desordem do Espectro da Neuropatia Auditiva) OR (“Desordem do Espectro da Neuropatia Auditiva”)) AND ((Percepção da Fala) OR (“Percepção da Fala”) OR (Percepção Auditiva) OR (“Percepção Auditiva”) OR (Linguagem Infantil) OR (“Linguagem Infantil”) OR (Desenvolvimento da Linguagem) OR (“Desenvolvimento da Linguagem”) OR (Aprendizagem Verbal) OR (“Aprendizagem Verbal”) OR (Transtornos do Desenvolvimento da Linguagem) OR (“Transtornos do Desenvolvimento da Linguagem”) OR (Transtornos da Linguagem) OR (“Transtornos da Linguagem”) OR (Reabilitação dos Transtornos da Fala e da Linguagem) OR (“Reabilitação dos Transtornos da Fala e da Linguagem”))
Spanish	((Audífonos) OR (“Audífonos”) OR (Audífono) OR (“Audífono”) OR (Implantes Cocleares) OR (“Implantes Cocleares”) OR (Implante Coclear) OR (“Implante Coclear“) OR (Implantación Coclear) OR (“Implantación Coclear”)) AND ((Neuropatía Auditiva) OR (“Neuropatía Auditiva”) OR (Neuropatías Auditivas) OR ("Neuropatías Auditivas") OR (Desincronía Auditiva) OR (“Desincronía Auditiva”) OR (Espectro de Desórdenes de la Neuropatía Auditiva) OR (“Espectro de Desórdenes de la Neuropatía Auditiva”)) AND ((Percepción del Habla) OR (“Percepción del Habla”) OR (Percepción Auditiva) OR (“Percepción Auditiva”) OR (Lenguaje Infantil) OR (“Lenguaje Infantil”) OR (Desarrollo del Lenguaje) OR (“Desarrollo del Lenguaje”) OR (Aprendizaje Verbal) OR (“Aprendizaje Verbal”) OR (Trastornos del Desarrollo del Lenguaje) OR (“Trastornos del Desarrollo del Lenguaje”) OR (Trastornos del Lenguaje) OR (“Trastornos del Lenguaje”) OR (Rehabilitación de los Trastornos del Habla y del Lenguaje) OR (“Rehabilitación de los Trastornos del Habla y del Lenguaje”))

