ABSTRACT Purpose: to investigate the frequency-following response (FFR) for sustained neural activity. Methods: 39 individuals, aged between 20 to 47 months old were divided into 2 groups: (i) 20 individuals without prenatal exposure to the congenital Zika syndrome (CZS) or hydrocephaly, normal development, no risk factors for hearing loss or syndromic hearing impairment and (ii) 19 individuals diagnosed with CZS and microcephaly - based on imaging studies linked to the clinical presentation of the condition. All participants exhibited normal click-ABR tests. FFR waveforms were documented using the /da/ syllable employing the Navigator Pro. The statistical analysis used was ANOVA (p-value <0.05). Results: no distinctions were observed concerning the variables of group, age, or gender with respect to FFR latency values, except for an interaction between gender and group for latency values associated with waves V and F. Children with CZS and microcephaly showed a difference for latency values in wave V for both males and females, when compared to the control group. Conclusion: children presented with CZS and microcephaly showed higher average latencies for waves V, A, C, D and F (male) compared to the control group, whereas, in waves E, F (female) and O they showed higher values in the control group.

RESUMO Objetivo analisar o efeito do mascaramento estável e modulado no Potencial Evocado Auditivo Cortical com estímulo de fala em adultos-jovens. Método participaram 14 indivíduos com idades entre 19 e 28 anos de ambos os sexos e sem perda auditiva. O exame de Potencial Evocado Auditivo Cortical foi realizado com estímulo de fala sintética /ba/ simultâneo ao ruído Speech Shaped Noise apresentado em três condições: ruído estável com intensidade de 30 dB NPSpe (ruído estável fraco), ruído estável com intensidade de 65 dB NPSpe (ruído estável forte) e ruído modulado em intensidade de 30 dB NPSpe e 65 dB NPSpe em 25Hz e com período de modulação de 40 ms. Resultados foram observadas maiores latências nos componentes corticais, exceto P2, na condição de ruído estável forte e medidas mais robustas de amplitude dos componentes corticais P1, N1 e P2 na condição de ruído modulado com diferença estatística significativa na comparação com a condição de ruído estável forte. Houve pior morfologia na condição de ruído estável forte, quando comparado aos demais registros. Os limiares eletrofisiológicos médios para as condições de ruído estável forte e ruído modulado foram 60 dB NPSpe e 49 dB NPSpe, respectivamente, mostrando 11,7 dB de diferença média. Conclusão podemos inferir que houve um menor efeito mascarante do ruído modulado, comparado à condição de ruído estável forte, nas medidas de amplitude dos componentes corticais e uma diferença média de 11,7 dB entre os limiares eletrofisiológicos (interpretado como a medida do Benefício do Mascaramento Modulado).

ABSTRACT Purpose To analyze the effect of masking on the Cortical Auditory Evoked Potential with speech stimulus in young adults. Methods Fourteen individuals aged between 19 and 28 years of both sexes with no hearing loss participated in the study. The Cortical Auditory Evoked Potential examination was performed with synthetic speech stimulus /ba/ simultaneous to Speech Shaped Noise presented under three conditions: steady noise with a 30 dB SPLep intensity (weak steady noise), steady noise with a 65 dB SPLep intensity o (strong steady noise) and modulated noise with 30 dB SPLep and 65 dB SPLep intensities at 25Hz and modulation period of 40 ms. Results Higher latencies were observed in the cortical components, except P2, in the condition of strong steady noise and more meaningful measures of amplitude of the cortical components P1, N1 and P2 in the condition of modulated noise with statistically significant difference in comparison to the strong steady noise condition. There was worse wave morphology in the condition of strong steady noise, when compared to the other records. The average electrophysiological thresholds for the conditions of strong steady noise and modulated noise were 60 dB SPLep and 49 dB SPLep, respectively, showing a 11.7 dB mean difference. Conclusion We could infer that there was a lower masking effect of modulated noise when compared to the strong steady noise condition, in the amplitude measurements of the cortical components and an average difference of 11.7 dB between the electrophysiological thresholds (interpreted as the measure of the Masking Release).

