Introduction: In the natural aging process, a decrease in synapses occurs between inner hair cells and spiral ganglion neurons of the auditory nerve, a phenomenon known as cochlear synaptopathy (CS). Studies suggest that short-latency auditory evoked potentials (AEP) can identify CS, but there are still gaps in the protocols and parameters used for this identification in clinical practice.Objective: To evaluate the applicability of short-latency AEPs in identifying aging-related CS in rodents. Method: Two studies were conducted. The first was a systematic literature review, registered in PROSPERO (CRD42025615318), aiming to synthesize data on the sensitivity of short-latency AEPs in identifying CS in aging rodents. The review followed the recommendations of the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA), with searches conducted in the PUBMED/MEDLINE, Cochrane Library, Scopus, Embase, Web of Science, Scielo, and LILACS databases, as well as gray literature. Article selection was performed independently and blindly by two reviewers, with the assistance of Rayyan and EndNote tools. The second study was a cross-sectional observational study, approved by the Animal Use Ethics Committee (protocol No. 2024-02-ISD). Ten healthy Wistar rats of both sexes, with no prior noise exposure, were used and divided into age groups: G1 (3–4 months), G2 (10 months), G3 (14–15 months), and G4 (24 months). The animals underwent auditory brainstem response (ABR) recording using the Eclipse equipment (EP25 model) under sedation. Electrodes were positioned at Fz (active), M1 and M2 (references), and the right paw (ground), with impedance below 5 kΩ. Click stimuli with alternating polarity at 90, 85, and 80 dBnHL were presented to each ear through 3A insert earphones at stimulation rates of 33.1, 15.1, and 7.1 clicks/s. The amplitudes of waves I and IV were analyzed blindly by two specialists. Data underwent descriptive and inferential statistical analysis in SPSS, adopting p<0.05. Results: In Study 1, 2,684 articles were identified, of which 15 were included. The most used model was the mouse (n=13), followed by Fisher 344 rats (n=1) and Wistar rats (n=1), with ages ranging from 3 to 33 months. All studies used ABR to identify CS, with wave I amplitude being the most frequent biomarker, and all confirmed CS through neurobiological analysis. In Study 2, examiner agreement was excellent (>90%). The mean amplitude was 1.33±0.69 μV for wave I and 0.75±0.62 μV for wave IV. Age did not influence the results, but a sex effect was observed. Wave I showed greater amplitude at 7.1 clicks/s compared to 33.1 clicks/s. Conclusion: Short-latency AEP demonstrated applicability in identifying CS in rodents, with wave I amplitude as a relevant biomarker and a significant effect of stimulation rate. The findings reinforce the use of ABR in CS investigation and provide insights for future studies.

Objective: To map the literature for validated and non-validated instruments used to assess oral reading of words and pseudowords in schoolchildren aged 6 to 14 (Study 1) and to study the psycholinguistic variables of a stimulus bank to be used as an assessment tool for oral reading of words and pseudowords (Study 2). Method: For Study 1, a scoping review was conducted following PRISMA-ScR guidelines. The research question was developed using the "PCC" strategy (Population, Concept, and Context). Relevant studies were searched in the National Library of Medicine (PubMed), Scopus, Latin American and Caribbean Health Sciences Literature (LILACS), EMBASE, Education Resources Information Center (ERIC), and LiVIVO databases, using terms in Portuguese, Spanish, and English, depending on the database. Studies that used assessment and/or monitoring tools for oral reading of words and pseudowords in schoolchildren aged 6 to 14 years and 11 months, in clinical or educational settings, were included. For Study 2, the Fluency IDB Portuguese app was used to evaluate word and pseudoword decoding in 1st, 2nd, and 3rd-grade elementary school students. Results: In Study 1, the analysis of 16 included studies revealed 11 assessment tools, with stimuli varying in syllabic complexity, regularity, frequency, and length, including high- and low-frequency regular and irregular words, short and long words, and pseudowords following the language rules of the test. However, there was limited description of the validation of the instruments used in the studies. In Study 2, a progressive improvement in performance was observed across school years, with a reduction in errors and an increase in correct responses in the 2nd and 3rd grades. Additionally, factors such as the number and syllabic complexity of the stimuli significantly influenced student performance during schooling. Conclusion: In Study 1, 11 tools for assessing oral reading of words and pseudowords in schoolchildren were analyzed, highlighting the diversity of methods and the frequent lack of validation information, which may compromise the accuracy of the results. Emphasis was placed on speed, accuracy, and features such as syllabic complexity, essential for evaluating lexical and sublexical processing. The findings reinforce the need to develop and validate more reliable tools, contributing to more effective educational policies and interventions. In Study 2, the results indicated that reading performance improves with school progression, influenced by syllabic complexity and lexical familiarity. Younger children struggle more with complex words, while older children perform better, suggesting that reading fluency depends on the development of phonological and orthographic skills. Pseudowords are harder to read than real words, emphasizing the importance of lexical familiarity. The results underscore the need to consider syllabic complexity and school grade in assessments, interventions, and teaching materials, promoting an appropriate progression in reading instruction.

: Introduction: The unequal distribution of specialized professionals has spurred research in digital health to address the needs of oral language care in childhood, given that language delays are common complaints during this period. In this sense, this dissertation, composed of two research articles presented below, aimed to contribute to the field. Article 1: A scoping review investigated: “Which instruments are applicable for screening and assessing oral language in early childhood using digital health?” Studies were included if they utilized screening and assessment tests for oral language via teleconsultation, applications, and web-based tools, without restrictions on time, language, or ethnicity, in clinical, educational, and non-clinical settings. The databases consulted were PubMed, Web of Science, LILACS, Embase, and Scopus, in addition to gray literature via Google Scholar and ProQuest Dissertations and Theses. Out of 2,435 studies identified, 20 comprised the final sample. Eleven studies evaluated language skills screening and nine investigated digital language assessment. Fourteen studies adapted previously validated in-person tests to an online format; four developed specific teleconsultation tools, and two conducted synchronous or asynchronous observations without defined protocols. Most research was conducted in clinical settings with speech-language pathologists, although community health workers also participated in some studies. Videoconferencing was the most frequently used digital modality. The findings of this review reinforce the feasibility of telehealth for screening and assessing oral language, highlighting the need for further research to consolidate evidence-based practice in teleaudiology Article 2: This prospective clinical study, approved by an Institutional Ethics Committee (protocol no. 6.754.773), involved 12 children of both sexes, aged between 21 and 74 months. Of these, seven had bilateral sensorineural hearing loss ranging from moderate to profound, and five exhibited language alterations without confirmed hearing loss. All were evaluated using the Behavioral Observation Protocol (PROC), administered both remotely and in person by trained, blinded researchers. Agreement between scores obtained in each session was assessed using the intraclass correlation coefficient (ICC) and the Kappa index, comparing in-person and remote evaluations. Results: In the hearing-impaired group, the ICC for the overall score was 0.964 (p ≤ 0.05), and in the at-risk group, it was 0.888 (p ≤ 0.05), with a Kappa of 1.0 (p ≤ 0.05) for both groups. In the at-risk group, variable ICCs were observed when analyzing the individual sections of the PROC separately. Conclusion: Language assessment via synchronous teleconsultation using the PROC demonstrated clinical applicability in the studied population.

