Effects of mild hearing loss on auditory processing

The impact on language learning of mild hearing loss due to otitis media with effusion has forced a new look at the dynamics of central auditory processing. A model of auditory deprivation that would produce the test results that define CAP deficits would be a mild conductive hearing loss. It is relevant to reexamine CAP theory in terms of such hearing loss.     

Central auditory processing disorder (CAPD) in children with specific language impairment (SLI). Central auditory tests

The aim of this project is to use central auditory tests for diagnosis of central auditory processing disorder (CAPD) in children with specific language impairment (SLI), in order to confirm relationship between speech-language impairment and central auditory processing. We attempted to establish special dichotic binaural tests in Czech language modified for younger children. Tests are based on behavioral audiometry using dichotic listening (different auditory stimuli that presented to each ear simultaneously). The experimental tasks consisted of three auditory measures (test 1-3)-dichotic listening of two-syllable words presented like binaural interaction tests. Children with SLI are unable to create simple sentences from two words that are heard separately but simultaneously. Results in our group of 90 pre-school children (6-7 years old) confirmed integration deficit and problems with quality of short-term memory. Average rate of success of children with specific language impairment was 56% in test 1, 64% in test 2 and 63% in test 3. Results of control group: 92% in test 1, 93% in test 2 and 92% in test 3 (p<0.001). Our results indicate the relationship between disorders of speech-language perception and central auditory processing disorders.     

The effect of spatial adaptation on auditory motion processing

Na(+) concentrations in endolymph must be controlled to maintain hair cell function since the transduction channels of hair cells are cation-permeable, but not K(+)-selective. Flooding or fluctuations of the hair cell cytosol with Na(+) would be expected to lead to cellular dysfunction, hearing loss and vertigo. This review briefly describes cellular mechanisms known to be responsible for Na(+) homeostasis in each compartment of the inner ear, including the cochlea, saccule, semicircular canals and endolymphatic sac. The influx of Na(+) into endolymph of each of the organs is likely via passive diffusion, but these pathways have not yet been identified or characterized. Na(+) absorption is controlled by gate-keeper channels in the apical (endolymphatic) membrane of the transporting cells. Highly Na(+)-selective epithelial sodium channels (ENaCs) control absorption by Reissner's membrane, saccular extramacular epithelium, semicircular canal duct epithelium and endolymphatic sac. ENaC activity is controlled by a number of signal pathways, but most notably by genomic regulation of channel numbers in the membrane via glucocorticoid signaling. Non-selective cation channels in the apical membrane of outer sulcus epithelial cells and vestibular transitional cells mediate Na(+) and parasensory K(+) absorption. The K(+)-mediated transduction current in hair cells is also accompanied by a Na(+) flux since the transduction channels are non-selective cation channels. Cation absorption by all of these cells is regulated by extracellular ATP via apical non-selective cation channels (P2X receptors). The heterogeneous population of epithelial cells in the endolymphatic sac is thought to have multiple absorptive pathways for Na(+) with regulatory pathways that include glucocorticoids and purinergic agonists.     

中枢听觉处理障碍和新生儿听力筛查

我国新生儿听力普遍筛查项目正逐渐有序地展开,我们对这个项目的意义、内涵的理解也在深化.在这里,我们建议在新生儿听力筛查、诊断和干预中要关注中枢听觉处理障碍(central auditory processing disorder,CAPD)的问题.     

轻度认知障碍对老年聋患者助听器效果的影响

目的研究轻度认知功能障碍对老年性聋患者佩戴助听器满意度及受益度的影响。方法依据研究入选标准选取于南京军区福州总医院听力检查中心验配并佩戴助听器6个月以上的老年性耳聋患者92例作为研究对象。根据蒙特利尔认知评价量表得分将研究对象分为两组,即认知功能正常组和轻度认知功能障碍组。使用助听器每日生活使用满意度调查表(SADL)、助听器效果国际性调查问卷(IOI-HA)进行问卷调查。结果认知功能正常组患者SADL总均分、积极作用、服务与价格两部分得分及IOI-HA总分值均高于轻度认知功能障碍组,且差异有统计学意义(P<0.05);但在SADL负面影响、个人形象两部分得分上,认知功能正常组患者低于轻度认知功能障碍组,两者无明显差异(P>0.05)。Pearson相关性分析结果显示:SADL总均分、IOI-HA总分值与MoCA总分均成正相关(r=0.670,0.785,P=0.000)。结论相比于认知功能正常的老年性聋患者,轻度认知功能障碍患者对佩戴助听器的受益度和满意度是降低的,并且两者呈正相关,即老年聋患者的认知功能水平越低,其对佩戴助听器的受益度和满意度越小。     

