Central Auditory Processing Research Articles

Asymmetry in Cortical Thickness of the Heschl's Gyrus in Unilateral Ear Canal Atresia.

Unilateral congenital conductive hearing impairment in ear canal atresia leads to atrophy of the gray matter of the contralateral primary auditory cortex or changes in asymmetry pattern if left untreated in childhood. Unilateral ear canal atresia with associated severe conductive hearing loss results in deteriorated sound localization and difficulties in understanding of speech in a noisy environment. Cortical atrophy in the Heschl's gyrus has been reported in acquired sensorineural hearing loss but has not been studied in unilateral conductive hearing loss. We obtained T1w and T2w FLAIR MRI data from 17 subjects with unilateral congenital ear canal atresia and 17 matched controls. Gray matter volume and thickness were measured in the Heschl's gyrus using Freesurfer. In unilateral congenital ear canal atresia, Heschl's gyrus exhibited cortical thickness asymmetry (right thicker than left, corrected p = 0.0012, mean difference 0.25 mm), while controls had symmetric findings. Gray matter volume and total thickness did not differ from controls with normal hearing. We observed cortical thickness asymmetry in congenital unilateral ear canal atresia but no evidence of contralateral cortex atrophy. Further research is needed to understand the implications of this asymmetry on central auditory processing deficits.

Assessment of Central Auditory Processing in Children Using a Novel Tablet-Based Platform: Application for Low- and Middle-Income Countries.

Evaluate whether a portable, tablet-based central auditory processing (CAP) test system using native language training videos and administered by minimally trained community health workers can produce CAP results comparable to previously published norms. Our secondary aim was to determine subject parameters that influence test results. Cross-sectional study. Community-based settings in Chontales, Nicaragua, New Hampshire, and Florida. English- and/or Spanish-speaking children and adolescents (n = 245; average age, 12.20 yr; range, 6-18 yr). Completion of the following tests with responses comparable to published norms: Pure-tone average (PTA), gap detection threshold (GDT), fixed-level frequency threshold, masking level difference (MLD), Hearing in Noise Test (HINT), Dichotic Digits Test (DDT), and Frequency Pattern Recognition (FPR) test. GDT, HINT, and DDT had comparable results to previously published normative values. MLD and FPR results differed compared with previously published normative values. Most CAP tests (MLD, GDT, HINT) results were independent of age and PTA (p = 0.1-0.9). However, DDT was associated with age and PTA (p < 0.0001). Pediatric CAP testing can be successfully completed in remote low- and middle- income country environments using a tablet-based platform without the presence of an audiologist. Performance on DDT improved with age but deteriorated with hearing loss. Further investigation is warranted to assess the variability of FPR.

Центральные слуховые расстройства: причины, симптомы и способы преодоления дефицита в условиях учебного процесса

&lt;p style="text-align: justify;"&gt;Central Auditory Processing Disorders (CAPD) are impairments in the ability to recognize sounds, localize their sources, and/or determine their identity and meaning due to functional impairments of the central auditory system. CAPD is observed in individuals with normal hearing levels and is not the result of high-level speech or cognitive impairment. This disorder is not well known to Russian specialists in the field of correctional psychology, while according to foreign sources it is observed in 2&amp;mdash;7% of schoolchildren and is often combined with other developmental disorders (dyslexia, speech developmental disorders, ASD, ADHD). Here we provide a brief review of CAPD: its causes, symptoms, and approaches to diagnosis. In particular, we draw the readers' attention to the insufficient development of tools and practices for diagnosing and treating CAPD in Russia. Next, we review current approaches to the correction of CAPD, with special emphasis on assistive technologies that improve the signal-to-noise ratio (FM systems). Evidence in the literature indicates that in addition to the immediate effect (improved speech understanding), prolonged use of FM systems has a positive long-term effect based on mechanisms of neural plasticity.&lt;/p&gt;

Effects of Age on the Auditory Cortex During Speech Perception in Noise: Evidence From Functional Near-Infrared Spectroscopy.

