Auditory Performance Research Articles

A New Objective Diagnostic Tool for Attention-Deficit Hyper-Activity Disorder (ADHD): Development of the Distractor-Embedded Auditory Continuous Performance Test

Background/Objectives: Attention-Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. Traditional diagnostic methods, which depend on subjective assessments, often lack precision. This study evaluates the validity and reliability of a newly developed diagnostic tool, the Distractor-Embedded Auditory Continuous Performance Test (da-CPT), which integrates auditory stimuli with distractors to enhance the clinical utility of ADHD diagnosis. Methods: The study included 160 children aged 6–12 years, comprising 80 with a confirmed ADHD diagnosis and 80 controls. All participants completed the da-CPT, a web-based tool designed to assess inattention, hyperactivity, impulsivity, and timing via an auditory-based task. To validate the da-CPT, participants also completed the Conners’ Parent Rating Scale—Revised Short Form (CPRS-R) and either the MOXO or IVA-2 tests. Data were analyzed using ROC curves and statistical correlations to assess sensitivity, specificity, and overall diagnostic accuracy. Results: The da-CPT demonstrated high diagnostic accuracy, with a sensitivity of 91.25% and specificity of 83.75%. ROC analysis indicated that the inattention index had the highest discriminatory power (AUC = 0.881), followed by timing, impulsivity, and hyperactivity (all p < 0.01). Furthermore, the da-CPT scores were strongly correlated with ADHD severity (p < 0.01). Conclusions: This study confirms that the da-CPT is a valid and reliable tool for diagnosing ADHD in children aged 6–12. By incorporating auditory stimuli and distractors, the tool offers a more ecologically valid assessment of ADHD symptoms in clinical settings, improving diagnostic precision and utility.

Associated factors and outcomes for quality of life in children receiving cochlear implantation before seven years of age.

To evaluate the relationship of cochlear implant-related factors with quality of life (QOL) outcomes in pediatric cochlear implantation (CI) recipients. In this cross-sectional study, data from 146 children who received CI before 7 years of age were collected. QOL was measured using the Children using Hearing Implants Quality of Life (CuHI-QoL) questionnaire. Auditory and language abilities were measured using categories of auditory performance II(CAP-II) scale and speech intelligibility rating (SIR) scale. The reliability and validity of the CuHI-QOL scale were tested using internal consistency tests and correlation analysis, respectively. Bivariate correlations were used to compare CuHI-QOL scores and educational placements to cochlear implant-related factors. QOL scores were further compared using ANOVA in different groups based on age at CI with different durations of implant use. The mean total CuHI-QOL scores was 60.13 (SD 8.97). The Cronbach's alpha of overall CuHI-QOL scale was 0.820. The CuHI-QOL total score was strongly to moderately correlated with CAP score (r = 0.542), SIR score (r = 0.545), duration of implant use (r = 0.403), and educational placement (r = 0.478). ANOVA showed the CuHI-QOL scores after 5 years post-CI were higher than those less than 2 years post-CI in children implanted ≤ 3 years of age. Good QOL could be obtained for children with CI and were significantly associated with young age at implantation, good auditory and speech abilities, speech rehabilitation training pre-CI, long duration of cochlear implant use, and mainstream educational placement.

Evaluation of auditory middle latency response during the menstrual cycle

Aim: The hormone levels during the menstrual cycle, directly and indirectly, affect the hearing system. In our study, it was aimed to examine the effects of changing hormone levels during the menstrual cycle on auditory middle latency responses in healthy individuals with different stimuli types and the psychosomatic effects of premenstrual complaints on auditory performance. Methods: In the study, 20 healthy women aged 18-35 years, with regular menstrual cycles and no auditory or vestibular complaints were evaluated for auditory middle latency responses with click and level-specific (LS) CE-Chirp® stimuli during the menstruation period of the follicular phase (1-5 day, menstrual phase), the ovulation phase (14-17 day) and the luteal phase (21-28 day). To evaluate the effect of premenstrual complaints on auditory performance, the participants were asked 5 questions. Results: In the auditory middle latency assessment with click stimuli, a statistically larger Na-Pa amplitude was obtained in the menstruation phase compared to the ovulation phase in both ears. In the auditory middle latency evaluation with LS CE-Chirp® stimulus, statistically shortened Nb latencies were obtained in the right ear in the menstruation phase compared to the ovulation phase. Conclusion: Although the clear effect of changing gonadal hormone levels on auditory evoked middle latency responses could not be determined, the findings show that neural transmission increases in the menstrual phase when the estrogen level is low. Click stimulus is more sensitive to hormonal changes, and the use of click stimulus has been recommended in the later side of lesion studies. In our study, no psychosomatic effect of complaints in the premenstrual period on auditory performance was observed.