The effect of hearing impairment in older people on the spouse

The prevalence of hearing impairment (HI) in older people and its detrimental effects on their quality of life and well-being is well known. To date however, there have been few studies investigating the impact on the person's spouse. To investigate this topic, a qualitative study consisting of in-depth interviews was conducted with five female and five male spouses of older people with HI. The aims of the study were: (1) to describe the spouses' experiences of living with someone with a HI; (2) to describe the effect of HI on the couples' communication and relationship; and (3) to identify coping strategies adopted by spouses. An interpretive analysis revealed four themes that described the experience of spouses of older people with HI: (1) the broad ranging effects of the HI on the spouses' everyday lives; (2) the spouses' need to constantly adapt to their partners' HI; (3) the effect of acceptance of the HI on the spouse; and (4) the impact of ageing and retirement. Spouses in this study experienced a wide range of effects as a result of their partners' HI. Implications for audiological rehabilitation are discussed.     

The effect of hearing impairment in older people on the spouse

The prevalence of hearing impairment (HI) in older people and its detrimental effects on their quality of life and well-being is well known. To date however, there have been few studies investigating the impact on the person's spouse. To investigate this topic, a qualitative study consisting of in-depth interviews was conducted with five female and five male spouses of older people with HI. The aims of the study were: (1) to describe the spouses’ experiences of living with someone with a HI; (2) to describe the effect of HI on the couples’ communication and relationship; and (3) to identify coping strategies adopted by spouses. An interpretive analysis revealed four themes that described the experience of spouses of older people with HI: (1) the broad ranging effects of the HI on the spouses’ everyday lives; (2) the spouses’ need to constantly adapt to their partners’ HI; (3) the effect of acceptance of the HI on the spouse; and (4) the impact of ageing and retirement. Spouses in this study experienced a wide range of effects as a result of their partners’ HI. Implications for audiological rehabilitation are discussed.     

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.     

Evaluation of selected auditory tests in school-age children suspected of auditory processing disorders

OBJECTIVE: To compare the auditory function of normal-hearing children attending mainstream schools who were referred for an auditory evaluation because of listening/hearing problems (suspected auditory processing disorders [susAPD]) with that of normal-hearing control children. DESIGN: Sixty-five children with a normal standard audiometric evaluation, ages 6-14 yr (32 of whom were referred for susAPD, with the rest age-matched control children), completed a battery of four auditory tests: a dichotic test of competing sentences; a simple discrimination of short tone pairs differing in fundamental frequency at varying interstimulus intervals (TDT); a discrimination task using consonant cluster minimal pairs of real words (CCMP), and an adaptive threshold task for detecting a brief tone presented either simultaneously with a masker (simultaneous masking) or immediately preceding it (backward masking). Regression analyses, including age as a covariate, were performed to determine the extent to which the performance of the two groups differed on each task. Age-corrected z-scores were calculated to evaluate the effectiveness of the complete battery in discriminating the groups. RESULTS: The performance of the susAPD group was significantly poorer than the control group on all but the masking tasks, which failed to differentiate the two groups. The CCMP discriminated the groups most effectively, as it yielded the lowest number of control children with abnormal scores, and performance in both groups was independent of age. By contrast, the proportion of control children who performed poorly on the competing sentences test was unacceptably high. Together, the CCMP (verbal) and TDT (nonverbal) tasks detected impaired listening skills in 56% of the children who were referred to the clinic, compared with 6% of the control children. Performance on the two tasks was not correlated. CONCLUSIONS: Two of the four tests evaluated, the CCMP and TDT, proved effective in differentiating the two groups of children of this study. The application of both tests increased the proportion of susAPD children who performed poorly compared with the application of each test alone, while reducing the proportion of control subjects who performed poorly. The findings highlight the importance of carrying out a complete auditory evaluation in children referred for medical attention, even if their standard audiometric evaluation is unremarkable.     

The effect of cochlear hearing loss on auditory brain stem response latency.

The effect of audiometric configuration on the auditory brain stem response was studied in a large patient sample, and wave I latencies, wave V latencies, and the I-V interwave intervals were compared to those from a previous report. Patients with notched hearing losses showed longer wave V latencies and I-V interwave intervals than those with other audiometric configurations, but the magnitude of the effect was relatively small, and the confidence limit for cochlear diagnosis was essentially the same as that based upon a cochlear hearing loss population without regard to audiometric configuration.     

The effect of mild hearing loss on academic performance in primary school children

Objectives

To determine the prevalence of mild hearing loss and its association with academic performance among primary school children.

