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array:23 [ "pii" => "S0214460319300543" "issn" => "02144603" "doi" => "10.1016/j.rlfa.2019.07.001" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "206" "copyright" => "Elsevier España, S.L.U. y Asociación Española de Logopedia, Foniatría y Audiología e Iberoamericana de Fonoaudiología" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Logop Fon Audiol. 2020;40:23-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0214460319300701" "issn" => "02144603" "doi" => "10.1016/j.rlfa.2019.07.002" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "208" "copyright" => "Elsevier España, S.L.U. y Asociación Española de Logopedia, Foniatría y Audiología e Iberoamericana de Fonoaudiología" "documento" => "article" "crossmark" => 1 "subdocumento" => "rev" "cita" => "Rev Logop Fon Audiol. 2020;40:30-44" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Revisión</span>" "titulo" => "Eficacia de los tratamientos para presbifonía en la población que envejece" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "30" "paginaFinal" => "44" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Efficacy of treatments for presbyphonia in the aging population" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1757 "Ancho" => 1672 "Tamanyo" => 87739 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Árbol que sintetiza el proceso de selección de los artículos incluidos en la revisión.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María García-Moreno, Berta Ausín" "autores" => array:2 [ 0 => array:2 [ "nombre" => "María" "apellidos" => "García-Moreno" ] 1 => array:2 [ "nombre" => "Berta" "apellidos" => "Ausín" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0214460319300701?idApp=UINPBA00004N" "url" => "/02144603/0000004000000001/v1_202002112140/S0214460319300701/v1_202002112140/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0214460319300531" "issn" => "02144603" "doi" => "10.1016/j.rlfa.2019.06.001" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "205" "copyright" => "The Author(s)" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "fla" "cita" => "Rev Logop Fon Audiol. 2020;40:12-22" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 367 "formatos" => array:3 [ "EPUB" => 26 "HTML" => 212 "PDF" => 129 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Proyecto <span class="elsevierStyleItalic">Petit UBinding:</span> método de adquisición y mejora de la lectura en primero de primaria. Estudio de eficacia" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "12" "paginaFinal" => "22" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "<span class="elsevierStyleItalic">Petit UBinding</span> project: An efficacy study of a reading acquisition and reading improvement method for first grade children" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figura 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1006 "Ancho" => 1389 "Tamanyo" => 49761 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Número medio de no-palabras leídas por minuto en noviembre, en mayo y el incremento entre ambas, en las escuelas <span class="elsevierStyleItalic">Petit UBinding</span> (gris oscuro) y en las escuelas control (gris claro) teniendo en cuenta solo al alumnado que comenzó por debajo del percentil 30.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jorge López-Olóriz, Violeta Pina, Sandra Ballesta, Soraya Bordoy, Laura Pérez-Zapata" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Jorge" "apellidos" => "López-Olóriz" ] 1 => array:2 [ "nombre" => "Violeta" "apellidos" => "Pina" ] 2 => array:2 [ "nombre" => "Sandra" "apellidos" => "Ballesta" ] 3 => array:2 [ "nombre" => "Soraya" "apellidos" => "Bordoy" ] 4 => array:2 [ "nombre" => "Laura" "apellidos" => "Pérez-Zapata" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0214460319300531?idApp=UINPBA00004N" "url" => "/02144603/0000004000000001/v1_202002112140/S0214460319300531/v1_202002112140/es/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Mismatch negativity in children with complaints of learning difficulties" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "23" "paginaFinal" => "29" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Laura Flach Schwade, Rafael Fabiano Machado Rosa, Paulo Ricardo Gazzola Zen, Pricila Sleifer" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Laura Flach" "apellidos" => "Schwade" "email" => array:1 [ 0 => "laura_fs_@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Rafael Fabiano Machado" "apellidos" => "Rosa" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Paulo Ricardo Gazzola" "apellidos" => "Zen" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Pricila" "apellidos" => "Sleifer" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Genética Clínica, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, Rio Grande do Sul, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Saúde e Comunicação Humana, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Mismatch Negativity en niños con quejas de dificultades de aprendizaje" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1156 "Ancho" => 1571 "Tamanyo" => 71030 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Schematic of the Mismatch Negativity (MMN). Source: Brossi, Borba, Garcia, Reis, & Isaac. Adapted.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Changes in hearing skills, particularly in central auditory processing, have been one of the theories used to try to explain the etiology of disorders and difficulties in the learning process of schoolchildren (<a class="elsevierStyleCrossRefs" href="#bib0060">Frizzo, 2015; Kraus et al., 1996; Murphy & Schochat, 2009; Regaçone, Gução, Giacheti, Romero, & Frizzo, 2014; Soares et al., 2011</a>).