Abstract Objective: To analyze the effect of noise on electrophysiological measurements (P1-N1-P2 complex) of cortical auditory evoked potentials in normal hearing individuals of different ages. Methods: The inclusion criteria for the study were young individuals, adults and elderly, aged 18–75 years, with auditory thresholds up to 25 dB. Participants were separated according to their age group: G1 (18–25 years old), G2 (31–59 years old) and G3 (60–75 years old). Cortical auditory evoked potentials were elicited with synthetic speech stimulus /da/ presented in two conditions: without masking and with masking (Delta-t 64ms). The results were expressed and analyzed using statistical measures. Results: High latencies and reduced amplitudes were observed in the Delta-t 64 ms condition, in all age groups. There were significant differences between the groups, both in P1 latencies for the two conditions and in N1 latencies in the Delta-t 64 ms condition. P1 latencies in the condition without masking were lower in G1 and P1 and N1 latencies in the Delta-t 64 ms condition were higher in G3. The described results show the influence of noise on cortical responses in all age groups, with G3 being the most affected by the masking presentation. Conclusion: The latency and amplitude measurements vary according to the stimulus presentation condition and age group. The forward masking phenomenon occurred with greater precision in G3. Level of evidence: (2c).

Abstract Introduction Prenatal exposure to the Zika virus can impair neurodevelopment and cause auditory damage. Objective To analyze the frequency-following response (FFR) and the auditory behavior (with the LittlEars® questionnaire) of children with and without prenatal exposure to Zika virus infection. Methods A total of 30 children participated in the present study, divided into 3 groups: 10 children with microcephaly and prenatal exposure to the Zika virus; 10 normocephalic children with prenatal exposure to the Zika virus; and 10 children with no evidence of prenatal exposure to the virus. The FFR test was performed with the /da/ syllable. The LittlEars® questionnaire was used with parents/guardians. Results For the FFR measurements, there was no difference between the groups. The children with exposure to the Zika virus presented a final score in the questionnaire below what is expected from children with normal hearing. A significant difference was observed for the final, semantic, and expressive scores between the group with microcephaly and the other groups. A strong negative correlation was seen between the LittlEars® questionnaire final score and the FFR measurements for the group with microcephaly when compared with the other groups. Conclusion Children exposed to the Zika virus, with and without microcephaly, presented FFR patterns similar to what was seen in children with no evidence of virus exposure. However, they showed signs of immature auditory behavior, suggesting auditory development delay.

RESUMO Objetivo Caracterizar os parâmetros de aquisição, análise e resultados do exame Frequency Following Response (FFR) em usuários de implante coclear. Estratégia de pesquisa As buscas foram realizadas nas bases Cochrane Library, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Ovid Technologies, PubMed, SciELO, ScienceDirect, Scopus, Web of Science e na literatura cinzenta. Critérios de seleção Foram incluídos estudos sobre o FFR em usuários de implante coclear ou que os comparassem à indivíduos com audição normal, sem restrição de idade. Foram excluídos estudos secundários e experimentais. Não houve restrição de idioma e ano de publicação. Análise dos dados Os dados foram analisados e redigidos de acordo com as etapas do Preferred Reporting Items for Systematic Reviews and Meta-Analyse (PRISMA) 2020. Para análise da qualidade metodológica foi utilizado o instrumento Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross Sectional Studies. As divergências foram resolvidas por um terceiro pesquisador. Resultados Seis estudos atenderam aos critérios de inclusão. Apenas um estudo foi do tipo comparativo com grupo controle de indivíduos com audição normal. As variações nos parâmetros de aquisição foram comuns e as análises predominaram no domínio do tempo. Usuários de implante coclear apresentaram diferenças nos resultados do FFR quando comparados a indivíduos com audição normal, considerando a literatura existente. A maioria dos artigos teve baixa qualidade metodológica. Conclusão Não existe padronização de um protocolo de aquisição e análise para o FFR em usuários de implante coclear. Os resultados são de alto risco de viés.