Objective: To map and analyze screening instruments to identify risks of reading difficulties and disorders in preschool and school-aged children in clinical and educational contexts (article 1) and to investigate initial evidence of validity of the Brazilian version of the SPRouT instrument for screening phonological processing in preschool and school-aged children. Method: Scoping review conducted according to the PRISMA-ScR guidelines. The search was carried out in the SciELO, PubMed, LILACS, ERIC, Google Scholar and Web of Science databases, including studies on the construction, validation and practical application of the instruments (article 1). The second study included a pilot validation, descriptive and analytical stage, carried out in a private school in Brazil with children between 4 and 8 years old, including participants with and without oral and written language complaints (article 2). Results: The analysis of 40 studies identified 32 screening instruments. The review pointed out gaps in the psychometric validation and accessibility of the instruments, which limits their application (article 1). Article 2, in turn, revealed significant negative correlations between the SPRouT and other instruments for assessing phonological processing. Conclusion: Although there are a variety of instruments for screening for reading difficulties, significant challenges, such as accessibility and psychometric validity, restrict their application in different contexts (article 1). The SPRouT, in turn, proved to be particularly effective in predicting performance in tasks associated with phonological processing, providing preliminary evidence of validity and highlighting its potential as a promising tool for the early identification of risk for reading difficulties (article 2).

The COVID-19 pandemic, in addition to requiring isolation and social distancing, has sparked debate about how different socioeconomic conditions can impact child development in different ways. Several studies indicate that socioeconomic conditions are related to language development in early childhood. However, different measures are considered to characterise socioeconomic status, such as maternal education and family income, without a consensus on which would be the most appropriate for measuring this aspect. Given this scenario, this dissertation aimed to contribute to this debate in two complementary studies. The first study comprises a scoping review, whose objective is to investigate which measures are used to measure socioeconomic status in studies related to language development. This scoping review was conducted in accordance with the Joanna Briggs Institute proposal and described according to the PRISMA-SCR guidelines. The second study, which was observational and cross-sectional in nature, aimed to compare the linguistic performance of children born in the first year of the COVID-19 pandemic according to their socioeconomic status. Data collection was conducted in a school setting and included both the application of a parental questionnaire to characterise socioeconomic status and family stimulation environment, and language assessment through standardised tests that evaluate phonological and expressive vocabulary skills. The results obtained in this dissertation allow us to contribute to the scientific debate, as well as providing reflections on clinical practice in the area of child language, whether in a clinical setting or in spaces designed to stimulate language development and social interaction.

Pragmatics relates to the functional use of language in social contexts. The social distancing imposed during the COVID-19 pandemic have significantly impacted the interaction and socialisation of a significant portion of the population. This impact may affect the development of communication skills in children born during this period, as their opportunities for social interaction and communication partners have been reduced. Considering this context, the aim of this dissertation was to investigate the pragmatic profile of children born during the context of social distancing and who present complaints related to language development. The study is cross-sectional and was conducted at the Speech Therapy Teaching Clinic of the Federal University of Rio Grande do Norte. A sample of 28 children, of both sexes, aged between 29 and 40 months, underwent a battery of assessments. This battery involved a questionnaire to characterise socioeconomic status and family environment, the language subscale of the Bayley III Scales, the Pragmatics section of the ABFW infant language test, and the Parent Observation of Social Interaction (POSI) section of the Survey of Wellbeing of Young Children (SWYC) protocol. The dissertation is structured into two complementary articles, resulting from analyses derived from this data collection. The first article investigated the concordance between the presence of risk for delayed language development (assessed by Bayley III) and indicators of social interaction difficulties (assessed by POSI-SWYC). The second article characterised the functional communication profile (ABFW Pragmatics) and related this profile to receptive and expressive communicative performance assessed by Bayley III.

Introduction: Identifying hearing loss in students is essential to ensure adequate educational and social development. Objective: To assess the agreement between auditory screening procedures and the Hearing-in-Noise Test (HINT) adapted as the Digits-in-Noise Test (DIN) in students. Method: This was a cross-sectional study conducted with 83 students from the Federal Institute of Rio Grande do Norte – Parnamirim Campus (52.2% female; 15 to 45 years old; mean age = 19.79 years), who underwent audiometric screening, transient-evoked otoacoustic emissions (TEOAE) screening, distortion product otoacoustic emissions (DPOAE) screening, tympanometric screening, and the Digits-in-Noise Test (DIN) in diotic and antiphasic modes. The DIN was administered via an online link on a smartphone using headphones, following an automated adaptive procedure, with cut-off points of –6.7 dB SNR (diotic) and –11 dB SNR (antiphasic). Agreement between procedures was analyzed using Fleiss’ Kappa and Cohen’s Kappa indices. Results: The diotic DIN showed the highest pass rate (98.80%), followed by the antiphasic DIN and DPOAEs (91.57%). The highest failure rate occurred in the TEOAEs (42.17%). Overall agreement between procedures was low (Fleiss’ kappa = –0.20), and pairwise agreement ranged from –0.02 to 0.34, indicating minimal to slight agreement among tests, with the highest agreement observed between tympanometry and DPOAEs. Conclusion: The DIN, particularly in the antiphasic mode, shows greater agreement with otoacoustic emissions in failure outcomes. Nevertheless, the sample size and differences in the distribution of outcomes may have limited the results. The DIN is a functional and promising tool for identifying hearing difficulties related to speech-in-noise recognition, although it does not replace traditional methods. The combination of different procedures contributes to a more sensitive hearing screening process among high school students.