</p><p id="par0010" class="elsevierStylePara elsevierViewall">The term learning difficulties does not refer to a single disorder but to a wide range of changes that may affect any area of academic performance (<a class="elsevierStyleCrossRefs" href="#bib0035">Engelmann & Ferreira, 2009; Frizzo, 2015</a>). They include skills such as word identification or decoding, reading comprehension, spelling and written expression, mathematical calculus and reasoning (<a class="elsevierStyleCrossRef" href="#bib0145">Pinheiro & Capellini, 2010</a>).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Several studies have correlated learning difficulties, especially changes in reading and writing skills, with possible disorders of central auditory processing (<a class="elsevierStyleCrossRefs" href="#bib0060">Frizzo, 2015; Halliday, Barry, Hardiman, & Bishop, 2014; Murphy & Schochat, 2009; Neuhoff et al., 2012; Pinheiro & Capellini, 2010; Roggia & Colares, 2008; Soares et al., 2011; Souza, Rocha, Berticelli, Didoné, & Sleifer, 2017; Volkmer & Schulte-Körne, 2018</a>). Auditory processing, phonological awareness and sound discrimination are factors that interfere in the learning of reading and writing because they are directly related to receptive hearing (<a class="elsevierStyleCrossRefs" href="#bib0105">Linnavalli, Putkinen, Huotilainen, & Tervaniemi, 2017; Kraus et al., 1996; Regaçone et al., 2014</a>).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Central auditory processing, as well as auditory abilities, can be studied through the electrophysiological assessment of hearing, as recommended by the American Speech-Language-Hearing Association (ASHA) (<a class="elsevierStyleCrossRef" href="#bib0005">ASHA, 2003</a>). Long-latency auditory evoked potentials (LLAEP) have been seen as one of the most promising electrophysiological tests to evaluate dysfunctions and disorders of the central auditory nervous system (<a class="elsevierStyleCrossRefs" href="#bib0045">Ferreira, Bueno, Costa, & Sleifer, 2017; Rocha-Muniz, Lopes, & Schochat, 2015</a>).</p><p id="par0025" class="elsevierStylePara elsevierViewall">Mismatch Negativity (MMN) is a LLAEP, and it is also one of the components of Event-Related Potentials (ERP). It reflects an electrical brain response from processing, sound discrimination, and auditory memory skills. It demonstrates especially attractive to study several dysfunctions of the central auditory system, being the auditory discrimination the main ability of the auditory processing evaluated through this potential. It is elicited by the detection of change, indicating a mismatch between the new sensory input and a standard auditory stimulus stored in short-term auditory sensory memory, and a negative polarity (negativity) presented in the register of this potential (<a class="elsevierStyleCrossRefs" href="#bib0125">Näätänen, Astikainen, Ruusuvirta, & Huotilainen, 2010; Rocha-Muniz et al., 2015; Roggia, 2015; Schwade, Didoné, & Sleifer, 2017; Kujala & Leminen, 2017</a>). <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows the trace of the MMN potential.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The most important fact is that MMN can be acquired without the influence of the subject's attention to the auditory stimuli that are being presented and without the requirement of tasks during testing. Therefore, MMN is a potential clinical instrument, particularly suitable for use in difficult-to-manage populations, such as children and subjects with cognitive and behavioral changes (<a class="elsevierStyleCrossRefs" href="#bib0050">Ferreira, Bueno, & Costa, 2018; Schwade et al., 2017; Sleifer, 2015</a>).</p><p id="par0035" class="elsevierStylePara elsevierViewall">Despite the considerable number of previous studies on MMN in children, there is still little research in Brazil about this subject (<a class="elsevierStyleCrossRefs" href="#bib0020">Bruckmann, Santos Filha, Biaggio, & Garcia, 2016; Ferreira et al., 2017</a>).</p><p id="par0040" class="elsevierStylePara elsevierViewall">The performance of students with learning difficulties in central electrophysiological auditory evaluations was the object of study of some researchers (<a class="elsevierStyleCrossRefs" href="#bib0035">Engelmann & Ferreira, 2009; Oliveira, Murphy, & Schochat, 2013; Regaçone et al., 2014; Soares et al., 2011; Wiemes, Kozlowski, Mocellin, Hamerschmidt, & Schuch, 2012</a>). A previous study, which analyzed MMN and cognitive potential (P300) in children with reading and writing disorders, evidenced alterations in MMN and P300 in these individuals and emphasized that MMN enabled a better characterization of auditory function in the study population (<a class="elsevierStyleCrossRef" href="#bib0185">Soares et al., 2011</a>). On the other hand, another study did not find alterations in the latency and amplitude values of MMN among the groups composed of healthy children and children with reading difficulties and attention deficits (<a class="elsevierStyleCrossRef" href="#bib0075">Huttunen, Halonen, Kaartinen, & Lyytinen, 2007</a>). In previous studies that analyzed MMN in children with dyslexia, which is considered to be a learning disorder, the authors found alterations in MMN responses and suggested impairment in hearing abilities in dyslexic children (<a class="elsevierStyleCrossRefs" href="#bib0070">Hernández Barros et al., 2007; Moll, Hasko, Groth, Bartling, & Schulte-Körne, 2016; Neuhoff et al., 2012</a>).</p><p id="par0045" class="elsevierStylePara elsevierViewall">Importantly, detection of deficits in the central auditory nervous system and early intervention in children with learning difficulties are essential to mitigate the negative impact on school and social life in this population (<a class="elsevierStyleCrossRefs" href="#bib0150">Regaçone et al., 2014; Roggia & Colares, 2008</a>).