Central Auditory Test Battery Research Articles

Effect of central auditory processing disorders on contralateral routing of offside signals (CROS) hearing aids performance

Objectives The aim of this study was to assess central auditory processing (CAP) tests in patients with single sided deafness (SSD)and to study the effect of central auditory processing disorders(CAPD) on the contralateral routing of signal (CROS) hearing aid performance in these subjects. Design This case-control study was performed in Audiovestibular unit, ENT Department. The study included 20 children with SSD and 20 healthy control children. All participants were subjected to CAP tests including pitch pattern sequence (PPS), gap in noise (GIN) and speech intelligibility in noise (SPIN) tests. The child was fitted with CROS and evaluated by SPIN test and bern benefit in single - sided deafness (BBSS) questionnaire. Results There were lower SPIN, PPS, and GIN total correct scores in children with SSD than the control group. The group with normal central test battery has higher SPIN score and significant performance with questionnaire when fitted with CROS. Conclusions Children with normal central auditory processing test battery performed better when fitted with CROS than those with abnormal test battery.

Auditory Processing Skills in Patients with Multiple Sclerosis

Background and Aim: Multiple sclerosis (MS) is neurological disease of the central nervous system. Central auditory nervous system can also be affected by MS. The present study aimed to evaluate monaural and binaural auditory processing in patients with MS. Methods: This cross-sectional study was conducted on 45 patients with MS and 45 normal peers as controls aged 25–45 years. They underwent a central auditory processing test battery including the Persian versions of Buffalo model questionnaire (BMQ), staggered spondee word (SSW) test, quick speech in noise test (QSIN), phonemic synthesis test (PST), and two- pair dichotic digit test (DDT). Results: The results of SSW test, QSIN test, PST, DDT and BMQ in the MS group were significantly different than in the control group (p≤0.001). The results showed the poor performance of patients compared to controls in some monaural and binaural auditory processing skills. Conclusion: Central auditory processing disorder is common among patients with MS. The BMQ is a suitable screening tool for identifying affected people. Dichotic listening skills, phonemic processing and speech perception in noise are impaired in MS patients which can have significant impacts on their quality of life. Keywords: Auditory processing; multiple sclerosis, central auditory nervous system; adults; speech perception

Masking Level Difference: Performance of School Children Aged 7–12 Years

Background and ObjectivesIn masking level difference (MLD), the masked detection threshold for a signal is determined as a function of the relative interaural differences between the signal and the masker. Study 1 analyzed the results of school-aged children with good school performance in the MLD test, and study 2 compared their results with those of a group of children with poor academic performance.Subjects and MethodsStudy 1 was conducted with 47 school-aged children with good academic performance (GI) and study 2 was carried out with 32 school-aged children with poor academic performance (GII). The inclusion criteria adopted for both studies were hearing thresholds within normal limits in basic audiological evaluation. Study 1 also considered normal performance in the central auditory processing test battery and absence of auditory complaints and/or of attention, language or speech issues. The MLD test was administered with a pure pulsatile tone of 500 Hz, in a binaural mode and intensity of 50 dBSL, using a CD player and audiometer.ResultsIn study 1, no significant correlation was observed, considering the influence of the variables age and sex in relation to the results obtained in homophase (SoNo), antiphase (SπNo) and MLD threshold conditions. The final mean MLD threshold was 13.66 dB. In study 2, the variables did not influence the test performance either. There was a significant difference between test results in SπNo conditions of the two groups, while no differences were found both in SoNo conditions and the final result of MLD.ConclusionsIn study 1, the cut-off criterion of school-aged children in the MLD test was 9.3 dB. The variables (sex and age) did not interfere with the MLD results. In study 2, school performance did not differ in the MLD results. GII group showed inferior results than GI group, only in SπNo condition.

Auditory and Cognitive Behavioral Performance Deficits and Symptom Reporting in Postconcussion Syndrome Following Mild Traumatic Brain Injury.