ABSTRACT Purpose To characterize the acquisition parameters, analysis, and results of the frequency-following response (FFR) in cochlear implant users. Research strategies The search was conducted in Cochrane Library, Latin American and Caribbean Health Sciences Literature (LILACS), Ovid Technologies, PubMed, SciELO, ScienceDirect, Scopus, Web of Science, and gray literature. Selection criteria Studies on FFR in cochlear implant users or that compared them with normal-hearing people, with no restriction of age, were included. Secondary and experimental studies were excluded. There was no restriction of language or year of publication. Data analysis The data were analyzed and reported according to the stages in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 2020. The methodological quality was analyzed with the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. Divergences were solved by a third researcher. Results Six studies met the inclusion criteria. Only one study was comparative, whose control group comprised normal-hearing people. The variations in acquisition parameters were common and the analysis predominantly approached the time domain. Cochlear implant users had different FFR results from those of normal-hearing people, considering the existing literature. Most articles had low methodological quality. Conclusion There is no standardized FFR acquisition and analysis protocol for cochlear implant users. The results have a high risk of bias.

ABSTRACT Purpose: to compare cortical auditory evoked responses using two speech stimuli, /ma/ and /da/, in normally hearing young adults. Methods: a cross-sectional, observational and analytical study, with a sample composed of nineteen normally hearing young adults, recruited by convenience, ages between 18 and 25 years old, from both genders, participated in the study. Cortical auditory evoked potentials (CAEP) were monaurally recorded in two conditions: 1) with a pair of speech stimuli /ba/ and /da/, and 2), with a pair of speech stimuli /ba/ and /ma/. The order of the experiments was randomized in a proportion of 50% for each of the two stimuli, totaling 100 stimuli for each experiment. Speech sounds were presented at 70 dB SPL. Descriptive and analytical statistical tests were performed. Results: mean latency values of the complex P1, N1, P2, N2 and P3 were lower for the /ma/ when compared to those of /da/ (p <0,05). There was no difference in amplitude values between responses evoked using /ma/ and /da/. Conclusion: cortical auditory evoked potentials, elicited by the speech stimulus /ma/ had, on average, lower latency peaks of P1-N1-P2-N2 and P3, when compared to those of speech stimulus /da/.

RESUMO Objetivo: investigar o reconhecimento auditivo da fala intermitente em função de diferentes taxas de modulação e em função da idade. Métodos: participaram do estudo vinte jovens, vinte adultos de meia idade, e dezesseis idosos, todos com limiares auditivos iguais ou menores que 25 dB NA até a frequência de 4000 Hz. Os participantes foram submetidos a testes de reconhecimento da fala intermitente apresentada em três condições de modulação: 4 Hz, 10 Hz e 64 Hz. Percentuais de acerto foram comparados entre grupos etários e taxas de modulação. Para a investigação do efeito da taxa de modulação foi realizada ANOVA e testes Post Hoc, enquanto para a investigação do efeito da idade, utilizou-se o modelo de regressão linear misto (p<0,001). Resultados: sobre o efeito da idade, os dados mostram diferença significante entre jovens e idosos, e entre adultos de meia idade e idosos. Sobre o efeito da taxa de modulação, os índices de acerto da taxa mais lenta (4Hz) foram significantemente menores nos três grupos etários. Conclusão: foi verificado um efeito da idade no reconhecimento da fala intermitente: idosos apresentaram maior dificuldade. Percebeu-se também um efeito de taxa de modulação nos três grupos etários: quanto maior a taxa, melhor o desempenho.

ABSTRACT Purpose: to investigate the auditory recognition of intermittent speech in relation to different modulation rates and ages. Methods: 20 young people, 20 middle-aged adults, and 16 older adults, all of them with auditory thresholds equal to or lower than 25 dB HL up to the frequency of 4000 Hz. The participants were submitted to intermittent speech recognition tests presented in three modulation conditions: 4 Hz, 10 Hz, and 64 Hz. The percentages of correct answers were compared between age groups and modulation rates. ANOVA and post hoc tests were conducted to investigate the modulation rate effect, and the mixed linear regression model (p < 0.001). Results: regarding the age effect, the data showed a significant difference between young people and older adults, and between middle-aged and older adults. As for the modulation rate effect, the indexes of correct answers were significantly lower at the slower rate (4 Hz) in the three age groups. Conclusion: an age effect was verified on intermittent speech recognition: older adults have greater difficulty. A modulation rate effect was also noticed in the three age groups: the higher the rate, the better the performance.