</p><p id="par0050" class="elsevierStylePara elsevierViewall">Based on previously established relationships, the aim of this study was to analyze the results of MMN in children with complaints of learning difficulties and to compare the results with children without complaints of learning difficulties.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Materials and methods</span><p id="par0055" class="elsevierStylePara elsevierViewall">The present study was observational, cross-sectional, comparative, contemporary and individual. It was approved by the Research Ethics Committee of the Institute of Psychology of the Federal University of Rio Grande do Sul (UFRGS), under Protocol No. 55977316.8.0000.533. All procedures were performed after the children had agreed to participate in the study and their parents or legal guardians had signed an Informed Consent Form. The study was carried out at the Study Center for Electrophysiology Testing, Audiology Clinic, UFRGS.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The convenience sample consisted of both male and female children, aged between 8 and 11 years and 11 months, divided into two groups: study group (SG), composed of children with complaints of learning difficulties, and control group (CG), formed by children without complaints of learning difficulties and with adequate and regular school development. To estimate the standardized effect size of .9 (moderate), a sample size of 32 children was calculated in each group. Significance level was set at .5 with power<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>90% (Epilnfo – Statcal).</p><p id="par0065" class="elsevierStylePara elsevierViewall">Data on age, gender, schooling, learning difficulties in reading, writing and mathematics were reported by the parents or guardians, as well as by the teachers and the language-speech therapist at the school.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Inclusion criteria for the SG were complaints of difficulties in the learning process of reading, writing and mathematics, for more than four months. For the GC, only children without the above-mentioned complaints were included. The children who participated in the SG were invited and referred to participate in this research by the teacher and language-speech therapist of the school they attended. All the children participating in this research are students in grades 3–5 of Elementary School, in state schools.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Exclusion criteria for both groups (SG and CG) were presence of auditory complaints, any type of hearing loss, history of otological diseases, intellectual disability, syndromes, psychiatric, neurological disorders or any other illness reported by the parents or legal guardians or confirmed by medical diagnosis. They were excluded if they did not perform the procedures or did not finish the tests.</p><p id="par0080" class="elsevierStylePara elsevierViewall">All children (SG and CG) were submitted to peripheral and central electrophysiological auditory evaluations. The peripheral auditory evaluation consisted of inspection of the external auditory meatus and pure-tone threshold audiometry (PTTA). PTTA was performed in an acoustic booth and the auditory thresholds of the frequencies of 250, 500, 1000, 2000, 3000, 4000, 6000 and 8000<span class="elsevierStyleHsp" style=""></span>Hz were investigated by air-conduction, while those of 500, 1000, 2000, 3000, 4000<span class="elsevierStyleHsp" style=""></span>Hz by bone-conduction.</p><p id="par0085" class="elsevierStylePara elsevierViewall">After that, vocal audiometry was performed with the speech recognition percentage index (SRPI) and the speech recognition threshold (SRT). SRPI was performed with 25 monosyllabic words, presented at a constant and comfortable intensity (40<span class="elsevierStyleHsp" style=""></span>dBHL above the three-tone average value of the frequencies of 500, 1000 and 2000<span class="elsevierStyleHsp" style=""></span>Hz by air-conduction) in each ear; the children were expected to repeat the words correctly. SRT also used the initial intensity of 40 dBNA above the three-tone average value by air-conduction. Such intensity was reduced until reaching the level of intensity in which the children understood and repeated 50% of the trisyllabic words presented. PTTA and vocal audiometry were performed with a previously calibrated Inventis audiometer (Harp Inventis).</p><p id="par0090" class="elsevierStylePara elsevierViewall">After PTTA was completed, Acoustic Immitance Measurements (AIM) were performed with an AT235<span class="elsevierStyleHsp" style=""></span>h Interacoustics Impedance Audiometer. Tympanometric curves were determined with a probe inserted into the children's external auditory canal. Static and dynamic complacencies were investigated. Then, a curve was drawn and characterized according to Jerger's (1970) classification. During testing of ipsilateral and contralateral acoustic reflexes, the thresholds were investigated for frequencies of 500, 1000, 2000 and 4000<span class="elsevierStyleHsp" style=""></span>Hz in both ears.</p><p id="par0095" class="elsevierStylePara elsevierViewall">In both groups (SG and CG), children who presented auditory thresholds higher than or equal to 15<span class="elsevierStyleHsp" style=""></span>dB were included in all frequencies tested in PTTA, according to the classification proposed by <a class="elsevierStyleCrossRef" href="#bib0135">Northens and Downs (2005)</a>, type A tympanogram curves (<a class="elsevierStyleCrossRef" href="#bib0085">Jerger, 1970</a>), and ipsilateral and contralateral acoustic reflexes present in both ears. Thus, only children with peripheral auditory evaluation without evidence of alterations were included.