AUTHOR/YEAR	OBJECTIVE	POPULATION	AGE AT EVALUATION	SPEECH PERCEPTION PROCEDURE	CLINICAL OUTCOME PROCEDURE	MAIN FINDINGS	LEVEL OF EVIDENCE
Trautwein et al. (2000)¹³13. Trautwein PG, Sininger YS, Nelson R. Cochlear implantation of auditory neuropathy. J Am Acad Audiol. 2000;11(6):309-15. https://doi.org/10.1055/s-0042-1748059. PMID: 10858002. https://doi.org/10.1055/s-0042-1748059... Case report	To present the potential benefits of CI in a case of a child with ANSD.	1 boy that received unilateral CI Profound hearing loss.	4 years and 3 months.	Ling’s sounds The Early Speech Perception test (ESP) *Test of Auditory Comprehension	Not provided	The child showed significant improvement in speech perception after implantation. When compared with 10 children who had cochlear hearing loss and used CI, their performance in the skills evaluated was similar.	5
Lin et al. (2005)²³23. Lin C, Chen Y, Wu J. Cochlear implantation in a Mandarin Chinese-speaking child with auditory neuropathy. Eur Arch Otorhinolaryngol. 2005;262(2):139-41. https://doi.org/10.1007/s00405-004-0757-5. PMID: 14999509. https://doi.org/10.1007/s00405-004-0757-... Case report	To report the case of a Mandarin speaking child with ANSD, who received the CI.	1 boy that received unilateral CI Profound hearing loss	3 years	*Mandarin Auditory Perception Test Battery (MAPTB)	Not provided	There was a significant improvement in speech perception skills after the CI.	5
Melo et al. (2008)³⁰30. Melo TM, Moret ALM, Bevilacqua MC. Speech production outcomes in children with multichannel cochlear implants. Rev Soc Bras Fonoaudiol. 2008;13(1):45-51. https://doi.org/10.1590/S1516-80342008000100009. https://doi.org/10.1590/S1516-8034200800... Case-control study	To compare the performance of speech production of two groups of children using CI, one group with sensorineural hearing loss and another group with ANSD, considering the time of CI use and the chronological age of the child at the time of evaluation.	10 CI users (5 children with ANSD paired with 5 children with sensorineural hearing loss). Profound hearing loss	2 years and 2 months to 5 years and 7 months.	Evaluation procedure of speech perception in children with profound hearing impairment from five years of age List of words as assessment procedure of speech perception for hearing impaired children	* Naming of figures of the ABFW Test - phonology and spontaneous speech test	The CI brought benefits to both groups of children, and no differences in performance in speech production were observed, which was higher for participants with a shorter period of sensory deprivation.	4
Rance et al. (2008)²⁶26. Rance G, Barker EJ. Speech perception in children with auditory neuropathy/dyssynchrony managed with either hearing aids or cochlear implants. Otol Neurotol. 2008;29(2):179-82. https://doi.org/10.1097/mao.0b013e31815e92fd. PMID: 18165792. https://doi.org/10.1097/mao.0b013e31815e... Case-control study	To evaluate the speech perception skills of children with ANSD who received the CI and compare with a group of children with ANSD who use hearing aids and a group of children with sensorineural hearing loss, who have CI.	20 children with ANSD (10 users of unilateral, bilateral or contralateral CI and 10 users of bilateral HA) and 37 children with sensorineural hearing loss, with unilateral, bilateral CI or with contralateral HA. Severe/profound loss of CI group with ANSD. Mild and severe loss of the HA group with ANSD.	ANSD + CI group: 89.6 months. ANSD + HA group: 94.2 months. Sensorineural hearing loss group: 92.6 months	*Consonant-nucleus-consonant (CNC) words	*Diagnostic Evaluation of Articulation and Phonology test	There was a significant advance in the speech discrimination of children with ANSD, and the performance of children using CI and HA was similar in this ability. However, both groups presented speech perception results lower than those obtained by children with sensorineural hearing loss.	4
Fukushima et al. (2009)³⁵35. Fukushima K, Kataoka Y, Maeda Y, Kariya S, Tominaga S, Nagayasu R et al. Cochlear implantation for children with auditory neuropathy among Japanese language users. In: Kaga k, Starr A. Neuropathies of the Auditory and Vestibular Eighth Cranial Nerves. Springer, Tokyo, 2009. p. 71-5. https://doi.org/10.1007/978-4-431-09433-3_8. https://doi.org/10.1007/978-4-431-09433-... Case series	To present the clinical course of children with the presence of otoacoustic emissions, hearing loss and cochlear implantation.	2 users of unilateral CI. Severe/profound hearing loss.	8 to 10 years.	*Monosyllabic speech perception tests	* Speech intelligibility test	The CI was effective and contributed to the development of the language of the cases presented.	5
