Temporal resolution: assessment procedures and parameters for school-aged children

Temporal resolution enables the identification of fine differences in speech segmental aspects. Random Gap Detection Test (RGDT) and Gaps-In-Noise Test (GIN) evaluate such skills, by using different acoustic parameters.ObjectiveTo compare the performance of normal school aged children without learning disabilities and/or hearing complaints in the GIN and RGDT, and analyze potential performance differences in these two procedures.MethodCross sectional contemporary cohort study. 28 children, aged 8-10 years were evaluated. After peripheral audiological evaluation, RGDT and GIN were performed.ResultsThere were no statistical differences in performance between gender and age on the RGDT and GIN tests, between the right and left ears on the GIN test, and between frequencies on the RGDT test. The mean detection threshold gap for RGDT was 9.25 ± 3.67 ms, and for GIN was 4.32 ± 0.61 ms (right ear) and 4.43 ± 0.79 ms (left ear). The results of the GIN Test were statistically lower than those from the RGDT (p < 0.001).ConclusionBoth tests indicated normal temporal resolution for all 28 children. GIN test presents advantages regarding the ease of application, task variable, stimuli and presentations form. However, the RGDT has advantages concerning the time required for administration and scoring.     

Comparison of two tests of auditory temporal resolution in children with central auditory processing disorder,adults with psychosis,and adult professional musicians

Abstract

Objective: Evaluate auditory temporal resolution threshold outcomes across three different populations. Design: Two commercially available tests of auditory gap detection (Random gap detection (RGDT) test, and Gaps-in-noise (GIN) test) were administered to all participants. Study sample: Adult professional musicians (APM) (N = 11, age range 28–61 years); children with central auditory processing disorder (CAPD) (N = 22, age range 7.5–17 years); and first episode psychosis patients (FEP) (N = 17, age range 18–48 years). Results: It was not possible to calculate a threshold for the RGDT for 13 of 22 children with CAPD and for 7 of 17 adults with FEP due to response inconsistency. Analysis of variance (ANOVA) excluding cases that produced inconsistent RGDT results showed that only RGDT thresholds differed across groups (F = 8.73, p = 0.001). Three t-tests comparing test means within group revealed statistically significant differences between the gap detection thresholds obtained with the RGDT vs. the GIN for each group. No significant correlations were seen between RGDT and GIN. Conclusion: Lower/better gap detection thresholds and smaller standard deviations were obtained using the GIN in all three groups. Lack of correlation between the two tests suggests that they may measure different processes.     

Adverse effects of pesticides on central auditory functions in tobacco growers

Objective: To investigate the effects of exposure to pesticides on the central auditory functions (CAF) of Brazilian tobacco growers. Design: This was a cross-sectional study carried out between 2010 and 2012. Participants were evaluated with two behavioural procedures to investigate CAF, the random gap detection test (RGDT) and the dichotic digit test in Portuguese (DDT). Study sample: A total of 22 growers exposed to pesticides (study group) and 21 subjects who were not exposed to pesticides (control group) were selected. Results: No significant differences between groups were observed for pure-tone thresholds. A significant association between pesticide exposure and the results for RGDT and DDT was found. Significant differences between pesticide-exposed and nonexposed subjects were found for RGDT frequency average and DDT binaural average, when including age and hearing level as covariates. Age was significantly associated with RGDT frequency average, DDT left ear score, DDT binaural average and DDT right ear advantage. Hearing levels were not significantly associated with any of the test scores. The relative risk of failing the DDT and RGDT for the study group was 1.88 (95% CI:?1.10–3.20) and 1.74 (95% CI:?1.06–2.86), respectively, as compared with the control group. Conclusions: The results showed that tobacco growers exposed to pesticides exhibited signs of central auditory dysfunction characterised by decrements in temporal processing and binaural integration processes/abilities.     