To evaluate the record of Hearing Aids use in a group of hard of hearing children rehabilitated in a SUS
service. Method: approved by institutional CEP under number 5,924,421. This is a mixed method, methodological, retrospective and cross-sectional research. The sample consisted of 32 children with mild to profound sensorineural hearing loss and their respective guardians. In study 1, with a methodological design, the cross-cultural adaptation of the Parent Hearing Aid Management Inventory into Brazilian Portuguese is presented as Article 1. Two stages and eight steps were carried out to achieve the adaptation: obtaining permission from the authors; formation of a committee of experts who worked on some of the steps to validate the translation, translation by 2 proficient translators, synthesis of translations and evaluation of equivalences, reverse translation and synthesis of the same, pilot study with 10 families to verify applicability of the instrument and synthesis of the final version of the instrument. In study 2, the trajectory of the time of hearing aids use was characterized, by collecting data from medical records, in the years 2019, 2022 and collecting current datalogging. Using an Excel® spreadsheet, data from 86 medical records was tabulated. Of these 86, it was found that there was complete information in 32 medical records. Statistical tests were applied to evaluate the normality of the data and repeated measures ANOVA to verify the variation in the time of use in the evaluated period. Results: the adaptation of the inventory, in Brazilian Portuguese, called Hearing Aid Management Inventory for the Family was presented (Article 1). Regarding the use record of the devices, there was no statistically significant variation in the time of use of hearing aids in the measurements carried out in the years 2019, 2022 and 2023, observing that the year 2019 was the period in which children used the devices less than 10h/day, below ideal for the acquisition and development of listening and language skills. Some individuals are alert to their use, since in the 3 periods evaluated they remained using the devices insufficiently. Children who use less than recommended are at risk for their hearing and language development. Conclusion: the adaptation of the PHAMI inventory to Brazilian Portuguese and the analysis of the use record of hearing aids in children brings contributions to auditory rehabilitation in childhood in our country. Monitoring the use of hearing devices is essential and should be part of the routine in auditory rehabilitation services, as a way of ensuring assertive therapeutic planning and effective results for this population. Follow-up and multicenter studies are relevant to enhance the use of hearing devices in the hearing-impaired child population.

Introduction: Myelomeningocele is a type of open spina bifida, resulting from inadequate closure of
the neural tube during the development period, which can cause motor, neurological and cognitive
changes. In Brazil, the prevalence of this condition is approximately 1.6 per 1000 live births. Due to
the various complications of the condition, the repercussions of the malformation can lead to
impairments in oral and written language and, consequently, intervention practices related to literacy
in this population can be better explored. Objective: To characterize written language skills in
children and adolescents with Myelomeningocele and investigate the effects of literacy practices in
this population. Method: Research structured in two studies: (1) cross-sectional to characterize written
language skills (phonological processing, reading, and writing) in 09 children and adolescents with
Myelomeningocele between 7 and 15 years of age who attend a Specialized Rehabilitation Center
and; (2) longitudinal to investigate literacy practices in the target population. Results: In study 1, 6
participants presented deficits in the skills of phonological awareness, rapid automatic naming,
phonological working memory, reading, and writing; in study 2, there was a benefit after literacy
practices in terms of the skills assessed, with better performance in phonological awareness, rapid
color naming, repetition of non-words, reading and writing. Conclusion: Changes in written language
in the studied group can harm the educational development of these children and adolescents,
however, literacy practices can serve as a protective factor that helps promote the development of
reading and writing.

Objective: To correlate functional performance and the impact of dysphagia on the quality of life of cancer patients. Method: Article 1) Cross-sectional and analytical study that aimed to correlate the functional performance and impact of dysphagia on the quality of life of cancer patients in palliative care. Article 2) A cross-sectional, analytical study that aimed to compare the impact of dysphagia on the quality of life and functional performance of cancer patients with different tumor sites. Descriptive methods were used to analyze the data from the two articles for categorical variables, while measures of central tendency, mean and standard deviation were calculated for quantitative variables. Pearson's test was used to correlate the scores of the test instruments in the first article, where the variables were normal, while Spearman's correlation was used in the second article due to the non-normality of the variables, and Mann- Whitney was used to compare the means of the groups, with a significance level of 5%. Results of the first article: 39 patients took part, 29 from the outpatient clinic and 10 from the ward. A positive and moderate correlation was identified between the results of the M. D. Anderson Dysphagia Questionnaire (MDADI) and the level of functionality according to the Palliative Performance Scale (PPS) in outpatients. It was concluded that cancer patients at the palliative care outpatient clinic showed a correlation between functional performance and the impact of dysphagia on quality of life. Results of the second article: four patients with head and neck cancer (HNC) and eight with non-localized head and neck cancer (NSCLC) participated. A statistically significant difference was found between the two groups for the MDADI and the global and physical domains, while no difference was found between the groups for the PPS scale. It is concluded that there was a different perception of dysphagia in each group and that in this study, the determining factor for the severity of the perception of dysphagia was the location of the tumor, rather than functionality.

Tinnitus is the perception of sound in the absence of an external sound source, its impact on quality of life can range from slight to catastrophic. Currently, there are several possibilities for tinnitus management, among them is neuromodulation. Transcranial Direct Current Stimulation (tDCS) is a painless and non-invasive neuromodulation technique that uses a low-intensity electrical current to stimulate or inhibit the central nervous system in order to normalize neuronal activity and alleviate tinnitus. Purpose: (1) to verify if there is a change in the annoyance and impact of tinnitus after tDCS in patients with chronic tinnitus. (2) to investigate the applicability and effectiveness of Transcranial Direct Current Stimulation as a therapeutic resource in individuals with chronic tinnitus complaints. Method: (1) pilot study designed as an uncontrolled clinical trial. (2) study designed as a randomized controlled clinical trial. Approved by the Research Ethics Committee of the Hospital Universitário Onofre Lopes (HUOL), opinion nº 5.622.441 and by ReBEC, nº RBR-109xh8d6. The sample consisted of adult patients referred from the Tinnitus clinic at HUOL, of both genders, with a current complaint of chronic tinnitus, after basic audiological evaluation. Patients who fit the contraindications to the use of neuromodulation were excluded. Anamnesis, high-frequency audiometry and, to characterize the outcome measures, acuphenometry, the Visual Analog Scale (VAS) and the Tinnitus Handicap Inventory (THI) questionnaire were performed. The intervention protocol consisted of applying a current of 2mA, for 20 minutes, with an anodic electrode in the left temporoparietal cortex and a cathodic electrode in the right dorsolateral prefrontal cortex, in five consecutive sessions (1), and during ten alternating sessions (2). The results were analyzed descriptively (1) and the preliminary data (2) submitted to inferential statistical analysis. Results: (1) Three female and two male patients were evaluated; average age of 45 years, hearing within normal ranges and decreased hearing sensitivity at high frequencies. After the five neuromodulation sessions, the mean total score on the THI ranged from 36.8 to 33.2 points and, on the VAS, it ranged from 5.16 to 4.4 points. (2) So far, the sample consisted of 17 patients (ten in the experimental group (EG) and seven in the control group (CG)), with a mean age of 49 years. The total average on the VAS reduced from 4.8 to 4.3 points (p= 0.17). There was a reduction in the scores of all THI subscales after neuromodulation, with a significant difference (p= 0.001) for the total score (38 to 28 points). There was also a significant difference (p= 0.0005) in the total THI score, in the comparison between the EG and GC after neuromodulation. Final considerations: (1) There was a decrease in the perception of tinnitus annoyance and damage after the neuromodulation sessions. (2) So far, there was a significant decrease in the perception of the impact of tinnitus on quality of life after the intervention through tDCS, in the experimental group and in the comparison between groups.

