Improving therapeutic outcomes in autism spectrum disorders: Enhancing social communication and sensory processing through the use of interactive robots

For children with autism spectrum disorders (ASDs), social robots are increasingly utilized as therapeutic tools in order to enhance social skills and communication. Robots have been shown to generate a number of social and behavioral benefits in children with ASD including heightened engagement, increased attention, and decreased social anxiety. Although social robots appear to be effective social reinforcement tools in assistive therapies, the perceptual mechanism underlying these benefits remains unknown. To date, social robot studies have primarily relied on expertise in fields such as engineering and clinical psychology, with measures of social robot efficacy principally limited to qualitative observational assessments of children's interactions with robots. In this review, we examine a range of socially interactive robots that currently have the most widespread use as well as the utility of these robots and their therapeutic effects. In addition, given that social interactions rely on audiovisual communication, we discuss how enhanced sensory processing and integration of robotic social cues may underlie the perceptual and behavioral benefits that social robots confer. Although overall multisensory processing (including audiovisual integration) is impaired in individuals with ASD, social robot interactions may provide therapeutic benefits by allowing audiovisual social cues to be experienced through a simplified version of a human interaction. By applying systems neuroscience tools to identify, analyze, and extend the multisensory perceptual substrates that may underlie the therapeutic benefits of social robots, future studies have the potential to strengthen the clinical utility of social robots for individuals with ASD.     

Adaptive Speech Audiometry and Speech Discrimination Space in Hearing-Impaired Subjects

Phonemic discrimination difficulties in a small group of patients with sensorineural hearing loss have been mapped using a new form of speech audiometry which is an automated, adaptive, audio-visual system, using a binary forced-choice response mode. Phonemic confusion patterns have been displayed in directed graph form and the cases presented here have been chosen to illustrate the potentialities of the test method for obtaining detailed information on the fine structure of speech reception in these patients.     

Audiological Performance with Cochlear Reimplantation from Analogue Single-Channel Implants to Digital Multi-channel Devices: Rendimiento audiológico con reimplantación coclear: de los implantes analógicos de un canal a los digitales multi-canal

Cochlear implantation has been performed for almost two decades at the Vienna University Hospital. Until 1994, single-channel implants were used (Ball-Electrode, SC6/2SC6, Vienna/Epoxy, Med-El, Innsbruck, Austria). The development of multi-channel devices (Combi 40/40+), which provide significantly improved speech recognition performance, led to the reimplantation of some patients who had previously received single-channel implants. It was of particular interest to find out if there was a deterioration of the central “learning process” by the reimplantation from the analogue single-channel device to the tonotopic pulsatile multi-channel stimulation. In this study, we attempted to demonstrate that single-channel implants have an impact on the neural organisation of the auditory system. Two groups of post-lingually deaf adult patients were tested. Group A had previously received single-channel implants and were reimplanted with the new Combi 40/40+ cochlear implant (Med-El, Innsbruck, Austria) in the same ear. Group B was implanted only with the Combi 40/40+. Six different speech recognition tests were subsequently performed on all patients, and the two groups performed similarly. Furthermore, it was discovered that group A obtained significant speech recognition improvement (p<0.05) with monosyllabic words and number tests 1 month following reimplantation.

Sumario

En el Hospital Universitario de Viena, desde hace casi dos décadas se han realizado implantes cocleares. Hasta 1994 se utilizaron implantes de un canal (Ball-Ekectrode, SC6/2SC6, Viena/Epoxy, Med-El, Innsbruck, Austria).El desarrollo de implantes de múltiples canales (Combi 40/40+), que permiten una discriminación del habla significativa-mente mejor, llevó a la reimplantación de algunos pacientes que habían recibido previamente implantes monocanal. Fue particularmente interesante saber si existía deterioro del “proceso central de aprendizaje” con el cambio de un implante analógico de un canal a la estimulación tonotópica pulsátil multicanal. En este estudio tratamos de demostrar que los implantes de un canal tienen impacto en la organización neural del sistema auditivo. Se incluyeron dos grupos de adultos ensordecidos. Los pacientes del grupo A habían recibido previamente un implante monocanal y se les reimplantó en el mismo oído el nuevo Combi40/40+ (Med-El, Innsbruck, Austria). Los del grupo B se implantaron por primera vez con el Combi 40/40+. A todos los paciente se les aplicaron seis pruebas diferentes de reconocimiento del lenguaje. Los dos grupos tuvieron un rendimiento similar; inclusive se demostró que el grupo A obtuvo un resultado significativamente mejor (p<0.05) en el reconocimiento de monosílabos y números un mes después de la reimplantación.     

