Implementation and evaluation of a Danish test battery for auditory processing disorder in children

Objective: This study presents a Danish test battery for auditory processing disorder (APD). The tests were evaluated as to normative cut-off values (pass-fail criteria) and their test–retest reliability. Design: The battery consists of four behavioural tests: the filtered words (FW) test, the dichotic digits (DD) test, the gap detection (GD) test and the binaural masking level difference (BMLD) test. The tests were evaluated through listening experiments on children with no known history of auditory problems. Study sample: The normative cut-off values were obtained from 158 children (75 boys and 83 girls, aged 6–16 years), whereas the test–retest reliability was obtained from 20 children (10 boys and 10 girls, aged 6–11 years). Results: For each of the four tests one to four different cut-off values were determined depending on whether the scores from the two ears and the different age groups could be pooled. For each of the four tests the test–retest reliability was found to be satisfactory. The test–retest reliability was highest for the FW and the DD test. Conclusions: A Danish APD test battery is now available for clinical use with normative data.     

Auditory processing efficiency and temporal resolution in children and adults.

Children have higher auditory backward masking (BM) thresholds than adults. One explanation for this is poor temporal resolution, resulting in difficulty separating brief or rapidly presented sounds. This implies that the auditory temporal window is broader in children than in adults. Alternatively, elevated BM thresholds in children may indicate poor processing efficiency. In this case, children would need a higher signal-to-masker ratio than adults to detect the presence of a signal. This would result in poor performance on a number of psychoacoustic tasks but would be particularly marked in BM due to the compressive nonlinearity of the basilar membrane. The objective of the present study was to examine the competing hypotheses of "temporal resolution" and "efficiency" by measuring BM as a function of signal-to-masker interval in children and adults. The children had significantly higher thresholds than the adults at each of the intervals. Subsequent modeling and analyses showed that the data for both children and adults were best fitted using the same, fixed temporal window. Therefore, the differences in BM threshold between adults and children were not due to differences in temporal resolution but to reduced detection efficiency in the children.     

Auditory processing disorders: acquisition and treatment

Auditory processing disorder (APD) describes a mixed and poorly understood listening problem characterised by poor speech perception, especially in challenging environments. APD may include an inherited component, and this may be major, but studies reviewed here of children with long-term otitis media with effusion (OME) provide strong evidence for changes in auditory processing acquired through altered experience (deprivation) and brain plasticity. Whether inherited or acquired, it is suggested that APD may be reversed by active learning. Training tunes both bottom-up and top-down neural mechanisms, some that are specific to the trained stimulus and some that reflect more generalised arousal. APD and its treatment therefore provide examples of brain plasticity working either in a negative or in a positive way to modulate listening. LEARNING OUTCOMES: (1) Readers will be able to discuss APD in the context of inheritance and experience. (2) Readers will be able to explain how OME has been shown to alter auditory processing. (3) Readers will be able to list examples of good and bad brain plasticity. (4) Readers will be able to explain what auditory learning is, list some of its properties, and provide examples of its application in therapy for communication disorders.     

Auditory temporal processing performance of young adults with reading disorders.

The present study investigated the temporal processing abilities of college students with diagnosed reading disorders. A behavioral test battery was used that involved discrimination of the pattern of presentation of tone triads in which individual components differed in either frequency or duration. An additional test involving measurement of frequency difference limens for long- and short-duration tones was also administered. The college students with reading disorders exhibited significantly higher error rates in discriminating duration patterns than the normal reading group. No group differences were found for the frequency pattern discrimination task. Both groups exhibited larger frequency difference limens with the shorter 20- and 50-ms tones than with the 200-ms tones. Significant correlations were found between reading ability measures and temporal processing abilities, specifically in word recognition and duration pattern processing, suggesting a relationship between lower level auditory temporal processing skills and decoding efficiency.     