Age-related speech perception difficulties may be related to a decline in central auditory processing abilities, particularly in noisy or challenging environments. However, how the activation patterns related to speech stimulation in different noise situations change with normal aging has yet to be elucidated. In this study, we aimed to investigate the effects of noisy environments and aging on patterns of auditory cortical activation. We analyzed the functional near-infrared spectroscopy signals of 20 young adults, 21 middle-aged adults, and 21 elderly adults, and evaluated their cortical response patterns to speech stimuli under five different signal to noise ratios (SNRs). In addition, we analyzed the behavior score, activation intensity, oxyhemoglobin variability, and dominant hemisphere, to investigate the effects of aging and noisy environments on auditory cortical activation. Activation intensity and oxyhemoglobin variability both showed a decreasing trend with aging at an SNR of 0 dB; we also identified a strong correlation between activation intensity and age under this condition. However, we observed an inconsistent activation pattern when the SNR was 5 dB. Furthermore, our analysis revealed that the left hemisphere may be more susceptible to aging than the right hemisphere. Activation in the right hemisphere was more evident in older adults than in the left hemisphere; in contrast, younger adults showed leftward lateralization. Our analysis showed that with aging, auditory cortical regions gradually become inflexible in noisy environments. Furthermore, changes in cortical activation patterns with aging may be related to SNR conditions, and that understandable speech with a low SNR ratio but still understandable may induce the highest level of activation. We also found that the left hemisphere was more affected by aging than the right hemisphere in speech perception tasks; the left-sided dominance observed in younger individuals gradually shifted to the right hemisphere with aging.

Incidence of Otolaryngological Manifestations in Individuals with Autism Spectrum Disorder: A Special Focus on Auditory Disorders.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by stereotyped and repetitive behavior patterns. In addition to neurological and behavioral problems, individuals with ASD commonly experience otolaryngological comorbidities. Individuals with ASD often have auditory disorders including hearing loss and auditory processing disorders such as central auditory processing disorder (CAPD), as well as both chronic and recurrent otitis media. These challenges negatively impact a person's ability to effectively communicate and may further impact their neurological functioning, particularly when not appropriately treated. Individuals diagnosed with ASD also have difficulty sleeping which contributes to increased irritability and may further aggravate the core behavioral symptoms of autism. The individuals with ASD also have a higher rate of sinusitis which contributes to the worsening of the autism behavior phenotype. The high prevalence of otolaryngological comorbidities in individuals with ASD warrants a better collaboration between their various healthcare providers and otolaryngologists with expertise in auditory, sleep, and sinus disorders in pursuit of improving the quality of life of affected individuals and their families/caregivers.

Exploring the relation between the central auditory processing functions and language development among Arabic-speaking children with attention deficit hyperactivity disorder

Abstract Background Debate still exists on the effect of central auditory processing disorder (CAPD) on the language of children with attention deficit hyperactive disorder (ADHD). This study aimed to explore the deficits of the central auditory processing (CAP) functions and their relation to language development and ADHD symptoms in 30 Egyptian Arabic-speaking children with ADHD between 4 and ≤ 7 years old. ADHD symptoms were rated by Conners’ Parent Rating Scale–Revised. Language development was assessed by the Modified Pre-school Language Scale (PLS) 4th edition, the Arabic version, and the Egyptian Arabic Pragmatic Language Test. CAP functions were tested by the Pediatric Speech Intelligibility (PSI) test (Arabic version). Results Sixty percent of the ADHD children had comorbid CAPD with predominance among ADHD children of combined type. There was a significant positive correlation between all PSI subtests assessing the monotonic auditory closure and dichotic auditory separation abilities in both ears and the language ages by the modified PLS-4. There was also a significant positive correlation between scores of the Egyptian Arabic Pragmatic Language Test (EAPLT) and the monotonic auditory closure ability in both ears and auditory separation ability in the right ear only.There was a non-significant mild difference in scores of the modified PLS-4 in favor of the ADHD children with normal CAP functions. Conclusion Not all children with ADHD have central auditory processing disorder as both ADHD and CAPD are independent disorders. Better central auditory processing functions are associated with well-developed language and higher pragmatic skills in ADHD children.

