Auditory Processing Assessment Research Articles

Auditory Processing Abilities in Children with Mild Hearing Loss

The purpose of this study was to investigate the effect of mild peripheral hearing loss on central auditory processing tests. A central auditory test battery in Korean (Central Auditory Processing Assessment, CAPA-K) that consisted of Speech-in-Noise Test (SINT), Low-passed Filtered Test (LPFT), Dichotic Digit Test (DDT), Frequency Pattern Test (FPT), and Binaural Fusion Test (BFT) was administrated to 10 school-aged children with mild peripheral hearing loss and the age matched controls with normal hearing. Scores of hearing-impaired children were significantly lower than control subjects’ scores when the test stimuli were presented at the comfortable presentation level. All of these tasks were affected by mild hearing loss, with the monaural-low-redundancy tasks being the most seriously affected. The results indicate that while the central auditory test battery can be administered to mild peripheral hearing losses, all results must be interpreted with caution.

Processamento auditivo temporal em crianças com transtorno do déficit de atenção com hiperatividade (TDAH)

OBJETIVO:comparar os achados da avaliação comportamental do processamento auditivo temporal em crianças com e sem Transtorno do Déficit de Atenção com Hiperatividade.MÉTODOS:participaram desse estudo 30 crianças na faixa etária de 8 a 12 anos, sendo 15 do grupo controle e 15 do grupo pesquisa, com limiares audiométricos dentro dos padrões de normalidade. Como procedimentos foram realizados os testes temporais de padrão de frequência e de duração.RESULTADOS:na comparação entre o grupo controle e grupo pesquisa em ambos os testes - padrão de frequência e padrão de duração foram verificadas diferenças significantes entre os grupos, sendo que o grupo pesquisa apresentou resultados alterados em sua maioria, enquanto que todas as crianças do grupo controle apresentaram resultados normais. Foi possível observar ainda que todas as crianças de ambos os grupos tiveram resultados inferiores para o Padrão de Duração quando comparado aos resultados do Padrão de Frequência e.CONCLUSÃO:a avaliação comportamental do processamento auditivo temporal de crianças com e sem Transtorno do Déficit de Atenção com Hiperatividade, mostrou que os sujeitos com Transtorno do Déficit de Atenção com Hiperatividade apresentaram alterações, enquanto que o grupo sem Transtorno do Déficit de Atenção com Hiperatividade resultados normais em ambos os testes. O presente estudo possibilitou um maior conhecimento da via auditiva central das crianças com e sem Transtorno do Déficit de Atenção com Hiperatividade, porém, outros estudos ainda se fazem necessários, principalmente na literatura nacional, a fim de se conhecer melhor o funcionamento do processamento auditivo dessas populações.

The Relation of Externalizing Behavior and Central Auditory Processing Deficits in 4-Year-Old Children

The integrity of the central auditory system is a fundamental condition for language development. Good language development is related to good academic performance and adaptive behavior. Therefore, the evaluation of auditory processing along with behavior as well as the verification of a possible relationship between them can indicate possible ways on how to deal with both problem behavior and difficulties in language. 187 parents of preschoolers (mean age 3.8 years) were interviewed individually and asked to fill in the CBCL (Child Behavior Checklist), for ages 1(1/2) to 5, providing a behavioral profile concerning externalizing and internalizing behavior. Children were assessed regarding central auditory processing skills through the Simplified Assessment of the Auditory Processing—SAAP (Pereira & Schochat, 1997) including Sound Source Localization (SSL); Non-Verbal Sound Sequence Memory (NVSSM); Verbal Sounds Sequence Memory (VSSM). To investigate a possible association between central auditory processing skills and behavioral problems, all the scores in CBCL and the total scores of Simplified Auditory Processing Assessment were correlated with functional parameters using the Spearman rank correlation. The behaviors “acts too young for age”; “constantly seeks help”; “does not eat well”; “does not seem to feel guilty after misbehaving”; “easily frustrated”; “nervous movements or twitching”; “nervous, highstrung, or tense”; “poorly coordinated or clumsy”; “repeatedly rocks head or body”; “stares into space and seems preoccupied”, “sulks a lot” and “wanders away” were correlated with poor auditory processing skills. This indicates that the school staff along with health professionals should provide informational counseling regarding, not only the communicative difficulties associated with a poor performance on central auditory processing skills but also the psychosocial difficulties that these children may be facing.