Auditory processing in dysphonic children

Contemporary cross-sectional cohort study. There is evidence of the auditory perception influence on the development of oral and written language, as well as on the self-perception of vocal conditions. The auditory system maturation can impact on this process.ObjectiveTo characterize the auditory skills of temporal ordering and localization in dysphonic children.Materials and MethodsWe assessed 42 children (4 to 8 years). Study group: 31 dysphonic children; Comparison group: 11 children without vocal change complaints. They all had normal auditory thresholds and also normal cochleo-eyelid reflexes. They were submitted to a Simplified assessment of the auditory process (Pereira, 1993). In order to compare the groups, we used the Mann-Whitney and Kruskal-Wallis statistical tests. Level of significance: 0.05 (5%).ResultsUpon simplified assessment, 100% of the Control Group and 61.29% of the Study Group had normal results. The groups were similar in the localization and verbal sequential memory tests. The nonverbal sequential memory showed worse results on dysphonic children. In this group, the performance was worse among the four to six years.ConclusionThe dysphonic children showed changes on the localization or temporal ordering skills, the skill of non-verbal temporal ordering differentiated the dysphonic group. In this group, the Sound Location improved with age.     

Auditory brain stem response test battery for multiple sclerosis patients: evaluation of test findings and assessment of diagnostic criteria

A battery of auditory brain stem response (ABR) tests has been used to evaluate 39 multiple sclerosis (MS) subjects (9 with probable, 8 with possible, 6 with suspected and 16 with definite MS, according to conventional classification of the disease). Test battery included evaluation of ABR waveform, latencies and interpeak intervals, test-retest variability, rate-induced ABR changes, binaural increase of wave-V amplitude and effect of ipsilateral masking with broad-band noise. Test results allowed a measure of the sensitivity, specificity and efficiency of each test in the battery. The high efficiency values thus obtained validated each test in the battery when normals were compared with definite MS patients. No single test, however, proved to be sufficient--by itself--to reliably distinguish subjects with earlier stages of the disease, suggesting that a combined evaluation of tests is necessary to fit better the clinical classification. When compared with 'conventional' ABR analysis, 'sensitized' ABR tests--i.e. the measures of test-retest variability, binaural increase of wave-V amplitude and the effect of ipsilateral broad-band noise masking--showed higher percentages of positive results in subjects with no clinical signs of brainstem and midbrain involvement. Sensitized tests therefore appeared more suitable to reveal a brainstem subclinical involvement.     

Auditory processing disorders, verbal disfluency, and learning difficulties: a case study

This case study reports the findings of auditory behavioral and electrophysiological measures performed on a graduate student (identified as LN) presenting verbal disfluency and learning difficulties. Results of behavioral audiological testing documented the presence of auditory processing disorders, particularly temporal processing and binaural integration. Electrophysiological test results, including middle latency, late latency and cognitive potentials, revealed that LN's central auditory system processes acoustic stimuli differently to a reference group with normal hearing.     

Parameters of emotional processing in neuropsychiatric disorders: conceptual issues and a battery of tests

Components of emotional processing were examined in psychiatric and neurological populations: communication channel (face/voice), processing mode (expression/perception), and emotional valence (positive/negative). These were assessed with an experimental affect battery which was administered to schizophrenic, unipolar depressive, right-brain-damaged, Parkinson's disease, and normal control right-handed adults. For expression, subjects were taped while producing facial and vocal emotional expressions. Judges rated the expressions for accuracy and intensity. For perception, subjects were asked to identify and discriminate facial and vocal emotions. Using correlational techniques, relationships between facial and vocal channels and between expressive and perceptual modes were explored. The test battery has good psychometric properties and discriminates among diagnostic groups.     

Auditory processing tests for Spanish-speaking adults: an initial study

There is no standardized material to assess auditory processing (AP) in Spanish-speaking adults. The purpose of this research was to develop and obtain initial normative data for AP tests for Spanish-speaking adults. The AP tests comprised the Hong Kong CAPA (Hong Kong central auditory processing assessment) including speech-in-noise, binaural fusion, filtered speech, and dichotic digit tests. In addition five tests already developed by other authors, but with no normative data reported for the target population, were included in the study. These tests were staggered spondaic words, random gap detection, pitch pattern sequence, duration pattern sequence, and masking level difference. Forty normal hearing Chilean adults were assessed to obtain the initial normative data. Several correlations were found between tests and between subtests within the same test category. 90th percentiles are suggested as initial normative data.     