Purpose This study examined auditory deficits and symptom reporting in individuals with long-term postconcussion symptoms following a single mild traumatic brain injury (mTBI) compared to age- and gender-matched controls without a history of mTBI. Method Case history interviews, symptom questionnaires, and a battery of central auditory and neuropsychological tests were administered to 2 groups. The mTBI group was a civilian population recruited from a local concussion management program who were seeking rehabilitation for postconcussion-related problems in a postacute period between 3 and 18 months following injury. Symptom validity testing was included to assess the rate of possible insufficient test effort and its influence on scores for all outcome measures. Analyses of group differences in test scores were performed both with and without the participants who showed insufficient test effort. Rates of symptom reporting, correlations among symptoms and behavioral test outcomes, and the relationships between auditory and cognitive test performance were analyzed. Results The mTBI group reported a high rate of auditory symptoms and general postconcussion symptoms. Performance on neuropsychological tests of cognitive function showed some differences in raw scores between groups, but when effort was considered, there were no significant differences in the rate of abnormal performance between groups. In contrast, there were significant differences in both raw scores and the rate of abnormal performance between groups for some auditory tests when only considering participants with sufficient effort. Auditory symptoms were strongly correlated with other general postconcussion symptoms. Conclusions Significant auditory symptoms and evidence of long-term central auditory dysfunction were found in a subset of individuals who had chronic postconcussion symptoms after a single mTBI unrelated to blast trauma. The rate of abnormal performance on auditory behavioral tests exceeded the rate of abnormal performance on tests of cognitive function. Supplemental Material https://doi.org/10.23641/asha.8329955.

Bilingualism and Speech Understanding in Noise: Auditory and Linguistic Factors.

Bilingual speakers often have difficulty understanding speech in noisy and acoustically degraded conditions. The first aim was to examine the potential source(s) of the difficulties that English-proficient bilingual listeners experience when hearing English speech in noise. The second aim was to assess how bilingual listeners perform on a battery of central auditory processing tests. A mixed design was used in this study. Normal-hearing college students (n = 24) participated in this study. The bilingual participants (n = 12) self-reported that they learned a second language before age 9 and the monolingual participants reported that they only knew American English. All participants considered themselves to be native speakers of American English. Participants were administered the Revised Speech Perception in Noise (R-SPIN) test to assess whether bilingual listeners' speech understanding in noise reflects auditory factors, linguistic factors, or a combination of the two. To minimize the influence of short-term memory and motor movements, only the final word of a sentence is repeated for this test. Sentence-final words were presented in two linguistic contexts: in the high-predictability condition, the final word can be deduced from the context created by the preceding words, and in the low-predictability condition, it cannot. The R-SPIN test was administered at two signal-to-noise ratios (SNRs) (0 and 3 dB). In addition, the participants were given a reading comprehension test to measure their ability to use context when linguistic stimuli are delivered to the visual, not auditory, modality. The central auditory test battery consisted of three tests: Competing Sentences, Dichotic Digits, and NU-6 Time-Compressed Speech with Reverberation. All test materials were given in American English. The bilingual and monolingual groups performed similarly in the low-context condition of the R-SPIN test. However, in comparison to the age-matched monolingual group, the bilingual group did not derive the same level of benefit from contextual cues, as seen by a smaller improvement in performance between the low- and high-predictability R-SPIN conditions. The bilingual and monolingual groups showed a similar decrement in performance when the SNR dropped. In addition, bilingual individuals underperformed on the Competing Sentences test when instructed to attend to the left ear. However, the bilingual and monolingual groups performed equally well on the reading comprehension test, as well as on the Time-Compressed Speech with Reverberation and Dichotic Digits tests. We show that individuals who are exposed to two languages from an early age, and self-report as having a high level of proficiency in English, perform like their monolingual counterparts in acoustically degraded conditions where context is not facilitative, but they underperform in conditions where sentence-level linguistic context is facilitative to understanding. We conclude that deficits observed in noise are likely not due to a perceptual deficit or a lack of linguistic competence, but instead reflect a linguistic system that performs inefficiently in noise. In addition, we do not find evidence of an auditory processing weakness or advantage in our bilingual cohort; however, the use of speech materials to assess auditory processing is a confound.