</p><p id="par0100" class="elsevierStylePara elsevierViewall">The electrophysiological central auditory evaluation tested Mismatch Negativity (MMN). For this test, the children were seated in a comfortable chair with a headrest. The examiner cleansed the children's skin with a skin prep gel (Nuprep®) and common gauze. Subsequently, silver electrodes were placed with an EEG conductive paste (Ten20®conductive) and adhesive tape. The ground electrode was placed on the forehead; the active (Fz), near the scalp; M1 on the right mastoid and M2 on the left mastoid. Finally, earphones (<span class="elsevierStyleItalic">TONE</span>™<span class="elsevierStyleItalic">GOLD</span>) were placed in both ears. The test was performed in an acoustically-treated and electrically-insulated room with a <span class="elsevierStyleItalic">MASBE ATC Plus</span> device manufactured by Contronic®. Electrical impedance was less than 5<span class="elsevierStyleHsp" style=""></span>Ω in each lead and the difference between the three electrodes did not exceed 2<span class="elsevierStyleHsp" style=""></span>Ω.</p><p id="par0105" class="elsevierStylePara elsevierViewall">After impedance measurement, electroencephalogram (EEG) scanning was performed to capture spontaneous brain electrical activity to check for artifacts that might affect the test results. The children were instructed not to hold their limbs, nor cross their legs or arms.</p><p id="par0110" class="elsevierStylePara elsevierViewall">For MMN recording, several equal stimuli (frequent stimulus) were presented at short time intervals, alternated with stimuli that differ in frequency (rare stimulus). During this process, the children were made to watch an interesting and quiet video on a tablet to divert their attention on the auditory stimuli that were presented. Before the beginning of the test, the children received instructions on how the test was going to be performed.</p><p id="par0115" class="elsevierStylePara elsevierViewall">For MMN recording, the auditory stimuli were presented monoaurally, with frequency of 1000<span class="elsevierStyleHsp" style=""></span>Hz (50 cycles) for the frequent stimulus and 2000<span class="elsevierStyleHsp" style=""></span>Hz (50 cycles) for the rare stimulus, in an intensity between 70<span class="elsevierStyleHsp" style=""></span>dB and 80<span class="elsevierStyleHsp" style=""></span>dB for both stimuli, with 1.8 stimuli per second. On average, 300 stimuli were presented. The oddball paradigm in use was 90/10, and polarity was alternated. During acquisition, full scale was 200<span class="elsevierStyleHsp" style=""></span>μV; high-pass filter<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>Hz; low-pass filter<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>Hz; time window<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>500<span class="elsevierStyleHsp" style=""></span>ms and tracing amplitude<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>7.5<span class="elsevierStyleHsp" style=""></span>μV. Importantly, for greater reliability in the analyses, at least two samples were collected in each ear to ensure reproducibility of the waves. In addition, all electrophysiological records were analyzed by two evaluators, at different times.</p><p id="par0120" class="elsevierStylePara elsevierViewall">In order to check the agreement on MMN analysis, methods of Kappa statistic were used (<a class="elsevierStyleCrossRef" href="#bib0100">Landis & Koch, 1977</a>). Correlations between strength of agreement and the Kappa value were interpreted on the basis of the scale: <.00 (poor), .00–.20 (negligible), .21–.40 (weak), .41–.60 (moderate), .61–.80 (substantial) and .81–1.00 (almost perfect). The interpretation of the Interclass Correlation Coefficient (<span class="elsevierStyleItalic">I</span>) was based on the following classification: <span class="elsevierStyleItalic">I</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.4 (poor correlation strength), <span class="elsevierStyleItalic">I</span> between .4 and .75 (fair correlation strength) and <span class="elsevierStyleItalic">I</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>.75 (excellent correlation strength) (<a class="elsevierStyleCrossRef" href="#bib0055">Fleiss, 1986</a>).</p><p id="par0125" class="elsevierStylePara elsevierViewall">The results were organized descriptively; the quantitative variables were described by means of standard deviation. Qualitative variables were reported through absolute and relative frequencies. To compare the ears between groups for latency and amplitude results, the <span class="elsevierStyleItalic">t</span>-student test was applied for the paired samples. The level of significance was set at 5% (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.05) and the analyses were performed in the Statistical Package for the Social Sciences (SPSS) version 21.0.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0130" class="elsevierStylePara elsevierViewall">Thirty-six children were invited to participate in this study to form the study group (SG). Only one of them was excluded because it could not adequately complete all the proposed procedures. Thus, the results refer to a sample of 35 children from the SG and 70 from the control group (CG), duplicated and paired by sex and age. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the characteristics of the sample.