ABSTRACT Purpose: to analyze forward masking in normally hearing young people, by using frequency-following responses. Methods: the synthetic syllable /da/ was used for the recordings of ten individuals, in the following conditions: /da/ with no masking, and /da/ after 4, 16, 32, and 64 milliseconds of masking. F-test (ANOVA) was applied for repeated measures with the Greenhouse-Geisser correction to compare testing conditions. For significant differences, multiple comparisons (between pairs of conditions) and Bonferroni correction were used. Data normality was verified by applying the Shapiro-Wilk test, and statistical significance was used at 5%. Results: wave latencies of all masking conditions were compared with those of no masking. A latency delay was observed in the transient region of the response (PV and A) in all masking conditions, except for 64 milliseconds. Latency delay also occurred for waves PW, PX, and PY, which corresponded to the sustained region of the response. Conclusion: forward masking was observed, by using frequency-following responses with /da/ syllable in four intervals (4, 16, 32, and 64 ms) of preceding masking. Forward masking was more evident in the transient region of the response than in the sustained one. This study highlights the importance of electrophysiological testing in temporal processing assessment.

ABSTRACT Purpose: to investigate the relation between forward masking and cognitive-language skills in children as a function of literacy stage. Methods: twenty-seven children registered in literacy stage at public schools, aged from 6 to 9 years old, with no learning difficulties or audiological problems reported, participated in this study. Frequency Following Responses were registered in two test conditions: 1) /da/ alone; 2) /da/ presented 4 milliseconds after a speech noise. Two language protocols were applied: a cognitive-linguistic skills protocol and a phonological awareness one. Results: forward masking was evident in Frequency Following Responses of all children regardless of literacy stage. Frequency Following Responses latencies in both testing conditions showed no difference among participants’ age. Cognitive-language skills scores were below those expected for all children, with significant improvement noticed as a function of age. No correlation between language performance and forward masking was found. Conclusion: there was no relation between forward masking and cognitive-language skills in children, as a function of literacy stage.

RESUMO Objetivo: investigar o pós-mascaramento em marcações com predominância de picos positivos comparado com as marcações com predominância de picos negativos nos registros de Frequency-Following Response (FFR) em indivíduos adultos jovens com audição normal. Métodos: trata-se de um estudo conduzido a partir de um banco de dados, onde foram selecionados 20 registros do FFR (10 homens; 10 mulheres, com idade entre 18 e 25 anos, com a audição normal) e realizada análise qualitativa por duas examinadoras experientes. Os registros foram analisados segundo dois protocolos distintos de marcação dos registros: (i) análise com predominância de picos positivos - marcação das ondas PV, A, PW, PX, PY, PZ e O; e, (ii) análise com predominância de picos negativos - marcação das ondas V, A, C, D, E, F e O. Foram realizados o teste de normalidade Shapiro-Wilk, o teste de Wilcoxon e o teste t de Student. Foi adotado o nível de significância de p<0,05. Resultados: a análise comparativa das marcações realizadas não mostrou diferença significante entre os protocolos estudados. Nos valores de desvio padrão, foram observados valores absolutos mais elevados quando houve a marcação dos picos negativos quando comparado com as respostas obtidas com a marcação dos picos positivos, demonstrando um padrão inverso ao que se espera. Conclusão: o pós-mascaramento foi identificado em ambas marcações propostas, sendo as marcações com predominância dos picos positivos se mostraram menos variáveis.

ABSTRACT Purpose: to investigate forward masking by comparing latencies values of positive and negative peaks in frequency-following responses (FFR) recordings, in normally hearing young adults. Methods: from a database, 20 FFR recordings were selected, 10 being from men, and 10 from women, aged 18 to 25 years, with normal hearing. They were qualitatively analyzed by two experienced researchers and also analyzed, according to two different protocols of recording identification: (i) predominance of positive peaks - PV, A, PW, PX, PY, PZ, and O waves; and (ii) predominance of negative peaks - V, A, C, D, E, F, and O waves. The Shapiro-Wilk normality test, the Wilcoxon test, and the Student’s t-test were conducted, by adopting the significance level of p<0.05. Results: the comparative analysis of latency peak values did not reveal any significant difference between the studied protocols. However, the standard deviation was higher for absolute latency values as compared to negative peaks, suggesting an inverted pattern of what was expected. Conclusion: forward masking was identified in both proposals and the protocol of predominant positive peaks was less variable.

