Central Auditory Processing Deficits Research Articles

Central Auditory Processing Disorders In Concussed Athletes

A central auditory processing disorder (CAPD) is a specific auditory dysfunction in sensory encoding and speech perception without any problems in peripheral hearing. The majority of studies with brain injured patients investigated peripheral hearing problems. Recently, a single case study found that a mild traumatic brain injury caused deficits for certain aspects of central auditory processing, including dichotic hearing, duration pattern recognition, compressed speech and competing speech comprehension (Musiek, Baran & Shinn, 2004). PURPOSE: To assess the presence of a central auditory disorder in university level male athletes who suffered a concussion. METHODS: We assessed peripheral and central auditory processing in a group of sport related concussed athletes and in a group of teammates who never suffered from a concussion, sport related or otherwise. All athletes came from contact sports, soccer and football. Peripheral and central auditory processing were assessed using standard clinical tests. RESULTS: The two groups of athletes had normal and comparable results on the tests of peripheral auditory perception. In contrast, the brain injured athletes showed central auditory processing deficits on frequency perception, duration perception and competing speech comprehension. CONCLUSIONS: The results show that a sport related concussion can disrupts the neurological mechanisms implicated in central auditory processing and suggest that central auditory perception should be considered in the clinical assessment of concussed athletes.

Wie korrelieren BAKO 1–4- und H-LAD mit auditiven Verarbeitungsprozessen?

An increasing number of children seem to have a deficiency in Central Processing as a reason for reading and writing difficulties (RWD) and attention deficit disorder (ADD). There is often also a delay in phonological consciousness. A test would therefore be useful to distinguish children with RWD and ADD. This study involved 75 consecutive schoolchildren from the 1 (st) to 5 (th) classes (ages 6-11), and was carried out at the Department of Phoniatric-Paediatric Audiology at the University ENT Clinic Ulm. Various tests were undertaken: hearing tests for peripheral hearing, central auditory tests, tests of phonological competence and a questionnaire completed with the parents. Statistical calculations were used to verify correlations with clinical findings and the questionnaire. BAKO 1-4 and H-LAD test phonological awareness and the T-values showed a good correlation, as expected. These are therefore reliable tests. No gender specific differences could be found. The BAKO 1-4 test was better statistically and this confirms other groups' findings. The questionnaire is not ready to be used for diagnosis. It is not possible to distinguish different diagnoses (central auditory processing disorder, writing difficulties, delayed speech acquisition and delay in phonological consciousness) by means of auditory tests. This means that the capacity to distinguish phonemes is not directly correlated to central auditory functions. Equally, one can also say that not every child with such problems has deficits in central auditory processing which require therapy. They all require an interdisciplinary management tailored to their own needs and underlying causes.

Auditory and vestibular dysfunction associated with blast-related traumatic brain injury

The dramatic escalation of blast exposure in military deployments has created an unprecedented amount of traumatic brain injury (TBI) and associated auditory impairment. Auditory dysfunction has become the most prevalent individual service-connected disability, with compensation totaling more than 1 billion dollars annually. Impairment due to blast can include peripheral hearing loss, central auditory processing deficits, vestibular impairment, and tinnitus. These deficits are particularly challenging in the TBI population, as symptoms can be mistaken for posttraumatic stress disorder, mental-health issues, and cognitive deficits. In addition, comorbid factors such as attention, cognition, neuronal loss, noise toxicity, etc., can confound assessment, causing misdiagnosis. Furthermore, some auditory impairments, such as sensorineural hearing loss, will continue to progress with age, unlike many other injuries. In the TBI population, significant clinical challenges are the accurate differentiation of auditory and vestibular impairments from multiple, many times overlapping, symptoms and the development of multidisciplinary rehabilitation strategies to improve treatment outcomes and quality of life for these patients.