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">There was an excellent concordance between the judges in the analysis of MMN components (Kappa .88). According to the interclass correlation coefficient, the value .77 was found for MMN, with a near perfect correlation.</p><p id="par0140" class="elsevierStylePara elsevierViewall">In the comparative analysis between the right ear (RE) and the left ear (LE) of the SG, there was no statistically significant difference for latency (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.387) and amplitude (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.391) values of MMN. These results indicate that the RE and the LE present equivalent latency and amplitude of MMN in this group. Likewise, there were no differences in latency and amplitude of MMN between the SG and the GC for any of the ears as regards sex (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.618 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.532, respectively).</p><p id="par0145" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the means and standard deviation of latency and amplitude of MMN in the SG and the CG, both in the RE and the LE. The data show that there were significant differences in the latency values of MMN between the SG and the CG (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.001), indicating that the children of the SG presented increased latency values of MMN in comparison to the CG.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0150" class="elsevierStylePara elsevierViewall">Complaints of learning difficulties in school-age children are frequent in speech-language therapy practice, and previous studies have indicated that MMN may be a promising measure to assist the investigation of auditory abilities in children with learning disorders (<a class="elsevierStyleCrossRefs" href="#bib0020">Bruckmann et al., 2016; Ferreira et al., 2017; Frizzo, 2015; Souza et al., 2017</a>). Changes in one or more auditory abilities have been found in this population (<a class="elsevierStyleCrossRefs" href="#bib0105">Linnavalli et al., 2017; Moll et al., 2016; Murphy & Schochat, 2009; Oliveira et al., 2013; Regaçone et al., 2014; Soares et al., 2011</a>).</p><p id="par0155" class="elsevierStylePara elsevierViewall">Long-latency auditory evoked potentials, including MMN, are one of the measures used in research on central auditory processing that reflects cortical activity, involving both the most simple and the most complex auditory abilities (<a class="elsevierStyleCrossRefs" href="#bib0080">Jansson-Verkasalo, Haverinen, Valkama, & Korpilahti, 2011; Regaçone et al., 2014</a>). The clinical use of MMN makes it possible to check if children with learning difficulties present disorders in central auditory processing and in other auditory abilities. This finding enables the design of more complete and efficient therapeutic plans to be performed in speech-language clinical practice, as well as in speech-language interventions in schools (<a class="elsevierStyleCrossRefs" href="#bib0045">Ferreira et al., 2017; Frizzo, 2015</a>).</p><p id="par0160" class="elsevierStylePara elsevierViewall">The sample of this research consisted of 105 children, aged between 8 and 11 years and 11 months. A decision was made to check MMN responses in children above 8 years of age, because it is believed that child have better literacy performance at this age group, and up to 11 years and 11 months of age, since this is the beginning of adolescence (<a class="elsevierStyleCrossRef" href="#bibe0010">Estatuto da Criança e do Adolescente do Brasil, 1990</a>).</p><p id="par0165" class="elsevierStylePara elsevierViewall">The results found in this study showed a significant difference in the mean latency values of MMN between the groups with and without complaints of learning difficulties. There was an increase in the average MMN latency values in the right and left ears of the SG participants compared to the CG individuals. This result suggests that the auditory discrimination and central auditory processing skills are compromised in children with learning difficulties. The reason is that the auditory stimuli take longer to be detected, differentiated and processed in the children from the SG.</p><p id="par0170" class="elsevierStylePara elsevierViewall">A previous study (<a class="elsevierStyleCrossRef" href="#bib0185">Soares et al., 2011</a>) that analyzed MMN in 12 children with reading and writing disorders resulted in an even higher average latency of MMN than in the present study; namely, 304.9<span class="elsevierStyleHsp" style=""></span>ms in the RE and 324.7<span class="elsevierStyleHsp" style=""></span>ms in the LE. This finding can be explained by differences in the MMN parameters used in their study, e.g., frequency of auditory stimuli. The study used 1000<span class="elsevierStyleHsp" style=""></span>Hz for the frequent stimulus and 1500<span class="elsevierStyleHsp" style=""></span>Hz for the rare stimulus, and this difference between the frequency of the auditory stimuli is lower than the one used in the present study; the lower the difference in frequency between the two stimuli, the more difficult auditory discrimination becomes (<a class="elsevierStyleCrossRef" href="#bib0010">Aurélio et al., 2006</a>). Therefore, it is assumed that this is one of the reasons why the above-mentioned study had more variation in the results for MMN than the present research.