Introduction: Extrinsic and intrinsic conditions of the individual can directly impact written
reading. Therefore, understanding these mechanisms contributes to identifying and managing the child's
specific needs. In cases of Autism Spectrum Disorder (ASD), with the complexity of language development,
these subjects may present difficulties in academic and social areas. Although there are advances in
intervention strategies, it is observed that more precise information about them is still limited. This
dissertation was divided into two studies, with the following objectives: Study 1: investigate written
language performance in children and adolescents with ASD. Study 2: verify the development of predictive
reading and written language skills of children and adolescents with ASD, pre and post intervention. Study
method 1: This is a cross-sectional and quantitative study. The sample consisted of 17 children and
adolescents with ASD. Phonological processing skills, intelligence and level of support for ASD were
assessed. Study method 2: this is a non-randomized clinical trial consisting of 8 individuals, who were
divided into 2 groups of 4 participants - control group (CG) and intervention group (IG). The IG received 13
phonological remediation sessions, lasting 45 minutes each. Results of study 1: it was observed that all
phonological processing skills are below what was expected for the age and education of the sample.
Furthermore, it was not possible to find significant correlations between phonological processing,
intelligence quotient (IQ) and level of ASD support, with the exception of phonological working memory -
digits in reverse order. Results of study 2: phonological processing skills evolved in the post-intervention
period. However, in the inferential analysis between groups, there were no significant differences.
Conclusion: It was observed that the written language skills of children and adolescents with ASD are
impaired. Therefore, the use of phonological remediation can present positive results for this population.
However, due to the limitations of this research, it is suggested that new studies be carried out, considering a
larger sample and an analysis of the long-term impacts of the intervention.

The combination of dental and skeletal malocclusion characterises dento-skeletal deformities. The condition is manifested by disharmony between the bone and tooth bases, and its arrangement influences the adjacent soft tissues and can have a significant impact on quality of life and the stomatognathic system. The combination of orthognathic surgery and orthodontic treatment enables effective correction of facial asymmetries, promoting the establishment of a harmonious balance between the facial pattern and adjacent structures. Despite orofacial skeletal balance and the establishment of favourable conditions for the execution of orofacial functions, altered functional patterns persist which can have a negative impact on orofacial myofunctional equilibrium. From this perspective, this dissertation was based on a scoping review and a scientometric review, the objectives of which will be addressed respectively. In order to compose the dissertation, the studies aimed to map the orofacial and cervical myofunctional intervention programmes developed for adults undergoing orthognathic surgery, and to analyse the scientific mapping of orthognathic surgery research patterns and trends related to the functions of the stomatognathic system. To develop the scoping review, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist was used, searching the Cochrane, EMBASE, LILACS, LIVIVO, PubMed/Medline, Scopus and Web of Science databases, as well as grey literature. The scientific review was carried out using the PubMed, Scopus and Web of Science databases, with no date or language restrictions, and analyses were carried out using the Bibliometrix package and VosViewer software. In order to compose the scoping review, studies were included that addressed therapeutic programmes, myofunctional exercises and their influence on the stomatognathic system of adults undergoing orthognathic surgery, without delimiting time or language, excluding secondary studies, populations under the age of 18 and comorbidities associated with dentofacial deformities. The scientometric analysis selected studies that assessed orofacial functions, excluding systematic reviews, books, book chapters, abstracts and grey literature. In total, five studies were eligible for the scoping review and 223 studies were included in the scientometric review. The five eligible studies were published between 2006 and 2019, with participants with an average age between 19 and 31 years, a predominance of females and the use of post-surgical guidelines and the practice of isometric, isotonic, postural and functional exercises, as well as tactile-kinesthetic and thermal stimulation, with a positive emphasis on the functional improvement of the stomatognathic system. The 223 studies included were analysed from 1981 to 2024, with an average annual growth rate of 2.96%, an average of 18.4 citations, 389 keywords, an average of 4.99 co-authors per document and 2.69% of international co-authorships, highlighting the gradual increase in productions, as well as the global and collaborative nature of scientific research. Thus, after detailed data extraction and analysis according to the methodology of each study, it can be concluded that despite the substantial gap identified in the scoping review, its mapping highlights a significant improvement in the performance of orofacial functions, suggesting an optimization of the functionality of the stomatognathic system, a better perception of oral health and improvements in the tone and mobility of orofacial structures in individuals who underwent orofacial and cervical myofunctional intervention after orthognathic surgery. The scientific analysis reveals a significant increase in the number of publications on orthognathic surgery and stomatognathic functions, emphasizing the relationship and importance between orthognathic surgery and the stomatognathic system.

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.

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.

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.

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.

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.

Introduction: Reading is an important skill that enables communication, knowledge and integration of information with the language, both in the academic and social spheres. Social vulnerability is a severely present reality in developing countries like Brazil. Despite being a political-social issue, continuous and extreme cases of vulnerability are still present, generating developmental and biological biological consequences in children who grow up in such environments. Consequences in neurodevelopment, such as behavioral difficulties, memory, executive functions and the like, can be observed in these children, as well as academic difficulties, with changes in language development, such as delays in predictive reading and writing skills that considerably hinder the learning process. literacy and other stages of an individual's student life. Objective: To identify the effects of an intervention response program on the reading decoding of socially vulnerable schoolchildren in the period prior to the COVID-19 pandemic. Method: Longitudinal, interventional, prospective, descriptive and correlational. The study sample is 39 students from a public school, in the second year of elementary school. The sample was divided into two groups: experimental group (EG) and control group (CG). The EG underwent a program of response to the intervention, in the classroom, in 12 meetings, three times a week of 60 minutes each, for 5 weeks, in addition to the school activities in the classroom. The CG remained in formal literacy and received intervention activities after the end of the research. In this program, phonological awareness skills and expressive vocabulary were stimulated. Before and after the intervention, expressive vocabulary skills, phonological awareness, letter recognition and reading of words and pseudowords were evaluated. Results found: The two study groups obtained improvements in all assessed skills, such as increased expressive vocabulary and improvements in average performance in phonological awareness (GE: p=0.038; CG: p=0.082), reading words and pseudowords ( GE: p=0.002; GC: p=0.009) and letter recognition (GE: p=0.001; GC: p=0.030), in addition to showing an increasing trend in the GE results. There was a strong correlation between the results of phonological awareness and improvement in reading ability. Conclusion: the results infer the effectiveness of the program to respond to the intervention in the school environment of children in social vulnerability