Processamento auditivo central e afasia: uma revisão de escopo

ABSTRACT Purpose: to report scientific evidence on the impact of aphasia on central auditory processing and map the contribution of auditory training to aphasic individuals. Methods: a scoping review approaching national and international databases (SciELO, LILACS, PubMed, Scopus, and Cochrane Library) and the gray literature (Google Scholar and Open Grey). The inclusion criteria covered articles that addressed the interface between central auditory processing and aphasia, excluding duplicates, literature reviews, and scientific abstracts. Literature Review: the review comprised 13 articles that met the eligibility criteria for this study. Seven of the selected articles assessed central auditory processing, four used electrophysiological examinations (such as auditory brainstem response and long-latency auditory evoked potentials) to assess the auditory pathway, and only one analyzed the intervention in aphasic individuals with auditory training. Conclusion: scientific evidence points to an important change in aphasic people’s central auditory processing, with impaired figure-ground, auditory closure, temporal resolution and ordering, and binaural integration. Moreover, it is relevant to assess auditory processing, given the contribution of auditory training in speech-language-hearing therapy for a better prognosis in the rehabilitation of aphasia.

Central auditory processing and phonological processing in Brazilian Portuguese-English bilingual subjects

RESUMO Objetivo: comparar as habilidades do processamento auditivo temporal (ordenação temporal) e do processamento fonológico em sujeitos bilíngues e monolíngues. Métodos: participaram 100 estudantes universitários (graduação e pós-graduação) divididos em Grupo Bilíngue (GB n=50) e Grupo Monolíngue (GM n=50). As habilidades do Processamento Fonológico (consciência fonológica, memória de trabalho - alça fonológica e acesso rápido ao léxico) e habilidades temporais do Processamento Auditivo (testes de Padrão de Frequência e Padrão de Duração) dos dois grupos, foram avaliadas. Foi utilizado, para análise estatística, o teste de Mann-Whitney (p=0,05). Resultados: observou-se melhor desempenho do GB em tarefas de consciência fonológica e memória de trabalho fonológica - repetição de não-palavras, em tarefas de nomeação rápida, exceto para nomeação de cores, e melhor desempenho nos dois testes de processamento auditivo, comparado com o desempenho do GM. Conclusão: indivíduos bilíngues apresentam melhor desempenho em testes fonológicos e auditivos. Essas habilidades favorecem a identificação e discriminação de variações na fonologia de ambos os idiomas, influenciando seu desempenho.

Central auditory processing and aphasia: A scoping review

RESUMO Objetivo: reportar as evidências científicas do impacto da afasia no Processamento Auditivo Central e mapear a contribuição do Treinamento Auditivo para a população afásica. Métodos: trata-se de uma revisão de escopo realizada nas bases de dados nacionais e internacionais: Scielo, Lilacs, Pubmed, Scopus, Cochrane Library e com uma busca adicional à literatura cinzenta no Google Scholar e Open Grey. Os critérios de inclusão abrangeram artigos que abordassem a interface do processamento auditivo central e afasia, excluindo-se as duplicações, artigos de revisão da literatura e resumos científicos. Revisão de Literatura: selecionaram-se 13 artigos que cumpriram os critérios de elegibilidade deste estudo. Dos artigos selecionados, sete apresentaram a avaliação do Processamento Auditivo Central, quatro apresentaram os exames eletrofisiológicos - como os exames de Potencial Evocado Auditivo de Tronco Encefálico (PEATE) e Potencial Evocado Auditivo de Longa Latência (PEALL) - para avaliação da via auditiva e apenas um estudo analisou a intervenção dos indivíduos afásicos por meio do treinamento auditivo. Conclusão: as evidências científicas apontam importante alteração no Processamento Auditivo Central dos afásicos, apresentando prejuízos nas habilidades auditivas de figura-fundo, fechamento auditivo, resolução e ordenação temporal e integração binaural. Ainda, demonstra-se como relevante a avaliação do processamento, devido à contribuição do Treinamento Auditivo nas terapias fonoaudiológicas para um melhor prognóstico na reabilitação das afasias.