Random Gap Detection Test and Random Gap Detection Test-Expanded results in children with auditory neuropathy

Objectives

In auditory neuropathy (AN) children with hearing aids (HAs) or cochlear implant (CI), the speech perception improvement may not be in a significant degree. These children may perform speech perception after a few repeats. This condition may show that these children had difficulties in receiving and processing speech sounds. If the children with AN cannot distinguish the heard tones one or two in Random Gap Detection Test (RGDT), their benefit performances between hearing aids or CI may not be significant. It is thought that the answer of this question is closely related with unique auditory processing performance of each child. The aim of the study is to investigate the RGDT and RGDT-Expanded (RGDT-EXP) performance of five children with AN.

Methods

In this study, RGDT was applied to five children with auditory neuropathy between ages of 7 and 13 years (study group) (3 male, 2 female). As a control group, RGDT was applied to 10 normal hearing children who had not auditory processing problem between ages of 7 and 16 years (5 male, 5 female). In the first test, all children were applied to RGDT and RGDT-EXP. Each child responded whether he/she heard one or two tones. Their responses were taken as verbally and/or hold up one finger or two fingers. In the second test, they were applied speech discrimination test in quiet environment and in noise. Gap detection thresholds (GDTs) were detected at 500-4000 Hz; and composite GDTs (CGDTs) were found for the study and control groups. GDT/CGDT >20 ms was considered as abnormal for temporal processing disorder.

Results

Any of the children with AN who has no HAs; with HAs; and CI, could not be able to perform RGDT. Therefore the RGDT-EXP was applied in this group. In the study group, GDTs was all over 50 ms at 500-4000 Hz; and CGDTs were all over 50 ms for all children included into the study group with AN. In control group, except child 9 (GDTs were 25 ms at 3000 and 4000 Hz); and child 10 (GDT was 25 ms at 500 Hz); GDTs were all in normal limits for 500-4000 Hz for all children included into the study as control group. CGDTs were all in normal limits for the control group, except child 9 (CGDTs were 22.50, slightly higher than normal limits). In the study group with AN, mean of the GDTs was all over the normal limits; and in control group, mean of GDTs were all in normal limits. The difference between the mean GDTs of the study group was significantly higher than the control groups at all frequencies of 500-4000. In AN group, CGDT (97.5 ± 9.57 ms) was significantly higher than that of the control group (10.35 ± 0.65 ms).

Conclusion

We concluded that these results may only not be explained by auditory processing performance or temporal aspects of audition of each child. Their gap detection was much worse for short duration stimuli than for longer duration stimuli. The present study showed that temporal processing, auditory timing and gap detection skills of the children with AN were found as delayed in advanced degree. These findings may indicate that the AN children cannot perform temporal asynchrony. Our results may help to understand why the children with AN cannot manage the speech perception; and why they understand the speech after a few repeats.     

Applicability of the P300 frequency pattern test to assess auditory processing

Temporal ordering and auditory attention are important skills in information processing, being evaluated by a behavioral test, as the frequency pattern test (FPT) in temporal ordering (TO) and electrophysiological testing, as the P300 in auditory attention.ObjectiveTo analyze the applicability of FPT and P300 as testing for auditory processing.MethodWe performed an integrative literature review, with papers that met the inclusion criteria, using the MedLine, LILACS and SciELO databases, with the keywords: hearing attention, P300 evoked potential, P300 and electrophysiology, temporal ordering, processing and FPT. We found 13 papers concerning the use of the TPF and 16 regarding the use of P300.ResultsThe TPF was the most used test in the evaluation of TO, presented in a diotic way in individuals with language disorders, musicians, blind people, rural workers and different age groups. The P300 is used in the frequency of 1000 Hz in the frequent stimulus and 2000 Hz for the rare stimulus, applicable in individuals of both genders, different age groups, and in patients with Down syndrome, liver cirrhosis, AIDS and Sleep Apnea Syndrome.ConclusionThe FPT and P300 are efficient instruments used to assess the intended skills.     

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.     