Introduction: The use of technologies integrated into teaching can make classes more dynamic and interesting and help the teaching-learning process. Objective: To develop and validate technologymediated tools for teaching audiology. Method: A prospective descriptive study, structured in two manuscripts: (I) Virtual patients: impact of computer simulation on practical performance in audiology and, (II) Virtual Audiometer: online tool for teaching and learning. In the first study, two professors and 35 students from two Speech-Language Pathology and Audiology courses answered a satisfaction questionnaire and a self-assessment scale of the impact on practical performance, both on a Likert scale. In the second manuscript, the online version of the virtual audiometer was used by 481 people from 17 states and the Federal District (DF). Of these, 98 students, 24 professors and nine audiologists registered their assessment in a Likert scale questionnaire, in addition to citing positive and negative points. Results: The audiometric simulator and the online version of the virtual audiometer were positively evaluated as auxiliary tools in teaching, with intra- and inter-category user agreement. In addition, there was a positive perception of the impact on audiological practice. In the content analysis, the predominant negative point was the “installation difficulty” for the simulator and the “lack of an instruction manual” for the virtual audiometer. Conclusion: The two tools developed were positively evaluated and can bring benefits to the audiology teaching. The similarity with the physical audiometer, the low cost and the ease of installation are fundamental aspects for the efficiency of these solutions.

Introduction: Scientific production regarding speech language intervention in the area of child language is still scarce. This intervention proves to be effective as long as the speech language therapist acts in accordance with the principles of evidence-based practice (EBP), using valid therapeutic approaches. However, there is a limited scientific evidence base available related to EBP and language intervention in Brazil, especially when it comes to Developmental Language  Disorder (DLD). Objective: To investigate the use of EBP principles by speech language therapists in DLD intervention in Brazil, and also describe the main therapeutic approaches applied. Method: Primary, cross-sectional and descriptive study. Initially, a data collection protocol was developed, consisting of five blocks of questions (sociodemographic, work field, knowledge about DLD, aspects of EBP and intervention principles). This protocol was based on a European questionnaire on intervention in DLD and on the adaptation to speech language therapy practice of a Brazilian questionnaire about EBP. Data collection began in August 2021 and consists of the protocol application in a virtual format by the Google Forms platform. The target audience of the study comprises speech language therapists who work clinically in the area of child language in Brazil. Expected results: It is expected to obtain an overview of the knowledge of EBP principles by Brazilian speech language therapists who work with DLD, as well as describe the main approaches used by these professionals. With such results, it is intended to contribute with proposals aimed at improving the clinical practice of speech language therapy.

Introduction: The video head impulse test (vHIT) objective assessment of the vestibulo-ocular reflex (VOR) at high frequency. Objective: (1) To characterize the effect of vestibular rehabilitation (VR) on VOR gain, saccades, body balance and quality of life in three patients with peripheral vestibular hypofunction. (2) To compare the values of VOR gain, asymmetry between the semicircular canals (SCCs) and saccadic parameters in patients with Méniere's Disease (DM) and Vestibular Migraine (VM). Method: Study approved by the Research Ethics Committee, opinion nº 4,462,519. Dissertation structured in two articles. (1) Report of three cases submitted to VR and monitored by vHIT. (2) A cross-sectional and retrospective study, medical records of individuals diagnosed with DM and VM who underwent vHIT were selected. Results: (1) An increase in VOR gain was observed, consistent with normality standards and, extinction or reduction of saccades, in the three cases. (2) The sample consisted of 33 individuals, 18 from group 1 (G1), with VM, and 15, from group 2 (G2), with DM. In vHIT, in both groups, there was a predominance of normality in RVO gain. There was no difference between the average gain, per CSC, nor between the right and left CSCs, between G1 and G2. There was a difference in asymmetry between the posterior CSCs (p=0.042). Conclusion: In this study, vHIT was considered a useful instrument in the monitoring of vestibular function, post VR (1), but it was a limited test in the functional differential diagnosis between DM and VM (2).

Introduction: As phonoaudiology gains ground inside the hospital, the necessity for specific knowledge also grows. In this scenario, the phonoaudiologist is a professional capable of assessing, diagnosing, and treating dysphagic patients early in emergency rooms. The presence of a phonoaudiologist is of great importance as early intervention allows for a better prognostic, reduces hospitalization time, and consequently reduces hospital costs with medications, enteral nutrition, human resources, besides improving quality of life. Objectives: Study 1: 1) it aims to characterize phonoaudiological care for hospitalized dysphagic patients, 2) correlate swallowing characteristics with basic pathologies. Study 2: it aims to analyze scientific production on the phonoaudiological action inside the hospital with adult patients with oropharyngeal dysphagia. Methods: study 1 was retrospective study, organizational, transversal, with 36 patients with a dysphagia diagnosis who were hospitalized at the wards and Intensive Care Units of Hospital Monsenhor Walfredo Gurgel in the city of Natal. Demographic and clinical data from de assessment and phonoaudiological therapy were collected and correlated to the characteristics of swallowing to verify if there was a difference between basic pathologies, using the form for Phonoaudiological Assessment and Evolution Ward and ICU from the rehabilitation sector. Study 2 was an integrative revision. Searches were done on databases for the following descriptors: “Speech-Language and Hearing Sciences”; “Swallowing”; “Swallowing disorders”; “Adult”; “Bed Capacity Hospital” and “Hospital”; in a ten-years’ time frame (2010-2020). Results: Study 1 found that the majority of patients was in average 60,78 years old, male, diagnosed with EVA, in regular clinical state, was making use of nasoenteral feeding tubes, in ambient air, adequate laryngeal elevation, they had no drooling, were on a thick liquified diet, with adequate capitation and preparation, functional swallowing and they received passive therapy, half of the patients were phonoaudiological discharged. Study 2 found 137 articles and selected 24. They approached several kinds of patients, assessment descriptions, dysphagia risk indicators and indicators for quality of dysphagia management. Also, emphasizing specific therapeutical resources on the rehabilitation of a dysphagic patient. Conclusion: In study 1, phonoaudiological treatment involved clinical assessment of the swallowing and the aspects of phonoaudiological therapy. It was also shown that half the patients under phonoaudiological intervention had their swallowing function rehabilitated and had had a diagnosis of stroke. There were significative correlations between some swallowing characteristics, however, there was no significative difference between groups of pathologies and the swallowing characteristics. In study 2, there was a heterogeneity among studies. Thus, a lack of studies was perceived regarding the whole therapeutical process, from the assessment to the complete rehabilitation of swallowing function.