Central auditory processing and self-perception questionnaire after acoustically controlled auditory training in individuals with mild traumatic brain injury

Central auditory processing and self-perception questionnaire after acoustically controlled auditory training in individuals with mild traumatic brain injury

Central auditory processing and self-perception questionnaire after acoustically controlled auditory training in individuals with mild traumatic brain injury.

To correlate behavioral assessment results of central auditory processing and the self-perception questionnaire after acoustically controlled auditory training. The study assessed 10 individuals with a mean age of 44.5 years who had suffered mild traumatic brain injury. They underwent behavioral assessment of central auditory processing and answered the Formal Auditory Training self-perception questionnaire after the therapeutic intervention - whose questions address auditory perception, understanding orders, request to repeat statements, occurrence of misunderstandings, attention span, auditory performance in noisy environments, telephone communication, and self-esteem. Patients were asked to indicate the frequency with which the listed behaviors occurred. Figure-ground, sequential memory for sounds, and temporal processing correlated with improvement in following instructions, fewer requests to repeat statements, increased attention span, improved communication, and understanding on the phone and when watching TV. Auditory closure, figure-ground, and temporal processing had improved in the assessment after the acoustically controlled auditory training, and there were fewer auditory behavior complaints.

Evidências de validade e fidedignidade do Teste de Fala Comprimida com Figuras

ABSTRACT Purpose To seek evidence of validity and reliability for the Compressed Speech Test with Figures. Methods The study was subdivided into three stages: construct validation, criteria and reliability. All participants were aged between 6:00 and 8:11. For the construct, Compressed Speech with Figures and the gold standard Adapted Compressed Speech test were applied to children with typical phonological development. For criterion analysis, Compressed Speech with Figures was applied in two groups, with typical (G1) and atypical (G2) phonological development. Finally, the application protocols underwent analysis by two Speech Therapists, with experience in the area of Central Auditory Processing, seeking to obtain an inter-evaluator reliability analysis. Results The correlation test indicated an almost perfect construct (correlation 0.843 for the right ear and 0.823 for the left ear). In the criterion analysis, it was noticed that both groups presented satisfactory results (G1 = 99.6 to 100%; G2 = 96 to 96.5%). The reliability analysis demonstrated that the protocol is easy to analyze, as both professionals presented unanimous responses. Conclusion It was possible to obtain evidence of validity and reliability for the Compressed Speech with Figures instrument. The construct analysis showed that the instrument measures the same variable as the gold standard test, with an almost perfect correlation. In the criterion analysis, both groups presented similar performance, demonstrating that the instrument does not seem to differentiate populations with and without mild phonological disorder. The inter-evaluator reliability analysis demonstrated that the protocol is easy to analyze and score.

The Prevalence of Central Auditory Processing Disorder in Elementary School Students of Kerman, Iran.