Improving speech intelligibility in noise and spatial perception: the critical role of hearing aid microphone position

IntroductionHearing aid (HA) manufacturers have introduced behind-the-ear (BTE) models where the microphone is positioned in the ear canal, which could impact auditory performance by distorting the pinna’s acoustic cues. This study aimed to compare two different BTE HAs with varying microphone positions: the receiver in the ear (RITE) and the transducer in the ear (TIE).MethodsThe study involved 10 participants who had never used HAs before. They used both RITE and TIE HAs bilaterally for 3 weeks. Auditory performance was assessed through free field hearing assessments (hearing thresholds, speech recognition threshold, and speech discrimination score), the Turkish Matrix Sentence Test (TURMatrix), a sound localization test, and the Satisfaction with Amplification in Daily Living (SADL) questionnaire.ResultsThere was no significant difference between TIE and RITE in the free field hearing assessments. However, TIE outperformed RITE in non-adaptive TURMatrix scores in quiet, adaptive TURMatrix scores in noise, and sound localization accuracy at various angles. SADL sub-scores (Positive Effect, Service and Cost, and Personal Image) and overall satisfaction scores were significantly better for TIE.DiscussionThe microphone position in HAs can influence auditory performance. This study demonstrated that TIE provided better speech intelligibility, localization accuracy, and user satisfaction compared to RITE.

Changes in Auditory Performance Following a Virtual Reality Music Concert.

The purpose of this study was to evaluate threshold and suprathreshold auditory risk from a newly popular platform of music concert entertainment; virtual reality (VR) headsets. Recreational noise exposure to music is the primary source of hearing hazard in young-adults, with noise doses of in-person concert venues and music festivals well in excess of the recommended daily exposure recommendation from the National Institute for Occupational Safety and Health. While research on the relationship between personal music players and noise-induced hearing loss risk is abundant, no study has yet evaluated noise-induced hearing loss risk from VR headsets, which are newest to the commercial market at this time. Thirty-one young-adult participants (18 to 25 years) with normal-hearing sensitivity (0 to 16 dB HL) experienced a VR music concert and participated in three data collection timepoints: Session A preexposure, Session A post-exposure, and Session B post-exposure. Participants underwent baseline testing for audiometry (0.25 to 20 kHz), distortion product otoacoustic emission testing (1 to 10 kHz), and Words-in-Noise testing. Participants then wore a commercially available VR headset (Meta Quest 2) and experienced a freely available online VR music concert (via the video-sharing website "YouTube"). The VR music concert duration was 90 min set to maximum volume, which yielded an average sound level equivalent of 78.7 dBA, max sound level of 88.2 dBA, and LC peak sound level of 98.6 dBA. Post-exposure testing was conducted immediately at the conclusion of the VR concert, and again within 24 hr to 1 week after the exposure. Participants also answered a questionnaire that estimated noise exposure history (National Acoustics Laboratory "Noise Calculator"). Post-exposure deficit was not observed in DPOAEs or Words-in-Noise score (p's > 0.05). However, statistically significant temporary post-exposure deficit was observed in audiometry at 4, 8, and 12.5 kHz (p's < 0.05) (mean differences: 2 to 3 dB HL). Twenty-four hours and 1-week post-exposure measurements revealed no permanent changes from baseline measurements (p's > 0.05) aside from one spurious difference at 12.5 kHz. Males tended to exhibit a significantly higher noise history score on average than females. The primary, secondary, and tertiary sources of noise hazard history in this young-adult cohort included amplified music. These preliminary data suggest that VR music concerts-which are likely to produce a substantially lower noise dose than in-person music concerts-may still be capable of producing at least slight, temporary threshold shifts on the order of 2 to 3 dB HL. Future research should include VR headsets in personal music player risk assessment, as the VR music concert platform is increasing rapidly in popularity among young-adults.