Carvalho et al. (2011)³¹31. Carvalho ACM, Bevilacqua MC, Sameshima K, Costa Filho OA. Auditory Neuropathy / Auditory Dyssynchrony in children with cochlear implants. Braz J Otorhinolaryngol. 2011;77(4):481-7. https://doi.org/10.1590/S1808-86942011000400012. PMID: 21860975. https://doi.org/10.1590/S1808-8694201100... Cross-sectional study	To evaluate the auditory performance and the characteristics of the Electrically Evoked Compound Action Potential (eCAP) in the Auditory Nerve, in a group of children with ANSD who use CI.	18 children with ANSD using CI. Profound and severe hearing loss.	Not provided	* Procedure for the Evaluation of Profound Hearing-Impaired Children * List of Words as a Procedure for Evaluating the Speech Perception for Hearing Impaired Children	Not provided	The CI was effective for the development of auditory skills in 94% of the participants. No changes were observed in the threshold and amplitude characteristics of the eCAP for the two stimulation frequencies tested, and the electrical stimulation was able to compensate for the alteration of neural synchrony resulting from the ANSD.	4
Fei et al. (2011)²²22. Fei J, Chen A, Hong M, Shi W, Li J, Yang SJ. Cochlear implantation in a child with auditory neuropathy spectrum disorder. J. Otol. 2011;6(2):29-37. https://doi.org/10.1016/S1672-2930(11)50019-4. https://doi.org/10.1016/S1672-2930(11)50... Case report	To present the case of an implanted patient, including preoperative evaluations and a series of postoperative evaluations, to provide preliminary clinical evidence of the efficacy of CI in patients with ANSD.	1 boy implanted unilaterally. Profound hearing loss.	4 years.	Meaningful Auditory Integration Scale (MAIS) Mandarin early speech perception test (MESP) *Categories of Auditory Performance (CAP)	*Speech Intelligibility Rating (SIR)	There were benefits for the patient presented, in relation to auditory sensitivity, speech recognition and communication, after the period of seven months of CI use.	5
Kim et al. (2013)²⁴24. Kim L, Jung S, Park Y, Heo M. Cochlear implantation in pediatric auditory neuropathy. Cochlear Implants Int. 2013;5(1):224-5. http://dx.doi.org/10.1179/cim.2004.5.Supplement-1.224. http://dx.doi.org/10.1179/cim.2004.5.Sup... Case report	To report a case of a child with ANSD and CI.	1 boy who received unilateral CI. There is no reported degree of hearing loss.	2 years and 7 months.	Phonetically Balanced Kindergarten (PBK): Word List and the Common Phrases	Peabody Picture Vocabulary Test (PPVT) Expressive One-Word Picture Vocabulary Test (EOWPVT)	The cochlear implant can be an effective method for auditory habilitation in patients with auditory neuropathy, by restoring neural synchrony and allowing the use of auditory information, favoring the development of communication	5
Yamaguti, (2013)³⁶36. Yamaguti EH. Avaliação da percepção da fala com ruído competitivo em crianças portadoras de deficiência auditiva neurossensorial com espectro da neuropatia auditiva usuárias de implante coclear [dissertation]. Bauru (SP): Universidade de São Paulo; 2013. Case-control study	To investigate speech perception in the presence of noise in children with ANSD who use CI .	14 children with ANSD who used CI and 12 control subjects (children with sensorineural hearing loss, users of CI). Severe/profound hearing loss.	Experimental group: 111.5 months. Control group: 127.4 months.	*Hearing in Noise Test (Portuguese version)	Not provided	The performance in the ability of speech perception in noise was similar between the group of children with ANSD and the group of children with sensorineural hearing loss. The cochlear implant proved to be a viable treatment option for this population, provided that the indication criteria are followed.	4
Liu et al (2014)³²32. Liu Y, Dong R, Li Y, Xu T, Li Y, Chen X et al. Effect of age at cochlear implantation on auditory and speech development of children with auditory neuropathy spectrum disorder. Auris Nasus Larynx. 2014;41(6):502-6. https://doi.org/10.1016/j.anl.2014.06.001. PMID: 25194855. https://doi.org/10.1016/j.anl.2014.06.00... Cohort study	To evaluate the auditory and language skills after CI in children with ANSD, with no cochlear nerve deficiency and to determine the role of age in implantation in the clinical data found.	10 children with ANSD, users of CI, divided by the age at which the implantation was performed (before or after 24 months). Profound hearing loss.	Not provided	Categories of Auditory Performance (CAP) Meaningful Auditory Integration Scale (MAIS)/Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) Monosyllabic Lexical Neighborhood Test (LNT Chinese version) Multisyllabic Lexical Neighborhood Test (MLNT Chinese version)	Speech Intelligibility Rating (SIR) Meaningful Use of Speech Scale (MUSS)	The CI is a treatment option for children with ANSD, and children implanted before 24 months presented superior performance for auditory and speech skills than children implanted after 24 months.	4