</p><p id="par0175" class="elsevierStylePara elsevierViewall">Previous studies analyzing MMN responses in children with dyslexia, a learning disorder particularly related to reading and writing difficulties, also found altered MMN results (<a class="elsevierStyleCrossRefs" href="#bib0025">Chobert, François, Habib, & Besson, 2012; Halliday et al., 2014; Maciejewska, Wiskirska-Woźnica, Świdziński, & Michalak, 2014; Žarić et al., 2014</a>). Delays in MMN latencies and deficits in auditory discrimination are found in research with dyslexic children (<a class="elsevierStyleCrossRef" href="#bib0200">Cobera, Escera, & Artigas, 2006</a>).</p><p id="par0180" class="elsevierStylePara elsevierViewall">The scientific literature (<a class="elsevierStyleCrossRef" href="#bib0045">Ferreira et al., 2017</a>) has reported that the most commonly performed analysis occurs through observation of latency and wave amplitude in research on long-latency auditory evoked potentials. It has also described that when there is an increase in latency values or a decrease in amplitude values, clinical and subclinical changes can be objectively evidenced. Latency informs the auditory processing activity time and also demonstrates the time required for the rare stimulus to be differentiated from the frequent stimulus, whereas wave amplitude is related to the greater or lesser ability of the auditory system to differentiate between rare and frequent stimuli (<a class="elsevierStyleCrossRef" href="#bib0160">Roggia, 2015</a>).</p><p id="par0185" class="elsevierStylePara elsevierViewall">Therefore, it is worth mentioning that the SG composed of children with complaints of learning difficulties had higher mean latency values in comparison to the CG, with statistically significant results. However, in a general analysis, both groups remained within the norms of normality in comparison to the data referred in the scientific literature, which mentions MMN latency values between 150 and 250<span class="elsevierStyleHsp" style=""></span>ms, which can vary from 200 to 300<span class="elsevierStyleHsp" style=""></span>ms in children (<a class="elsevierStyleCrossRefs" href="#bib0050">Ferreira et al., 2018; Roggia, 2015</a>).</p><p id="par0190" class="elsevierStylePara elsevierViewall">As for amplitude, in this study, the mean values of MMN amplitudes were similar between the groups and similar to the mean described in other studies that reported MMN amplitude values between .5 and 5<span class="elsevierStyleHsp" style=""></span>μV (<a class="elsevierStyleCrossRefs" href="#bib0030">Duncan et al., 2009; Ferreira et al., 2018</a>). However, it has been reported that, when there is an increase in the degree of discrepancy between the frequent stimuli and the rare stimuli of MMN, amplitude also tends to increase (<a class="elsevierStyleCrossRef" href="#bib0050">Ferreira et al., 2018</a>). It is believed that, for this reason, the mean values of MMN amplitude found in the present study are similar to the maximum values described in the literature.</p><p id="par0195" class="elsevierStylePara elsevierViewall">Considering that reading is a particular type of information gathering, formed by events that elapse over time, it is assumed that the integrity of the auditory physiological mechanisms plays a fundamental role in the perception of speech, in learning in understanding language; it is, therefore, a prerequisite to learn reading and writing (<a class="elsevierStyleCrossRef" href="#bib0185">Soares et al., 2011</a>).</p><p id="par0200" class="elsevierStylePara elsevierViewall">Thus, it is becoming increasingly important to evaluate central auditory processing abilities in children who are in the learning phase, because disorders in auditory abilities may influence their learning process, hence it is crucial to diagnose and intervene as early as possible. This research may help the professional to choose the MMN test in order to investigate the central auditory nervous system of children with complaints of learning difficulties, since, as seen in this study, they may present changes in the latencies of MMN, and such alterations in the latencies of MMN may indicate clinical alterations regarding auditory discrimination and central auditory processing.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusions</span><p id="par0205" class="elsevierStylePara elsevierViewall">In the study sample, there was evidence of changes in the mean MNN latencies in children with complaints of learning difficulties compared to children without complaints of learning difficulties. These results suggest that, in the target sample, the children with complaints may have difficulty in hearing discrimination and possible disorders in other central auditory processing skills.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0210" class="elsevierStylePara elsevierViewall">This research was funded by <span class="elsevierStyleGrantSponsor" id="gs1">CAPES</span> (Coordination for the Improvement of Higher Education Personnel).</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interest</span><p id="par0215" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1305092" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Materials and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1205212" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1305091" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Antecedentes y objetivo" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1205211" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-01-22" "fechaAceptado" => "2019-07-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1205212" "palabras" => array:5 [ 0 => "Evoked potentials" 1 => "Audiology" 2 => "Electrophysiology" 3 => "Children" 4 => "Learning" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1205211" "palabras" => array:5 [ 0 => "Potenciales evocados" 1 => "Audiología" 2 => "Electrofisiología" 3 => "Niños" 4 => "Aprendizaje" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Mismatch Negativity (MMN) is an electrophysiological measure of hearing that reflects the skills of auditory discrimination and central auditory processing.