Questionário para monitoramento do desenvolvimento auditivo e de linguagem no primeiro ano de vida

Alvarenga, Kátia de Freitas; Araújo, Eliene Silva; Melo, Tatiana Mendes de; Martinez, Maria Angelina Nardi; Bevilacqua, Maria Cecília

Resumos

OBJETIVO: Validar um questionário de monitoramento do desenvolvimento da função auditiva e de linguagem, aplicado por agentes comunitários de saúde no primeiro ano de vida. MÉTODOS: Setenta e seis agentes comunitários de saúde, capacitados previamente em saúde auditiva infantil, aplicaram o questionário às famílias de 304 crianças de 0 a 1 ano de idade. O questionário constitui-se de questões sobre o desenvolvimento da função auditiva e da linguagem, sendo que para todas as faixas etárias possui a questão "Seu filho ouve bem?". A validade do questionário foi averiguada por meio da análise das taxas de falso-positivo e falso-negativo das crianças investigadas por ele. Para tanto, foi utilizado um estudo duplo-cego em que todas as crianças investigadas pelo questionário foram submetidas à avaliação audiológica realizada por fonoaudiólogos. RESULTADOS: Foram diagnosticadas quatro crianças (1,32%) com perda auditiva sensorioneural, sendo duas unilaterais e 69 crianças (22,7%) com perda auditiva condutiva. O questionário de acompanhamento demonstrou especificidade de 96% e sensibilidade de 67%, com taxa de falso-negativo de 33%, por não identificar as perdas auditivas unilaterais, e falso-positivo de 4%. CONCLUSÃO: A utilização do questionário proposto mostrou-se viável e pertinente às ações desenvolvidas pelos agentes comunitários de saúde da Estratégia de Saúde da Família, demonstrando alta especificidade e moderada sensibilidade. A utilização do instrumento validado deve ser considerada como forma complementar aos Programas de Triagem Auditiva Neonatal, a fim de identificar as alterações auditivas de caráter adquirido ou de início tardio.

Monitoramento; Perda auditiva; Triagem neonatal; Questionários; Programa saúde da família; Audiologia

PURPOSE: To validate a monitoring questionnaire about hearing and language development applied by community health agents in the first year of life. METHODS: Seventy six community health agents, previously trained on infant hearing health, administered a questionnaire to the families of 304 children with ages from 0 to 1 year. The questionnaire contains questions regarding hearing and language development and, for all age groups, the question "Does your child hear well?" was presented. The validity of the questionnaire was assessed by analyzing false positive and false negative rates of the identified children. A double-blind study was conducted so that all children assessed by the questionnaire were submitted to hearing evaluation performed by audiologists. RESULTS: Four children (1.32%) were diagnosed with sensorineural hearing loss (two unilateral), and 69 (22.7%) with conductive hearing loss. The monitoring questionnaire showed specificity of 96% and sensitivity of 67%, with a false-negative rate of 33% for not identifying the unilateral hearing loss, and a false-positive rate of 4%. CONCLUSION: The questionnaire used has shown to be feasible and relevant to actions of the community health agents of the Family Health Strategy program, with high specificity and moderate sensitivity. The use of the validated instrument should be considered to complement Newborn Hearing Screening Programs, in order to identify late onset or acquired hearing loss.

Monitoring; Hearing loss; Neonatal screening; Questionnaires; Family health program; Audiology