Praveena et al. (2014)²⁷27. Praveena J, Prakash H, Rukmangathan TM. Language outcomes using hearing aids in children with auditory dyssynchrony. Audiol Res. 2014;4(1)36-39. https://doi.org/10.4081/audiores.2014.80. PMID: 26557348. https://doi.org/10.4081/audiores.2014.80... Case report	To verify the language development of children with ANSD who use hearing aids.	3 children using bilateral hearing aids. Moderate/severe hearing loss.	2 years and 10 months to 5 years and 1 month.	Not provided	* Language Development Assessment (LDA)	Advances were observed in the development of the receptive age in relation to expressive age. This result may be characteristic of children with ANSD who use hearing aids.	5
Attias et al. (2016)³³33. Attias J, Greenstein T, Peled M, Ulanovski D, Wohlgelernter J, Raveh E. Auditory performance and electrical stimulation measures in cochlear implant recipients with auditory neuropathy compared with severe to profound sensorineural hearing loss. Ear Hear. 2017;38(2):184-93. https://doi.org/10.1097/aud.0000000000000384. PMID: 28225734. https://doi.org/10.1097/aud.000000000000... Case-control study	To compare the auditory result of CI between children with ANSD and children with sensorineural hearing loss, and to investigate the impact of different pathophysiology underlying ANSD and sensorineural hearing loss on objective and subjective electrical parameters of CI.	16 children with ANSD using uni or bilateral CI and 16 children with sensorineural hearing loss using unilateral or bilateral HF. Severe/profound hearing loss.	5 to 12 years.	The Infant-Toddler Meaningful Auditory Integration Scale Monosyllabic speech test: Spondee word Test Everyday sentences test	Not provided	Children with ANSD presented auditory performance similar to children with sensorineural hearing loss after CI. In addition, children with ANSD require a lower electrical current of CI stimulation than children with sensorineural hearing loss, which may be due to biological differences in cochlear conditions between these two groups.	4
Fernandes et al. (2016)¹²12. Fernandes NF, Yamaguti EH, Morettin M, Costa OA. Speech perception in users of hearing aid with auditory neuropathy spectrum disorder. CoDAS. 2016;28(01):22-6. https://doi.org/10.1590/2317-1782/20162014157. PMID: 27074185. https://doi.org/10.1590/2317-1782/201620... Case series	To analyze the speech perception of children with ANSD who use bilateral hearing aids.	4 children using bilateral hearing aids. Mild to moderate hearing loss.	9 years to 12 years and 2 months.	List of recognition of monosyllabic words and disyllables List of recognition of meaningless syllables: List of sentence recognition Meaningful Auditory Integration for Young Children (IT MAIS) scale Hearing category	* Meaningful Use of Speech Scale (MUSS) *Language categories	The auditory performance of the participants who used hearing aids was satisfactory, allowing the maximum development of auditory skills	5
Daneshi et al. (2018)²⁵25. Daneshi A, Mirsalehi M, Hashemi SB, Ajalloueyan M, Rajati M, Ghasemi MM et al. Cochlear implantation in children with auditory neuropathy spectrum disorder: a multicenter study on auditory performance and speech production outcomes. Int J Pediatr Otorhinolaryngol. 2018;108:12-6. https://doi.org/10.1016/j.ijporl.2018.02.004. PMID: 29605339. https://doi.org/10.1016/j.ijporl.2018.02... Cohort study	To evaluate the auditory performance and speech production of implanted children with ANSD.	136 children implanted unilaterally. Severe/profound hearing loss.	Not provided	*Categories of Auditory Performance (CAP)	*Speech Intelligibility Rating (SIR)	Children with ANSD benefit from CI. The improvement in auditory performance and speech production ability depends on the age at which the CI surgery was performed and the duration of the postoperative follow-up period.	4
Alzhrani et al. (2019)³⁴34. Alzhrani F, Yousef M, Almuhawas F, Almutawa H. Auditory and speech performance in cochlear implanted ANSD children. Acta Otolaryngol. 2019;139(3):279-83. https://doi.org/10.1080/00016489.2019.1571283. PMID: 30947614. https://doi.org/10.1080/00016489.2019.15... Case-control study	To evaluate the auditory and speech performance of implanted children with ANSD and to compare the results obtained with implanted children with sensorineural hearing loss.	58 users of unilateral or bilateral CI: 18 com ANSD 40 controls. Severe/profound hearing loss.	Not provided	*Categories of auditory Performance (CAP)	*Speech Intelligibility Rating (SIR)	Children with ANSD, implanted early, benefit from CI, achieving auditory and speech performance similar to that of children implanted without ANSD.	4