RESUMO Objetivo: investigar a magnitude do benefício da modulação do mascaramento no reconhecimento de sentenças, em função do nível de compressão temporal da fala e da taxa de modulação do ruído. Métodos: foram utilizadas sentenças do Hearing in Noise Test versão Português do Brasil. Foram determinados os limiares de reconhecimento das sentenças em função do nível de compressão temporal da fala (0%, 33% e 50%) em presença de ruído estável e modulado, em diferentes taxas de modulação (4, 10, 32 Hz). Foi realizada uma análise de variância para medidas repetidas, adotando nível de significância de 5%. Resultados: os limiares de reconhecimento de sentenças foram mais elevados com o aumento do nível de compressão temporal nos diferentes tipos de ruídos, no entanto, foram menores em presença dos ruídos modulados. Além disso, a magnitude do benefício da modulação do mascaramento diminuiu com o aumento do nível de compressão temporal da fala. Contudo, não foi observada diferença na fala comprimida entre as diferentes taxas de modulação do ruído, em função do nível de compressão temporal da fala. Conclusão: a magnitude do benefício do mascaramento modulado diminuiu com o aumento da compressão temporal da fala e as reduções no benefício do mascaramento modulado em função do nível de compressão temporal da fala não diferiram entre as taxas de modulações do ruído mascarante (4 Hz, 10 Hz e 32 Hz).

ABSTRACT Purpose: to investigate the magnitude of the modulation masking release in sentence recognition as a function of compression level and modulation rate. Methods: sentences of the Brazilian Portuguese version of the Hearing in Noise Test sentences were used as stimulus. The sentence recognition thresholds were established as a function of speech compression level (0%, 33%, and 50%) in steady and modulated noise at different modulation rates (4, 10, 32 Hz). The analysis of variance was performed for repeated measures, using the 5% significance level. Results: sentence recognition thresholds were higher for higher compression levels in the different types of noise. However, thresholds were smaller for modulated noises. Also, the magnitude of modulation masking release decreased as speech compression level increased. Nevertheless, no difference was observed in compressed speech between different noise modulation rates, in relation to the speech compression level. Conclusion: the magnitude of the modulation masking release decreased as the speech time-compression increased. Also, the reductions in modulation masking release, in relation to the speech time-compression level, did not differ between the masking-noise modulation rates (4, 10, and 32 Hz).

RESUMO Objetivo Investigar o efeito da idade no benefício da modulação do ruído mascarante (masking release) e no pós-mascaramento ( forward masking). Métodos Participaram da pesquisa jovens (média de idade de 18 anos e quatro meses) e idosos (média de idade de 64 anos e três meses) falantes nativos do Português Brasileiro e com audição normal. Mediante uso de sentenças da versão brasileira do Hearing in Noise Test, determinou-se, para ambos os grupos, limiares de reconhecimento em presença de ruído estável e em presença de ruído modulado em amplitude (10 Hz). Para a pesquisa do pós-macaramento, foram determinados limiares auditivos em intervalos de tempo de 4, 16, 64 e 128 milissegundos, após a interrupção do ruído. Para avaliar a normalidade dos resultados obtidos, foi aplicado o teste de Shapiro-Wilk. Nas variáveis em que a normalidade foi indicada, aplicou-se o teste t de Student para amostras independentes e nos casos em que a normalidade não foi encontrada, aplicou-se o teste de Mann-Whitney. Foi considerado o nível de significância de 5% Resultados Observou-se o benefício da modulação do mascaramento nos dois grupos. Porém, esse benefício foi menor para o grupo dos idosos (p-valor < 0,001). Na investigação do pós-mascaramento, houve diferença significativa entre os grupos, na média de limiares em 128 milissegundos, após a cessação do ruído (p-valor = 0,006). Conclusão O estudo mostra efeito da idade no benefício de modulação do ruído mascarante e no pós-mascaramento.