Rhythm-based Temporal Expectations: Unique Contributions of Predictability and Periodicity.

Anticipating events and focusing attention accordingly are crucial for navigating our dynamic environment. Rhythmic patterns of sensory input offer valuable cues for temporal expectations and facilitate perceptual processing. Rhythm-based temporal expectations may rely on oscillatory entrainment, where neural activity and perceptual sensitivity synchronize with periodic stimuli. However, whether entrainment models can account for aperiodic predictable rhythms remains unclear. Our study aimed to delineate the distinct roles of predictability and periodicity in rhythm-based expectations. Participants performed a pitch-identification task preceded by periodic predictable, aperiodic predictable, or aperiodic unpredictable temporal sequences. By manipulating the temporal position of the target sound, we observed how auditory perceptual performance was modulated by the target position's relative phase relationship to the preceding sequences. Results revealed a significant performance advantage for predictable sequences, both periodic and aperiodic, compared with unpredictable ones. However, only the periodic sequence induced an entrained modulation pattern, with performance peaking in synchrony with the inherent sequence continuation. Event-related brain potentials corroborated these findings. The target-evoked P3b, possibly a neural marker of attention allocation, mirrored the behavioral performance patterns. This supports our hypothesis that temporal attention guided by rhythm-based expectations modulates perceptual performance. Furthermore, the predictive sequences were associated with enhanced target-preceding negativity (akin to the contingent negative variation), indicating enhanced target preparation. The periodic-specific modulation likely reflects more precise temporal expectations, potentially involving neural entrainment and/or more focused attention. Our findings suggest that predictability and periodicity influence perception through distinct mechanisms.

Relationship Between Socioeconomic Status and Basic Auditory Processing in Young Adults.

The current study aimed at investigating the relationship between socioeconomic status (SES) and basic auditory processing in young adults with normal hearing. Specifically, we sought to determine whether SES metrics, including parental education, parental occupation, and individual education attainment, influenced performance on tasks of basic auditory processing. Secondarily, we also aimed at understanding the interactive effects of SES and working memory on basic auditory processing. A total of 38 young adults were included in the study. Self-reported SES measures were recorded through Likert scales, and auditory processing measures included tests for temporal fine structure (TFS) and spectrotemporal sensitivity (STS). Pearson correlation analyses were conducted to probe the relationships between SES indicators and auditory processing performance. Multiple linear regressions were conducted to understand the interactive effects of SES and working memory on auditory processing performance. The analysis revealed no significant correlation between SES measures and basic auditory processing performance across TFS and STS tasks. Furthermore, analysis investigating the interaction between SES and working memory also yielded nonsignificant results. These findings indicate that, within this specific age cohort, SES information may not be indispensable for assessing basic auditory processing. Our study suggests that SES may not significantly influence basic auditory processing in young adults with normal hearing. However, further research with larger sample sizes and longitudinal designs is warranted to confirm these findings and explore potential age-related differences in the impact of SES on auditory processing across the lifespan.

Effects of automatic auditory scene classification on speech perception in noise and real-world functional communication in children using cochlear implants

Objectives To investigate the effects of automatic scene classification (SCAN) on speech perception in noise and real-world functional performance in children using cochlear implants (CIs). Methods We used a within-subjects repeated measures design in two studies. The first study assessed speech perception in noise with or without SCAN enabled in 25 school-aged children. The second study evaluated functional auditory performance in real life. Parents of 18 children provided ratings using the Parents’ Evaluation of Aural/oral Performance of Children (PEACH) questionnaire; and children provided ratings using the Self Evaluation of Listening Function (SELF) questionnaire. Analyses of variance with repeated measures were used to examine the effect of SCAN. Results On average, speech perception in noise was significantly better with SCAN enabled (mean SRT: −4.1 dB; SD: 4.0), compared to SCAN disabled (mean SRT: 0.5 dB; SD: 3.5). Children’s functional performance in real life was similar between the two device settings. Conclusion Automatic auditory scene classification provides significant benefits for speech perception in noise (4.6 dB improvement). On average, there were no perceived detrimental or beneficial effects in real life. These findings support the use of SCAN in CIs for young children.