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To analyze MMN results in children with complaints of learning difficulties and to compare the results with children without complaints of learning difficulties.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Materials and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional and comparative study. The sample consisted of 105 male and female children, aged between 8 and 11 years and 11 months, 3rd to 5th graders at Elementary School. The study group consisted of 35 children with learning difficulties and the control group, of 70 children without complaints. All children underwent pure-tone threshold audiometry (PTTA), vocal audiometry, acoustic immittance measurements and Mismatch Negativity (MMN) evaluations.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The mean latency of MMN was 213.3<span class="elsevierStyleHsp" style=""></span>ms in the right ear and 215.2<span class="elsevierStyleHsp" style=""></span>ms in the left in the study group, and 169.3<span class="elsevierStyleHsp" style=""></span>ms in the right ear and 170.4<span class="elsevierStyleHsp" style=""></span>ms in the left in the control group. The mean MMN latency was significantly higher in the study group compared to the control group (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.001). The mean amplitude of MMN in the study group was 5.76<span class="elsevierStyleHsp" style=""></span>μV in the right ear and 5.62<span class="elsevierStyleHsp" style=""></span>μV in the left, while in the control it was 5.01<span class="elsevierStyleHsp" style=""></span>μV in the right ear and 5.22<span class="elsevierStyleHsp" style=""></span>μV in the left.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">In the study sample, children with complaints of learning difficulties had significantly higher mean significances than those without the same complaints.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Materials and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Antecedentes y objetivo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La Mismatch Negativity (MMN) es una medida electrofisiológica de la audición que refleja las habilidades de discriminación auditiva y el procesamiento auditivo central. El objetivo de este estudio fue analizar los resultados de la MMN en los niños con quejas de dificultades de aprendizaje, y comparar los resultados con niños sin quejas de dificultades de aprendizaje.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Materiales y métodos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal y comparativo. La muestra fue constituida por 105 niños de ambos sexos, con edad comprendidas entre 8 y 11 años y 11 meses, 3.ª a 5.ª series de la enseñanza fundamental. El grupo de estudio fue constituido por 35 niños con dificultades de aprendizaje y el grupo control, de 70 niños sin quejas. Todos los niños fueron sometidos a la audiometría tonal liminar (PTTA), a la audiometría vocal, a las medidas de imitancia acústica y a la MMN.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La latencia media de la MMN fue de 213,3<span class="elsevierStyleHsp" style=""></span>ms en el oído derecho y 215,2<span class="elsevierStyleHsp" style=""></span>ms en el izquierdo en el grupo de estudio, y 169,3<span class="elsevierStyleHsp" style=""></span>ms en el oído derecho y 170,4<span class="elsevierStyleHsp" style=""></span>ms en el izquierdo en el grupo control. La latencia media de la MMN fue significativamente mayor en el grupo de estudio en comparación con el grupo control (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,001). La amplitud media de la MMN en el grupo de estudio fue de 5,76<span class="elsevierStyleHsp" style=""></span>μV en el oído derecho y de 5,62<span class="elsevierStyleHsp" style=""></span>μV en el oído izquierdo, mientras que en el control fue de 5,01<span class="elsevierStyleHsp" style=""></span>μV en el oído derecho y 5,22<span class="elsevierStyleHsp" style=""></span>μV en el oído izquierdo.</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">En la muestra estudiada, los niños con quejas de dificultades de aprendizaje tuvieron significados significativamente mayores que aquellas sin las mismas quejas.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Antecedentes y objetivo" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Conclusiones" ] ] ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1156 "Ancho" => 1571 "Tamanyo" => 71030 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Schematic of the Mismatch Negativity (MMN). Source: Brossi, Borba, Garcia, Reis, & Isaac. Adapted.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Caption: <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>number of children; study group<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>children with complaints of learning difficulties; control group<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>children without complaints of learning difficulties; SD<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>standard deviation.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study group (SG) (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>35) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Control group (CG) (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>70) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Age (years)</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>(Minimum–maximum) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(8–11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(8–11) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Sex – n(%)</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Males \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (51.