Temporal Resolution: performance of school-aged children in the GIN - Gaps-in-noise test

Time resolution hearing skill is the minimum time necessary to solve acoustic events, which is fundamental for speech understanding, and which may be assessed by gap-detection tests, such as the Gaps-in-noise test (GIN).Aimthe purpose of this study was to verify the performance of time processing ability in children with no hearing and/or education difficulties by applying the GIN test in both genders and ages from 8 to 10 years.Study designa prospective cross-sectional contemporary cohort.Material and methodThe GIN test was applied to 75 school-aged children separated into three groups by age.ResultsThe findings showed no statistical differences among age groups or ears. Males had slightly better responses than females on the percentage of correct responses only.ConclusionThe gap threshold and percentage of correct responses were calculated regardless of the ear, gender or age, and were respectively 4.7ms and 73.6%. Based on a 95% confidence interval, the cut-off criterion for normal and abnormal performance was 6.1ms for the mean gap detection threshold and 60% for the percentage of correct responses.     

Peripheral hearing loss and auditory temporal ordering ability in children

Objective

The main objective of this study was to assess the influence of peripheral hearing loss (abnormal encoding of the auditory system) on auditory information processing. We examine the ability of children with and without hearing loss to correctly reproduce sequence blocks of acoustic stimuli that vary in type, number, and temporal ordering.

Methods

Twenty-six children between 8 and 12 years old, 13 with hearing loss and 13 without hearing loss, participated in the study. They performed an auditory temporal ordering task (auditory sequential organization task) by recalling two, three, and five verbal (/ba/-/da/and/a/-/da/) and nonverbal stimuli (acoustic transformation of /ba/-/da/) with a fixed interstimulus interval (ISI) of 425 ms. They also reproduced sequences of two elements with variables ISI, 20, and 1000 ms.

Results

Children with hearing loss had significantly lower correct responses than children with normal hearing for sequences of two, three, and five verbal stimuli with similar and complex acoustic features (/ba/-/da/), for an ISI of 425 ms. There was no significant difference in performance between children with hearing loss and their peers with normal hearing on nonverbal sequences or verbal sequences with different and complex acoustic features (/a/-/da/) when ISI was 425 ms. Furthermore, children with hearing loss performed significantly lower than their peers on the three groups of stimuli when ISI was 20 ms between two stimuli.

Conclusion

Peripheral hearing loss can influence auditory information processing in the central auditory system.     

Cognitive evoked potentials and central auditory processing in children with reading and writing disorders

Learning disorders are often magnified by auditory processing disorders (APD).ObjectiveThis paper aims to verify whether individuals with reading and writing disorders and P300 latencies above the average also present altered Staggered Spondaic Word (SSW) and speech-in-noise test results suggestive of APD.Materials and MethodsThis is a cross-sectional cohort study. Twenty-one individuals with reading and writing disorders aged between 7 and 14 years were enrolled.ResultsAll subjects had normal findings on ENT examination, audiological tests, and brainstem auditory evoked potentials. The average P300 latency (334,25 ms) of all patients was picked as a cutoff point to divide the subjects into two groups: group A with latencies above 335 ms, and group B with latencies below 335 ms. Individuals in group A underwent SSW and speech-in-noise testing.ConclusionAltered results in the SSW and speech-in-noise tests suggestive of APD were found in the group of individuals with reading and writing disorders with P300 latencies above 335 ms.     

Evaluation of temporal and suprasegmental auditory processing in patients with unilateral hearing loss

ObjectivesTo determine the temporal order, resolution, and perception of prosody skills in Single-Sided Deafness (SSD) compared to an age- and sex-matched normal hearing group's same side ear and both ears.MethodsThis was a Case-Control study including 30 subjects with SSD, and age- and sex-matched 30 subjects with bilateral normal hearing (total of 60 subjects- mean age: 38.7 ± 11.6 years). The Montreal Cognitive Assessment (MoCA), Frequency Pattern Test (FPT), Duration Pattern Test (DPT), Random Gap Detection Test (RGDT), Evaluation of Motor Response Time and Emotional Prosody Assessment were performed on the clinically normal ear in the SSD group, the same side ear in the normal hearing group, and both ears of the normal hearing group (the SSD, MNH, and BNH groups, respectively).ResultsIndividuals with SSD had worse results in DPT (p < .001), gap detection at 0.5 kHz (p < .001), gap detection at 4 kHz (p < .001), and composite score (p < .001) than the BNH group. For reaction time measurements, the SSD group had slower performance scores than the BNH group for DPT (p < .001) and FPT (p < .001).ConclusionsPoor temporal processing ability and reduced reaction times may help explain the difficulties in those with SSD in performing daily living activities such as speech understanding in noise and requires more processing efforts. However, there were no significant differences between the groups in frequency pattern performance and emotional prosody skills, supporting the claim that fundamental frequency is one of the most important measures of perception in emotional prosody. We demonstrated that unilateral hearing is adequate to analyze frequency patterns to aid in prosody perception. Analysis of reaction times in temporal processing and emotional prosody could provide different perspectives of auditory processing. Slower reaction time of SSD should be considered for habilitation purposes.     