Auditory Memory and Visual Memory in Typically Developing Children: Modality Dependence/ Independence.

The study aimed to determine whether there was a difference or an association between auditory memory and visual memory in typically developing children. Eighteen children, aged 8 to 12 years, with normal hearing and visual acuity, were evaluated using the Children's Memory Scale (CMS) to determine their auditory and visual memory performance. Using the core subtest battery of the CMS, auditory/verbal (immediate and delayed), visual/nonverbal (immediate and delayed), and general memory index scores were assessed. No significant difference was found between auditory/verbal memory and visual/nonverbal memory scores for both immediate and delayed recall. Likewise, no correlation between auditory/verbal memory and visual/nonverbal memory scores was found. However, there was a significant correlation between immediate and delayed recall scores within each modality. The non-significant difference between the two modalities for both immediate and delayed recall gives the impression that memory is modality independent. However, the lack of any correlation between the two suggests there was no association between them. The absence of a significant difference between modalities can be attributed to the auditory and visual test material used in CMS not being analogous. It can thus be inferred that the auditory and visual modalities are independent. While the visual material evaluates simultaneous/concurrent perception, the auditory material assesses sequential perception.

Children with Auditory Brainstem Implants: Language Proficiency and Reading Comprehension Process.

Auditory performance and language proficiency in young children who utilize auditory brainstem implants (ABI) throughout the first three years of life is difficult to predict. ABI users have challenges as a result of delays in language proficiency and the acquisition of reading comprehension, even if ABI technology offers auditory experiences that enhance spoken language development. The aim of this study was to evaluate about the impact of language proficiency on reading comprehension skills in children with ABI. In this study, 20 children with ABI were evaluated for their reading comprehension abilities and language proficiency using an Informal Reading Inventory, Test of Early Language Development (TELD-3), Categories of Auditory Performance-II (CAP-II), and Speech Intelligibility Rating (SIR). Three distinct aspects of reading comprehension were assessed and analyzed to provide a composite score for reading comprehension abilities. TELD-3, which measures receptive and expressive language proficiency, was presented through spoken language. Studies have shown that there was a relationship between language proficiency and reading comprehension in children with ABI. In the present study, it was determined that the total scores of reading comprehension skills of the children who had poor language proficiency and enrolled in the school for the deaf were also low. The children use short, basic sentences, often repeat words and phrases, and have a restricted vocabulary. In addition, the children had difficulty reading characters and detailed paragraphs and could not remember events in a logical order. Children with ABI may potentially have complicated reading comprehension abilities due to lack of access to all the speech formants needed to develop spoken language. In addition, variables affecting the reading levels of children with ABI include factors such as age at implantation, duration of implant use, presence of additional disability, communication model and access to auditory rehabilitation. The reading comprehension skills of ABI users were evaluated in this study for the first time in the literature and may constitute a starting point for the examination of variables affecting reading comprehension in this area.

The Role of Hearing Difficulty: Cognitive-Communication and Speech-in-Noise Deficits in Adults Following Mild Traumatic Brain Injury