An underestimated issue: unsuspected decrease of sound processor microphone sensitivity,technical, and clinical evaluation

Abstract

Objective

To describe the rate of occurrence of unsuspected decrease in sensitivity of the sound processor microphone and to evaluate its effect on the patient's audiological performance in terms of reduction in speech recognition scores.

Design

Speech processor microphones were tested by connecting the speech processor acoustic monitor circuit to a hearing aid analyzer. The response curves were compared with those obtained from fully working microphones.

During a 6-month investigation period, microphone response curves were measured from a group of cochlear implant recipients who had not reported any problems. Despite the absence of any subjective problem, some microphones were found to show a loss of sensitivity. Their users, aged between 4 and 67 years, were tested both with the defective and a working microphone in order to calculate the correlation between the degree of microphone failure and the decline in audiological performance.

To quantify the effect of microphone failure, patients’ speech recognition skills were measured by live voice connected discourse tracking series administered in different conditions and by recorded sentences lists.

Results

A total of 120 apparently fully functioning sound processors were tested in the investigation: 33 (27.5%) were affected by a subjectively unreported sensitivity decrease. Speech-tracking scores correlated significantly with the loss of microphone sensitivity in all test conditions (r = 0.69–0.77, P < 0.05). A high degree of correlation was also found for speech audiometry tests (r = 0.70–0.73, P < 0.05). Microphone sensitivity loss affected speech recognition skills, especially without lip reading and in the presence of background noise.

Conclusion

The results indicate that any reduction in sound processor microphone sensitivity causes a degree of hearing decline that negatively affects the cochlear recipient's clinical performance. Microphone faults are often unreported events, and their occurrence rate is underestimated. To establish that the microphone is providing correct input to the speech processor a standard control procedure, including technical and clinical checks, is needed in clinical practice.     

Treatment outcome after neonatal cleft lip repair in 5-year-old children with unilateral cleft lip and palate

IntroductionThe aim of this study was to assess speech outcomes and dental arch relationship of 5-year-old Czech patients with unilateral cleft lip and palate (UCLP) who have undergone neonatal cleft lip repair and one-stage palatal closure.Methods and materialsTwenty-three patients with UCLP, born between 2009 and 2010, were included in the study. Three universal speech parameters (hypernasality, articulation and speech intelligibility) have been devised for speech recordings evaluation. Outcomes of dental arch relationship were evaluated by applying the GOSLON Yardstick and subsequently compared with the GOSLON outcome of other cleft centers.ResultsModerate hypernasality was present in most cases, the mean value for articulation and speech intelligibility was 2.07 and 1.93, respectively. The Kappa values for inter-examiner agreement for all the three speech outcomes ranged from 0.786 to 0.808. Sixty-three percent of patients were scored GOSLON 1 and 2, 26% GOSLON 3, and 10% GOSLON 4. GOSLON mean score was 2.35. Interrater agreement was very good, represented by kappa value of 0.867.ConclusionThe treatment protocol, involving neonatal cleft lip repair and one-stage palatal repair performed up to the first year of UCLP patient's life, has shown good speech outcomes and produced very good treatment results in regard to maxillary growth, comparable with other cleft centers.     

Velopharyngeal insufficiency,submucous cleft palate and a phonological disorder as the associated clinical features which led to the diagnosis of Jacobsen syndrome. Case report and review of the literature

Jacobsen syndrome is an uncommon but well-known contiguous gene syndrome caused by partial deletion involving the long arm of chromosome 11. Most common features include: psychomotor impairment, facial dysmorphism, and thrombocytopenia. Cleft palate has been rarely reported.     

A Clinical Test for the Assessment of Binaural Speech Perception in Noise

The present paper describes a clinical test for the assessment of speech perception in noise. The test was designed to separate the effects of several relevant monaural and binaural cues. Results show that the performance of individual hearing-impaired listeners deviates significantly from normal for at least 2 of the following aspects: (1) perception of speech in steady-state noise; (2) relative binaural advantage due to directional cues; (3) relative advantage due to masker fluctuations. In contrast, both the hearing loss for reverberated speech and the relative binaural advantage due to interaural signal decorrelation, caused by reverberation, were essentially normal for almost all hearing impaired.