Evaluation protocol for amusia - portuguese sample

Amusia is a disorder that affects the processing of music. Part of this processing happens in the primary auditory cortex. The study of this condition allows us to evaluate the central auditory pathways.ObjectiveTo explore the diagnostic evaluation tests of amusia.MethodThe authors propose an evaluation protocol for patients with suspected amusia (after brain injury or complaints of poor musical perception), in parallel with the assessment of central auditory processing, already implemented in the department. The Montreal Evaluation of Battery of amusia was the basis for the selection of the tests. From this comprehensive battery of tests we selected some of the musical examples to evaluate different musical aspects, including memory and perception of music, ability concerning musical recognition and discrimination. In terms of memory there is a test for assessing delayed memory, adapted to the Portuguese culture. Prospective study.Results and ConclusionsAlthough still experimental, with the possibility of adjustments in the assessment, we believe that this assessment, combined with the study of central auditory processing, will allow us to understand some central lesions, congenital or acquired hearing perception limitations.     

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.     

Random Gap Detection Test (RGDT) performance of individuals with central auditory processing disorders from 5 to 25 years of age

Objective

The aim of the present study was to assess the auditory temporal resolution ability in individuals with central auditory processing disorders, to examine the maturation effect and to investigate the relationship between the performance on a temporal resolution test with the performance on other central auditory tests.

Methods

Participants were divided in two groups: 131 with Central Auditory Processing Disorder and 94 with normal auditory processing. They had pure-tone air-conduction thresholds no poorer than 15 dB HL bilaterally, normal admittance measures and presence of acoustic reflexes. Also, they were assessed with a central auditory test battery. Participants who failed at least one or more tests were included in the Central Auditory Processing Disorder group and those in the control group obtained normal performance on all tests. Following the auditory processing assessment, the Random Gap Detection Test was administered to the participants. A three-way ANOVA was performed. Correlation analyses were also done between the four Random Gap Detection Test subtests data as well as between Random Gap Detection Test data and the other auditory processing test results.

Results

There was a significant difference between the age-group performances in children with and without Central Auditory Processing Disorder. Also, 48% of children with Central Auditory Processing Disorder failed the Random Gap Detection Test and the percentage decreased as a function of age. The highest percentage (86%) was found in the 5-6 year-old children. Furthermore, results revealed a strong significant correlation between the four Random Gap Detection Test subtests. There was a modest correlation between the Random Gap Detection Test results and the dichotic listening tests. No significant correlation was observed between the Random Gap Detection Test data and the results of the other tests in the battery.

Conclusion

Random Gap Detection Test should not be administered to children younger than 7 years old because other reduced capacities might influence their performance. Also, Random Gap Detection Test assesses a specific auditory ability, different than the one evaluated with the other auditory tests. Finally, it is suggested to test individuals at only one frequency of the Random Gap Detection Test because results provide similar information than when assessing them on all subtests.     

Comparison of children's performance on four tests of temporal resolution

This paper presents a brief review of temporal processing, its relevance to audiologists, and methods for its clinical evaluation. Results are then summarized from the administration of four tests of auditory temporal resolution (Auditory Fusion Test-Revised [AFTR], Random Gap Detection Test [RGDT], Binaural Fusion Test [BFT], and Gaps-In-Noise Test [GIN]) to ten children with normal hearing (mean age = 8.7 years). Statistically significant differences in mean temporal resolution thresholds derived from the four tests resulted from differences in stimulus and task variables. From a clinical perspective, however, all tests yielded comparable results, indicating normal temporal resolution for all 10 children. Differences among the four tests with regard to ease of use, time required for administration and scoring, and face validity are discussed. Additional research is needed to determine the relative sensitivity and specificity, and, therefore, the clinical utility of these four temporal resolution tests in both pediatric and adult populations.     