Purpose: Mild traumatic brain injury (TBI) has a high rate of occurrence across the lifespan. Following mild TBI (mTBI), perceived deficits in cognitive communication and hearing may be noted. This study aimed to determine if adults with a history of mTBI and hearing difficulty perceived greater degrees of cognitive-communication difficulty and performed poorer on a speech-in-noise task when compared to participants with mTBI and controls without reported hearing difficulty. Method: Adults aged 19–77 years with and without a history of mTBI were analyzed. Participants were divided into three groups: control ( n = 49), mTBI ( n = 22), and mTBI with hearing difficulty (mTBI-HD, n = 26). Perception of hearing difficulty was based on a score of ≥ 20 on the Hearing Handicap Inventory or a score ≥ 2 on the Adult Auditory Performance Scale. Self-perceived cognitive communication was measured using the Cognitive Difficulties Scale (CDS) and the La Trobe Communication Questionnaire (LCQ). Speech-in-noise performance was measured using the low-cue speech recognition threshold (SRT) from the Listening in Spatialized Noise–Sentences (LiSN-S) test. Results: Adults in the mTBI-HD group reported significantly greater degrees of cognitive-communication difficulties (higher CDS and LCQ scores) and exhibited significantly poorer speech-in-noise performance on the low-cue LiSN-S condition when compared to the control and mTBI groups. Results also revealed significant correlations between the LiSN-S low-cue SRT and perceived cognitive communication on the CDS. Conclusions: Results of the current study indicate that adults with a history of mTBI and hearing difficulty experience greater subjective cognitive-communication difficulties and perform more poorly on difficult speech-in-noise tasks than adults who do not experience self-perceived hearing difficulties. The results of this study support the consideration of hearing and cognitive-communication difficulties when determining appropriate speech, language, and hearing assessment, treatment, and intervention strategies for individuals following mTBI.

Age-Related Listening Performance Changes Across Adulthood.

This study compares auditory processing performance across different decades of adulthood, including young adults and middle-aged individuals with normal hearing and no spontaneous auditory complaints. We assessed 80 participants with normal hearing, at least 10 years of education, and normal global cognition. The participants completed various auditory tests, including speech-in-noise, dichotic digits, duration, pitch pattern sequence, gap in noise, and masking level difference. In addition, we conducted working memory assessments and administered a questionnaire on self-perceived hearing difficulties. Our findings revealed significant differences in auditory test performance across different age groups, except for the masking level difference. The youngest group outperformed all other age groups in the speech-in-noise test, while differences in dichotic listening and temporal resolution emerged from the age of 40 and in temporal ordering from the age of 50. Moreover, higher education levels and better working memory test scores were associated with better auditory performance as individuals aged. However, the influence of these factors varied across different auditory tests. It is interesting that we observed increased self-reported hearing difficulties with age, even in participants without spontaneous auditory complaints. Our study highlights significant variations in auditory test performance, with noticeable changes occurring from age 30 and becoming more pronounced from age 40 onward. As individuals grow older, they tend to perceive more hearing difficulties. Furthermore, the impact of age on auditory processing performance is influenced by factors such as education and working memory.

Long-term analysis of ABI auditory performance in patients with neurofibromatosis type 2-related schwannomatosis.

This retrospective monocentric study aimed to evaluate long-term auditory brainstem implant (ABI) function in patients with neurofibromatosis type 2, and to investigate the prognostic factors for ABI use. Between 1997 and 2022, 27 patients with at least five years of follow-up underwent implantation with 32 ABIs. At 1- and 5-years post-implantation and at last follow-up, ABIs were classified as used or non-used and the size of the ipsilateral tumor was recorded. For patients who used their ABIs, we assessed speech perception (disyllabic words, MBAA sentences) in quiet conditions with the ABI only, by lip-reading (LR), and with a combination of the two (ABI + LR). Hearing improvement was calculated as ABI = (ABI + LR)-LR scores. Predictive factors for ABI use were analyzed. One year post-implantation, 74% patients were ABI-users and 66% of the ABIs were used. Two of these patients were non-users at five years, and another two at last follow-up (14 ± 5.2years); 54% of the patients were ABI-users at last follow-up. ABI revealed a hearing improvement of 32-41% (disyllabic words) and 28-37% (MBAA sentences). Among 16 ABIs with at least LR improvement at 1-year post-implantation, 4 decreased their performance, coinciding with a large growing ipsilateral tumor in 3/4 ABIs. We identified no significant prognostic factors for ABI use. ABIs are indicated in case of bilateral deafness with a non-functional cochlear nerve. Half the patients with ABIs used their implants and auditory performance remained stable over time, except in cases of ipsilateral tumor growth.