Development of dichotic digit test in Tulu

Purpose of the study: Behavioral tests are widely used due to their ease of accessibility, simple instrumentation, less variability, feasibility for interpretation. These behavioral tests are useful clinical tools even for the evaluation of auditory processing skills. The use of these tests in regional languages like Tulu will make the subjects comfortable. Tulu is spoken Tulu is spoken as mother tongue by over 2 million people in India which demands the need of development of test in Tulu. Method: The study was done in two phases. In the phase one of study development of material was done which included two lists (List A and List B - each containing 20 digit pairs). In Phase two of study the recorded material was administered on normal population. 66 native Tulu speaking adults of age range of 18 to 55 yrs consented and participated in the study. These adults had no associated sensory motor deficits or history of middle ear effusion and audiological evaluation showing PTA≤ 15dBHL; SIS > 90%. Descriptive statistics was used to compile mean and standard deviation and Paired sample t test was used to check the statistical significance between ears. Results: The present study revealed, significant difference between right ear and left ear, indicating of greater right ear advantage in Tulu speakers. Conclusion: Language plays an important role in performance of behavioral tests used, even in central auditory test battery, which led to development of test in Tulu. The scores obtained from this test from this test can be utilized in demarcating the normal population from peripheral loss, CAPD, cortical / brainstem lesions and dyslexic groups, in Tulu speaking population.

Auditory Processing Abilities of Parkinson's Disease Patients.

Since Parkinson's Disease (PD) primarily affects older people, a majority of PD patients have age-related hearing loss (HL) that will worsen over time. The goal of this study was to assess peripheral and central auditory functions in a population of PD patients and compare the results with a group of age-matched control subjects. Study participants included 35 adults with PD (mean age = 66.9 ± 11.2 years) and a group of 35 healthy control subjects (mean age = 65.4 ± 12.3 years). Assessments included questionnaires, neuropsychological tests, audiometric testing, and a battery of central auditory processing tests. Both study groups exhibited patterns of sensorineural hearing loss (slightly worse in the PD group) which were typical for their age and would contribute to difficulties in communication for many participants. Compared to the control group, PD patients reported greater difficulty in hearing words people are speaking. Although 27 PD patients (77%) were good candidates for amplification, only 7 (26%) of these hearing aid candidates used the devices. Because it is important for PD patients to optimize communication with their family members, caregivers, friends, and clinicians, it is vital to identify and remediate auditory dysfunction in this population as early as possible.

Reading difficulty in children: auditory and visual modalities\u2019 affection

BackgroundMany research studies have explained that an auditory processing deficit might be the underlying cause for some forms of reading difficulties. However, deficits affecting other modalities, such as vision might be the other potential contributing factor.ObjectivesThis research investigated both central auditory processing abilities and the visual pathway in children having scholastic underachievement due to reading difficulties.Patients and methodThe study group consisted of 15 children (eight male and seven female) between the age of 5 and 15 years. They had scholastic underachievement due reading difficulties. All children were subjected to a standardized Arabic central auditory test battery for children. It included tests for selective auditory attention, dichotic listening, memory, and temporal processing abilities. Other tests that were administered included electrophysiologic measures, auditory event-related potentials (P300), and visual-evoked potential (P100), as well as the Illinois test of psycholinguistic abilities and screening test for risk for dyslexia to verify reading complains and to assess psycholinguistic abilities.ResultsCentral auditory test battery that was accompanied by abnormal auditory event-related potentials (P300) revealed abnormal pattern mainly affecting temporal processing and memory abilities. However, some children had additional dichotic listening or selective auditory attention deficit. Abnormal visual-evoked potential (P100) was detected in the majority of children. The Illinois test revealed visual pattern affection in those children.ConclusionChildren with reading difficulties had temporal processing disorder and memory deficit pattern. Furthermore, there was an association between visual affection and reading difficulty that supports multimodality affection in those children. Hence, the remediation program for these children should include both auditory and visual modalities.