ABSTRACT Purpose The purpose of this study was to investigate the age-related effects of modulation masking release and forward masking. Methods Ten younger (mean age of 18.4) and ten older (mean age of 64.3) adults participated in the study. All participants were native speakers of Brazilian Portuguese with normal hearing. Sentences of the Brazilian version of the Hearing in Noise Test were used to obtain speech recognition thresholds in the presence of steady-state noise and amplitude-modulated noise (10 Hz). To investigate forward masking, auditory thresholds were determined at time intervals of 4, 16, 64, and 128 ms after noise interruption. The Shapiro-Wilk test was applied to evaluate the normality of the results. In the variables in which normality was indicated, the Student’s t-test was applied for the independent samples, and the Mann-Whitney test was applied in cases where normality was not found. A significance level of 5% was adopted for all statistical analyses. Results Modulation masking release was present in both groups; however, it was significantly smaller in the elderly group. As for forward masking investigation, higher thresholds were obtained after noise interruption, and improved as the time interval between noise and stimulus presentation increased. Forward masking was higher in the elderly group, whit higher thresholds for the time interval of 128 ms. Conclusion An age-related effect was identified on modulation masking release and forward masking.

RESUMO Objetivo Validar uma matriz de indicadores para avaliação de estrutura e processo em serviços de saúde auditiva infantil. Método Estudo de validação semântica de conteúdo com especialistas da área de Enfermagem e Fonoaudiologia. O instrumento continha 20 indicadores com pontuações a serem analisadas pelos especialistas. A condição para a adequação da validade de cada indicador e pontuação foi o Índice de Validação de Conteúdo por Item (I-IVC) de 0,80 e o IVC por nível de Escala (S-IVC) de 0,80. Resultados Participaram da pesquisa 22 especialistas. 59% eram enfermeiros e 41% fonoaudiólogos, sendo 32% especialistas, 45% mestres, 18% doutores e 5% pós-doutores. As médias dos I-IVC e S-IVC dos indicadores avaliados como adequados foi de 0,96, e nas pontuações sugeridas o I-IVC foi de 0,80 e o S-IVC de 0,82. Conclusão A matriz de indicadores foi considerada válida para avaliação de serviço de saúde auditiva infantil.

ABSTRACT Objective To validate a matrix of indicators to assess the structure and process of child hearing health services. Method A study of semantic and content validation with specialists in the area of Nursing and Speech therapy. The instrument contained 20 indicators with scores to be analyzed by experts. The condition for the validity suitability of each indicator and scores were an Item-level Content Validity Index (I-CVI) of 0.80 and a Scale-level CVI (S-CVI) of 0.80. Results Twenty-two (22) specialists participated in the study, with 59% being nurses and 41% speech therapists, of which 32% had specializations, 45% had a Master’s degree, 18% had a Doctorate degree and 5% had a Post-doctorate degree. The mean I-CVI and S-CVI of the indicators evaluated as suitable were 0.96, while for the suggested scores the I-CVI was 0.80 and the S-CVI was 0.82. Conclusion The matrix of indicators was considered valid for evaluating child hearing health services.

RESUMEN Objetivo Validar una matriz de indicadores para evaluación de estructura y proceso en servicios de salud auditiva infantil. Método Estudio de validación semántica de contenido con expertos del área de Enfermería y Fonoaudiología. El instrumento contenía 20 indicadores con puntajes que serían analizadas por los expertos. La condición para la adecuación de la validez de cada indicador y puntaje fue el Índice de Validación de Contenido por Ítem (I-IVC) de 0,80 y el IVC por nivel de Escala (S-IVC) de 0,80. Resultados Participaron en la investigación 22 expertos. El 59% eran enfermeros y el 41% fonoaudiólogos, siendo el 32% con especialización, el 45% con máster, el 18% doctores y el 5% post doctores. Los promedios de los I-IVC y S-IVC de los indicadores evaluados como adecuados fueron de 0,96 y en los puntajes sugeridos el I-IVC fue de 0,80 y el S-IVC de 0,82. Conclusión La matriz de indicadores fue considerada válida para evaluación de servicio de salud auditiva infantil.