Auditory processing tests for Spanish-speaking adults: An initial study

There is no standardized material to assess auditory processing (AP) in Spanish-speaking adults. The purpose of this research was to develop and obtain initial normative data for AP tests for Spanish-speaking adults. The AP tests comprised the Hong Kong CAPA (Hong Kong central auditory processing assessment) including speech-in-noise, binaural fusion, filtered speech, and dichotic digit tests. In addition five tests already developed by other authors, but with no normative data reported for the target population, were included in the study. These tests were staggered spondaic words, random gap detection, pitch pattern sequence, duration pattern sequence, and masking level difference. Forty normal hearing Chilean adults were assessed to obtain the initial normative data. Several correlations were found between tests and between subtests within the same test category. 90^th percentiles are suggested as initial normative data.

Sumario

No existe material estandarizado para evaluar el procesamiento auditivo (AP) en los adultos hablantes del español. El propósito de esta investigación fue desarrollar y obtener datos normativos iniciales para las pruebas de AP en adultos hablantes del español. Las pruebas de AP comprendieron la evaluación del procesamiento auditivo central de Hong Kong (CAPA) que incluye lenguaje en ruido, fusión binaural, lenguaje filtrado y la prueba de dígitos dicóticos. Adicionalmente se incluyeron otras cinco pruebas desarrolladas para esta población por otros autores que carecen de datos normativos. Estas pruebas incluyen palabras espondaicas imbricadas, detección aleatoria de intervalos, secuencia de patrones de tono, secuencia de patrones de duración y diferencia en el nivel de enmascaramiento. Se evaluaron cuarenta adultos chilenos para obtener los datos normativos iniciales. Se encontraron varias correlaciones entre pruebas y entre sub-pruebas dentro de la misma categoría. Se sugieren los percentiles 90 como datos normativos iniciales.     

Slope analysis of Auditory Brainstem Responses in children at risk of central auditory processing disorders.

The method of slope vectors was used to quantify Auditory Brainstem Responses (ABR) obtained from nine normal children and nine children at risk for central auditory processing disorders (CAPD) with language impairment, for monaural and binaural stimulation conditions. Slopes thus obtained were subjected to K-Means Cluster Analysis. Distinction between the two groups was obtained only for binaural stimulation conditions, wherein all normal children were grouped under cluster 1 with higher slope values and 6 out of 9 CAPD children were grouped under cluster 2 with lower slopes. The results suggest that there may be several subcategories among children who are found to be at risk for CAPD. One of the subcategories may comprise children who exhibit poor ABR morphology, especially during binaural stimulation conditions, which could be due to binaural interference.     

Auditory event-related potentials and function of the medial olivocochlear efferent system in children with auditory processing disorders

Objective: The objectives were to investigate the function of central auditory pathways and of the medial efferent olivocochlear system (MOCS).

Design: Event-related potentials (ERP) were recorded following the delivery of the stimulus /da/ in quiet and in ipsilateral, contralateral, and binaural noise conditions and correlated to the results of the auditory processing disorders (APD) diagnostic test battery. MOCS function was investigated by adding ipsilateral, contralateral, and binaural noise to transient evoked otoacoustic emission recordings. Auditory brainstem responses and pure tone audiogram were also evaluated.

Study Sample: Nineteen children (7 to 12?years old) with APD were compared with 24 age-matched controls.

Results: Otoacoustic emissions and ABR characteristics did not differ between groups, whereas ERP latencies were significantly longer and of higher amplitudes in APD children than in controls, in both quiet and noise conditions. The MOCS suppression was higher in APD children.

Conclusions: Findings indicate that children with APD present with neural deficiencies in both challenging and nonchallenging environments with an increase in the timing of several central auditory processes correlated to their behavioural performances. Meanwhile, their modulation of the auditory periphery under noisy conditions differs from control children with higher suppression.