Introduction: Communication disorders include impairments in language, speech and communication. Knowing the close relationship between hearing and language and speech development, hearing tests can be used in an attempt to assist in the early identification and therapeutic process of children with these disorders. Objective: To investigate the acoustic stapedial reflex (ASR) responses in children with developmental language disorder (DLD) or phonological disorder (PD), as well as to verify the characteristics of the cortical auditory evoked potential (CAEP) in childhood apraxia of speech (CAS). Method: Dissertation structured in two manuscripts: (1) cross-sectional study in which the sample was composed of subjects with DLD, PD, with language complaints or without language complaints. The participants underwent a complete audiological evaluation and, subsequently, those responsible answered a questionnaire about the development of their respective children; (2) case report of a male child, with a previous diagnosis of CAS and referred for audiological diagnosis. Complete audiological evaluation and CAEP with speech stimulus were performed. Results: The highest number of absent or increased ASR was found in children with DLD or PD compared to subjects without language complaints. In addition, asymmetry was observed between the ears in the latency values of the CAEP in a clinical case with CAS. Conclusion: Changes in the ASR proved to be prevalent in children with language disorders and, together with the CAEP, they can be objective indicators for the early identification of communication disorders.

Introduction: Diseases of the central nervous system (CNS) affect the brain and spinal cord. CNS damage associated with vestibular symptoms occurs due to lesions in the central vestibular pathways. Objective: (1) To review the scientific literature on the applicability and results of vHIT in diseases of the CNS. (2) To characterize the neurological and vestibular findings of clinical cases diagnosed with Multiple Sclerosis (MS). Method: Dissertation structured in two articles. The first (1) is an integrative review of 18 scientific publications on the use of vHIT in individuals with CNS disease. The second (2) is the description of three clinical cases with MS. Results: (1) As for vHIT, the RVO gain was reduced in most studies, with the occurrence of compensatory withdrawals and described changes in oculomotor tests, such as the presence of spontaneous and semispontaneous nystagmus, in the RVO with and without visual optimization, in the test saccadic chase and tilt deviation. (2) Vestibular symptoms and alterations were observed in at least one of the clinical tests of body balance and cerebellar function. In vHIT, changes in oculomotor tests, such as the presence of semi-spontaneous nystagmus and in some parameter of saccadic chase, in addition to the reduction in gain in one or more vertical channels. The association of these findings suggests the presence of vestibular dysfunction of the mixed type, compatible with the central lesions detected in imaging exams. Conclusion: The findings of both studies provided evidence of changes in vestibular function and body balance in different neurological conditions.

Introduction: Syphilis is a global public health problem with complex challenges. In pregnant women, treponema paliidum can be transmitted to the fetus, leading to congenital syphilis, being a risk indicator for hearing loss, as there is evidence of the presence of sensorineural late hearing loss related to vertical transmission to the baby. Based on this premise, the efferent auditory pathway, in particular, the medial olivocochlear region and the outer hair cells, can be assessed by suppressing the otoacoustic supplied by transients, contributing to the identification of the maturation of important physiological processes of this pathway with congenital syphilis. Objective: Study 1 - To characterize the suppression of otoacoustic emissions by transients in children without risk indicators for hearing loss in the first year of life. Study 2 - Analyze the inhibitory effect of contralateral noise on otoacoustic emissions by transients in babies with congenital syphilis. Methodology: Study 1 - Systematic review registered in PROSPERO (nº CRD42020187035). The search took place in the EMBASE, LILACS, LIVIVO, PubMed, Scopus and Web of Science databases. The gray literature included Google Scholar, Open Gray and ProQuest, manual search of references of included studies and consultation with experts. Study 2 - Cross-sectional and prospective study approved by the Research Ethics Committee (nº 3,360,991). The total sample consisted of 35 babies divided into two groups (control -14 babies and study - 21 babies), all of which presented I-III-V waves in the BAEP at 80 dB nNA and wave V at 30 dB nNA and the presence of non-linear TEOAE bilaterally. The suppression analysis was performed using linear TEOAE without noise at 60 dB SPL with white noise contralateral to 60 dB SPL. The mean of inhibition was obtained by subtracting the TEOAE without noise from the TEOAE with noise. Results: Study 1 - 3796 articles were found, after the selection steps 14 studies met the eligibility criteria. All studies showed efferent inhibition in neonates without risk indicators for hearing loss. Suppression was greater in studies that applied non-linear and unfiltered click with averages greater than 1 dB in neonates in the first weeks of life. Study 2 - The study group (SG) showed greater inhibition in RE for the frequency bands from 1.5 to 4KHz. The general amplitudes in both test conditions were higher in the control group (CG), in relation to gender, but they did not present statistical significance. The SG presented 27.8% inhibition ≥ 1 dB and 25% for the CG in the right ear, on the left there was 33.3% ≥ 1 dB in the SG 46.2% in the CG. Conclusion: Study 1 - TEOAE suppression occurs in babies without risk indicators for hearing loss in protocols with different uptake characteristics, generating mean responses that do not allow a normative clinical value so far. Study 2 - The inhibitory effect of contralateral noise on TOAEs of babies with congenital syphilis does not differ from those without risk indicators for hearing loss.

Aim: To verify the accuracy of the diotic and antiphasic digits-in-noise (DRT) test in Brazilian Portuguese in four criteria for analyzing the golden pattern test and the influence of demographic and socioeconomic variables. Method: Two studies were designed: Accuracy Study 1 with normal-hearing and hearing impaired subjects applying TDR with diotic and antiphasic stimuli, by smartphone with in-ear headphones. ROC curves were established to define the cutoff point, measures of sensitivity, specificity, positive and negative predictive values for diotic and antiphasic TDR considering four criteria for analysis of pure tone audiometry (best and worst ear ≤ 25 and 40 dB). Study 2 was cross-sectional and prospective with normal hearing subjects. The diotic TDR was applied and the influences of sex, age, socioeconomic level, and education were analyzed. Results: In study 1 there were 102 subjects (18 to 90 years), 15.68% normal hearing, 69.60% with sensorineural hearing loss and 14.70% mixed. The highest sensitivity measure (96.51%) was found in the antiphasic stimulus for the worst ear mean criterion (≤ 25dB) with a cutoff of -11.90 dB in the TDR. There was a positive correlation between diotic and antiphasic TDR and degree of hearing loss. In study 2, 151 normal hearing subjects demonstrated the influence of age, education and socioeconomic level on the TDR, with no influence of gender. Conclusion: The sensitivity and specificity values in the diotic and antiphasic conditions were above 75% among the analyzed criteria. Age, schooling and socioeconomic level influence the response to diotic TDR.