Referências bibliográficas

¹ White KR, Forsman I, Eichwald J, Munoz K. The evolution of early hearing detection and intervention programs in the United States. Semin Perinatol. 2010 Apr;34(2):170-179.
² Barreira-Nielsen C, Futuro Neto, HA, Gattaz G. Processo de implantação de Programa de Saúde Auditiva em duas maternidades públicas. Rev Soc Bras Fonoaudiol. 2007 Jun;12(2):99-105.
³ Bevilacqua MC, Alvarenga KF, Costa OA, Moret ALM. The universal newborn hearing screening in Brazil: from identification to intervention. Int J Pediatr Otorhinolaryngol. 2010 May;74(5):510-5.
⁴ Alvarenga KF, Melo TM, Lopes AC, Bevilacqua MC, Moret ALM. Participação das famílias em Programas de Saúde Auditiva: um estudo descritivo. Rev Soc Bras Fonoaudiol. 2011 Jan-Mar;16(1):49-53.
⁵ Korres SG, Balatsouras DG, Gkoritsa E, Eliopoulos P, Rallis E, Ferekidis E. Success rate of newborn and follow-up screening of hearing using otoacoustic emissions. Int J Pediatr Otorhinolaryngol. 2006 Jun;70(6):1039-43.
⁶ Mukari SZ, Tan KY, Abdullah A. A pilot project on hospital-based universal newborn hearing screening: lessons learned. Int J Pediatr Otorhinolaryngol. 2006 May;70(5):843-51.
⁷ Hatzopoulos S, Qirjazi B, Martini A. Neonatal hearing screening in Albania: results from an ongoing universal screening program. Int J Audiol. 2007 Apr;46(4):176-82.
⁸ Datzell LE, MacDonald MS. Follow up. In: Spivak LG (ed). Universal newborn hearing screening. New York: Thieme; 1998. p. 187-224.
⁹ Joint Committee of Infant Hearing, (2007). Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007 Oct;120(4):898-921.
¹⁰ Pryor SP, Madeo AC, Reynolds JC, Sarlis NJ, Arnos KS, Nance WE et al. SLC26A4/PDS genotype-phenotype correlation in hearing loss with enlargement of the vestibular aqueduct (EVA): evidence that Pendred syndrome and non-syndromic EVA are distinct clinical and genetic entities. J Med Genet. 2005 Feb;42(2):159-65.
¹¹ Nance WE, Lim BG, Dodson KM. Importance of congenital cytomegalovirus infections as a cause for pre-lingual hearing loss. J Clin Virol. 2006 Feb; 35(2):221-5.
¹² Vohr B, McDermott C, Hess MC, Dorros C. The journey from newborn hearing screening to EHDI system: a historical perspective. In: NHS 2004 Book of Abstracts, Como, Italy, 2004. p. 2-8.
¹³ Assis AMO, Santos SMC, Freitas MCS, Santos JM, Silva MCM. O Programa Saúde da Família: contribuições para uma reflexão sobre a inserção do nutricionista na equipe multidisciplinar. Rev Nutr. 2002 Set;15(3):255-66.
¹⁴ Alvarenga KF, Bevilacqua MC, Martinez MANS, Melo TM, Blasca WQ, Taga MFL. Proposta para capacitação de agentes comunitários de saúde em saúde auditiva. Pro Fono. 2008 Jul-Set;20(3):171-6.
¹⁵ Melo TM, Alvarenga KF, Blasca WQ, Taga MFL. Capacitação de agentes comunitários de saúde em saúde auditiva: efetividade da videoconferência. Pro Fono. 2010 Apr-Jun;22(2):139-44.
¹⁶ World Health Organization. Report of the International Workshop on Primary Ear and Hearing Care, Cape Town, South Africa, 12-14 March, 1998. Geneva: World Health Organization; 2000.
¹⁷ World Health Organization. Primary ear and hearing care training resource. 4v. Geneva: Switzerland; 2006.
¹⁸ American Academy of Pediatrics, Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home Initiatives for Children with Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics. 2006 July;118(1):405-20.
¹⁹ Ling D. Foundations of Spoken Language for Hearing-Impaired Children. Washington: Alex Graham Bell, Association for the Deaf; 1989.
²⁰ Azevedo MF, Vilanova LCP, Vieira RM. Desenvolvimento auditivo de crianças normais e de alto risco. São Paulo: Plexus;1995.
²¹ Newton VE, Liu X, Ke X, Xu L, Bamford JM. Evaluation of the use of a questionnaire to detect hearing loss in babies in China. Int J Pediatr Otorhinolaryngol. 1999 May 5;48(2):125-9.
²² Newton VE, Macharia I, Mugwe P, Ototo B, Kan SW. Evaluation of the use of a questionnaire to detect hearing loss in Kenyan pre-school children. Int J Pediatr Otorhinolaryngol. 2001 Mar;57(3):229-34.
²³ Olusanya BO. Early detection of hearing impairments in a developing country: what options? Audiology. 2001 May-Jun;40(3):141-7.
²⁴ Bu X, Li X, Driscoll C. The Chinese hearing questionnaire for school children. J Am Acad Audiol. 2005 Oct;16(9):687-97.
²⁵ Stewart MG, Ohlms LA, Friedman EM, Sulek M, Duncan NO, Fernandez AD et al. Is parental perception an accurate predictor of childhood hearing loss? A prospective study. Otolaryngol Head Neck Surg. 1999 Mar;120(3):340-4.
²⁶ Gomes M, Lichtig I. Evaluation of the use of a questionnaire by non-specialists to detect hearing loss in preschool Brazilian children. Int J Rehabil Res. 2005 Jun;28(2):171-4.
²⁷ American Academy of Family Physicians; American Academy of Otolaryngology-Head and Neck Surgery; American Academy of Pediatrics Subcommittee on Otitis Media With Effusion. Otitis media with effusion. Pediatrics. 2004 May;113(5):1412-29.
²⁸ Northern JL, Downs MP. Hearing in children. 4th ed. Baltimore: Williams and Wilkins;1991.
²⁹ Pagnossim DF, Oliveira TMT. Comparação das informações que os pais de diferentes classes sociais têm sobre audição. Pro fono. 1998 Mar;10(1):8-16.
³⁰ Yoshinaga-Itano C. Levels of evidence: universal newborn hearing screening (UNHS) and early hearing detection and intervention systems (EHDI). J Commun Disord. 2004 Sep-Oct;37(5):451-65.