ABSTRACT Objective To validate a matrix of indicators to assess the structure and process of child hearing health services. Method A study of semantic and content validation with specialists in the area of Nursing and Speech therapy. The instrument contained 20 indicators with scores to be analyzed by experts. The condition for the validity suitability of each indicator and scores were an Item-level Content Validity Index (I-CVI) of 0.80 and a Scale-level CVI (S-CVI) of 0.80. Results Twenty-two (22) specialists participated in the study, with 59% being nurses and 41% speech therapists, of which 32% had specializations, 45% had a Master’s degree, 18% had a Doctorate degree and 5% had a Post-doctorate degree. The mean I-CVI and S-CVI of the indicators evaluated as suitable were 0.96, while for the suggested scores the I-CVI was 0.80 and the S-CVI was 0.82. Conclusion The matrix of indicators was considered valid for evaluating child hearing health services.

RESUMEN Objetivo Validar una matriz de indicadores para evaluación de estructura y proceso en servicios de salud auditiva infantil. Método Estudio de validación semántica de contenido con expertos del área de Enfermería y Fonoaudiología. El instrumento contenía 20 indicadores con puntajes que serían analizadas por los expertos. La condición para la adecuación de la validez de cada indicador y puntaje fue el Índice de Validación de Contenido por Ítem (I-IVC) de 0,80 y el IVC por nivel de Escala (S-IVC) de 0,80. Resultados Participaron en la investigación 22 expertos. El 59% eran enfermeros y el 41% fonoaudiólogos, siendo el 32% con especialización, el 45% con máster, el 18% doctores y el 5% post doctores. Los promedios de los I-IVC y S-IVC de los indicadores evaluados como adecuados fueron de 0,96 y en los puntajes sugeridos el I-IVC fue de 0,80 y el S-IVC de 0,82. Conclusión La matriz de indicadores fue considerada válida para evaluación de servicio de salud auditiva infantil.

RESUMO Objetivo Validar uma matriz de indicadores para avaliação de estrutura e processo em serviços de saúde auditiva infantil. Método Estudo de validação semântica de conteúdo com especialistas da área de Enfermagem e Fonoaudiologia. O instrumento continha 20 indicadores com pontuações a serem analisadas pelos especialistas. A condição para a adequação da validade de cada indicador e pontuação foi o Índice de Validação de Conteúdo por Item (I-IVC) de 0,80 e o IVC por nível de Escala (S-IVC) de 0,80. Resultados Participaram da pesquisa 22 especialistas. 59% eram enfermeiros e 41% fonoaudiólogos, sendo 32% especialistas, 45% mestres, 18% doutores e 5% pós-doutores. As médias dos I-IVC e S-IVC dos indicadores avaliados como adequados foi de 0,96, e nas pontuações sugeridas o I-IVC foi de 0,80 e o S-IVC de 0,82. Conclusão A matriz de indicadores foi considerada válida para avaliação de serviço de saúde auditiva infantil.

RESUMO Objetivo: compreender a atuação em rede da equipe de saúde da família diante da perda auditiva infantil. Métodos: trata-se de uma pesquisa qualitativa a partir do estudo de caso. A coleta de dados consistiu na realização de três grupos focais com as equipes de saúde da família do distrito sanitário IV, no município de Recife. Os dados foram analisados pela condensação de significados. Resultados: a maioria dos profissionais desempenham suas funções de modo individualizado, o que pode fragilizar a assistência integral à saúde. Associados a isso, a falta de articulação com os demais níveis de complexidade para atender as diversas ações requeridas pela equipe impossibilita o cuidado contínuo da criança. Conclusão: a organização das equipes e suas relações com outros serviços assistenciais são envoltas por fragilidades que tornam a assistência pouco efetiva no que diz respeito à saúde auditiva.

ABSTRACT Purpose: to understand the network performance of family health staff on child hearing loss. Methods: a qualitative case-study research. Data collection consisted in three focus groups of family health staff from district IV in the city of Recife. Data were analyzed by meaning condensation. Results: most professionals perform their functions individually, which might weaken the comprehensive health care. Additionally, the lack of interaction with other complexity levels to meet the various actions and the absence of counter-reference required by the staff prevents the child's ongoing care. Conclusion: the teams’ organization and their relationships with other health care services are surrounded by weaknesses that make assistance ineffective regarding hearing health.