Da suspeita à intervenção em surdez: caracterização deste processo na região de Campinas/SP

Abstract

From suspicion to intervention in deafness: characterization of this process in Campinas/SP Da suspeita à intervenção em surdez: caracterização deste processo na região de Campinas/SP ABSTRACT Purpose: To identify and detail the current situation of diagnosis and assistance to deaf children in two cities belonging to the administrative region of Campinas (SP). Methods: It was conducted a survey of 320 medical records of patients diagnosed with prelingual deafness in the period between 1996 and 2005, in two institutions located in the region of Campinas: a university clinic and a clinic specialized in the assistance to deaf individuals. Results: Regarding the suspicion of hearing loss, the average age of the subjects was 1 year and 9 months. The mean age of children referred to medical or speech-language pathology service was 3 years and 6 months; the mean age for deafness diagnosis was 4 years and 3 months; the mean age for the beginning of clinical intervention was 6 years and 1 month; and the mean age for hearing aid adaptation was 7 years and 5 months. Conclusion: Suspicion of deafness, the first visit to a doctor, diagnosis, intervention and hearing aid adaptation were all delayed when compared to current recommended diagnostic standards and conditions of access to services. In addition, there was a significant delay between each stage, especially in the period between the suspicion of deafness and the beginning of clinical intervention. Although Campinas region is well developed in economic terms, offering a broad network of health assistance services, this network was little efficient regarding assistance to deafness. RESUMOObjetivo: Identificar e detalhar a situação do diagnóstico e atendimento de crianças surdas de dois municí-pios que pertencem à região administrativa de Campinas (SP). Métodos: Foi realizado levantamento de 320 prontuários referentes à pacientes com diagnóstico de surdez pré-lingual no período de 1996 a 2005, em duas instituições localizadas na região de Campinas: uma clínica especializada no atendimento à surdez e uma clínica universitária. Resultados: Quanto a suspeita da perda auditiva, a média de idade foi de um 1 e 9 meses.A média de idade da primeira consulta com o médico ou fonoaudiológico foi de 3 anos e 6 meses; para o diagnóstico da surdez 4 anos e 3 meses; para o início de intervenção clínica 6 anos e 1 mês; e para a adaptação de aparelho de amplificação sonora individual (AASI) 7 anos e 5 meses. Conclusão: A suspeita, primeira consulta médica, diagnóstico, intervenção e adaptação de AASI ocorreram tardiamente, se considerados os padrões diagnósticos e de acesso aos serviços preconizados na atualidade. Além disso, há um intervalo de tempo importante entre cada uma das etapas, destacando-se principalmente o período entre a suspeita da surdez e o início da intervenção clínica. A região de Campinas é bastante desenvolvida economicamente, dispõe de uma ampla rede de serviços de saúde, mas se mostra pouco eficiente no que se refere ao atendimento em surdez.

Auditory and language skills of children using hearing aids

“…The increased duration of the diagnostic step can be related to the greater number of audiological tests required for completion of diagnosis in these children. 24 In this study, regardless of the degree of hearing loss, age at diagnosis and ISAD fitting occurred late, which is in disagreement with what is proposed in the literature, i.e., that the auditory diagnosis should be established before the third month of life and speech therapy intervention be started by 6 months of age. 1,22,25 Some studies carried out in Brazil also showed that it was difficult to achieve the recommended standards.…”

“…In a study that assessed the status of the diagnosis and care of patients with hearing loss aged 0---14 years in the city of Campinas, the mean age at diagnosis was 4.3 years and the mean age at ISAD fitting was 7.5 years. 24 In the study that aimed to characterize the age at diagnosis and intervention of children treated at the Hospital das Clínicas de São Paulo, the mean age at these steps was 5.4 years and 6.8 years, respectively. 6 These aspects of language intervention become relevant because the age at diagnosis and adaptation are determining factors for the prognosis of auditory and language skill development in children with hearing impairment.…”

Equipe de Saúde da Família: relatos de conduta diante da perda auditiva infantil

“…It is recommended that identification of HL occur within the first three months of life, so that intervention measures can be adopted before six months of age (8) . Nevertheless, some studies (22)(23) have described that the time between the suspicion of auditory alteration and its confirmation can reach 48 months.…”

Acompanhamento em programas de saúde auditiva infantil: Uma revisão integrativa

“…Some factors may contribute to this monitoring, bringing improvements to the effectiveness of the child hearing health programme, such as investment in guidance to families about the importance of listening to language development, to improve their adherence to audiological monitoring and consequently provide the diagnosis of possible hearing loss 1,4,8 . In certain cases, even without the presence of risk indicators, the family should return to the programme after hearing screening for other hearing tests of the child in order to complete the diagnosis.…”