Datas de Publicação

Publicação nesta coleção
08 Abr 2013
Data do Fascículo
2013

Histórico

Recebido
26 Ago 2011
Aceito
09 Abr 2012

This work is licensed under a Creative Commons Attribution 4.0 International License.

[1] ¹ White KR, Forsman I, Eichwald J, Munoz K. The evolution of early hearing detection and intervention programs in the United States. Semin Perinatol. 2010 Apr;34(2):170-179.

[2] ² Barreira-Nielsen C, Futuro Neto, HA, Gattaz G. Processo de implantação de Programa de Saúde Auditiva em duas maternidades públicas. Rev Soc Bras Fonoaudiol. 2007 Jun;12(2):99-105.

[3] ³ Bevilacqua MC, Alvarenga KF, Costa OA, Moret ALM. The universal newborn hearing screening in Brazil: from identification to intervention. Int J Pediatr Otorhinolaryngol. 2010 May;74(5):510-5.

[4] ⁴ Alvarenga KF, Melo TM, Lopes AC, Bevilacqua MC, Moret ALM. Participação das famílias em Programas de Saúde Auditiva: um estudo descritivo. Rev Soc Bras Fonoaudiol. 2011 Jan-Mar;16(1):49-53.

[5] ⁵ Korres SG, Balatsouras DG, Gkoritsa E, Eliopoulos P, Rallis E, Ferekidis E. Success rate of newborn and follow-up screening of hearing using otoacoustic emissions. Int J Pediatr Otorhinolaryngol. 2006 Jun;70(6):1039-43.

[6] ⁶ Mukari SZ, Tan KY, Abdullah A. A pilot project on hospital-based universal newborn hearing screening: lessons learned. Int J Pediatr Otorhinolaryngol. 2006 May;70(5):843-51.

[7] ⁷ Hatzopoulos S, Qirjazi B, Martini A. Neonatal hearing screening in Albania: results from an ongoing universal screening program. Int J Audiol. 2007 Apr;46(4):176-82.

[8] ⁸ Datzell LE, MacDonald MS. Follow up. In: Spivak LG (ed). Universal newborn hearing screening. New York: Thieme; 1998. p. 187-224.

[9] ⁹ Joint Committee of Infant Hearing, (2007). Year 2007 position statement: principles and guidelines for early hearing detection and intervention programs. Pediatrics. 2007 Oct;120(4):898-921.

[10] ¹⁰ Pryor SP, Madeo AC, Reynolds JC, Sarlis NJ, Arnos KS, Nance WE et al. SLC26A4/PDS genotype-phenotype correlation in hearing loss with enlargement of the vestibular aqueduct (EVA): evidence that Pendred syndrome and non-syndromic EVA are distinct clinical and genetic entities. J Med Genet. 2005 Feb;42(2):159-65.

[11] ¹¹ Nance WE, Lim BG, Dodson KM. Importance of congenital cytomegalovirus infections as a cause for pre-lingual hearing loss. J Clin Virol. 2006 Feb; 35(2):221-5.