A Systematic Review and Meta-analysis Examining Outcomes of Cochlear Implantation in Children With Bilateral Cochlear Nerve Deficiency.

To assess hearing and speech outcomes in pediatric patients with bilateral cochlear nerve deficiency (CND) who underwent cochlear implantation (CI) and to identify factors associated with improved outcomes. PubMed, Embase, Web of Science, and Cochran databases were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that reported hearing and speech outcomes of pediatric patients with bilateral CND who underwent CI were included. Demographics, comorbidities, inner ear abnormalities, CND classification (aplasia or hypoplasia), details of diagnostic workup, and outcomes data were extracted. Outcomes were assessed using the four-level auditory performance level (APL) scale. Meta-analysis, using Cochran-Armitage tests, was performed on patients with individual data to assess factors associated with performance. A total of 314 papers were screened, and 40 papers with 378 total patients met inclusion criteria. A total of 339 patients had patient-level data and were included in the meta-analysis. Of the 339 patients, 19% (n = 63) of patients had no measurable stimulation, 28% (n = 95) had improved detection, 22% (n = 76) achieved closed-set speech perception, and 31% (n = 105) achieved open-set speech perception. Patients with cochlear nerve aplasia (p = 0.016) and syndromes (p < 0.001) had significantly worse APL scores relative to patients with cochlear nerve hypoplasia and patients without syndromes, respectively. While most patients with bilateral CND benefit from CI and almost one-third of patients achieved open-set speech perception, outcomes were heterogenous and one-fifth of patients did not experience measurable benefit from CI.

Longitudinal follow-up of hearing, speech, and language skills in 6-year-old children with congenital moderate hearing loss

ObjectivesChildren born with moderate hearing loss present with speech and language outcomes at both ends of the spectrum. To explore reasons for this, the objective of this study was to follow up a group of children born with moderate sensorineural hearing loss at 6 years of age (n=7) by investigating their outcomes in hearing, speech, and language development from time point of hearing aid fitting at 6 months. Another objective was to investigate the relationship between earlier outcomes on precursing variables to the current status in auditory, speech and language development. MethodEarlier data from a project with the same participants of auditory variables, speech, and language development were compared to the current study outcomes at 6 years of age. Children in this study performed standardized tests of phonology (SVANTE), expressive vocabulary (BNT), and speech-in-noise test (Hagerman´s sentences). Parents reported on their child´s functional auditory performance in everyday life (PEACH), and demographics and general development (questionnaire). Etiology and frequency of speech and language-directed intervention from time point of diagnosis to 6 years of age were collected through medical journals. ResultsHearing levels were stable over time in all children but one, who had received bilateral cochlear implants. Performance on speech-in-noise testing varied in aided condition (-0.8 to 8, mean 2.65, SD 3.09) and unaided condition (7.2 dB to 21.2 dB, mean 12.06, SD 4.82). Scores on the PEACH indicated further review in four of the seven children. Mean group score on consonant proficiency had increased from 3 to 6 years of age and were within age norms. Vocabulary scores were below the norms of children with typical hearing. Outcomes on vocabulary measures at 2.5 years years showed strong correlations that were significant to scores on the BNT at 6 years of age (r = 0.87, p = 0.05). Correlations between hours of hearing aid use and vocabulary was not significant at 6 years of age. The frequency of intervention sessions in the first 6 years varied between participants (4 to 55, mean 19.1, SD 17.1). ConclusionDespite homogeneous hearing and other background variables in the participants from birth, large individual variations in speech and language outcomes at 6 years of age were found. Considering the many factors involved that impact the development of children with moderate hearing loss, the results suggest that monitoring early precursors in auditory, speech and language development may be helpful in setting commensurate goals for each child. Detecting additional conditions that may pose challenges in future speech and language as early as possible is important. There is ample room for improvement in terms of increasing the frequency of intervention for children with moderate hearing loss and their families.

Analysis of the therapeutic effect of pestle needle and EEG biofeedback and methylphenidate in the treatment of attention-deficit/hyperactivity disorder.