A long-term follow-up of children and adolescents referred for assessment of auditory processing disorder

Objective: This study investigated whether young adults (between 18 and 30 years at the time of the project) who were assessed for auditory processing disorder (APD) in childhood (between 7 and 16 years) experience persistence of listening and communication difficulties. Design: Participants completed a mixed methods questionnaire focusing on common areas of complaint in APD and two open-ended questions exploring participants’ past and present experiences with listening and communication difficulties. Study sample: Ninety-seven of the 722 potential participants returned completed questionnaires, of whom 66 had been diagnosed with APD (APD group) at the time of their auditory processing assessment and 31 had not met diagnostic criteria (NAPD group) at that time. Results: Substantial commonality was noted in the reported listening and communication difficulties between the APD and NAPD participants. Volunteered comments aggregated into four major content themes which included: listening and communication difficulties; participants’ sense of self; change; and participation. Members of the APD group reported greater communication difficulty than NAPD group members, irrespective of environmental listening conditions. Conclusions: Young adults with a prior referral for, and in some cases a diagnosis of, APD as children continue to experience auditory processing difficulties across a range of daily situations.

Behavioral assessment of auditory processing disorder in children with non-syndromic cleft lip and/or palate

ObjectivePeripheral hearing disorders have been frequently described in children with non-syndromic cleft lip and/or palate (NSCL/P). However, auditory processing problems are rarely considered for children with NSCL/P despite their poor academic performance in general compared to their craniofacially normal peers. This study aimed to compare auditory processing skills, using behavioral assessment techniques, in school age children with and without NSCL/P. MethodsOne hundred and forty one Mandarin-speaking children with NSCL/P aged from 6.00 to 15.67 years, and 60 age-matched, craniofacially normal children, were recruited. Standard hearing health tests were conducted to evaluate peripheral hearing. Behavioral auditory processing assessment included adaptive tests of temporal resolution (ATTR), and the Mandarin pediatric lexical tone and disyllabic-word picture identification test in noise (MAPPID-N). ResultsAge effects were found in children with cleft disorder but not in the control group for gap detection thresholds with ATTR narrow band noise in the across-channel stimuli condition, with a significant difference in test performance between the 6 to 8 year group and 12 to 15 year group of children with NSCL/P. For MAPPID-N, the bilateral cleft lip and palate subgroup showed significantly poorer SNR-50% scores than the control group in the condition where speech was spatially separated from noise. Also, the cleft palate participants showed a significantly smaller spatial separation advantage for speech recognition in noise compared to the control group children. ConclusionATTR gap detection test results indicated that maturation for temporal resolution abilities was not achieved in children with NSCL/P until approximately 8 years of age compared to approximately 6 years for craniofacially normal children. For speech recognition in noisy environments, poorer abilities to use timing and intensity cues were found in children with cleft palate and children with bilateral cleft lip and palate compared to craniofacially normal children. Consequently, it is worthwhile to consider the potential for auditory processing disorder in when assessing the auditory status of children with NSCL/P.

Biomarker Symptom Profiles for Schizophrenia and Schizoaffective Psychosis

Background: Neuroscience can assist clinical understanding and therapy by finding neurobiological markers for mental illness symptoms. Objectives: To quantify biomarkers for schizophrenia and schizoaffective disorder and relate these to discrete symptoms of psychosis. Methods: Within a case-control design with multiple exclusion criteria to exclude organic causes and confounding variables, 67 DSM IV-R diagnosed and 67 control participants from a defined hospital, clinic and community catchment area were investigated for candidate markers. Participants underwent protocol-based diagnostic-checking and symptom rating via Brief Psychiatric Rating Scale and Positive and Negative Syndrome Scale, functional-rating scales, biological sample-collection and sensory-processing assessment. Blood and urine samples were analysed for monoamine neurotransmitters, their metabolites, vitamin cofactors and intermediate-substances related to oxidative stress and metabolism of monoamines. Neurocognitive assessment of visual and auditory processing was conducted at both peripheral and central levels. Biomarkers were defined by Receiver Operating Curve (ROC) analysis. Spearman’s analysis explored correlations between discrete symptoms and the biomarkers. Results: Receiver Operating Curve (ROC) analysis identified twenty-one biomarkers: elevated urinary dopamine, noradrenaline, adrenaline and hydroxy pyrroline-2-one as a marker of oxidative stress. Other biomarkers were deficits in vitamins D, B6 and folate, elevation of serum B12 and free serum copper to zinc ratio, along with deficits in dichotic listening, distance vision, visual and auditory speed of processing, visual and auditory working memory and six middle ear acoustic reflex parameters. Discrete symptoms such as delusions, hostility, suicidality and auditory hallucinations were biomarker-defined and symptom biomarker correlations assumed an understandable pattern in terms of the catecholamines and their relationship to biochemistry, brain function and disconnectivity. Conclusions: In the absence of a full diagnosis, biomarker-symptom-signatures inform psychiatry about the structure of psychosis and provide an understandable pattern that points in the direction of a new neurobiological system of