[12] ¹² Vohr B, McDermott C, Hess MC, Dorros C. The journey from newborn hearing screening to EHDI system: a historical perspective. In: NHS 2004 Book of Abstracts, Como, Italy, 2004. p. 2-8.

[13] ¹³ Assis AMO, Santos SMC, Freitas MCS, Santos JM, Silva MCM. O Programa Saúde da Família: contribuições para uma reflexão sobre a inserção do nutricionista na equipe multidisciplinar. Rev Nutr. 2002 Set;15(3):255-66.

[14] ¹⁴ Alvarenga KF, Bevilacqua MC, Martinez MANS, Melo TM, Blasca WQ, Taga MFL. Proposta para capacitação de agentes comunitários de saúde em saúde auditiva. Pro Fono. 2008 Jul-Set;20(3):171-6.

[15] ¹⁵ Melo TM, Alvarenga KF, Blasca WQ, Taga MFL. Capacitação de agentes comunitários de saúde em saúde auditiva: efetividade da videoconferência. Pro Fono. 2010 Apr-Jun;22(2):139-44.

[16] ¹⁶ World Health Organization. Report of the International Workshop on Primary Ear and Hearing Care, Cape Town, South Africa, 12-14 March, 1998. Geneva: World Health Organization; 2000.

[17] ¹⁷ World Health Organization. Primary ear and hearing care training resource. 4v. Geneva: Switzerland; 2006.

[18] ¹⁸ American Academy of Pediatrics, Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home Initiatives for Children with Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics. 2006 July;118(1):405-20.

[19] ¹⁹ Ling D. Foundations of Spoken Language for Hearing-Impaired Children. Washington: Alex Graham Bell, Association for the Deaf; 1989.

[20] ²⁰ Azevedo MF, Vilanova LCP, Vieira RM. Desenvolvimento auditivo de crianças normais e de alto risco. São Paulo: Plexus;1995.

[21] ²¹ Newton VE, Liu X, Ke X, Xu L, Bamford JM. Evaluation of the use of a questionnaire to detect hearing loss in babies in China. Int J Pediatr Otorhinolaryngol. 1999 May 5;48(2):125-9.

[22] ²² Newton VE, Macharia I, Mugwe P, Ototo B, Kan SW. Evaluation of the use of a questionnaire to detect hearing loss in Kenyan pre-school children. Int J Pediatr Otorhinolaryngol. 2001 Mar;57(3):229-34.

[23] ²³ Olusanya BO. Early detection of hearing impairments in a developing country: what options? Audiology. 2001 May-Jun;40(3):141-7.

[24] ²⁴ Bu X, Li X, Driscoll C. The Chinese hearing questionnaire for school children. J Am Acad Audiol. 2005 Oct;16(9):687-97.

[25] ²⁵ Stewart MG, Ohlms LA, Friedman EM, Sulek M, Duncan NO, Fernandez AD et al. Is parental perception an accurate predictor of childhood hearing loss? A prospective study. Otolaryngol Head Neck Surg. 1999 Mar;120(3):340-4.

[26] ²⁶ Gomes M, Lichtig I. Evaluation of the use of a questionnaire by non-specialists to detect hearing loss in preschool Brazilian children. Int J Rehabil Res. 2005 Jun;28(2):171-4.

[27] ²⁷ American Academy of Family Physicians; American Academy of Otolaryngology-Head and Neck Surgery; American Academy of Pediatrics Subcommittee on Otitis Media With Effusion. Otitis media with effusion. Pediatrics. 2004 May;113(5):1412-29.

[28] ²⁸ Northern JL, Downs MP. Hearing in children. 4th ed. Baltimore: Williams and Wilkins;1991.

[29] ²⁹ Pagnossim DF, Oliveira TMT. Comparação das informações que os pais de diferentes classes sociais têm sobre audição. Pro fono. 1998 Mar;10(1):8-16.

[30] ³⁰ Yoshinaga-Itano C. Levels of evidence: universal newborn hearing screening (UNHS) and early hearing detection and intervention systems (EHDI). J Commun Disord. 2004 Sep-Oct;37(5):451-65.

Questionário para monitoramento do desenvolvimento auditivo e de linguagem no primeiro ano de vida

Questionnaire for monitoring auditory and language development in the first year

Resumos

Referências bibliográficas

Datas de Publicação

Histórico