This research aimed to analyze the therapeutic effect of the pestle needle combined with electroencephalogram (EEG) biofeedback and methylphenidate in the treatment of attention-deficit/hyperactivity disorder (ADHD) in children. Seventy-eight children with ADHD were selected and randomized into a control group and an observation group (n = 39 each). The control group received EEG biofeedback and methylphenidate treatment, whereas the observation group received pestle needle therapy on this basis. Both groups received continuous treatment for 3 mo. The clinical efficacy, scores of Conners Parents Symptom Questionnaire (PSQ), Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), and Pittsburgh Sleep Quality Index (PSQI), EEG θ/β changes in values, serum indicators such as adrenocorticotropic hormone (ACTH) and cortisol (CORT), and incidence of adverse reactions were compared in the two groups. The total effective rate of the observation group was 92.31% (36/39), which was higher than the control group's 69.23% (27/39) (P < 0.05). After treatment, reduced PSQ scores, PSQI scores, EEG θ/β values, and ACTH levels and elevated IVA-CPT and CORT levels were observed in both groups; the observation group had the best improvement effect after treatment (P < 0.05). Pestle needle combined with EEG biofeedback and methylphenidate in the treatment of ADHD children can elevate the IVA-CPT score, improve EEG waves and sleep quality, regulate serum indicators such as ACTH and CORT, reduce behavioral problem scores, and have high efficacy and safety.NEW & NOTEWORTHY The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can elevate the IVA-CPT score. The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can improve EEG waves. The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can improve sleep quality. The pestle needle combined with EEG biofeedback and methylphenidate in ADHD children can regulate serum indicators.

Age as an important variable that affects auditory and language results after cochlear implant

AbstractCochlear implant (CI) benefits deaf children's speech perception, language development and speech production. Early fitting of an implant results in improved outcomes. Over a period of more than 3 decades, cochlear implantation (CI) is firmly known as safe and effective treatment for children with bilateral severe to profound sensorineural hearing loss (SNHL) who develop minimal or no benefit from conventional hearing aid use. The primary aim of CI is to improve auditory perception of the child and hence the spoken language. The development of functional spoken language would be the major long-term benefits of CI. Children who received a cochlear implant before a real delay in spoken language development (i.e., between 12–16 months) were more able to achieve age-appropriate spoken language. These results strengthen the idea of doing cochlear implantation before 24 months of age, especially for children with a better ear aided pure tone with average thresholds greater than 65 dB prior to surgery.The main aim is to study the effect of age on CI patients results by applying simple questioners on 31 CI children, that are easy to assess the auditory perception and discrimination as an important prerequisite for language development.Results There was an inverse correlation between; age at CI, categories of auditory performance (CAPS), and meaningful auditory integration scale (MAIS) scores. While; there was direct correlation between MAIS &amp; CAPS scores.Conclusions The auditory perception development after CI in children being 3 years old or younger is much better than the older children which would be reflected on their speech perception and acquiring their 1st word and sentence, but language development did not differ between both groups for this period of follow up. With a need of further detailed full language aspects assessment and follow up to ensure these results.

B - 89 Evaluation of the Differential Effect of Cognitive and Somatic Anxiety Symptoms as Predictors of Verbal Learning and Memory Performance

Abstract Objective Anxiety is known to exacerbate cognitive difficulties associated with aging; however, little it is less clear how specific symptoms of anxiety, particularly cognitive and somatic symptoms, impact learning and memory performance among older adults. This study explored the relationship between moderate-to-severe symptoms of cognitive and somatic anxiety on auditory learning and memory performance. Method A sample of 95 outpatients referred for neuropsychological were administered the California Verbal Learning Test -3rd Edition-Brief Form (CVLT), Wechsler Memory Scales – 4th Edition Logical Memory (LM), and the Beck Anxiety Inventory (BAI) as part of a standardized battery. Results The sample was 45.3% female and 50.5% black (Age: M = 64.69, SD = 8.1; Education: M = 13.60, SD = 3.0). BAI items were dichotomized into somatic and cognitive symptoms. Items rated as moderate or severe were summed to create total somatic anxiety (S-Anx), and cognitive (C-Anx), and total moderate–severe (T-Anx) scores. Regression analyses indicated that T-Anx and S-Anx, significantly predicted CVLT Trial 1 (T1) learning (β = −0.24; β = −0.24, respectively) and total learning performance (β = −0.20; β = −0.23, respectively). C-Anx predicted T1 learning (β = −0.22,), but not total learning. None of the anxiety scales predicted CVLT delayed recall, nor LM learning or retrieval. Conclusion Multiple regression revealed that S-Anx remained a significant predictor of total learning when controlling for C-Anx. Findings indicate that both moderate-to-severe somatic and cognitive anxiety impact unstructured auditory one-trial learning, while somatic anxiety has a more broad impact on learning over trials, which was sustained after controlling for the effect of cognitive anxiety, suggesting potentially independent symptom construct clusters.