This study aimed to determine the prevalence of central auditory processing disorder (CAPD) in elementary school students in Kerman, Iran, during 2018-2019. This cross-sectional study was conducted on 1369 elementary school students in Kerman. These students were selected by cluster sampling from different areas of Kerman and then screened using the Buffalo Model Questionnaire (BMQ). Based on the data obtained from the questionnaire, normal children were excluded from the study. Then, children with suspected central auditory processing disorder (CAPD) underwent ear exams and were excluded from the study in case of abnormal results in the tympanic membrane examination (rapture-effusion). The remaining subjects underwent peripheral audiometry evaluation, and children with abnormal audiometry were excluded from the study. Finally, the remaining children with suspicious screening results, a normal examination, and normal audiometry underwent a specific test to detect Central auditory processing disorder. Data analysis was carried out using SPSS software. One thousand three hundred sixty-nine primary school students with a mean age of 9.15 ±2.63 years enrolled in this study. 52%% of students were male. 8.03% of them had CAPD. A statistically significant relationship was found between the prevalence of CAPD and gender (P<0.001), place of residence (P<0.001), history of middle ear inflammation (P<0.001) and history of head injury. The quality of life of these students with CAPD can be improved via timely recognition of CAPD and the provision of appropriate preventive and therapeutic facilities.

Auditory and academic skills self-perception in adults.

To describe and analyze auditory and academic complaints of students and employees of a federal public university. The study was carried out using a non-probabilistic. The EAPAC Scale with adaptations was used to fulfill the research objectives. It has 14 questions about complaints related to listening skills and 12 questions related to the academic environment. Descriptive data analysis was performed through the frequency distribution of categorical variables and Pearson's chi-square test was used for association analyses. 646 individuals aged between 17 and 67 years old participated in the research. The most prevalent complaints were academic difficulty related to memory, concentration, and planning, hearing and understanding speech in noise, and memorization of tasks that were only heard. There was an association with bidirectional statistical significance between academic and auditory complaints. It was possible to observe that there is an association between auditory and academic complaints in adults, marked by the relationship between cognitive and auditory aspects. It is relevant that these factors are considered when performing assessments of Central Auditory Processing when intervening in patients with auditory complaints, and in student life.

Evidence of validity and reliability of the Compressed Speech Test with Figures.

To seek evidence of validity and reliability for the Compressed Speech Test with Figures. The study was subdivided into three stages: construct validation, criteria and reliability. All participants were aged between 6:00 and 8:11. For the construct, Compressed Speech with Figures and the gold standard Adapted Compressed Speech test were applied to children with typical phonological development. For criterion analysis, Compressed Speech with Figures was applied in two groups, with typical (G1) and atypical (G2) phonological development. Finally, the application protocols underwent analysis by two Speech Therapists, with experience in the area of Central Auditory Processing, seeking to obtain an inter-evaluator reliability analysis. The correlation test indicated an almost perfect construct (correlation 0.843 for the right ear and 0.823 for the left ear). In the criterion analysis, it was noticed that both groups presented satisfactory results (G1 = 99.6 to 100%; G2 = 96 to 96.5%). The reliability analysis demonstrated that the protocol is easy to analyze, as both professionals presented unanimous responses. It was possible to obtain evidence of validity and reliability for the Compressed Speech with Figures instrument. The construct analysis showed that the instrument measures the same variable as the gold standard test, with an almost perfect correlation. In the criterion analysis, both groups presented similar performance, demonstrating that the instrument does not seem to differentiate populations with and without mild phonological disorder. The inter-evaluator reliability analysis demonstrated that the protocol is easy to analyze and score.

Comparative Study of the Effect of Experience on Auditory Processing Abilities in Voice Therapists and Other Speech-Language Pathologist in Auditory Perceptual Judgment of Voice