Abnormal frequency discrimination in children with SLI as indexed by mismatch negativity (MMN)

For several decades, the aetiology of specific language impairment (SLI) has been associated with a central auditory processing deficit disrupting the normal language development of affected children. One important aspect for language acquisition is the discrimination of different acoustic features, such as frequency information. Concerning SLI, studies to date that examined frequency discrimination abilities have been contradictory. We hypothesized that an auditory processing deficit in children with SLI depends on the frequency range and the difference between the tones used. Using a passive mismatch negativity (MMN)-design, 13 boys with SLI and 13 age- and IQ-matched controls (7–11 years) were tested with two sine tones of different frequency (700 Hz versus 750 Hz). Reversed hemispheric activity between groups indicated abnormal processing in SLI. In a second time window, MMN2 was absent for the children with SLI. It can therefore be assumed that a frequency discrimination deficit in children with SLI becomes particularly apparent for tones below 750 Hz and for a frequency difference of 50 Hz. This finding may have important implications for future research and integration of various research approaches.

Lassen sich auditive Verarbeitungs- und Wahrnehmungsstörungen (AVWS) bei Kindern mit Lese-Rechtschreib-Störungen nachweisen?

In this paper the dichotic tests and the CERA (Cortical Evoked Response Audiometry) of children with dyslexia had been examined, in order to find out if there are auditory processing and perception disorders. 33 children with dyslexia had been compared with 28 children without problems of writing and reading. The mean age of the children was 9 years. All of the children had been examined by the following audiometric measurements: tympanometry, pure-tone-audiometry, speech-audiometry, dichotic Tests by Uttenweiler and Feldmann and the Cortical Evoked Response Audiometry (CERA) rated according to Esser. The intelligence quotients were in the group of dyslexic children significantly lower. The Uttenweiler and Feldmann tests were in dyslexic children significantly lower in the control group as well. The late cortical responses ware normal or near normal in both groups. Dichotic speech tests indicate central auditory processing and perception deficits in dyslexia. These tests are confounded, however, by attention and memory deficits. The CERA rated according to Esser does not point out to these auditory disorders in dyslexia.

Central auditory processing deficits in patients with auditory hallucinations as shown by event-related potentials: preliminary results.

Central auditory processing deficits in patients with auditory hallucinations as shown by event-related potentials: preliminary results.

The 100‐ to 150‐ms window of auditory temporal processing and its consequences

Robert Efron (Percept. Psychophys. 14, 518–530 [1973]) demonstrated that the minimum duration of a percept is between 100 and 130 ms for auditory, vibrotactile, and visual stimuli, suggesting the presence of a most likely centrally located temporal integrator with a time window of about that length. Single‐unit studies in the cat auditory cortex also unveiled an integration time of 100‐150 ms (C. E. Schreiner and R. V. Urbas, Hear. Res. 21, 227–241 [1986]). This window corresponds to the lower limit of the longest among Ira Hirsh’s three‐tiered temporal processing ranges [in Sensation and Perception, edited by H. R. Moskovitz et al. (Riedel, Dordrecht, 1974), pp. 251–258]. The present study argues that a temporal window of this duration can account for a variety of auditory perceptual results requiring temporal processing, such as temporal order identification, segregation of dynamically changing streams, robust speech intelligibility, and backward masking. Results also show that this window routinely becomes longer with age, with the possibility that the increased length of the window may account for some well‐known central auditory processing deficits in aging. [Work supported by NIH, the VA Medical Research, and the 21st Century COE Progam, Kyushu University.]

Measurement of extensive auditory discrimination profiles using the mismatch negativity (MMN) of the auditory event-related potential (ERP)

Objective Mismatch negativity (MMN), a change-specific component of the auditory event-related potential (ERP), is sensitive to deficits in central auditory processing associated with many clinical conditions. The aim of this study was to obtain a comprehensive multi-dimensional profile of central auditory processing by extending the recently developed fast multi-feature MMN paradigm [Näätänen R, Pakarinen S, Rinne T, Takegata R. The mismatch negativity (MMN): towards the optimal paradigm. Clin Neurophysiol 2004;115:140–144]. Methods MMN responses to changes in sound duration, frequency, intensity, and perceived sound-source location at six different magnitudes of deviation were recorded from healthy young adults by using the multi-feature MMN paradigm. In addition, behavioural discrimination accuracy and speed were measured to examine the relationship between MMN and behavioural performance. Results All the 24 sound changes elicited significant MMNs. MMN amplitude increased and latency decreased with increasing magnitude of sound change. Furthermore, the MMN amplitude and latency predicted the subjects’ accuracy and speed in detecting these deviations. Conclusions This new paradigm provides an extensive auditory discrimination profile for several auditory attributes at different deviation magnitudes in a minimal recording time. Significance The auditory discrimination profiles can offer a comprehensive view of the development, plasticity, and deficits of central auditory processing.