Introduction: The World Health Organization and the Ministry of Health have

recommended the articulation of Child Hearing Health Programs with primary health

care, with the Community Health Agent (CHA) playing an extremely important role in

this proposal, due to the scope of the Family Health Strategy and the close relationship

of this professional with the families. Objective: To implement and evaluate a child

hearing      health     program     in     primary     care.     Method:       Prospective     longitudinal

observational study, structured in two stages: (1) Analysis of the effectiveness of an

online course for the training of CHA in the area of child hearing health; (2) Analysis of

a Child Hearing Health Program in Primary Care. 2859 enrolled participants in this

online course, and of these, 23 formed a specific group of CHA from two basic health

units, with face-to-face monitoring. Results: 1842 participants (63.34%) finished the

course, with representation from all Brazilian states and also from abroad and from

various specialties, predominantly in the medical field. The course was well evaluated

and reflected in improved post-training knowledge. 102 children aged zero to two years

were followed up by the CHA during the period of one year, proceeding with the referral

of 15 of them. A case of conductive hearing loss was found. Conclusion: The self-

instructional online course proved to be effective for distance education of CHAs in the

area of child hearing health. The Child Hearing Health Program linked to primary care

is feasible and promising, however, strategies are necessary to minimize the existing

problems.

Introduction: Heart Failure (HF) presents high prevalence, several etiologies and high mortality rates. Vestibular symptoms, secondary to HF, are not commonly studied, but it is known that, besides generating physical symptoms, they can lead to losses in the performance of social activities of these patients. Objective: To verify the association between the findings of the clinical evaluation of postural balance, the gain of vestibulo-ocular reflex (VOR), the self-perception of cardiological and vestibular symptoms with the advancement of age in patients with HF. Method: Cross-sectional, analytical-descriptive, observational, prospective study, structured in two stages: (1) Report of three cases on high-frequency vestibular evaluation in patients with Chagas cardiomyopathy. (2) Clinical and objective assessment of vestibular function in patients with HF, divided by age group. Participated 34 subjects submitted to clinical assessment of postural balance, quality of life questionnaires and vestibular evaluation through the Video Head Impulse Test (vHIT).  Results: The prevalence of reduced VOR gain in the vertical semicircular channels (SCC) was found, as well as some loss of postural balance in patients with HF, whether of Chagas origin (study 1), multifactorial or ischemic cardiomyopathies (study 2). In study 2, there was no significant association between the gain of VOR, self-perception of cardiological and vestibular symptoms with advancing age. However, there was a statistical association of the results of the Unterberger-Fukuda test with parameters evaluated by vHIT, among the age groups. Conclusion: In both studies, the prevalence of peripheral vestibular hypofunction was observed in patients with HF, regardless of age and etiology.

The impact of hearing loss is widely known for its effects on child development. Hearing impairment can be caused by genetic, congenital or acquired factors. Among the congenital factors are the presence of infections that can occur during pregnancy, such as: toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis, HIV and Zika virus. The high fetal and neonatal morbidity and mortality and the presence of important sequelae of affected patients make congenital infections a public health problem and their prevention, diagnosis, monitoring and treatment are necessary before, during and after pregnancy. Objective: To verify the frequency of hearing loss in children attended at the SUVAG Center of RN with risk indicators for congenital infections. Methods: This is a retrospective, observational and descriptive study. The study population consisted of 4806 children aged 0 to 3 years attended at the SUVAG Center of RN in the period from 2011 to 2019. Of this total, 692 children had a history of congenital infections alone or in combination with other risk indicators from the recorded data in the institution's database. 134 were excluded because they did not complete the audiological evaluation. Thus, the sample of this study was composed of 558 children. Descriptive analysis was carried out to establish the frequency of hearing loss in relation to each congenital infection isolated or associated with other risk indicators. Results: The frequency of hearing loss was 1.25% in children with reports and / or confirmation of congenital infections, with the presence of sensorineural hearing loss in six children (85.71%) and conductive hearing loss (14 , 29%), of which six were bilateral (85.71%) and one unilateral (14.29%). Conclusion: The present study allowed us to verify that there was a reduced frequency of hearing loss related to the report of congenital infections.

Congenital syphilis is considered a risk indicator for hearing loss in children, but the real impacts caused by syphilis on these children over their general development, including hearing, are still unknown. Objectives: Study1: Verify the parameters used to acquire the frequency following response (FFR) response in children up to 24 months of age through systematic review; Study 2: Analyze the results of the frequency following response in babies with congenital syphilis. Method: In study 1: The protocol was registered in PROSPERO, following the recommendations of PRISMA. The research was carried out by two independent reviewers in six databases (LILACS, Livivo, psycINFO, PubMed, Scopus, Web of Science); gray literature (Google Scholar, Open Gray, Proquest) and manual searches on bibliographic references. In study 2, the sample consists of 9 children with congenital syphilis (EG) and 5 children without syphilis (CG), aged between 12 and 24 months. All participants present responses in the Brainstem Auditory Evoked Potential at 80 dB nNA and transient evoked otoacoustic emissions present. They performed the FTA-ABS laboratory test from 18 months and the FFR with stimulus / da /, lasting 170 ms, speed of 3.70 / s, at an intensity of 80dBnNA in both ears. Results: In study 1: 459 studies were identified. After reading the full text, 15 studies were included. The acquisition parameters vary according to the studies. The most common among the studies were: Vertical assembly of the electrodes, alternating polarity, sampling rate of 20,000 Hz, / da / synthesized. In study 2: There was no difference between the groups studied in the analysis of parameters of the time and frequency domain in the FFR response. Conclusion: Study 1: There is a consensus on the use of some parameters of acquisition of the FFR with speech stimulus, such as alternating polarity, the sampling rate of 20,000 Hz, the syllable / da / synthesized stimulus and a 40 ms duration stimulus. Although these parameters have a consensus, the results show the lack of a single protocol established for the acquisition of data for the collection of the frequency following response with speech stimulus in children in the investigated age group. Study 2: Children aged 12 to 24 months with notification of congenital syphilis at birth have the same pattern of central auditory neural response assessed by the FFR as children without congenital syphilis.