Patients and methods

A comparative cross sectional study was conducted on standard (grade) five school children in a state in Malaysia. Five schools were selected by using simple random sampling. There were three classes (A, B and C) of standard five in each school. Student's selection into these classes was made by respective school administration based on their final term examination in standard four. Class A was for the best academic achievers while class C was for the poorest. Ear examinations were done followed by pure tone audiometry for confirmation of the hearing status. In this study, mild hearing loss was defined as an average threshold of 20-39 dB at 0.5, 1, 2 and 4 kHz. Data analysis was done using SPSS Version 12.0 software. Chi-square test was used to determine the association between mild hearing loss and academic performance. The significant level was set at p = 0.05.

Results

From a total of 257 students, 234 have completed the examinations (response rate = 91.0%). Fifty-three percent of them were boys while 47% were girls. A hundred and forty-nine (63.7%) of them were from class A while 85 (36.3%) were from class C. The prevalence of hearing loss in our school population was 15% (95% CI: 11.0-20.0%). Thirty-two (88.9%) of them were having conductive type. Out of the total, 38.9% were having problems in both ears. The students who have poor academic performance have been shown to be significantly associated with mild hearing loss (p < 0.001).

Conclusions

There was a high prevalence of mild hearing loss among primary school children. This problem could affect their academic performance. Therefore, hearing assessment is highly recommended to be done on every child especially to those who have poor academic achievement.     

增龄对年龄相关性听力减退大鼠听觉神经通路形态学的影响

目的 探讨年龄相关性听力减退大鼠听觉神经通路组织形态随增龄的变化.方法 通过乙酰胆碱酯酶染色耳蜗基底膜铺片,蜗核、听皮层石蜡切片甲苯胺兰染色,比较3月龄和18月龄大鼠耳蜗底回的传出神经末梢数,蜗核、听皮层的神经元数量.结果 18月龄大鼠耳蜗底回传出神经末梢较3月龄大鼠减少36%(P＜0.0 1),缺失以2、3排外毛细胞为主;蜗核神经元减少24%(P＜0.01);但听皮层神经元两组之间无显著差异(P＞0.05).结论 年龄相关性听力减退大鼠听觉神经通路随增龄而退变.     

Assessment of two central auditory tests in elderly patients without hearing complaints

Speech understanding disorders in the elderly may be due to peripheral or central auditory dysfunctions. Asymmetry of results in dichotic testing increases with age, and may reflect on a lack of inter-hemisphere transmission and cognitive decline.Aim: To investigate auditory processing of aged people with no hearing complaints.Study design: clinical prospective.Materials and Methods: Twenty-two voluntary individuals, aged between 55 and 75 years, were evaluated. They reported no hearing complaints and had maximal auditory thresholds of 40 dB HL until 4 KHz, 80% of minimal speech recognition scores and peripheral symmetry between the ears. We used two kinds of tests: speech in noise and dichotic alternated dissyllables (SSW). Results were compared between males and females, right and left ears and between age groups.Results: There were no significant differences between genders, in both tests. Their Left ears showed worse results, in the competitive condition of SSW. Individuals aged 65 or older had poorer performances than those aged 55 to 64.Conclusion: Central auditory tests showed worse performance with aging. The employment of a dichotic test in the auditory evaluation setting in the elderly may help in the early identification of degenerative processes, which are common among these patients.     

Monotic auditory processing disorder tests in the older adult population

The purpose of this study was to determine if peripheral hearing loss of varying degrees in elderly subjects affected performance on monotic auditory processing disorder (APD) tests. A battery of monotic APD tests was administered to a group of well-educated and high-functioning older adults who were divided into three subgroups based on hearing acuity but similar in age: (1) normal hearing out to 4000 Hz with a slight high-frequency slope above that point, (2) normal hearing in the speech range but greater high-frequency loss (sloping configuration), and (3) hearing loss in both the low and high frequencies (low/high). The findings documented that subjects with normal hearing in the speech range performed well on all the APD tests. The subjects in the two hearing loss groups, however, performed more poorly on certain tests. The low/high loss subjects did significantly poorer than did the sloping subjects. These data suggest that low/high-frequency peripheral hearing loss is a factor for poor performance on certain monotic APD tests. Results further showed that when cognitive ability and presentation level are held constant, chronological age does not appear to be a contributing factor to performance on the majority of these monotic APD tests. If APD tests are to be administered to elder subjects, peripheral hearing loss configuration needs to be documented. For subjects with low/high-frequency losses, the tester needs to be aware that serious contamination of the results may occur.     

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.