Spoken Language Processing: A Convergent Approach to Conceptualizing (Central) Auditory Processing

Spoken Language Processing: A Convergent Approach to Conceptualizing (Central) Auditory Processing

Processing of speech in complex listening environments by individuals with obscure auditory dysfunction

Obscure auditory dysfunction (OAD) is a disorder for which patients report excessive amounts of difficulty understanding speech in the presence of background noise, despite no obvious evidence of hearing loss. It has been hypothesized that OAD may be the result of mild cochlear dysfunction, central auditory processing deficits, and/or psychological disorders. We evaluated 10 persons with self-reported problems understanding speech in noisy environments and 10 controls. Both groups had normal-hearing sensitivity and excellent word recognition in quiet. The following tests were administered to each participant: DPOAE and ABR assessment, central auditory processing screening, personality inventory, and tests involving speech recognition in complex environments. The speech recognition measures were a subset of tests reported in Hawley et al. [J. Acoust. Soc. Am. 115, 833–843 (2004)] and were designed to probe binaural processing ability, as well as spectral and temporal processing of speech in complex environments. The OAD participants had poorer overall speech recognition ability than did the controls in both single- (1.5 dB, p=0.017) and two-competitor environments (0.9 dB, p>0.05). However, the reported problems in these OAD participants are not attributable to poor binaural processing. [Funding provided by NIDCD.]

Temporal Processing Deficits in Hebrew Speaking Children With Reading Disabilities

The purpose of this study was to assess to what extent specific reading disabilities and poor phonologic processing in children who read Hebrew, a primarily consonant orthography, are related to central auditory temporal processing deficits (TPDs).Twenty-four Hebrew-speaking children (ages 10-13) with and without reading disabilities were asked to discriminate auditorily pairs of syllables (/ba/ vs. /pa/) that differ by voice onset time (VOT) only. Two paradigms were used, 1 with a short interstimulus interval (ISI) (50 ms) and 1 with a long ISI (500 ms). Event-related potentials (ERPs) were measured in response to the two syllables in an auditory oddball task. Results showed significantly lowered accuracy, longer reaction times, and prolonged P3 latency among the group with reading disabilities compared with the control group. No significant differences were found between the short ISI task and the long ISI task. However, significant correlations were found between the phonologic processing tasks and the short ISI task. These findings in the Hebrew language are consistent with findings from other languages and add support to the central TPD hypothesis of reading disabilities. The discussion highlights how investigating different orthographic systems can deepen our understanding of the role TPD plays in reading.

EEG coherence measures during auditory hallucinations in schizophrenia

We studied the change in EEG alpha-band average coherence between auditory hallucination (AH) and non-auditory hallucination (non-AH) states in seven auditory hallucinating schizophrenia patients. Four cortical regions were considered based on the existing dominant models for auditory hallucinations, the inner speech model and the central auditory processing deficit (CAPD) model. Coherences between electrodes located over Broca's area (BA 44/45) and Wernicke's area (BA 22/42) and between electrodes located over left–right temporal cortices were examined. There was no significant change observed in the coherence between Broca's and Wernicke's areas, but a significant increase was observed in coherence between the left and right superior temporal cortices during AHs compared with non-AHs, suggesting increased bilateral coherence between auditory cortical areas. Since coherence is a pairwise measure of functional correlation between regions, our findings suggest abnormally increased synchrony between the left and right auditory cortices during AHs in schizophrenia. Further, a significant increase in relative power was observed in the left, but not in the right auditory cortex during AHs. Thus our findings support the CAPD model and are consistent with that which postulate reduced prosodic processing during AHs.