Chapter 11 - Audiometry and other hearing tests

Hearing tests of the peripheral auditory system are well established and the pure-tone audiogram is generally regarded as the screening test of choice in adults. It allows the distinction to be made between conductive, i.e., outer- and middle-ear, and sensorineural, i.e., cochlear, hearing loss, and also to describe the configuration of the hearing thresholds in terms of severity and the frequency affected. Electrophysiologic testing with auditory potentials, e.g., the auditory brainstem response, can identify sites of lesion in the eighth nerve, brainstem, and more centrally. However, it is only in the last two decades that a battery of central auditory tests has been established that can probe the central pathways in more details, i.e., when the pure-tone audiogram may be normal, and yet the patient still has symptoms of hearing dysfunction.

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.

Random Gap Detection Test (RGDT) performance of individuals with central auditory processing disorders from 5 to 25 years of age

Objective The aim of the present study was to assess the auditory temporal resolution ability in individuals with central auditory processing disorders, to examine the maturation effect and to investigate the relationship between the performance on a temporal resolution test with the performance on other central auditory tests. Methods Participants were divided in two groups: 131 with Central Auditory Processing Disorder and 94 with normal auditory processing. They had pure-tone air-conduction thresholds no poorer than 15 dB HL bilaterally, normal admittance measures and presence of acoustic reflexes. Also, they were assessed with a central auditory test battery. Participants who failed at least one or more tests were included in the Central Auditory Processing Disorder group and those in the control group obtained normal performance on all tests. Following the auditory processing assessment, the Random Gap Detection Test was administered to the participants. A three-way ANOVA was performed. Correlation analyses were also done between the four Random Gap Detection Test subtests data as well as between Random Gap Detection Test data and the other auditory processing test results. Results There was a significant difference between the age-group performances in children with and without Central Auditory Processing Disorder. Also, 48% of children with Central Auditory Processing Disorder failed the Random Gap Detection Test and the percentage decreased as a function of age. The highest percentage (86%) was found in the 5–6 year-old children. Furthermore, results revealed a strong significant correlation between the four Random Gap Detection Test subtests. There was a modest correlation between the Random Gap Detection Test results and the dichotic listening tests. No significant correlation was observed between the Random Gap Detection Test data and the results of the other tests in the battery. Conclusion Random Gap Detection Test should not be administered to children younger than 7 years old because other reduced capacities might influence their performance. Also, Random Gap Detection Test assesses a specific auditory ability, different than the one evaluated with the other auditory tests. Finally, it is suggested to test individuals at only one frequency of the Random Gap Detection Test because results provide similar information than when assessing them on all subtests.

Effect of auditory training on the middle latency response in children with (central) auditory processing disorder

The purpose of this study was to determine the middle latency response (MLR) characteristics (latency and amplitude) in children with (central) auditory processing disorder [(C)APD], categorized as such by their performance on the central auditory test battery, and the effects of these characteristics after auditory training. Thirty children with (C)APD, 8 to 14 years of age, were tested using the MLR-evoked potential. This group was then enrolled in an 8-week auditory training program and then retested at the completion of the program. A control group of 22 children without (C)APD, composed of relatives and acquaintances of those involved in the research, underwent the same testing at equal time intervals, but were not enrolled in the auditory training program. Before auditory training, MLR results for the (C)APD group exhibited lower C3-A1 and C3-A2 wave amplitudes in comparison to the control group [C3-A1, 0.84 microV (mean), 0.39 (SD--standard deviation) for the (C)APD group and 1.18 microV (mean), 0.65 (SD) for the control group; C3-A2, 0.69 microV (mean), 0.31 (SD) for the (C)APD group and 1.00 microV (mean), 0.46 (SD) for the control group]. After training, the MLR C3-A1 [1.59 microV (mean), 0.82 (SD)] and C3-A2 [1.24 microV (mean), 0.73 (SD)] wave amplitudes of the (C)APD group significantly increased, so that there was no longer a significant difference in MLR amplitude between (C)APD and control groups. These findings suggest progress in the use of electrophysiological measurements for the diagnosis and treatment of (C)APD.

