Audiometric thresholds and auditory processing in children with early malnutrition
a retrospective cohort study
Keywords:
Malnutrition, Child nutrition disorders, Hearing, Ear, inner, Hearing disordersAbstract
CONTEXT AND OBJECTIVE: Malnutrition is one of the causes of changes in cell metabolism. The inner ear has few energy reserves and high metabolism. The aim of this study was to analyze whether malnutrition at an early age is related to impairment of auditory processing abilities and hearing abnormalities. DESIGN AND SETTING: Retrospective cohort study conducted in a tertiary public hospital. METHODS: 45 children participated, divided as follows: G1, children diagnosed with malnutrition in their first two years of life; G2, children without history of malnutrition but with learning difficulties; G3, children without history of malnutrition and without learning difficulties. Tympanometry, pure-tone audiometry and the Staggered Spondaic Word (SSW) test (auditory processing) were performed. Statistical inferences were made using the Kruskal-Wallis test (α = 5%) and the test of equality of proportions between two samples (α = 1.7%). RESULTS: None of the 45 children participating in this study presented hearing deficiencies. However, at six of the eight frequencies analyzed, the children in G1 presented hearing thresholds lower than those of the other groups. In the auditory processing evaluation test, it was observed that 100% of the children in G1 presented abnormal auditory processing and that G1 and G2 had similar proportions of abnormalities (P-values: G1/G2 = 0.1; G1/G3 > 0.001; G2/G3 = 0.008). CONCLUSIONS: Malnutrition at an early age caused lowering of the hearing levels, although this impairment could not be considered to be a hearing deficiency. Every child in this group presented abnormalities in auditory processing abilities.
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References
Friederici AD. The neural basis of language development and its impairment. Neuron. 2006;52(6):941-52.
Dobbing J. Vulnerable periods in developing brain. In: Davidson NAJ, Dobbing J, editors. Applied Neurochemistry. 1st ed. Oxford: Blackwell Scientific Publications; 1968. p. 287-316.
Morgane PJ, Mokler DJ, Galler JR. Effects of prenatal protein malnutrition on the hippocampal formation. Neurosci Biobehav Rev. 2002;26(4):471-83.
Olusanya BO. Is undernutrition a risk factor for sensorineural hearing loss in early infancy? Br J Nutr. 2010;103(9):1296-301.
Galler JR, Shumsky JS, Morgane PJ. Malnutrition and brain development. In: Walker WA, Watkins J, editors. Nutrition in Pediatrics: basic science and clinical applications. 1st ed. France: Decker Europe 1995. p. 194-210.
Odabas D, Caksen H, Sar S, et al. Auditory brainstem potentials in children with protein energy malnutrition. Int J Pediatr Otorhinolaryngol. 2005;69(7):923-8.
Vandana, Tandon OP. Auditory evoked potential responses in chronic malnourished children. Indian J Physiol Pharmacol. 2006;50(1):48-52.
Central Auditory Processing: Current Status of Research and Implications for Clinical Practice. Task Force on Central Auditory Processing Consensus Development. American Journal of Audiology. 1996;5(2):41-52. Available from: http://aja.asha.org/content/vol5/ issue2/index.dtl. Accessed in 2013 (Sep 12).
Stein LM. TDE - Teste de desempenho escolar: manual para aplicação e interpretação. São Paulo: Casa do Psicólogo; 1994.
Northern JL, Downs MP. Hearing in children. 3rd ed. Philadelphia: Williams & Wilkins; 1984.
Pereira LD, Shochat E. Teste dicótico de dissílabos alternados (SSW - Staggered Spondaic Words). In: Pereira LD, Shochat E, editores. Testes auditivos comportamentais para avaliação do processamento auditivo central. Carapicuíba: Pró-Fono; 2011. p. 65-6.
Trune DR. Ion homeostasis in the ear: mechanisms, maladies, and management. Curr Opin Otolaryngol Head Neck Surg. 2010; 18(5):413-9.
Bainbridge KE, Hoffman HJ, Cowie CC. Diabetes and hearing impairment in the United States: audiometric evidence from the National Health and Nutrition Examination Survey, 1999 to 2004. Ann Intern Med. 2008;149(1):1-10.
Frazza MM, Caovilla HH, Munhoz MS, et al. Audiometria tonal e vocal. In: Munhoz MS, Caovilla HH, Silva MLG, Ganança MM, editores. Audiologia clínica. São Paulo: Atheneu; 2003. p. 49-72.
Albernaz PLM. Doenças metabólicas da orelha interna [Metabolic disorders of the ear]. Rev Bras Med Otorrinolaringol. 1995;2(1):18-22.
Magalhães MSQ, Oliveira PRP, Assencio-Ferreira VJ. Desnutrição como fator etiológico de deficiência auditiva em crianças de 0 a 2 anos [Malnutrition as an ethiologic factor for hearing impairment of children aged 0 to 2 years]. Rev CEFAC. 2001;3(2):183-6. Available from: www.cefac.br/revista/revista32/Artigo%2012.pdf. Accessed in 2013 (Apr 23).
Gallo J, Dias KZ, Pereira LD, Azevedo MF, Sousa EC. Avaliação do processamento auditivo em crianças nascidas pré-termo [Auditory processing evaluation in children born preterm]. J Soc Bras Fonoaudiol. 2011;23(2):95-101.
Yoshinaga-Itano C, Sedey AL, Coulter DK, Mehl AL. Language of early- and later-identified children with hearing loss. Pediatrics. 1998;102(5):1161-71.
Akeroyd MA. Are individual differences in speech reception related to individual differences in cognitive ability? A survey of twenty experimental studies with normal and hearing-impaired adults. Int J Audiol. 2008;47 Suppl 2:S53-71.
Chermak GD. Deciphering auditory processing disorders in children. Otolaryngol Clin North Am. 2002;35(4):733-49.
Zekveld AA, Kramer SE, Festen JM. Pupil response as an indication of effortful listening: the influence of sentence intelligibility. Ear Hear. 2010;31(4):480-90.
Moore DR, Cowan JA, Riley A, Edmondson-Jones AM, Ferguson MA. Development of auditory processing in 6- to 11-yr-old children. Ear Hear. 2011;32(3):269-85.