Introduction: The written language is an extension of the oral language and its development occurs under the influence of several factors, among which we can highlight in the oral language, the phonological level and among the phonological processing skills, the phonological awareness. The phonological level is related to the system of sounds present in a given language and it has demonstrated a possible relationship with the development of reading and writing. Phonological awareness is one of the phonological processing skills of greatest influence for the acquisition of written language. Objective: To evaluate the phonological system and phonological awareness in low-income preschool children and correlate the skills with each other. Method: Observational, cross-sectional, retrospective and documentary study. Sample made up of 93 children from level IV of early childhood education, students from Municipal Centers of Early Childhood Education (CMEI) from 3 regions of the city of Natal / RN (West, South and East), aged between 5 and 6 years and 11 months, of both sexes. The results of the phonology evaluations of the Child Language Test - ABFW and the phonological awareness of the CONFIAS instrument were analyzed. For the analysis of the phonological level, it was considered the Percentage of Consonants Correct (PCC), Percentage of Consonants Correct - Revised (PCC-R), Index of Occurrence of Processes (PDI) and the productivity of phonological processes and, for phonological awareness , the correctness of syllabic and phonemic skills and the total score were considered. Results: In study 1, adequacy of the PCC and PCC-R values was observed in most participants (PCC: 82 children - 88,2%; PCC R: 84 children - 90,4%), productivity of the processes of liquid simplification (SL), simplification of consonant clusters (SEC), simplification of final consonant (SCF) and frontalization palatal (FP) and very strong negative correlation between the variables PCC x PDI and PCC-R x PDI. In study 2, on the other hand, the sample presented a performance below the expected in all CONFIAS scores, showing weaknesses in the phonological awareness skills. The correlation between PCC and phonological awareness and PCC R and phonological awareness and PDI and phonological awareness was weak.

AIM: to verify the evidences based on content validity of a vocabulary screening instrument for children aged from 3 to 7 years old. METHODS: This study was divided into three steps: 1º) Integrative literature review on nacional and international database Scielo, Lilacs, Eric and Pubmed, to verify the vocabulary screening instruments used recently (Article 1); 2º) Content analysis: the instrument was sent to fifteen judges, who analyzed the content validity based on the criterias of Theory, Screening Principles and Materials, considering the Content Validity Index (CVI) and Content Validity Index Item (Article 2); 3º) Aplicability of the instrument: screening of 133 children from 3 to 7 years old, students of four public schools (Article 3). RESULTS: from the theorical review, it was possible to construct the receptive and expressive vocabulary screening instrument, named TRILHAR. On the content validity analysis, the CVI has proven itself adequate. However, the CVI-I for the subcriterias of graphic aspects and description of the application sheet was inadequate, indicading the necessity of revision for those items. On the pilot study, there was differences on the performance between the groups and correlation between these variables, showing that the result on the screening improves according to the advencement of age. Besides that, there was a positive correlation between receptive and expressive vocabulary. CONCLUSION: the results of this research showed that TRILHAR is an adequate instrument for infant vocabulary screening. However, more validity studies are necessary to verify it's capability to identify children with vocabulary delays.

ABSTRACT: There are a large range of predictors of the reading development in the literature. Regarding the language aspects, the phonological awareness, rapid automatized naming, phonological working memory and letter identification have been widely described as relevant for this process. Aim: to characterize the predictors of reading skills in first grade students of public schools in Natal-RN and correlate theses habilities with each other. Method: 138 children between 6- and 7-years-old participated, from three public schools of Natal/RN. The assessment was made based on phonological awareness – Phonological Awareness Test – Sequencial assessment instrument CONFIAS; phonological access of the lexicon – Rapid automatized naming test; Phonological working memory – Working memory task – pseudowords and digits; Letter identification – letter identification subtest – PROLEC; expressive vocabulary – vocabulary subtest – Infant language test ABFW. Results: the children had worst performance than expected on expressive vocabulary, especially on the categories of clothing, food, places, shapes and colors; phonological processing, except on RAN ‘objects’, and letter identification; the habilities showed a weak correlation with each other. Conclusion: the children from this study performed worst than expected according to their schooling on phonological processing tasks, vocabulary and letter identification, which can influence the literacy process, highlighting the need of further studies as to intervention practice, in order to minimize the impact of these difficulties over the school life.

Introduction: Hearing screening through smartphones is an attractive strategy because it is self-manageable, affordable and affordable. The use of speech materials, such as digits, in the presence of background noise, makes hearing screening more sensitive to identify hearing loss, since they simulate everyday situations. Objective: 1) To identify the effectiveness of cellular applications for the detection of hearing loss through a systematic review and 2) to verify the accuracy of the software-based noise test in Brazilian Portuguese. Method: The research presents two studies: a systematic review and a study of accuracy, in the first, the sample was composed by 12 diagnostic articles that used smartphone applications for hearing screening; In the second one, 186 subjects were evaluated by means of the audiological tests considered gold standard in the diagnosis of hearing loss and the Software-Based Noise Test in the Portuguese version. Results: In the one study it was observed that all 11 applications studied showed values of sensitivity and specificity favorable to diagnostic tests (AUC> 60%). In the second study, the Noise Digit Test presented a final cut-off point of -6.9dB for the pass / fail criterion, 92.7% sensitivity and 67.1% specificity. Conclusion: The systematic review provided significant information to show which applications may be considered the most effective in identifying hearing loss and the accuracy study inserts TDR in Portuguese as a new effective method of hearing screening

Objectives: 1) To review the literature regarding the effectiveness of screening instruments for Auditory Processing Disorder (APD); 2) Compare the final Digits in Noise Test (DNT) signal-to-noise ratio (SNR) in children with APD versus typical children and analyze the accuracy of the instruments DNT, SCAN, and QFISHER. Methods: In study 1, the search went over six databases and gray literature. Risk of bias of the included articles through QUADAS 2 was analyzed. In study 2, the convenience sample consisted of 30 children, 23 with APD (G2) and seven without the disorder (G1), aged 8 to 12 years that performed audiological evaluation; tympanometry; visual numerical recognition; DNT; auditory processing screening; and behavioral assessment of auditory processing to diagnose APD. The analysis used DNT final SNR comparing G1 and G2. The accuracy of the three instruments was calculated with significance level of 5%. Results: From study 1, 1.114 articles were identified. In the analysis of title and abstract, 24 articles went to full-article analysis, remaining five after this. Three articles had a high risk of bias in at least one domain. For study 2, the mean SNR was -7.25 dB in G2 subjects and -8.34 dB in G1. Conclusions: In study 1, all instruments have good specificity, however, only the STAP and seven German battery tests are sensitive in identifying APD. Regarding study 2, the performance in DNT of children with APD was similar to children without disorder.