This study aimed to compare the effect of experience on central auditory processing skills in voice therapists and other Speech-Language Pathologists in the auditory perceptual evaluation of voice. This research is a descriptive-analytical cross-sectional observational study. Our study population includes three groups; first-year speech-language pathology students who have not undergone any training or education in the evaluation of auditory samples (group 1; n=10), Speech-Language Pathologists who do not have any activity in the field of voice disorders (group 2; n=10), and therapists who have at least 2years of experience in auditory-perceptual judgment (group 3; n=10). Initially, the participants underwent a basic audiological evaluation (Pure Tone Audiometry, Speech Recognition Threshold, Speech Discrimination Score, tympanometry, and acoustic reflex) to assess peripheral hearing. In the next step, the auditory processing skills of the participants were evaluated with the Buffalo model (staggered spondaic word (SSW) test, phonemic synthesis test (PST), speech in noise (SPN) test). In the third step, four recorded voice samples of patients with voice disorders and healthy individuals were randomly selected for auditory perceptual judgment. These samples were the same for all participants. All the voices were previously subjected to auditory perceptual analysis by two Speech-Language Pathologist who had at least 6years of experience in the evaluation and treatment of voice disorders; the voices were played for participants to assess auditory perception using the grade, roughness, breathiness, asthenia, strain (GRBAS) scale. All subjects had normal hearing and auditory processing abilities but there were some differences among the groups in processing skills. A difference was found in the SSW-qualifier and SPN-R components between the three groups. The third group had significant differences with the other two groups in the evaluation of auditory perception in the components of R, B, and S (from the GRBAS scale) in voice number one, and the components of G, R, and A in voice number three. In voice number two, there was a correlation between the SSW order effect component and the G component, as well as between the PST component and the A component. In voice number three, there was a correlation between the SPN-L component and the G component, and between the SSW condition, SSW qualifier, and SSW All errors components with the S component. In voice number four, there was a correlation between the SSW-RC, SSW-LC, SSW condition, SSW competing, and SSW order effect components with the A component. Lastly, there was a correlation between the SSW order effect and SSW type A components with the R component in voice number three in group three. The results of the present study indicate that experience has an impact on auditory processing skills and the participants of the third group, who had more experience in the evaluation of voice disorders obtained better scores than the other two groups in the auditory processing skills. Additionally, the level of experience is related to the accuracy of auditory perceptual judgment of voice. The participants of the third group performed better than the other two groups, and the performance of the first and second groups was almost the same.

Cognitive Auditory Training: Comparative Impact of Telerehabilitation and In-person Training

Abstract Background: Cognitive auditory approach has been shown effective in assessment and intervention with children with Central Auditory Processing Disorders (CAPD). Objective: To compare the intervention methods: telerehabilitation for synchronous auditory training through an Online Cognitive Auditory Training Program, with the traditional rehabilitation method, called acoustically controlled auditory training, carried out in person in an acoustic booth. Methods: The sample included 23 children between the ages of 7 and 9, of both genders, living in the state of São Paulo, Brazil, who were divided into two groups: Group I - 13 children undergoing telerehabilitation and Group II - 10 children undergoing auditory training in an acoustic booth. The instruments used were: i) Pediatric Speech Intelligibility (PSI) test in the ipsilateral competitive messages (ICM condition); ii) Digit Dichotic (DD) in binaural integration and separation skills test in auditory separation and integration skills. Results: In this study the following results were: a) there were statistically significant differences in the performance of children who underwent telerehabilitation for CAPD, revealing the reliability of the method, b) there were statistically significant differences both in the effect of auditory training carried out through telerehabilitation and in the effect of auditory training carried out in person, proving that the effectiveness of the two methods is equivalent, c) there were statistically significant differences in the performance of school-age students with CAPD who used the Online Cognitive Auditory Training Program, showing that the cognitive auditory approach is effective in intervention with children with CAPD. Conclusion: There is efficacy in cognitive auditory training through the telerehabilitation intervention. Results shown that intervention through the Online Cognitive Auditory Training Program support student learning and communication skills. Keywords: Auditory Processing, Cognitive Auditory Training, Telerehabilitation, Central Auditory Processing Disorders (CAPD).