Age-related altering temporal processing and binaural interaction functions in normal hearing individuals: Observational and cross-sectional study

ObjectiveThis study aimed to investigate the temporal processing and binaural interaction functions of central auditory processing tests according to the anatomical localizations of young and elderly individuals. It also sought to evaluate the relationships between the same individuals’ central auditory processing tests.MethodsThis observational and cross-sectional study included individuals with normal hearing between 18 and 30 and 60–75 years of age, who were referred to as the young group and the elderly group, respectively. The evaluation of the central auditory processing tests was completed using the frequency pattern test, duration pattern test, masking level difference test, and random gap detection test. Furthermore, speech discrimination and speech in noise scores were analyzed for both groups.ResultsStatistically significant differences were identified between the groups’ scores for the speech in noise test, masking level difference test, random gap detection test, frequency pattern test, and duration pattern test (p < 0.05). A statistically significant relationship was observed between the age and the results of the central auditory processing tests (p < 0.05).ConclusionWhen compared to younger individuals, elderly individuals presented with declined temporal sequences, temporal resolutions, and binaural interaction skills.     

Central auditory skills in blind and sighted subjects.

Three different central auditory skills were compared and evaluated in 56 blind and 40 sighted subjects. The study consisted of three experiments conducted in three subgroups. Experiment A was performed in order to evaluate the localization function; experiment B for the temporal auditory resolution ability of the blind adult, and experiment C to test the ability of the blind person to discriminate speech material in noise. In all three experiments the blind subjects obtained significantly better results than the sighted subjects. From these results it was concluded that there is supporting evidence of a certain superiority of the blind individual with regard to central auditory function.     

An auditory health program for neonates in ICU and/or intermediate care settings

Auditory screening and early identification and management of patients with hearing loss improve the development prospects of infants.ObjectiveTo analyze the outcomes produced by an Auditory Health Program in neonates managed in an intensive care unit.MethodThis prospective cross-sectional study enrolled neonates referred to the neonatal care unit at hospital CAISM/Unicamp with stays lasting for 48 hours and more within a period of 13 months.Automated monitoring of brainstem auditory evoked potentials was used in the auditory screening of neonates at the time of discharge. Children with poor BAEPs were sent to undergo audiological, otorhinolaryngological, and genetic tests.ResultsAuditory screening was performed for 84.7% of the live births; 39.7% were screened at 30 days or more of age. Diagnostic tests revealed that 63.8% of the children had normal hearing. Incidence of hearing loss was 4%; sensorineural hearing loss was observed in 1.4% of the subjects; 0.24% had auditory neuropathy spectrum disorder; and 2.2% had conductive hearing loss.ConclusionNeonatal auditory screening was not offered universally, and nor was it carried out, in many cases, within the child's first month of life. Screening must be performed before neonates are discharged and in more than one stage. A high incidence of hearing loss was observed.     

Acoustic stimulation effect on temporal processing skills in elderly subjects before and after hearing aid fitting

Aging can alter, temporal processing and affect speech perception.Aim: To compare temporal processing auditory processing in elderly subject to and new hearing aid users.Materials and Methods: The study included 60 elderly patients with bilateral sensorineural hearing loss. The procedures selected were the Duration Pattern Tests (DPT) and gaps in noise (GIN) test were used to analyze the responses of correct identification, and the temporal acuity threshold before and after the fitting of hearing aids. Study design: clinical and experimental research with non-probability sample of convenience.Results: There was no statistically significant difference between the responses from GI and GII individuals. The elderly users of hearing aids had a lower gap detection threshold, greater recognition of gaps and of discrimination of the duration pattern in relation to when they were only potential users.Conclusion: There was a deterioration in temporal processing skills, regardless of hearing loss degrees. Thus, the effect of acoustic stimulation by the use of a hearing aid improved resolution and temporal ordering.