Effects of Methylphenidate on Auditory Processing Assessment: A Case Study

Effects of Methylphenidate on Auditory Processing Assessment: A Case Study

Avaliação audiológica comportamental e eletrofisiológica no transtorno do espectro do autismo

Objetivo descrever os achados das avaliações audiológicas comportamentais e eletrofisiológicas de pacientes com diagnóstico de transtorno do espectro do autismo. Métodos estudo descritivo, de coorte contemporânea com corte transversal, composto por nove pacientes com diagnóstico de transtorno do espectro do autismo, submetidos a avaliação comportamental e eletrofisiológica da audição. Os resultados foram analisados por meio de estatística descritiva. Resultados todos os pacientes avaliados apresentaram limiares audiométricos dentro dos padrões de normalidade. Oito pacientes apresentaram curva timpanométrica do tipo A, e um do tipo C. Observou-se emissões otoacústicas por produto de distorção presentes em todos os pacientes avaliados. Os resultados do potencial evocado auditivo de tronco encefálico demonstraram integridade das vias auditiva. Conclusão a população estudada apresentou resultados compatíveis com a normalidade tanto na avaliação comportamental como na avaliação eletrofisiológica da audição. Pelo fato de não haver consenso, na literatura especializada, quanto aos achados audiológicos nesta população, principalmente no que se refere à avaliação eletrofisiológica do processamento auditivo, sugere-se a realização de novos estudos.

Association between language development and auditory processing disorders

IntroductionIt is crucial to understand the complex processing of acoustic stimuli along the auditory pathway; comprehension of this complex processing can facilitate our understanding of the processes that underlie normal and altered human communication. AimTo investigate the performance and lateralization effects on auditory processing assessment in children with specific language impairment (SLI), relating these findings to those obtained in children with auditory processing disorder (APD) and typical development (TD). Material and methodsProspective study. Seventy-five children, aged 6-12 years, were separated in three groups: 25 children with SLI, 25 children with APD, and 25 children with TD. All went through the following tests: speech-in-noise test, Dichotic Digit test and Pitch Pattern Sequencing test. ResultsThe effects of lateralization were observed only in the SLI group, with the left ear presenting much lower scores than those presented to the right ear. The inter-group analysis has shown that in all tests children from APD and SLI groups had significantly poorer performance compared to TD group. Moreover, SLI group presented worse results than APD group. ConclusionThis study has shown, in children with SLI, an inefficient processing of essential sound components and an effect of lateralization. These findings may indicate that neural processes (required for auditory processing) are different between auditory processing and speech disorders.

Manutenção das habilidades auditivas pós treinamento auditivo

Objetivo Verificar a eficácia do Treinamento Auditivo e a manutenção das habilidades auditivas treinadas após um, dois, ou três anos do seu término, com o intuito de comprovar a eficácia do treino em longo prazo. Métodos Dez crianças com alteração do processamento auditivo - graus variando entre leve a moderado, moderado e moderado a severo - passaram por um programa de treinamento auditivo de oito semanas e foram reavaliadas imediatamente após o treino (PÓS-1) e um, dois, ou três anos depois (PÓS-2). Resultados Foram observadas diferenças significativas no desempenho médio, entre a avaliação pré-treino e as avaliações PÓS-1 e PÓS-2, sem diferenças entre as duas últimas. Não foram observadas correlações entre o intervalo de tempo entre PÓS-1 e PÓS-2 e a diferença no desempenho dessas avaliações. Em PÓS-1, a maioria das avaliações apresentou-se dentro da normalidade, ou com alterações leves do PA, sendo que 60% dos indivíduos mantiveram tais resultados em PÓS-2. Conclusão Verificamos, neste estudo, que o Treinamento Auditivo é eficaz na intervenção dos Transtornos do Processamento Auditivo e que os benefícios obtidos após o treinamento se mantêm, mesmo após um, dois, ou três anos do seu término.