Specific features of psychosocial functioning of children with central auditory processing disorders in the educational environment

Central auditory processing disorders (CAPD) occur in 2–7% of the population of school-age children. They are among the most severe neurodevelopmental disorders that impede learning progress irrespective of the child’s intellectual abilities, whether average or above-average. In this paper, the author delineates the unique nature of issues related to CAPD and discusses the special educational and developmental needs of pupils affected by the condition. Difficulties in children’s psychosocial and educational functioning, which may result from central auditory processing disorders, are described. In the subsequent section of the study, the author emphasises the role of the school environment in supporting and facilitating effective implementation of the assumptions of the core curriculum during early education. Following that, the author outlines the specific methodology required for working with pupils with CAPD. Children with central auditory processing disorders present with significantly more mental health problems than normally developing children in the general population. Working with children with CAPD at school requires a multifaceted approach, which may include adjustments in teaching, therapy, and emotional support. What is particularly important in this context is a personalised approach that considers individual needs and facilitates the child’s attainment of educational success. Teachers, in collaboration with psychologists and other specialists employed at school, should adjust their teaching methods to address the challenges children may face in processing sounds.

OBSTRUCTIVE SLEEP APNEA RISK AND LONGITUDINAL TRAJECTORY OF FUNCTIONAL HEARING LOSS OVER EIGHT YEARS OF FOLLOW-UP

Abstract Hearing loss prevention is important for physical, cognitive and psychosocial health among older adults. Obstructive sleep apnea (OSA) might cause functional hearing loss through ischemic damages to the cochlea or central auditory processing, but there is a lack of longitudinal evidence. The National Health and Aging Trends Study (NHATS) is a longitudinal panel survey of Medicare beneficiaries aged 65+ years. STOP-Bang is a validated screening tool for OSA risk and a subsample of NHATS round 3 participants responded to a modified version (age&amp;gt;50, male, high blood pressure, body mass index &amp;gt;35 kg/m2, snore loudly, observed apnea, tiredness; range 0-7, elevated risk if ≥3). Functional hearing loss at follow-up (rounds 3-11) was defined as self-reported deafness, hearing aid use, or inability to hear well enough to use the telephone or have conversations in a room with the television or radio on. We used generalized estimating equations logistic regression with inverse probability attrition weighting, adjusting for demographics and comorbidities. Among 1,433 participants, elevated OSA (58%) was associated with higher odds of hearing loss at baseline (odds ratio:1.50, 95% confidence interval[CI]:1.08, 2.10). Both OSA groups had significant annual increases in odds of functional hearing loss (Low:1.07, 95% CI:1.01, 1.13; Elevated:1.12, 95% CI:1.07, 1.18) during the first 4 years. Afterwards, the low OSA risk group continued to have significant increase in odds of functional hearing loss but not the elevated OSA risk group. OSA might be a novel risk factor for hearing loss. Screening and treating OSA might be important for hearing loss prevention.

The Effects of a Home Personal Computer-based Auditory Training Program on the Binaural Listening Skills of Children With Specific Learning Disability: A Protocol for a Randomized Clinical Trial

Background and Objectives: A high prevalence of central auditory processing disorders has been reported in children with learning disabilities. One of the crucial auditory processing disorders in these children is a binaural processing problem. Binaural hearing leads to improved auditory performance in noisy situations. This research aims to develop an auditory training program based on binaural interaction at the brainstem level and to investigate its effect on the binaural listening skills of children with a specific learning disability. Methods: After developing the rehabilitation program and determining its validity, this intervention study is conducted in three stages. The first stage includes baseline assessments, the second stage includes the implementation of rehabilitation intervention and the third stage consists of the re-implementation of the tests of the first stage once immediately after intervention and then once after 45 days of training. Masking level differences (MLD), Persian auditory recognition of words in noise (PARWIN), and binaural speech-auditory brainstem response (Speech-ABR) tests are the primary outcome measures. Persian randomized dichotic digits test (PRDDT), Persian pediatric competing word test (PPCWT), Persian pediatric competing sentences test (PPCST), and Persian version of the auditory processing disorder questionnaire (APDQ-P) were included as secondary outcome measures. The sample size in each intervention and control group was 15 people and the duration of training was 3 months. Conclusion: Considering the importance of brainstem function in binaural hearing, it is recommended to investigate the effectiveness of the developed binaural interaction training program in improving hearing in background noise in children with specific learning disabilities.