Responses of Ventral Cochlear Nucleus Neurons to Contralateral Sound After Conductive Hearing Loss

Conductive hearing loss (CHL) is an attenuation of signals stimulating the cochlea, without damage to the auditory end organ. It can cause central auditory processing deficits that outlast the CHL itself. Measures of oxidative metabolism show a decrease in activity of nuclei receiving input originating at the affected ear but, surprisingly, an increase in the activity of second-order neurons of the opposite ear. In normal hearing animals, contralateral sound produces an inhibitory response to broadband noise in approximately one third of ventral cochlear nucleus (VCN) neurons. Excitatory responses also occur but are very rare. We looked for changes in the binaural properties of neurons in the VCN of guinea pigs at intervals immediately, 1 day, 1 wk, and 2 wk after the induction of a unilateral CHL by ossicular disruption. CHL was always induced in the ear ipsilateral to the VCN from which recordings were made. The main observations were as follows: 1) ipsilateral excitatory thresholds were raised by at least 40 dB; 2) contralateral inhibitory responses showed a small but statistically significant immediate decrease followed by an increase, returning to normal by 14 days; and 3) there was a large increase in the proportion of units with excitatory responses to contralateral BBN. The increase was immediate and lasting. The latencies of the excitatory responses were at least 6 ms, consistent with activation by a path involving several synapses and inconsistent with cross talk. The latencies and rate-level functions of contralateral excitation were similar to those seen occasionally in normal hearing animals, suggesting an upregulation of an existing pathway. In conclusion, contralateral excitatory inputs to the VCN exist, which are not normally effective, and can compensate rapidly for large changes in afferent input.

Interpreting Central Auditory Test Results: Implications for Management

No AccessPerspectives on Hearing and Hearing Disorders in ChildhoodArticle1 Oct 2002Interpreting Central Auditory Test Results: Implications for Management Jeanane M. Ferre Jeanane M. Ferre Private Practice, Oak Park, IL Google Scholar More articles by this author https://doi.org/10.1044/hhdc12.3.9 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationTrack Citations ShareFacebookTwitterLinked In References ASHA (1996). Central auditory processing: Current status of research and implications for clinical practice..American Journal of Audiology, 5 (2),41–54. Google Scholar Bellis, T. J. (1996). Assessment and management of central auditory processing disorders in the educational setting: From science to practice.: San Diego, CA: Singular Publishing Group. Google Scholar Bellis, T. J., & Ferre, J. M. (1999). Multidimensional approach to differential diagnosis of central auditory processing disorders in children..Journal of the American Academy of Audiology, 10 (6), 319–328. Google Scholar Cognitive (1997). Earobics—Auditory development and phonics program.: Evanston, IL: Cognitive Concepts. Google Scholar Cognitive Concepts (1998). Earobics— Step two auditory development and phonics program.: Evanston, IL: Cognitive Concepts. Google Scholar Ferre, J. M. (1997). Processing power: A guide to capd assessment and management.: San Antonio, TX: The Psychological Corporation. Google Scholar Ferre, J. M. (1998) The M3 model for treating CAPD..M. G. Masters, N. A.. Stecker, & J. Katz (Eds.), Central auditory processing disorders: Mostly management (pp. 103–115). Boston, MA: Allyn & Bacon. Google Scholar FerreJ. M. (2002a). Behavioral therapeutic approaches for central auditory problems..J. Katz (Ed.), Handbook of clinical audiology (5th ed., pp. 525–531). Philadelphia: Lippincott Williams & Wilkins. Google Scholar Ferre, J. M. (2002b, in press). Managing children’s central auditory processing deficits in the real world: what teachers and parents want to know..Seminars in Hearing. Google Scholar Ferre, J. M., & Wilber, L. A. (1986). Normal and learning disabled children’s central auditory processing skill: An experimental test battery..Ear and Hearing, 7 (5), 336–343. Google Scholar Jerger, J., & Musiek, F. (2000). Report on the consensus conference on the diagnosis of auditory processing disorders in school-age children..Journal of the American Academy of Audiology, 11 (9), 467–474. Google Scholar Jerger, S.,Martin, R. C., & Jerger, J. (1987). Specific auditory perceptual dysfunction in a learning disabled child..Ear and Hearing, 8 (2), 78–86. Google Scholar Katz, J. (1968). The SSW test: An interim report..Journal of Speech and Hearing Disorders, 33, 137–146. Google Scholar Keith, R. W. (2000). SCAN-C: Test for Auditory Processing Disorders in Children-Revised.: San Antonio, TX: The Psychological Corporation. Google Scholar Medwetsky, L. (2002). Central auditory processing testing: A battery approach..J. Katz (Ed.), Handbook of clinical audiology (5th ed., pp. 510-524). Philadelphia, PA: Lippincott, Williams & Wilkins. Google Scholar Musiek, F. E. (1983). Assessment of central auditory dysfunction: The dichotic digits test revisited..Ear and Hearing, 4 (2), 79–83. Google Scholar Pinheiro, M. L. (1977). Tests of central auditory function in children with learning disabilities..R. W. Keith (Ed.), Central auditory dysfunction (pp. 223–256). New York: Grune & Stratton. Google Scholar Scientific Learning Corporation. (1997). Fast ForWord training program for children. Procedure manual for professionals.: Berkeley, CA: Scientific Learning Corporation. Google Scholar Sloan, C. (1986). Treating auditory processing difficulties in children.: San Diego, CA: Singular Publishing Group. Google Scholar Tallal, P., & Piercy, M. (1974). Developmental aphasia: The perception of brief vowels and extended consonants..Neuropsychologia, 13, 69–74. Google Scholar Tillery, K. L.,Katz, J., & Keller, W. D. (2000) Effects of methylphenidate (Ritalin) on auditory performance in children with attention and auditory processing disorders..Journal of Speech Language Hearing Research, 43 (, 43 (4), 893–901. Google Scholar Willeford, J. (1977). Assessing central auditory behavior in children: A test battery approach..R. W. Keith (Ed.), Central auditory dysfunction (pp. 43–68). New York: Grune & Stratton. Google Scholar Willeford, J. (1980). Central auditory behaviors in learning disabled children..Seminars in Speech Language and Hearing, 1, 127–140. Google Scholar Additional Resources FiguresReferencesRelatedDetails Volume 12Issue 3October 2002Pages: 9-14 Get Permissions Add to your Mendeley library History Published in issue: Oct 1, 2002 Metrics Topicsasha-topicsasha-sigsasha-article-typesCopyright & Permissions© 2002 American Speech-Language-Hearing AssociationPDF downloadLoading ...

