Spatial Processing in children with a history of otitis media

Introduction: The Spatial Processing Test of Sentences in Noise in Portuguese (PROSER) assesses Spatial Processing (SP), a skill that allows you to focus on the main message and suppress competing stimuli coming from different positions. Changes in this ability can make it difficult to understand speech in noisy environments, characterizing Spatial Processing Disorder (SPD), the main cause of which is a history of otitis media (OM). Objective: To analyze the SP of children with a history of OM. Methods: This prospective and cross-sectional study was approved by the Institution`s Research Ethics Committee (no. 6,752,209). The sample included 80 children aged 6 to 10 years, divided into three groups: Experimental Group I (EGI), with 30 children with cleft lip and palate and a history of OM; Experimental Group II (EGII), with 20 children with a history of OM and use of a ventilation tube in the first five years of life; Control Group (CG), with 30 children with no history of OM. The children underwent basic audiological evaluation and only those with normal results were included. PROSER was administered via software, with headphones, producing a three-dimensional auditory environment. The children heard sentences with competitive stimuli (children`s stories) and repeated the greatest number of words. Stories were presented at 65 dB SPL and sentences at 72 dB SPL. The Speech Recognition Threshold (SRT) was defined by the signal/noise ratio that resulted in 50% intelligibility in four test conditions, considering the location of the stimulus (0º vs 90º) and the speaker`s voice (same or different). Three advantage measures were calculated (spatial, speaker and total). Results: In the evaluated conditions MV0° (same voice), MV±90° (same voice, stimulus at 90°), VD0° and VD±90° (conditions with different voices), EGI and EGII showed worse performance when compared with the CG. The same occurred with the advantage measures.
Considering altered results in at least one condition or advantage, PROSER was altered, 45% of GEII, 56.6% of GEI and 13.3% of CG. Conclusion: Sensory deprivation resulting from OM negatively affected the SP in children, impairing their ability to focus on the message in noisy environments and to suppress competitive stimuli coming from different directions.

Acknowledgment to FAPESP: grant number 2017/25267-0: LiSN-S TEST: Database Development in Portuguese and normality criteria for schoolchildren aged 6 to 11 years.