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (50) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Females \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (48.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (50) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2235751.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the sample: measures of central tendency and variability for age; absolute and relative distribution for sex.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Caption: study group<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>children with complaints of learning difficulties; control group<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>children without complaints of learning difficulties; MMN<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">mismatch negativity</span>.</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">ms<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>millisecond; μV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>microvolt; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>sample number; SD<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>standard deviation; Student's <span class="elsevierStyleItalic">t</span>-test, significant</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Variables \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Study group (SG) (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>35) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Control group (CG) (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>70) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p</span>-value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>SD \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">MMN latency (ms)</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Right ear \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">213.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>39.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">169.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>39.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Left ear \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">215.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>39.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">170.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>33.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><.001<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">MMN amplitude (μV)</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Right ear \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.76<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.01<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.195 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Left ear \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.62<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.22<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.273 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2235750.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="npar0005"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>≤<span class="elsevierStyleHsp" style=""></span>.001.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Comparison of MMN results among children with complaints of learning disabilities (study group) and without complaints (control group).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:40 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "ASHA, 2003" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for competencies in auditory evoked potential measurement and clinical applications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "ASHA (American Speech-Language Hearing Association)" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2003" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "Aurélio et al., 2006" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contribuição do Mismatch Negativity na avaliação cognitiva de indivíduos portadores de esclerose múltipla" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Aurélio" 1 => "R. Santos" 2 => "M.S. Lei" 3 => "M.A.L. Peixoto" 4 => "V. Geraldi" 5 => "J.L. Rodrigues" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/S0034-72992006000600011" "Revista" => array:6 [ "tituloSerie" => "Revista Brasileira Otorrinolaringologia" "fecha" => "2006" "volumen" => "72" "numero" => "6" "paginaInicial" => "800" "paginaFinal" => "808" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0020" "etiqueta" => "Bruckmann et al., 2016" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aplicabilidade do mismatch negativity em crianças e adolescentes: Uma revisão descritiva" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Bruckmann" 1 => "V.A.V. dos Santos Filha" 2 => "E.P.V. Biaggio" 3 => "M.V. Garcia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/1982-0216201618423415" "Revista" => array:6 [ "tituloSerie" => "Revista CEFAC" "fecha" => "2016" "volumen" => "18" "numero" => "4" "paginaInicial" => "952" "paginaFinal" => "959" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0025" "etiqueta" => "Chobert et al., 2012" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Deficit in the preattentive processing of syllabic duration and VOT in children with dyslexia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Chobert" 1 => "C. François" 2 => "M. Habib" 3 => "M. 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