Auditory Localization Performance in Cochlear Implant Recipients With Single-Sided Deafness: The Challenges and Limitations of Current Outcome Metrics.

Acoustic localization accuracy metrics currently employed in clinical literature both overestimate and underestimate performance benefit of cochlear implantation (CI) for single-sided deafness (SSD). Although localization in SSD with CI has been investigated, performance characterization has relied heavily on average error. Although attractively concise, this measure may misrepresent performance. Here, we characterize frequency-specific localization on a granular level in subjects with CI for SSD as a critical analysis of localization outcome metrics. Eight CI recipients with SSD were recruited. Stimuli of broadband (BBN) and narrowband noise (NBN) at low (500 Hz), mid (1000 Hz), and high (4000 Hz) frequencies were presented in a semianechoic chamber. Localization accuracy was quantified in mean angular error (MAE) and linear regression slope. Use of a CI for SSD subjects improved localization performance by slope for all stimuli ( p ≤ 0.0033) to a level that was equal to normal-hearing controls at 1 and 4 kHz ( p ≥ 0.2281). MAE was also significantly improved for SSD subjects using CI for BBN stimuli ( p ≪ 0.0001); however, no statistically significant improvement in MAE was seen for NBN ( p ≥ 0.5773) with CI use. Descriptive analysis of individual subject performance highlights the reasons for contradictory results. There is inherent challenge in characterizing localization benefit for individuals with CI for SSD. Our data demonstrate the limitations of utilization of average error as the sole metric for outcome benefit. We emphasize the importance of continued research investigating alternative outcome measures as we work toward a more refined understanding of the potential benefits and limitations of cochlear implantation for SSD.

Evaluation of cognitive deficits and limit of stability in chronic low back pain patients with and without fear-avoidance beliefs

ObjectiveThis study aimed to compare the cognitive performance and limit of stability parameters between chronic low back pain (CLBP) patients with and without fear-avoidance beliefs (FABs) and healthy control subjects. MethodsThirty-four CLBP patients with and without FABs and 17 healthy controls were recruited into the study. Three cognitive components, including working memory, attention, and problem-solving, were assessed using Wechsler's Digit Span subtest, the Tower of London test, and the Integrated Visual and Auditory Continuous Performance Test (IVACPT), respectively.The study assessed the limit of stability using MARS software. One-way ANOVA with Bonferroni-corrected post-hoc comparisons revealed between-group differences. Additionally, Hedge's g effect size was calculated. ResultsThere was no significant difference between CLBP patients with and without FABs in Wechsler's Digit span and the Tower of London test. However, CLBP patients with FABs had lower scores and slower reaction times in the IVACPT(p < 0.05).The statistical analysis of movement velocity during the limit of stability (LOS) tasks revealed no significant difference between chronic low back pain patients with and without fear-avoidance beliefs in all directions. However, CLBP patients with FABs exhibited significantly slower reaction times in the forward (p = 0.001), backward (p = 0.001), and right (p = 0.001) directions. ConclusionThe study indicates that chronic low back pain (CLBP) patients with FABs experience more pronounced cognitive impairments and balance disturbances compared to CLBP patients without FABs. These results underscore the significance of considering psychological factors when assessing the functional abilities of individuals with chronic low back pain.