Automatic processing of tones and speech stimuli in children with specific language impairment.

It is well known from behavioural experiments that children with specific language impairment (SLI) have difficulties discriminating consonant-vowel (CV) syllables such as /ba/, /da/, and /ga/. Mismatch negativity (MMN) is an auditory event-related potential component that represents the outcome of an automatic comparison process. It could, therefore, be a promising tool for assessing central auditory processing deficits for speech and non-speech stimuli in children with SLI. MMN is typically evoked by occasionally occurring 'deviant' stimuli in a sequence of identical 'standard' sounds. In this study MMN was elicited using simple tone stimuli, which differed in frequency (1000 versus 1200 Hz) and duration (175 versus 100 ms) and to digitized CV syllables which differed in place of articulation (/ba/, /da/, and /ga/) in children with expressive and receptive SLI and healthy control children (n=21 in each group, 46 males and 17 females; age range 5 to 10 years). Mean MMN amplitudes between groups were compared. Additionally, the behavioural discrimination performance was assessed. Children with SLI had attenuated MMN amplitudes to speech stimuli, but there was no significant difference between the two diagnostic subgroups. MMN to tone stimuli did not differ between the groups. Children with SLI made more errors in the discrimination task, but discrimination scores did not correlate with MMN amplitudes. The present data suggest that children with SLI show a specific deficit in automatic discrimination of CV syllables differing in place of articulation, whereas the processing of simple tone differences seems to be unimpaired.

Automatic processing of tones and speech stimuli in children with specific language impairment