An Update on Professional Education and Clinical Practices in Central Auditory Processing

Results of an online questionnaire probing audiologists' professional education and clinical practices in central auditory processing and its disorders are reported. Respondents demonstrated scant knowledge of the efficiency of central auditory tests and procedures; however, they were rather consistent in reporting more frequent use of tests and procedures they rated as more efficient. Many of the tests and procedures (including electrophysiologic measures) reported as most frequently used are among those cited in the literature as having good sensitivity and specificity. Respondents recognized the audiologist's treatment responsibilities in the areas of environmental accommodations and assistive listening devices; however, less than half of the respondents judged auditory training to fall within the audiologist's purview. Comparison with a similar study published in 1998 revealed an increase in respondents' academic preparation in (C)APD, with little change in clinical preparation, and use of a more efficient central auditory test battery.

Auditory and verbal working memory deficits in a child with congenital aniridia due to a PAX6 mutation

PAX6 encodes a transcriptional regulator that is essential for brain morphogenesis. Heterozygous PAX6 mutation is associated with aniridia and abnormalities of the interhemispheric pathway in humans. We present the case of a 12 year old boy with a known mutation of the PAX6 gene. There were parental concerns regarding his hearing, but repeated pure-tone audiograms were normal. He had a battery of standard central auditory tests, which gave abnormal results in tests which required auditory interhemispheric transfer (dichotic digits and pattern tests). A speech and language assessment, which yielded age-appropriate scores for speech, receptive and expressive language, revealed impaired verbal working memory. These test results were interpreted as indicating impaired auditory sensory and higher order interhemispheric transfer, consistent with reported findings in adults with mutations in PAX6, and correlated with his parent-reported hearing difficulties. This is the first report of central auditory and verbal working memory deficits in a child with a PAX6 mutation. Further research is needed to assess how these deficits impact on academic performance particularly in childhood.

Auditory Processing Disorder in Children Diagnosed With Nonverbal Learning Disability

To determine whether children with a nonverbal learning disability (NVLD) have a higher incidence of auditory processing disorder (APD), especially in the tolerance-fading memory type of APD, and what associations could be found between performance on neuropsychological, intellectual, memory, and academic measures and APD. Eighteen children with NVLD ranging in age from 6 to 18 years received a central auditory processing test battery to determine incidence and subtype of APD. Psychological measures for assessment of NVLD included the Wechsler Scales, Wide Range Assessment of Memory and Learning, and Wechsler Individual Achievement Test. Neuropsychological measures included the Category Test, Trails A and B, the Tactual Performance Test, Grooved Pegs, and the Speech Sounds Perception Test. Neuropsychological test scores of the NVLD+APD and NVLD groups were compared using analysis of covariance procedures, with Verbal IQ and Performance IQ as covariates. Sixty-one percent of the children were diagnosed with APD, primarily in the tolerance-fading memory subtype. The group of children with APD and NVLD had significantly lower scores on Verbal IQ, Digit Span, Sentence Memory, Block Design, and Speech Sounds Perception than children without APD. An ancillary finding was that the incidence of attention deficit/hyperactivity disorder was significantly higher in children with NVLD (with and without APD) than in the general population. The results indicate that children with NVLD are at risk for APD and that there are several indicators on neuropsychological assessment suggestive of APD. Collaborative, interdisciplinary evaluation of children with learning disorders is needed in order to provide effective therapeutic interventions.

Development of a Central Auditory Test Battery for Adults: Desarrollo de una bateria de pruebas auditivas centrales para adultos

There is little standardized test material in Dutch to document central auditory processing disorders (CAPDs). Therefore, a new central auditory test battery was composed and standardized for use with adult populations and older children. The test battery comprised seven tests (words in noise, filtered speech, binaural fusion, sentences in noise, dichotic digits, frequency and duration patterns, backward masking) and a questionnaire. Descriptive statistics obtained from 28 Dutch adults with normal hearing are presented. Eleven of the subjects were retested. The test-retest results showed that the variability between subjects was not due to systematic effects. Except for the backward masking test, the results were comparable with data from other studies. As most test scores did not follow a normal distribution, cut-off scores are recommended to evaluate individual subjects. Experiments on subjects with suspected CAPDs are in progress to validate the test battery and to see whether the number of tests can b...

