Synthetic Sentence Identification Test Research Articles

Left Ear Hearing Predicts Functional Activity in the Brains of Patients with Alzheimer's Disease Dementia.

To determine whether central speech processing ability, as measured by hearing in noise, differs between right and left ears in adults with Alzheimer's disease related dementia (AD) as well as whether differences in central speech processing ability correlate with an fMRI-based measurement of global functional brain connectivity. This prospective study was carried out at a tertiary referral center. Patients with an AD diagnosis and pure tone averages 40 dB HL or better were included. They were examined using resting-state fMRI and underwent central audiometric testing using the Dichotic Sentence Identification Test (DSI), the Dichotic Digits Test (DD), and the Synthetic Sentence Identification Test (SS), which test hearing in noise. DSI scores were correlated with resting-state fMRI connectivity between 361 distinct gray matter brain regions of interest (ROIs). Average global connectivity was calculated as mean functional connectivity between an ROI and the other 360 regions, a quantitative marker representing overall functional connectivity in the brain. Sixteen subjects had adequate fMRI and hearing data. The average age was 71.5 years old (±6.0). The average DSI score for the left ear was 40% (±34%) compared to 90% (±10%) in the right ear (P < .001). No difference between ears was noted on the DD. SS does not differentiate between ears, but worsening scores were noted with increasing background noise. Of the fMRI ROIs, 269 of the 361 had multiple comparison corrected significant correlations between global connectivity and DSI of the left ear (P = .004, r = .673), and all 269 showed higher functional connectivity for individuals with higher left DSI score. No correlations between DSI of the right ear and functional connectivity were found. Correlation was noted between left sided DSI and functional connectivity in patients with AD. Auditory input from the left ear was more susceptible to impairment, suggesting that side-specific auditory input may influence central auditory processing.

Voice Quality and Auditory Processing in Subjects with and Without Musical Experience

The relationship between voice and auditory processing is complex and has aroused increasing scientific interest in the last decades. Little is known about the relationship between voice quality and auditory processing in individuals with and without musical experience. To assess voice quality and auditory processing in subjects with and without musical experience. Total 120 individuals were split into three groups: GS = singers (N = 47), GI = instrumentalists (N = 43), and NM = nonmusicians (N = 30); group GS was subdivided into GS = 20 singers only and GSI = 27 singers and instrumentalists at the same time. Subjects were undertaken vocal assessment by means of Perceptual Assessment of voice recording followed by self-assessment of a potential voice problem using the Brazilian validated version of the Voice Symptom Scale (VoiSS) (Escala de Sintomas Vocais - ESV). The central auditory processing was carried out following such temporal processing tests: Frequency Pattern Test (FPT), Random Gap Detection Test (RGDT), and auditory-perceptual analysis of distorted speech as indicated: Synthetic Sentence Identification (SSI) test, with Ipsilateral Competing Message. GSI reported a higher number of voice symptoms compared to the other groups for the VoiSS. Throughout the groups, most individuals did not present voice disorders and, when presented, were mild. Subgroup GSI showed the best auditory abilities of temporal ordering for the FPT-Humming and FPT-Verbal, whereas NM had the worst performance. Negligible correlation strength alone was found between the different central auditory processing tests, the overall degree of vocal deviation in the auditory-perceptual analysis of voice quality, and the total score of the Voice Symptom Scale protocol. The voice quality of musicians and nonmusicians was correlated with their auditory processing; although with negligible strength. It was verified that singers-instrumentalist reported more voice symptoms compared to the other groups. Despite the large variation throughout the groups concerning auditory processing, musicians, especially singers-instrumentalists, have shown better auditory abilities of temporal ordering, suggesting that musical training and experience may account for such performance.

Central auditory processing findings in a group of cognitively impaired individuals

Introduction: Prevalence of central auditory processing disorders (CAPD) increases with age. Central auditory dysfunction is also more prevalent in older people with mild memory impairment compared with cognitively normal older people. These findings suggest that CAPD could be a marker of subtle cognitive dysfunction. A logical question is whether tests of CAPD have a potential role in evaluation of possible cognitive decline in elderly people with hearing complaints. This question has direct clinical relevance because tests for CAPD are widely available, easy to administer in a short time.Methods: Fifty-one patient having cognitive impairment (diagnosed according Diagnostic and Statistical Manual of Mental disorders, fifth edition 2013 (DSM-V) comprise the study group. The control group includes twenty age and gender matched individuals. A detailed neuropsychological assessment of both groups with tests from various cognitive domains (Visuospatial functions, executive function, short-term memory and verbal episodic memory). Behavioural central auditory tests included the Arabic versions of speech in noise test (SPIN) and/or synthetic sentence identification (SSI) test according to education of patient, the dichotic digits test (DDT), The auditory fusion test (AFT) and auditory memory tests.Results: There was a statistically significant difference between both groups in the behavioural central auditory tests.Conclusions: The relation of some measures of auditory processing to deficits in cognitive function might enable the early identification of cognitive decline with such measures in the older population. Aging can contribute to changes in central auditory processing (CAP) in the elderly especially in Speech understanding in background noise, Dichotic listening and Temporal Processing.

The role of the cerebellum in auditory processing using the SSI test

AbstractThe Synthetic Sentence Identification (SSI) test assesses central auditory pathways by measuring auditory and visual sensitivity and testing selective attention. Cerebellum activation in auditory attention and sensorial activity modulation have already been described. Assessing patients with cerebellar lesions alone using the SSI test can confirm the role of the cerebellum in auditory processing. AimTo evaluate the role of the cerebellum in auditory processing in individuals with normal hearing and in those with chronic cerebellum lesions, using the SSI test. Materials and MethodsCross-sectional cohort study. A study group comprising 18 patients with chronic cerebellar lesion and a control group of 20 healthy individuals were assessed. The SSI test was applied in an Ipsilateral Competitive Message (ICM) and Contralateral Competitive Message (CCM) modes. To compare the results between groups, we used the chi-square test for qualitative variables. ResultsA statistically significant difference was found between the study and control groups using the ICM mode of the SSI test (p=0.035), but not in the CCM mode (p=0.083). ConclusionThe results on the SSI confirmed cerebellar participation in auditory processing in individuals with chronic cerebellar lesions and in those with normal hearing assessed in this study.

Central auditory functions in elderly individuals

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

Billing Edits for Auditory Processing Disorder In Effect April 1, 2012

You have accessThe ASHA LeaderBottom Line1 Apr 2012Billing Edits for Auditory Processing Disorder In Effect April 1, 2012 Lisa SatterfieldMS, CCC-A Lisa Satterfield Google Scholar More articles by this author , MS, CCC-A https://doi.org/10.1044/leader.BML.17052012.3 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In As of April 1, 2012, audiologists may not bill certain codes together for the evaluation of (central) auditory processing disorder [(C)APD] for the same Medicare- or Medicaid-eligible patient on the same day. The restrictions are contained in the 2012 National Correct Coding Initiative (NCCI) edits. NCCI edits prohibit billing certain procedure codes on the same day and are intended to promote correct coding methods and to control improper coding leading to inappropriate payment. They are mandatory for Medicare and Medicaid services but optional for private health plans. The Centers for Medicare and Medicaid Services (CMS) develops the NCCI edits based on definitions in the CPT (Current Procedural Terminology, © American Medical Association) manual, national and local policies, standard clinical practice, and current coding practices. Evaluation and Individual Tests Many audiologists administer and bill for (C)APD evaluations and individual tests because of an elaborate history surrounding the codes. In 2005, CMS approved two new (C)APD evaluation codes. It took nearly two years of ASHA advocacy to receive approval for the codes: CPT 92620 (evaluation of central auditory function, with report; initial 60 minutes) and CPT 92621 (each additional 15 minutes). When the codes did receive approval, however, they were undervalued by CMS. Clinicians responded to the low values by requesting that they be allowed to bill the individual test codes—specifically the filtered speech test (92571), staggered spondaic word test (92572), and synthetic sentence identification test (92576), in addition to the timed central auditory function codes. CMS, however, recommended that 92620 and 92621 not be billed in combination with 92571, 92572, or 92576. CMS indicated that the individual tests could be reported only if they are performed in isolation, using the single code representing that procedure. If a battery of tests is performed, the individual tests should not be billed in addition to 92620/92621. CMS reasoned that using the time-valued codes (92620 and 92621) allows the audiologist to capture the time spent on the evaluation for site of lesion and other tests of central auditory function often used to determine the presence of (C)APD. Additionally, billing 92620 and 92621 avoids the suggestion that the three individual tests are required as part of the test battery to evaluate central auditory function, and instead allows the audiologist to determine the tests most appropriate for the patient. Unanticipated Action It was anticipated that NCCI would apply this soon after the CPT codes were published in 2005. The initial NCCI edit, however, did not prohibit billing the individual test codes with 92620 and 92621. Instead, it restricted billing 92506 (evaluation of speech, language, voice, communication, and/or auditory processing) with 92620 and 92621. This edit remains in effect. Seven years later, NCCI is enforcing the edit that prohibits billing individual test codes with the timed codes. Therefore, as of April 1, billing 92620/92621 with 92571, 92572, or 92576 on the same day for Medicare or Medicaid patients is no longer allowed. For updates and additional edits, visit ASHA’s reimbursement webpage. Author Notes Lisa Satterfield, MS, CCC-A, director of health care regulatory advocacy, can be reached at [email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 17Issue 5April 2012 Get Permissions Add to your Mendeley library History Published in print: Apr 1, 2012 Metrics Downloaded 99 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2012 American Speech-Language-Hearing AssociationLoading ...

Auditory Processing After Sport-Related Concussions

The aim of the study is to investigate whether sport-related concussions disrupt auditory processes. Sixteen university athletes participated in the study: eight had one or more sport-related concussions, and eight never experienced a concussion. The Frequency Pattern Sequence test, the Duration Pattern Sequence test, the Synthetic Sentence Identification test, and the Staggered Spondaic Word test were used to assess auditory processing. All nonconcussed athletes have normal auditory processing. In contrast, more than half of the concussed athletes had deficits for one or more of the auditory processing tests. The pattern of results suggests that sport-related concussions can disrupt the neurological mechanisms implicated in several auditory processes, including monaural low-redundancy speech recognition, tone pattern recognition, and dichotic listening.

Cross-Sectional Age-Changes of Hearing in the Elderly

Compare the rates of change with age in tests of hearing function that measure the peripheral and central segments of the auditory system. Cross-sectional cohort study. Two hundred forty-one volunteer members of a dementia surveillance cohort aged 71 to 96 yrs selected by having sufficient and symmetric auditory function to perform central auditory tests. Measures of central auditory function declined with age at a faster rate than did measures of peripheral auditory function. The mean distortion product otoacoustic emission thresholds at 1, 2, and 3 kHz (Distortion Product Otoacoustic Emissions1,2,3) increased 0.34 dB/yr (95% C.I. 0.07, 0.60) or 0.45 standard deviations (S.D.)/decade, whereas the pure-tone threshold average of 1, 2, and 3 kHz (PTA1,2,3) increased by 0.5 dB/yr (95% C.I. 0.32, 0.81) or 0.59 S.D./decade. The auditory-evoked potential latencies for wave V of the Auditory Brain Stem Response, Pa of the middle latency response, and P2 of the late latency response did not vary by age. The mean Synthetic Sentence Identification test with ipsilateral competing message scores dropped 1.7 percentage points (95% C.I. -2.2, -1.2) per year or 0.78 S.D./decade, which was significantly greater than the drop with age in either the Distortion Product Otoacoustic Emissions1,2,3 or the PTA1,2,3. After adjustment for drop in hearing threshold level with age, the decline in Synthetic Sentence Identification test with ipsilateral competing message was still significant and averaged 1.1 percentage points per year (95% C.I. 1.8, -0.88). Central auditory function is a prominent component of presbycusis and should be assessed routinely. Rehabilitative measures for presbycusis should take central auditory function into account.

Identificação de sentenças sintéticas (SSI) e reflexo acústico contralateral

The study of the relationship of the contralateral acoustic reflex with the auditory skill of closure. To analyze the identification of a speech signal in the presence of competitive sounds in subjects with absence of contralateral acoustic reflex. Application of the synthetic sentence identification (SSI) test under the conditions of competitive contralateral message (SSI-CCM), with the signal-to-noise ratio of 0 and -40dB, and ipsilateral competitive message (SSI-ICM), with the signal-to-noise ratio of 0, -10, -15 and -20dB, in 43 young adults (group A = 21 subjects with contralateral acoustic reflex present in all of the investigated frequencies, and group B = 22 subjects with contralateral reflex absent at the frequency of 500Hz, or in all of the investigated frequencies, or still in some of the investigated frequencies necessarily including 500Hz), of both gender, with no hearing, otologic or learning disabilities. The acoustic reflex threshold was above 100dB NA in 59% of the individuals in group B and in 14% of the individuals in group A. All subjects performed according to the normal pattern suggested in the specialized literature for the SSI test. The performance of group B in the SSI-ICM test was inferior to that of group A for all the signal-to-noise ratios used, although the difference was not statistically significant. Group B, which presented an acoustic reflex threshold higher than 100dB NA or the absence of the acoustic reflex, was also the group that presented the worse performance in the SSI test. The absence of the contralateral acoustic reflex seems to interfere in the identification of the speech signal in the presence of competitive noises.

The Impact of New Codes for the Evaluation of Central Auditory Function

The Impact of New Codes for the Evaluation of Central Auditory Function

Older adult performance on an altered version of the SSI test.

The Synthetic Sentence Identification (SSI) test has been used extensively in investigations of reduced speech understanding skills in older adults. In this study the SSI test was altered by adding noise to the competing message and by administering practice lists and equivalent test lists, as well as versions of the test that have 4- and 12-s interstimulus intervals (ISIs), along with the standard 8-s ISI. The purpose was to determine the effect of these alterations on performance in a group of older adults with average pure-tone average 2 values less than 33 dB HL. Performance changed as a function of the ISI, with less rollover occurring for the 4-s ISI condition than the other 2 ISIs.

The Development of Two Speech Based Tests of Central Auditory Function for Australian Use

The Synthetic Sentence Identification (SSI) test and Dichotic Sentence Identification (DSI) test are chiefly used to assess central auditory function. These tests are reportedly more tolerant of hearing loss than other measures and used together, provide analogous but differing measures of central auditory function which can be administered within an acceptable time frame. The purpose of this study was to generate and evaluate an Australian version of the DSI test and the SSI test. The test materials were trialed on younger and older normal hearing adults whose first language was Australian English. Results show near perfect performance for young adults using comfortable listening levels while older adults showed greater variability in performance. In addition, there was decreasing performance with age on both test measures for the left ear. These results were compared with those reported for the original SSI and DSI tests and similar outcomes were found.

Practice and list effects on the synthetic sentence identification test in young and elderly listeners.

A high prevalence of central auditory processing disorders (CAPD) has been reported in the elderly based on scores for the Synthetic Sentence Identification Test (SSI). This study examined practice effects and list differences on the Auditec version of the SSI with an ipsilateral competing message in 30 young and 20 elderly participants. Results for the younger participants suggested that a minimum of one practice list should be used with the SSI, whereas results for the elderly participants suggested that a minimum of three practice lists should be used. The binomial model of A. R. Thornton and M. J. M. Raffin (1978) was suggested for use in determining the required number of lists needed to obtain reliable SSI performance. Significant list differences were found with the Auditec version of the SSI. It was recommended to use only Lists A, C, D, E, G, and I for consistent results across lists. Practice effects and list differences should be accounted for when using the SSI for the assessment of CAPD in elderly and young listeners.

Performance of Monolingual and Bilingual Speakers of English and Spanish on the Synthetic Sentence Identification Test

Differences in the performance of adults with normal hearing were evaluated on the English and Spanish versions of the Synthetic Sentence Identification (SSI) test in the ipsilateral competing message (ICM) format. Previous work has shown that bilingual subjects perform significantly better on the Spanish version of the SSI at a –30 dB message-to-competition ratio (MCR). The previous investigators attributed this difference in performance to the existence of a greater number of pauses in the competing message of the Spanish version compared to the English version. In the present study, seven bilingual speakers and ten monolingual speakers each of English and Spanish completed two conditions—the standard competing message (SC) and the competing message mixed with speech noise (SC+N)—in order to reduce or eliminate the effect of pauses on performance. Bilingual subjects’ scores in each language were not significantly different from monolingual subjects’ scores. Scores from bilinguals were significantly better in Spanish compared to English—even when speech noise was used to fill in the natural pauses present in the competing message at a –10 dB MCR. It is suggested that this performance difference may be a result of the unequal average number of syllables per stimulus sentence in the English and Spanish versions. However, further research will be needed to explore the impact that different language structures have on SSI performance.

Speech Perception in Noise with Bicros Hearing Aids

The speech perception in noise abilities of 14 asymmetrically hearing-impaired subjects who had been fitted with Bilateral Contralateral routing of Signal (BICROS) hearing aids was evaluated. Speech tests were administered with subjects wearing both conventional monaural amplification and their own BICROS aids. Test procedures involved the use of sentence lists from the Speech Perception in Noise (SPIN) test and the Synthetic Sentence Identification (SSI) test, presented in a background of recorded four-talker babble. The performance of the subjects was found to be significantly better with the BICROS aids than with monaural amplification alone.

Hearing in the Elderly—The Framingham Cohort, 1983-1985

The relation between central auditory processing disorders (CAPD) and age has been described in selected subjects. However, the prevalence of CAPD in the general population has not been established. We tested 1026, 64- to 93-yr-old members of the Framingham Heart Study cohort with Central Institute for the Deaf W-22 lists (CID W-22) in quiet, the Synthetic Sentence Identification test with ipsilateral competing message (SSI-ICM), and the Staggered Spondaic Word test. The presence or absence of CAPD could be established with at least one of three indices in 1018 subjects. The CID W-22 performance-intensity function rollover index was greater than 0.20 in 1.4% of 1009 subjects. The difference between maximum CID W-22 and SSI-ICM (0 dB message-to-competition ratio) scores was greater than 20% in 18.2% of 816 subjects. The Staggered Spondaic Word category was moderately, severely, over-corrected moderately, or over-corrected severely abnormal in 10.7% of 941 subjects (using 12-59-yr-olds' norms and adjusting scores when appropriate). Abnormal results on any one index occurred in 22.6% of the subjects. Thus, we conclude that the prevalence of CAPD in the elderly is less common than previous studies would suggest. Furthermore, although the rate of CAPD increased with age, age accounted for no more than 15% of the variability of any of the three indices. Therefore, its presence is dominated by factors other than chronological age.

Effect of Linguistic Interference on Sentence Identification

This study was designed to investigate the extent to which continuous speech competition, in sentence identification paradigm, produces linguistic interference over and above acoustic masking. We evaluated performance on the Synthetic Sentence Identification (SSI) test in 24 bilingual speakers of English and Spanish under four experimental conditions: (1) target and competition both in English, (2) target and competition both in Spanish, (3) target in English, competition in Spanish, and (4) target in Spanish, competition in English. After controlling for the effects of acoustic masking, results showed significantly better performance in conditions when target and competition were in different languages (interlingual interference) than when target and competition were in the same language (intralingual interference). The difference in performance is attributed to the effects of greater linguistic interference when target and competition were in the same language.

Perceived Benefits of Amplification as a Function of Central Auditory Status in the Elderly

A measure of perceived hearing aid benefit was obtained from 24 older hearing-impaired adults who had received their hearing aids a minimum of 6 months prior to this study. Subjects were also administered a battery of tests, including comparisons of maximum scores for phonetically balanced words and the Synthetic Sentence Identification Test to identify central auditory disorder. There appears to be no relationship between perceived hearing aid benefit and central auditory function as measured in this study. Several explanations for these somewhat surprising findings are offered, as well as clinical implications regarding the use of hearing aids by older adults.

A comparison of stutterers and nonstutterers on masking level differences and synthetic sentence identification tasks

Ten stutterers and ten nonstutterers, matched for sex, were tested for Masking Level Differences (MLDs) at 500 Hz, and were evaluated on the Synthetic Sentence Identification test with Ipsilateral Competing Message (SSI-ICM) under message-to-competition ratios (MCRs) of 0, -10,and -20 dB. No significant differences on the SSI-ICM task were seen between groups, but the stutterers did produce significantly ( p<.01) poorer MLDs than the nonstutterers. This may be interpreted as support for Kent's (1983) hypothesis that stutterers may be poorer at temporal processing. In addition, the present results support the concept of a continuum of auditory processing ability, with normals and stutterers of different degrees of disfluency revealing decreasing performance measures.

Otoneurological findings in Friedreich's ataxia and other inherited neuropathies.

Fifteen cases of Friedreich's ataxia (FA) were examined using an otoneurological test battery that included tone and speech audiometry, the synthetic sentence identification (SSI) test, impedance audiometry, cortical auditory-evoked response (CAER), brainstem auditory-evoked response (ABR) and electronystagmography. We also obtained ABR and CAER findings in 2 cases of familial spastic paraplegia, in 5 cases of Charcot-Marie-Tooth disease and 6 in cases of atypical FA of uncertain classification. The results of puretone and impedance audiometry were normal in all cases. ABR could not be elicited in 11 FA patients and were abnormal at higher intensity levels in the remaining 4 patients. In these 4 cases, however, the latencies were normal. ABR did not show any marked abnormalities in patients with familial spastic paraplegia or Charcot-Marie-Tooth disease. CAERs were normal in all 28 patients. ABRs tended to be absent with the progression of FA. ABR thresholds were correlated with the Inherited Ataxias Clinical Rating Scale score, which is an index of the severity of the illness. ABRs contributed to the diagnosis or to excluding FA in patients with an atypical clinical picture. The absence of ABRs and the normal latencies of the waves, when evoked, agree with the pathological finding of a reduction of fibers in the spinal root ganglion. SSI abnormalities and vestibular findings agree with this hypothesis.