It is well known from behavioural experiments that children with specific language impairment (SLI) have difficulties discriminating consonant‐vowel (CV) syllables such as /ba/,/da/, and /ga/. Mismatch negativity (MMN) is an auditory event‐related potential component that represents the outcome of an automatic comparison process. It could, therefore, be a promising tool for assessing central auditory processing deficits for speech and non‐speech stimuli in children with SLI. MMN is typically evoked by occasionally occurring‘deviant’stimuli in a sequence of identical 'standard’sounds. In this study MMN was elicited using simple tone stimuli, which differed in frequency (1000 versus 1200Hz) and duration (175 versus 100 ms) and to digitized CV syllables which differed in place of articulation (/ba/, /da/, and /ga/) in children with expressive and receptive SLI and healthy control children (n=21 in each group, 46 males and 17 females; age range 5 to 10 years). Mean MMN amplitudes between groups were compared. Additionally, the behavioural discrimination performance was assessed. Children with SLI had attenuated MMN amplitudes to speech stimuli, but there was no significant difference between the two diagnostic subgroups. MMN to tone stimuli did not differ between the groups. Children with SLI made more errors in the discrimination task, but discrimination scores did not correlate with MMN amplitudes. The present data suggest that children with SLI show a specific deficit in automatic discrimination of CV syllables differing in place of articulation, whereas the processing of simple tone differences seems to be unimpaired.

Pediatric HIV/AIDS: Issues and Strategies for Intervention

Pediatric HIV/AIDS: Issues and Strategies for Intervention

Managing Children's Central Auditory Processing Deficits in the Real World: What Teachers and Parents Want to Know

A diagnosis of (central) auditory processing disorder has been made. What do you tell the child's teacher(s) regarding management of the disorder's effects in the classroom? How do you get the parents to understand and become involved in the management process? This article describes environmental modifications and curriculum-based compensations for specific types of central auditory processing deficits (CAPD) as well as common games and everyday activities that can improve auditory and auditory-related skills to create long-term benefit for children with CAPD.

Infant Intersubjectivity: Research, Theory, and Clinical Applications

We review research evidence on the emergence and development of active "self-and-other" awareness in infancy, and examine the importance of its motives and emotions to mental health practice with children. This relates to how communication begins and develops in infancy, how it influences the individual subject's movement, perception, and learning, and how the infant's biologically grounded self-regulation of internal state and self-conscious purposefulness is sustained through active engagement with sympathetic others. Mutual self-other-consciousness is found to play the lead role in developing a child's cooperative intelligence for cultural learning and language. A variety of preconceptions have animated rival research traditions investigating infant communication and cognition. We distinguish the concept of "intersubjectivity", and outline the history of its use in developmental research. The transforming body and brain of a human individual grows in active engagement with an environment of human factors--organic at first, then psychological or inter-mental. Adaptive, human-responsive processes are generated first by interneuronal activity within the developing brain as formation of the human embryo is regulated in a support-system of maternal tissues. Neural structures are further elaborated with the benefit of intra-uterine stimuli in the foetus, then supported in the rapidly growing forebrain and cerebellum of the young child by experience of the intuitive responses of parents and other human companions. We focus particularly on intrinsic patterns and processes in pre-natal and post-natal brain maturation that anticipate psychosocial support in infancy. The operation of an intrinsic motive formation (IMF) that developed in the core of the brain before birth is evident in the tightly integrated intermodal sensory-motor coordination of a newborn infant's orienting to stimuli and preferential learning of human signals, by the temporal coherence and intrinsic rhythms of infant behaviour, especially in communication, and neonates' extraordinary capacities for reactive and evocative imitation. The correct functioning of this integrated neural motivating system is found to be essential to the development of both the infant's purposeful consciousness and his or her ability to cooperate with other persons' actions and interests, and to learn from them. The relevance of infants' inherent intersubjectivity to major child mental health issues is highlighted by examining selected areas of clinical concern. We review recent findings on postnatal depression, prematurity, autism, ADHD, specific language impairments, and central auditory processing deficits, and comment on the efficacy of interventions that aim to support intrinsic motives for intersubjective communication when these are not developing normally.

Central Auditory Processing Ability in Children with ADHD With and Without Learning Disabilities

A few studies have shown more central auditory processing deficits in children with attention-deficit/hyperactivity disorder (ADHD) than in nondisabled children. Because these studies failed to screen participants with ADHD for learning disabilities (LD), it is not clear whether these deficits are correlates of ADHD or LD or both. In the present study, the central auditory processing ability of children with ADHD, ADHD with LD, and no disabilities was examined. Results indicated lower central auditory processing ability, and significant correlations between reading and ADHD symptoms and reading and central auditory processing ability in the ADHD with LD group compared with the other two groups. These findings suggest that central auditory processing deficits are more likely to be associated with LD than ADHD.