Application of a central auditory test battery in normal hearing adults with auditory problems

Objective. To study the validity of a recently developed test battery for normal hearing adults with central auditory processing problems. Materials and methods. The test battery comprised a questionnaire 1 and seven central auditory tests. 2 This test battery was administered in 10 normal hearing adults who visited our clinic because of speech perception problems. Results. The test scores of the subjects was compared with those of a reference group (n = 28). On average, test scores were significantly lower for the speech-in-noise test, filtered speech test and backward masking test. In addition, individual scores were examined, based on percentile scores. A significant relationship was found between the subjects complaints (as quantified by the questionnaire) and test scores. Conclusion. First results suggest that the test battery is valid.

Central Auditory Processing Disorders and Reduced Motivation: Three Case Studies

The central auditory test results for three normal-hearing children who were initially diagnosed as having a central auditory processing disorder and learning disability are presented. They were referred to the authors for second-opinion consultations. Central auditory processing retesting was performed by the authors under the condition of no reinforcement and then the condition of reinforcement with the child's favorite food, hobby, or toy. For all three cases, the central auditory test scores improved markedly bilaterally under the condition of reinforcement as compared with the condition of no reinforcement. We hypothesize that the improvement was related to increased motivation associated with the reinforcement and that these children represented false-positive results on the central auditory test battery. Large-sample studies are needed to investigate the effect of reinforcement on test performance in children with reduced central auditory test scores.

The relations between auditory problems and cognitive, linguistic, and intellectual measures in first grade children

The relations between hearing ability and several sensory, perceptual, and cognitive abilities were determined for all children entering first grade in the Benton County, Indiana school system for three consecutive years. This research was part of a multi-disciplinary, epidemiological, longitudinal study of the factors that influence the development of reading and language skills in the early grades. As a result of an auditory evaluation that included otoscopy, tympanometry, pure-tone screening, and speech audiometry, two groups of children with auditory problems were identified who also had lower scores on nonauditory measures. In the total sample of 459 children, 24 had hearing thresholds excess of 20 dB HL and 51 had either excessive ear wax or evidence of ear infection based on otoscopy. Scores for both groups on measures of reading, cognitive/intellectual abilities, and on the SCAN central auditory test battery were significantly lower than for children with normal auditory function. At entry into second grade, however, reading achievement for both groups was within normal limits. The association between these measures of auditory function and socio-economic status will be discussed. [Work supported by the Benton County School System and by a grant from Indiana University.]

Effectiveness of Central Auditory Processing Tests With Children.

The purpose of this investigation was to determine central auditory processing (CAP) individual test efficacy and test battery efficacy and to estimate the costs that are associated with the identification of a targeted sample. Ninety-one children with normal learning (NL) abilities and 147 children with a classroom learning disability (CLD) and presumed CAP disorders (CAPDs) ranging in age from 7 to 13 years were given a battery of seven CAP tests. The test battery consisted of: (1) Binaural Fusion Test (BFT), (2) Masking Level Difference (MLD) test, (3) Filtered Speech Test (FST), (4) Time Compressed Speech (TCS) test, (5) Dichotic Digits Test (DDT), (6) Staggered Spondaic Word (SSW) test, and (7) Pitch Pattern Test (PPT).We believe that this investigation is the first report regarding the assessment of the utility of CAP tests using clinical decision analysis (CDA). We determined that the BFT separated the two samples most effectively and that the FST was the next most effective. A test protocol with BFT and FST or BFT and MLD represented the best battery approach when hit rate, false positive rate, and cost factors were considered. However, if the intent is to be certain that a child with CLD has CAPD given a positive test result, then the BFT and MLD would be the test battery of choice.