Checklist: Case Reports
Questions	Trautwein et al. (2000) ¹³	Lin et al. (2005) ²³	Fei et al. (2011) ²²	Kim et al. (2013) ²⁴	Praveena et al. (2014) ²⁷
1. Were patient’s demographic characteristics clearly described?	Y	Y	Y	Y	N
2. Was the patient’s history clearly described and presented as a timeline?	Y	Y	Y	N	N
3. Was the current clinical condition of the patient on presentation clearly described?	Y	Y	Y	Y	Y
4. Were diagnostic tests or assessment methods and the results clearly described?	Y	Y	Y	N	Y
5. Was the intervention(s) or treatment procedure(s) clearly described?	Y	Y	Y	N	Y
6. Was the post-intervention clinical condition clearly described?	Y	Y	Y	Y	Y
7. Were adverse events (harms) or unanticipated events identified and described?	NA	NA	NA	NA	NA
8. Does the case report provide takeaway lessons?	Y	Y	Y	Y	Y
Risk of bias (% “YES”)	100% (Low)	100% (Low)	100% (Low)	57,40% (Moderate)	71,43% (Low)
Checklist: Case-Control Studies
Questions	Melo et al. (2008) ³⁰	Rance et al. (2008) ²⁶	Yamaguti (2013) ³⁶	Attias et al. (2016) ³³	71,43% (Low)	Alzhrani et al. (2019) ³⁴
1. Were the groups comparable other than the presence of disease in cases or the absence of disease in controls?	Y	Y	Y	Y	Y
2. Were cases and controls matched appropriately?	Y	Y	Y	Y	N
3. Were the same criteria used for identification of cases and controls?	Y	Y	Y	Y	Y
4. Was exposure measured in a standard, valid and reliable way?	NA	NA	NA	NA	NA
5. Was exposure measured in the same way for cases and controls?	Y	Y	Y	Y	Y
6. Were confounding factors identified?	N	Y	Y	Y	N
7. Were strategies to deal with confounding factors stated?	N	Y	Y	Y	N
8. Were outcomes assessed in a standard, valid and reliable way for cases and controls?	Y	Y	Y	Y	Y
9. Was the exposure period of interest long enough to be meaningful?	U	NA	NA	NA	U
10. Was appropriate statistical analysis used?	Y	Y	Y	Y	Y
Risk of bias (% “YES”)	66,67% (Moderate)	100% (Low)	100% (Low)	100% (Low)	55,56% (Moderate)
Checklist: Case Series
Questions		Fukushima et al. (2009) ³⁵		Fernandes et al. (2016) ¹²
1. Were there clear criteria for inclusion in the case series?		Y		Y
2. Was the condition measured in a standard, reliable way for all participants included in the case series?		Y		Y
3. Were valid methods used for identification of the condition for all participants included in the case series?		Y		Y
4. Did the case series have consecutive inclusion of participants?		Y		N
5. Did the case series have complete inclusion of participants?		U		U
6. Was there clear reporting of the demographics of the participants in the study?		Y		Y
7. Was there clear reporting of clinical information of the participants?		Y		Y
8. Were the outcomes or follow up results of cases clearly reported?		N		Y
9. Was there clear reporting of the presenting site(s)/clinic(s) demographic information?		NA		NA
10. Was statistical analysis appropriate?		Y		Y
Risk of bias (% “YES”)		77,78% (Low)		77,78% (Low)
Checklist: Cohort Studies
Questions		Liu et al. (2014) ³²		Daneshi et al. (2018) ²⁵
1. Were the two groups similar and recruited from the same population?		Y		Y
2. Were the exposures measured similarly to assign people to both exposed and unexposed groups?		Y		Y
3. Was the exposure measured in a valid and reliable way?		Y		Y
4. Were confounding factors identified?		Y		Y
5. Were strategies to deal with confounding factors stated?		Y		Y
6. Were the groups/participants free of the outcome at the start of the study (or at the moment of exposure)?		U		N
7. Were the outcomes measured in a valid and reliable way?		Y		Y
8. Was the follow up time reported and sufficient to be long enough for outcomes to occur?		Y		Y
9. Was follow up complete, and if not, were the reasons to loss to follow up described and explored?		U		N
10. Were strategies to address incomplete follow up utilized?		U		N
11. Was appropriate statistical analysis used?		Y		Y
Risk of bias (% “YES”)		72,73% (Low)		72,73% (Low)
Checklist: Cross Sectional Studies
Questions			Carvalho et al. (2011) ³¹
1. Were the criteria for inclusion in the sample clearly defined?			Y
2. Were the study subjects and the setting described in detail?			Y
3. Was the exposure measured in a valid and reliable way?			Y
4. Were objective, standard criteria used for measurement of the condition?			Y
5. Were confounding factors identified?			NA
6. Were strategies to deal with confounding factors stated?			NA
7. Were the outcomes measured in a valid and reliable way?			Y
Risk of bias (% “YES”)			100% (Low)

[1] Corresponding author: Eliane Maria Carrit Delgado-Pinheiro, Departamento de Fonoaudiologia, Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP, Avenida Hygino Muzzi Filho, 737, Mirante, CEP: 17.525-900 - Marília, São Paulo, Brasil, E-mail: eliane.delgado@unesp.br

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Speech perception and spoken language of children with auditory neuropathy spectrum disorder: a systematic literature review

ABSTRACT

Purpose:

Methods:

Literature Review:

Conclusion: