Mismatch negativity in children with specific language impairment and auditory processing disorder

IntroductionMismatch negativity, an electrophysiological measure, evaluates the brain's capacity to discriminate sounds, regardless of attentional and behavioral capacity. Thus, this auditory event-related potential is promising in the study of the neurophysiological basis underlying auditory processing.ObjectiveTo investigate complex acoustic signals (speech) encoded in the auditory nervous system of children with specific language impairment and compare with children with auditory processing disorders and typical development through the mismatch negativity paradigm.MethodsIt was a prospective study. 75 children (6–12 years) participated in this study: 25 children with specific language impairment, 25 with auditory processing disorders, and 25 with typical development. Mismatch negativity was obtained by subtracting from the waves obtained by the stimuli /ga/ (frequent) and /da/ (rare). Measures of mismatch negativity latency and two amplitude measures were analyzed.ResultsIt was possible to verify an absence of mismatch negativity in 16% children with specific language impairment and 24% children with auditory processing disorders. In the comparative analysis, auditory processing disorders and specific language impairment showed higher latency values and lower amplitude values compared to typical development.ConclusionThese data demonstrate changes in the automatic discrimination of crucial acoustic components of speech sounds in children with specific language impairment and auditory processing disorders. It could indicate problems in physiological processes responsible for ensuring the discrimination of acoustic contrasts in pre-attentional and pre-conscious levels, contributing to poor perception.     

Association between language development and auditory processing disorders

IntroductionIt is crucial to understand the complex processing of acoustic stimuli along the auditory pathway; comprehension of this complex processing can facilitate our understanding of the processes that underlie normal and altered human communication.AimTo investigate the performance and lateralization effects on auditory processing assessment in children with specific language impairment (SLI), relating these findings to those obtained in children with auditory processing disorder (APD) and typical development (TD).Material and methodsProspective study. Seventy-five children, aged 6-12 years, were separated in three groups: 25 children with SLI, 25 children with APD, and 25 children with TD. All went through the following tests: speech-in-noise test, Dichotic Digit test and Pitch Pattern Sequencing test.ResultsThe effects of lateralization were observed only in the SLI group, with the left ear presenting much lower scores than those presented to the right ear. The inter-group analysis has shown that in all tests children from APD and SLI groups had significantly poorer performance compared to TD group. Moreover, SLI group presented worse results than APD group.ConclusionThis study has shown, in children with SLI, an inefficient processing of essential sound components and an effect of lateralization. These findings may indicate that neural processes (required for auditory processing) are different between auditory processing and speech disorders.     

Auditory processing abilities in children with chronic otitis media with effusion

Conclusion The study results indicate that children with a history of otitis media with effusion (OME) suffer from auditory processing disorder to some degree. The findings support the hypothesis that fluctuating hearing loss may affect central auditory processing during critical periods.

Objectives Evidence suggests that prolonged OME in children can result in an auditory processing disorder, presumably because hearing has been disrupted during an important developmental period. A lack of auditory stimulation leads to the abnormal development of the hearing pathways in the brain. The aim of the present study was to determine the effects of OME on binaural auditory function and auditory temporal processing.

Method In the present study, the dichotic digit test (DDT) was used for binaural hearing, and the gap in noise (GIN) test was used to evaluate temporal hearing processing.

Results The average values of GIN differed significantly between children with a history of OME and normal controls (p?p?=?0.002).     

Developing the auditory processing domains questionnaire (APDQ): a differential screening tool for auditory processing disorder

Abstract

Objective: The aim of this study was to develop a screening questionnaire for auditory processing disorder (APD).

Design: Fifty-two questions were created to enable parent/teacher proxies to rate students listening skills in terms of auditory processing, attention and language factors.

Study sample: Parents rated their child’s frequency of competent performance (regularly, often, sometimes or rarely) on 52 questions. Scores were calculated for three scales: auditory processing, attention and language. Data was collected from 198 normal controls, 20 students with auditory processing disorder, 40 students with attention deficit hyperactivity disorder and 10 students with a learning disability. Subjects were split into a younger group (7–10?y) and an older group (11–17?y).

Results: Factor analysis revealed substantial internal validity. Analysis of external validity using a regression model revealed significant differences between normal and clinical groups for all scales (p?<?0.001) and also significantly separated the three clinical groups. A group differential analysis of scale score results clearly demonstrated inter-group differences at 89% (on average) sensitivity and specificity levels.

Conclusion: The auditory processing domains questionnaire appears to be an effective screening questionnaire for APD with scale score patterns likely to be helpful in making appropriate clinical referrals.     

疑似听觉处理障碍儿童案例研究

目的本文介绍了中枢听觉功能测试方法，探讨了对听觉处理障碍儿童的诊断和处理原则。方法选择3例疑似听觉处理障碍儿童作为研究案例，进行系统的听力学，教育心理学、言语病理学测试和听觉中枢处理评估。结果在随机间隔探测测试和空间噪音听力测试（Iistening in spatializecl noise test，LISN）中，得分低于同龄组的平均值超过5个标准差；高一提示信号的LISN测试结果显示，数值低于平均值超过2个标准差。结论中枢听觉处理测试序列说明此3例儿童存在双耳听觉处理缺陷。通过改善教室的信噪比，应用听觉闭合训练、听觉定位和辨别训练，加强语言处理技能训练，能够使这3名儿童受益。     

Children with developmental language disorder: a frequency following response in the noise study

IntroductionChildren with developmental language disorder have been reported to have poor temporal auditory processing. This study aimed to examine the frequency following response.ObjectiveThis work aimed to investigate speech processing in quiet and in noise.MethodsTwo groups of children were included in this work: the control group (15 children with normal language development) and the study group (25 children diagnosed with developmental language disorder). All children were submitted to intelligence scale, language assessment, full audiological evaluation, and frequency following response in quiet and noise (+5QNR and +10QNR).ResultsResults showed no statically significant difference between both groups as regards IQ or PTA. In the study group, the advanced analysis of frequency following response showed reduced F0 and F2 amplitudes. Results also showed that noise has an impact on both the transient and sustained components of the frequency following response in the same group.ConclusionChildren with developmental language disorder have difficulty in speech processing especially in the presence of background noise. Frequency following response is an efficient procedure that can be used to address speech processing problems in children with developmental language disorder.     

Behavioral profiles associated with auditory processing disorder and specific language impairment

PurposeTo describe and compare behavioral profiles associated with auditory processing disorder (APD) and specific language impairment (SLI) in school-age children.MethodThe participants in this cross-sectional observational study were 64 children (mean age 10.1 years) recruited through clinician referrals. Thirty-five participants had a clinical diagnosis of APD and 29 were receiving services for language impairment. Participants completed 18 behavioral measures of spoken language, auditory processing, reading, memory, and motor speed. Responses were used to classify children as affected/not affected with APD, and affected/not affected with SLI. Comparisons were made between children with and without an APD diagnosis, and between children assigned to the APD/not APD and SLI/not SLI groups. Agreement between clinical status and test-based classifications is also reported.ResultsThere were no group mean differences between children with and without a clinical diagnosis of APD. Group mean differences on Cube Design and reading fluency were observed for children classified as APD/not APD; and group mean differences on nonword repetition, spatial working memory, and two auditory processing tests were observed for children classified as SLI/not SLI.ConclusionsThe behavioral profiles of children with APD and SLI were very similar. Although group mean differences were found, they were difficult to interpret in terms of current theories.Learning outcomes: The reader will be able to: (1) describe similarities and differences found between children with SLI and children with APD and (2) discuss assessment problems posed by overlapping behavioral characteristics of SLI and APD.     

Auditory and language skills in children with cleft lip and palate

Objectivesto investigate auditory and language skills in children with repaired cleft lip and palate.MethodsThe sample was composed of 22 children registered at the hospital where the study was conducted, seven to nine years old, 50% being female, with repaired unilateral cleft lip and palate (right or left), without associated malformations. Auditory skills were assessed using four central auditory processing tests: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test, Sustained Auditory Attention Ability Test. Language performance was evaluated by four standardized instruments: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test and Phonological Skills Profile. The association between auditory and language skills was evaluated by the Fisher exact test at a significance level of 5% (p < .05).ResultsThe central auditory processing tests evidenced that only one child presented adequate performance in all skills analysed, five children presented impaired performance in all skills, and 16 exhibited deteriorations in one to three auditory skills, highlighting that temporal resolution was the most impaired skill (81%). Concerning language, three children presented adequate performance in all tests applied, and Visual Association and Auditory Association were the most impaired skills (40%). No association was observed between deteriorations in auditory and language skills.ConclusionThere was high occurrence of impairment of auditory skills, which compose the central auditory processing, as well as of language skills, with greatest impairment of receptive language.     

Association between top-down skills and auditory processing tests

Today, we are questioning how top-down skills may interfere with performance on auditory processing tests.ObjectiveTo investigate the existence of a possible association between memory, attention and language skills in auditory processing tests in “normal” development children.MethodTwenty children (ages 7 to 9 years), without complaints related to verbal and/or written language skills; without overt neurological or psychological involvement or delayed psychomotor development. We employed Hearing and auditory Processing Assessment tests in addition to psychophysical tests (visual and auditory attention tests; memory tests for digits and syllables and phonological awareness tests).Resultsthere was a “very strong” correlation between Frequency Pattern and Memory for Digits Tests; a “strong” correlations between SSW (LE) test and Memory for Syllables, and SSW (LE) test and phonemic tasks.Conclusionthe Frequency Pattern Test showed a strong correlation with the phonological working memory skill; just as the SSW had with language and memory skills for syllables. It is noteworthy the difficult to clinically interpret the results of each auditory processing test alone, since these may be dependent on skills not necessarily related to the auditory modality, such as memory and language.     

A randomized control trial of interventions in school-aged children with auditory processing disorders

Objective: The primary purpose of the study was to compare intervention approaches for children with auditory processing disorder (APD): bottom-up training including activities focused on auditory perception, discrimination, and phonological awareness, and top-down training including a range of language activities. Another purpose was to determine the benefits of personal FM systems. Design: The study is a randomized control trial where participants were allocated to groups receiving one of the two interventions, with and without personal FM, or to the no intervention group. The six-week intervention included weekly one-hour sessions with a therapist in the clinic, plus 1–2 hours per week of parent-directed homework. Study sample: 55 children (7 to 13 years) with APD participated in the study. Intervention outcomes included reading, language, and auditory processing. Results: Positive outcomes were observed for both training approaches and personal FM systems on several measures. Pre-intervention nonverbal IQ, age, and severity of APD did not influence outcomes. Performance of control group participants did not change when retested after the intervention period. Conclusions: Both intervention approaches were beneficial and there were additional benefits with the use of personal FM. Positive results were not limited to the areas specifically targeted by the interventions.     

A systematic review of electrophysiological outcomes following auditory training in school-age children with auditory processing deficits

Abstract

Objective: To systematically review the peer-reviewed literature on electrophysiological outcomes following auditory training (AT) in school-age children with (central) auditory processing disorder ([C]APD). Design: A systematic review. Study sample: Searches of 16 electronic databases yielded four studies involving school-aged children whose auditory processing deficits had been confirmed in a manner consistent with and and compared to a treated and/or an untreated control group before and after AT. A further three studies were identified with one lacking a control group and two measuring auditory processing in a manner not consistent with and . Results: There is limited evidence that AT leads to measurable electrophysiological changes in children with auditory processing deficits. Conclusion: The evidence base is too small and weak to provide clear guidance on the use of electrophysiological outcomes as a measure of AT outcomes in children with auditory processing problems. The currently limited data can only be used to suggest that click-evoked AMLR and tone-burst evoked auditory P300 might be more likely to detect such outcomes in children diagnosed with (C)APD, and that speech-evoked ALLR might be more likely to detect phonological processing changes in children without a specific diagnosis of (C)APD.     

Development of auditory and language skills in children using cochlear implants with two signal processing strategies

IntroductionThe increase in the spectral information offered by the sound processing strategy HiRes 120 has led to great expectations for the pediatric population. Due to a shorter duration of auditory deprivation and higher neural plasticity, children could benefit more substantially from the spectral information of this sound processing strategy.ObjectiveTo compare auditory and language skills in Brazilian children with cochlear implants using the HiRes and HiRes 120 sound processing strategies.MethodsThirty children, aged 1–3 years, with congenital hearing loss, were divided into two groups, according to the signal processing strategy adjusted at the time of the cochlear implant activation. The assessed children were matched according to chronological age and the time of the cochlear implant use. The auditory and language skills were evaluated longitudinally through the Infant-Toddler Meaningful Auditory Integration Scale and Production Infant Scale Evaluation, carried out before surgery, and 3, 6 and 12 months after device implantation. The Mann–Whitney test was applied for the comparison between the two groups with a 5% significance level.ResultsThe findings indicated development of hearing and language skills in the first year of cochlear implant use; however, there was no statistically significant difference in the evolution of such skills due to the adjusted processing strategy in the activation of the cochlear implant electrodes.ConclusionThe development of auditory and language skills in the assessed children was similar during the entire study period, regardless of which signal processing strategy was used.     

Central auditory processing: behavioral and electrophysiological assessment of children and adolescents diagnosed with stroke

IntroductionCentral auditory processing refers to the efficiency and effectiveness with which the central nervous system uses auditory information: it may be altered in neurological disorders and brain injuries, such as strokes. However, despite evidence of probable alterations in the pediatric population, functional abilities and post-stroke limitations are still not well documented in the literature.ObjectiveTo analyze the findings of the electrophysiological and behavioral evaluations of central auditory processing of children and adolescents diagnosed with stroke from a reference outpatient clinic, as well as to investigate possible associations with the variables: type and location of the stroke and age group.MethodsThe present study is characterized as comparative cross-sectional. The sample, for convenience, included individuals aged 7–18 years divided into two groups: study group, composed of individuals with a diagnosis of stroke, and control group, composed of individuals with typical development. The evaluation consisted of the following procedures: anamnesis, basic audiological evaluation, behavioral evaluation of the auditory processing disorder (dichotic digit test, dichotic consonant-vowel, synthetic sentence identification/pediatric speech intelligibility, gaps in noise, pitch pattern sequence, masking level difference), and electrophysiological evaluation (P300 and mismatch negativity).ResultsNineteen children and adolescents were included in the study group. The control group was composed of 19 children and adolescents with typical development. In the comparison between the groups, a worse performance is observed for the study group in all the evaluated tests, behavioral and electrophysiological. In the behavioral evaluation of central auditory processing, there was a statistical difference for all tests, except for masking level difference and dichotic digit test, binaural separation step on the left. In the electrophysiological evaluation, there was a statistical difference in the latency of mismatch negativity and P300. No associations were found between the behavioral and electrophysiological findings and the location of the stroke and age group variables.ConclusionChildren and adolescents diagnosed with stroke present a worse performance in the electrophysiological and behavioral evaluations of central auditory processing when compared to a control group.     

The relation between working memory capacity and auditory lateralization in children with auditory processing disorders

ObjectiveAuditory processing disorder (APD) describes a complex and heterogeneous disorder characterized by poor speech perception, especially in noisy environments. APD may be responsible for a range of sensory processing deficits associated with learning difficulties. There is no general consensus about the nature of APD and how the disorder should be assessed or managed. This study assessed the effect of cognition abilities (working memory capacity) on sound lateralization in children with auditory processing disorders, in order to determine how “auditory cognition” interacts with APD.MethodsThe participants in this cross-sectional comparative study were 20 typically developing and 17 children with a diagnosed auditory processing disorder (9–11 years old). Sound lateralization abilities investigated using inter-aural time (ITD) differences and inter-aural intensity (IID) differences with two stimuli (high pass and low pass noise) in nine perceived positions. Working memory capacity was evaluated using the non-word repetition, and forward and backward digits span tasks. Linear regression was employed to measure the degree of association between working memory capacity and localization tests between the two groups.ResultsChildren in the APD group had consistently lower scores than typically developing subjects in lateralization and working memory capacity measures. The results showed working memory capacity had significantly negative correlation with ITD errors especially with high pass noise stimulus but not with IID errors in APD children.ConclusionsThe study highlights the impact of working memory capacity on auditory lateralization. The finding of this research indicates that the extent to which working memory influences auditory processing depend on the type of auditory processing and the nature of stimulus/listening situation.     

Evaluation of auditory processing and phonemic discrimination in children with normal and disordered phonological development

Auditory processing and phonemic discrimination are essential for communication. Type of study: Retrospective.AimTo evaluate auditory processing and phonemic discrimination in children with normal and disordered phonological development.Material and MethodsAn evaluation of 46 children was carried out: 22 had phonological disorders and 24 had normally developing speech. Diotic, monotic and dichotic tests were applied to assess auditory processing and a test to evaluate phonemic discrimination abilities.DesignCross-sectional, contemporary.ResultsThe values of normally-developing children were within the normal range in all auditory processing tests; these children attained maximum phonemic discrimination test scores. Children with phonological disorders performed worse in the latter, and presented disordered auditory processing.ConclusionAuditory processing and phonemic discrimination in children with phonological disorders are altered.     

Central auditory processing in teenagers with non-cholesteatomatous chronic otitis media

IntroductionEvidences of possible effects of early age otitis media with effusion in the central auditory processing, emphasize the need to consider such effects also in subjects with chronic otitis media.AimTo investigate and analyze the impact of non-cholesteatomatous chronic otitis media on central auditory processing in teenagers.MethodsThis is a study in which 68 teenagers were recruited, 34 with a diagnosis of non-cholesteatomatous chronic otitis media (study group) and 34 without otological disease history (control group). The evaluation of the subjects consisted of: anamnesis, pure-tone threshold audiometry, speech audiometry and a behavioral test battery for assessment of central auditory processing.ResultsA statistically significant difference was found between the means observed in the study and control groups in all tests performed. An association was found between the control group and subgroups of the study group with unilateral alterations in all tests. An association was shown between the results for the control group and study group for family income, with a greater impact on subjects with a lower income.ConclusionsNon-cholesteatomatous chronic otitis media affects the central auditory processing in teenagers suffering from the disorder, and monaural low-redundancy hearing is the most affected auditory mechanism. Unilateral conductive changes cause more damage than bilateral ones, and lower family income seems to lead to more changes to the central auditory processing of subjects with non-cholesteatomatous chronic otitis media.     

Electrophysiological characteristics in children with listening difficulties,with or without auditory processing disorder

Abstract

Objective: To determine if the auditory middle latency responses (AMLR), auditory late latency response (ALLR) and auditory P300 were sensitive to auditory processing disorder (APD) and listening difficulties in children, and further to elucidate mechanisms regarding level of neurobiological problems in the central auditory nervous system.

Design: Three-group, repeated measure design.

Study sample: Forty-six children aged 8–14 years were divided into three groups: children with reported listening difficulties fulfilling APD diagnostic criteria, children with reported listening difficulties not fulfilling APD diagnostic criteria and normally hearing children.

Results: AMLR Na latency and P300 latency and amplitude were sensitive to listening difficulties. No other auditory evoked potential (AEP) measures were sensitive to listening difficulties, and no AEP measures were sensitive to APD only. Moderate correlations were observed between P300 latency and amplitude and the behavioural AP measures of competing words, frequency patterns, duration patterns and dichotic digits.

Conclusions: Impaired thalamo-cortical (bottom up) and neurocognitive function (top-down) may contribute to difficulties discriminating speech and non-speech sounds. Cognitive processes involved in conscious recognition, attention and discrimination of the acoustic characteristics of the stimuli could contribute to listening difficulties in general, and to APD in particular.     

Implications of musical practice in central auditory processing: a systematic review

IntroductionRecent studies have shown that musical practice and training are effective and have the potential to assist in the acquisition and improvement of auditory skills.ObjectiveTo verify the scientific evidence on the implications of musical practice in central auditory processing.MethodsA systematic review was carried out in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using the Medline (Pubmed), LILACS, SciELO, BIREME, Scopus and Web of Science databases. The search period for the articles covered the last 5 years (2015–2020), without restriction of language and location. The quality of the articles was assessed, and the review included articles with a minimum score of 6 in a modified literature quality scale.ResultsInitially, 1362 publications were found, of which 1338 were excluded after the title screening, 15 were excluded due to the abstract, with nine articles being analyzed in full and four of them excluded after the analysis, as they did not answer the guiding question proposed for this research. Five articles that met the proposed inclusion criteria were admitted for this research. It was found that in adults, musical ability is associated with better performance of several auditory processing skills, as well as the fact that musical training in children promoted an accelerated maturity of auditory processing and exposure to music facilitated the learning of auditory information in newborns.ConclusionConsidering the scientific evidence, it was found that the musical experience can improve specific skills of the central auditory processing, regardless of age, optimizing children’s linguistic development.     

Paradoxical and labile medial olivocochlear functioning as a potential marker of auditory processing disorder in a child with learning disabilities

IntroductionThe medial olivocochlear system (MOCS) is composed of fibres projecting directly onto outer hair cells and plays a role in improving the signal-to-noise ratio. The MOCS can be evaluated by measuring suppression of the otoacoustic emissions evoked by contralateral acoustic stimulation. Dyslexic children present an increased probability of auditory processing disorder (APD). These children may present paradoxical MOCS dysfunction.Case reportWe report the case of a dyslexic child with APD, who was severely disabled in a noisy environment. Audiometric tests were normal, and the central auditory assessment showed labile MOCS functioning that was not only ineffective, but also potentially deleterious, possibly accounting for this child's hearing impairment in a noisy environment.DiscussionThis case illustrates the importance of audiological assessment and objective investigation of MOCS function in children with a learning disability, especially with hearing difficulties in the presence of noise, in whom auditory training can be beneficial.