Severe auditory processing disorder secondary to viral meningoencephalitis

Objective: To describe auditory function in an individual with bilateral damage to the temporal and parietal cortex. Design: Case report. Study sample: A previously healthy 17-year old male is described who sustained extensive cortical injury following an episode of viral meningoencephalitis. He developed status epilepticus and required intubation and multiple anticonvulsants. Results: Serial brain MRIs showed bilateral temporoparietal signal changes reflecting extensive damage to language areas and the first transverse gyrus of Heschl on both sides. The patient was referred for assessment of auditory processing but was so severely impaired in speech processing that he was unable to complete any formal tests of his speech processing abilities. Audiological assessment utilizing objective measures of auditory function established the presence of normal peripheral auditory function and illustrates the importance of the use of objective measures of auditory function in patients with injuries to the auditory cortex. Conclusions: Use of objective measures of auditory function is essential in establishing the presence of normal peripheral auditory function in individuals with cortical damage who may not be able to cooperate sufficiently for assessment utilizing behavioral measures of auditory function.

Prevalence and Severity of Auditory Processing Deficits in Adjudicated Adolescents Screened with Dichotic Listening Tests: Implications for Diagnosis and Intervention

Children with auditory processing disorders have difficulties with reading, spelling, and language. Untreated disorders are likely to exacerbate academic underachievement and may contribute to negative behaviors including delinquency. Clinical referrals for auditory processing assessment are rare in the population of adjudicated adolescents for whom personal, family, and school conditions complicate diagnosis and intervention for disabilities. Screening methods were used in this study to identify adjudicated adolescents at risk for auditory processing disorder (APD) to establish prevalence and severity of several types of auditory processing weakness that are assessed with dichotic listening tests. Seventy-two percent of the 399 adjudicated adolescents screened with the Randomized Dichotic Digits Test produced abnormally low auditory processing scores with 17% producing equally poor performance in both ears (decoding), 25% producing poor performance in only one ear (amblyaudia), and 30% producing poor performance in both ears together with a large interaural asymmetry (amblyaudia plus). A majority of abnormal results fell into the borderline category of severity for both dominant ear performance and interaural asymmetry, but many adolescents produced abnormal scores indicative of mild to severe disabilities (16.4% in the decoding category and 25.9% in the amblyaudia category). Results from adjudicated adolescents were similar to scores obtained by children assessed clinically for APD. The generally poor performance and high prevalence of mildly to severely abnormal scores in this population indicate a significant need for follow-up screening, diagnosis, and intervention.

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.

Central auditory functions in elderly individuals

AbstractElderly individuals often have more difficulty in understanding speech than younger adults, particularly in noisy environments. Three models that attempt to explain this are as follows: (a) deterioration in peripheral hearing; (b) structural changes to the central auditory system; and (c) changes in normal cognitive processes. The aim of this study was to assess the central auditory functions in an elderly population and compare them with those of an adult population. Participants and methods The study group included 60 elderly individuals; they were older than 60 years of age and were divided into two subgroups: the first subgroup A included 24 elderly individuals with normal peripheral hearing and the second subgroup B included 36 elderly individuals with presbycusis with a mild degree of hearing loss. The control group included 30 individuals ranging in age from 18 to 30 years. Both the study and the control group were subjected to an otological examination, immittancemetry, pure tone audiometry, speech audiometry, and central auditory processing assessment using the following selected few behavioral central auditory tests: synthetic sentence identification test with ipsilateral competing message (SSI-ICM), dichotic digits test (DDT), auditory fusion test-revised (AFT-R), and pitch pattern sequences test (PPT). Results There were elevated hearing thresholds at mostly all frequencies with statistically significant differences on comparing both study subgroups A and B with the control group. On using SSI-ICM, in the competition ratio (−15 dB), there were statistically significantly low scores in subgroups A and B compared with the control group. Results of DDT showed statistically significantly low scores on comparing the results between the left ear and the right ear in both subgroups A and B. There was a statistically significant elevated gap threshold for tonal stimuli in the AFT-R test on comparing both subgroups A and B with the control group. The results of PPT showed that subgroup B obtained a statistically significantly lower score compared with the control group. There was a statistically significant negative correlation between age and the results of SSI-ICM in the competition ratio 0 dB when presented to the left ear, DDT, and PPT. There was a statistically significant positive correlation between age and the results of AFT-R when presented at 4000 Hz. Conclusion Age-related changes to auditory processing will occur in most adults 60 years of age and older that may or may not be concomitant with peripheral hearing loss. Aging decreases the capacity of digit recognition and also increases interaural asymmetries. Many older listeners show reduced temporal resolution even when potential influences of hearing loss are absent. Temporal ordering abilities decrease with age. Recommendation It is important to include central auditory tests in the audiologic assessment protocol of the elderly. The utilization of these tests in assessment of the elderly enables us to improve the quality of therapeutic-rehabilitative interventions.

Children With Phenylketonuria Treated Early

Individuals with phenylketonuria (PKU) can exhibit deficits in executive functions, intelligence, attention, visual-spatial processing abilities, and efficiency stemming presumably from deficient neurotransmitter synthesis, even when the disorder is diagnosed and treated early. Basic audiological and electrophysiological evaluations were used to examine the peripheral and central auditory pathways of children with early-treated PKU, who followed adequate versus inadequate diets. Results were compared with those of age-matched children without PKU. The control group included 35 children aged 5 to 16 years, and the experimental group included 25 children with classic PKU, all of whom were diagnosed and treated early. The experimental group comprised children of two subgroups, divided according to their dietary control, as follows: 8 children aged 6 to 13 years with adequate diets (group A); 17 children ages 6 to 15 years demonstrating inadequate diets (group B). All participants underwent auditory evaluations, including otoscopy, pure-tone and speech audiometry, immittance testing (tympanometry and assessment of contralateral stapedial reflex thresholds), and evaluations of auditory brainstem and middle latency responses. The demographic variables and audiological examination results were analyzed for all groups. Results among groups and subgroups were compared using analysis of variance with repeated measures to test statistical significance across factors and measures at the p = 0.05 level. Audiometric evaluation revealed results within normal limits for all groups, except for one child from the inadequate diet group, who showed a mild bilateral conductive hearing loss. Results of speech and immittance audiometry suggested the children in group B as having poorer average speech-discrimination scores and higher stapedial reflex thresholds at 4000 Hz. Auditory brainstem response results revealed longer average latencies for waves III and V and greater interaural differences for wave V in group B, although both groups A and B showed longer average latencies for the interpeak interval I-V, compared with the control group. Middle latency responses showed no significant differences in the latencies of the Na and Pa waves or the Na-Pa amplitude for the experimental group, but electrode or ear effects were present in 87.5% of group A and 58.8% of group B. Overall, differences observed tended to be small (by clinical diagnostic standards), yet suggest that children with PKU exhibit some effect of this disorder on the pontine auditory pathway, even when diagnosed/treated early and independent of the appropriateness of diet. It thus seems prudent to follow PKU children with auditory processing assessments to evaluate functional implications of these findings.

Relação entre potenciais evocados auditivos de média latência e distúrbio de processamento auditivo: estudo de casos

O Potencial Evocado Auditivo de Média Latência é um teste objetivo promissor na audiologia na pesquisa neuro-diagnóstica das disfunções do sistema auditivo. Tem como vantagens a precisão e objetividade na avaliação e por isso é útil em crianças. O presente estudo teve como objetivo analisar os potenciais evocados auditivos de média latência em dois pacientes com distúrbio de processamento auditivo e relacionar as medidas objetivas e comportamentais. Para tanto foi realizado estudo de caso de dois pacientes (P1= feminino, 12 anos; P2= masculino, 17 anos), ambos com ausência de alterações sensoriais, distúrbios neurológicos, neuropsiquiátricos. Ambos foram submetidos à anamnese, inspeção do meato acústico externo, avaliação audiológica e avaliação do exame de potencial evocado auditivo de média latência. Houve associação significante entre os resultados dos exames comportamentais e objetivos. Na anamnese, houve queixas referentes à dificuldade de escuta em ambiente ruidoso, localização sonora, desatenção, além de trocas fonológicas na escrita e na fala. Foram observadas alterações no processo de decodificação auditiva à direita em ambos os casos na avaliação comportamental do processamento auditivo e no exame de potencial evocado auditivo de média latência a resposta da via contralateral direita foi deficitária, confirmando as dificuldades dos pacientes estudados na atribuição de significado às informações acústicas em condição de competição sonora à direita nos dois casos. Para os casos estudados comprovou-se à associação entre os resultados, porém há necessidade de novos estudos com maior amostra para confirmação dos dados.

Case Study of Central Auditory Processing in Patients with Stroke

This study aimed to investigate central auditory processing dysfunction in patients with stroke. Three patients who had suffered strokes with confirmed auditory pathway involvement, participated. All subjects had normal hearing bilaterally, and were right-handed. All subjects completed K-MMSE (Korean version of Mini-Mental State Exam) and K-WAB (Korean version-the Western Aphasia Battery), and performed Korean Central Auditory Processing Assessment (CAPA-K) battery, including Frequency Pattern test, Dichotic Digit test, Filtered Word test, Compressed Speech test, Speech in Noise test, and Binaural Fusion test. The scores for the each test were evaluated by comparing the normative data in young adult population for the standardization of CAPA-K battery. The results of the study revealed that all three subjects had difficulties in central auditory processing. S1 (male, 17 years, Rt. middle cerebral artery infarction including Rt. insula and basal ganglia) showed poor performance in contralateral ear to the lesion in all speech recognition tests. Contralateral ear suppression was also seen in dichotic testing. Furthermore, frequency pattern recognition was poorer in the linguistic labeling condition than in the humming condition in both ears. S2 (female, 46 years, both pontine infarction including lateral lemniscus and superior olivary complex) demonstrated difficulties through the entire tests whereas S3 (male, 51 years, Lt. pontine infarction including lateral lemniscus) showed normal performance in speech recognition test and monaural-low redundancy speech tests in both ears. Regardless of side of lesion, temporal processing difficulties in both ears were found in patients associated with pontine infarction. In these cases, auditory dysfunction resulting from stroke varied with the location and extent of auditory pathway infarction. Therefore, more cases are needed to identify the central auditory dysfunction in patients with stroke.

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.

Efficacy of Auditory Training Using the Auditory Brainstem Response to Complex Sounds: Auditory Processing Disorder and Specific Language Impairment

Objectives: This study verified the efficacy of a formal auditory training (AT) program in children with hearing and language disorders using the auditory brainstem response to complex sounds (c-ABR) with and without background noise. Patients and Methods: Thirty children (7–13 years) were distributed into four groups: typical development (TD: n = 7), auditory processing disorder (APD: n = 9) and specific language disorder (SLIa: n = 6, and SLIb: n = 8). All children underwent behavioral assessment of auditory processing and c-ABR with and without background noise. The APD and SLIa groups underwent 8 weeks of formal AT, but all children were reevaluated 12 weeks after the initial assessment. Results: The TD group presented better behavioral performance than the other groups. For c-ABR in silence, no significant differences were observed among groups or assessments, except regarding VA complex measures, which were altered in the APD group. For c-ABR with background noise, however, the APD, SLIa and SLIb groups presented delayed latencies. Groups that underwent formal AT improved behavioral performance and decreased latencies to c-ABR in background noise at final assessment. Conclusions: These data suggest that efficacy of formal AT can be demonstrated by c-ABR with background noise.

Binaural speech processing in individuals with auditory neuropathy

Auditory neuropathy disrupts the neural representation of sound and may therefore impair processes contingent upon inter-aural integration. The aims of this study were to investigate binaural auditory processing in individuals with axonal (Friedreich ataxia) and demyelinating (Charcot–Marie–Tooth disease type 1A) auditory neuropathy and to evaluate the relationship between the degree of auditory deficit and overall clinical severity in patients with neuropathic disorders.Twenty-three subjects with genetically confirmed Friedreich ataxia and 12 subjects with Charcot–Marie–Tooth disease type 1A underwent psychophysical evaluation of basic auditory processing (intensity discrimination/temporal resolution) and binaural speech perception assessment using the Listening in Spatialized Noise test. Age, gender and hearing-level-matched controls were also tested.Speech perception in noise for individuals with auditory neuropathy was abnormal for each listening condition, but was particularly affected in circumstances where binaural processing might have improved perception through spatial segregation. Ability to use spatial cues was correlated with temporal resolution suggesting that the binaural-processing deficit was the result of disordered representation of timing cues in the left and right auditory nerves. Spatial processing was also related to overall disease severity (as measured by the Friedreich Ataxia Rating Scale and Charcot–Marie–Tooth Neuropathy Score) suggesting that the degree of neural dysfunction in the auditory system accurately reflects generalized neuropathic changes.Measures of binaural speech processing show promise for application in the neurology clinic. In individuals with auditory neuropathy due to both axonal and demyelinating mechanisms the assessment provides a measure of functional hearing ability, a biomarker capable of tracking the natural history of progressive disease and a potential means of evaluating the effectiveness of interventions.