Effect of delayed auditory feedback on stuttering with and without central auditory processing disorders.

There is a history of debate and controversy about the assessment and intervention of children diagnosed with auditory processing disorder (APD). Professionals in communication sciences and disorders view APD from different perspectives. Speech-language pathologists (SLPs) tend to view APD from the language and literacy perspective, or a top-down model, whereas audiologists tend to view APD from an auditory perception perspective, or a bottom-up model. Professionals who assess and treat children with APD need to bridge the gap and merge their different perspectives to plan effective intervention for children with APD. A panel of audiologists who demonstrated expertise in the area of Central Auditory Processing Disorders (CAPDs) developed The American Speech-Language-Hearing Association's (ASHA's) technical report on APDs (ASHA, 2005). This report was approved by ASHA's Executive board in 2005. In this report, central auditory processing refers to the efficiency and effectiveness by which the central nervous system uses auditory information. Central auditory processing includes the auditory mechanisms underlying the skills of sound localization and lateralization; auditory discrimination; auditory pattern recognition; temporal aspects of audition, including temporal integration, temporal discrimination, temporal ordering, and temporal masking; auditory performance in competing acoustic signals; and auditory performance with degraded acoustic signals (ASHA, 1996; Bellis, 2003; Chermak & Musiek, 1997; Jerger, 2009). A CAPD is a deficit in processing auditory input that is not due to higher-order language, cognitive, or related factors (Musiek, Bellis, & Chermak, 2005; Musiek & Chermak, 2007). However, children diagnosed with CAPD may experience difficulties in academic learning, speech, language, social skills, and literacy (e.g., encoding, decoding, reading comprehension, reading fluency, and written language).

The theoretical issues surrounding central auditory processing disorders (CAPD) are reviewed here, especially with reference to the central auditory behavioral processes and the auditory test measures as prescribed in the ASHA (1996, American Journal of Audiology, 5(2), 41-54) statement on CAPD. A simplified nomenclature is recommended that directly relates process and test measure to facilitate the diagnostic process in CAPD. This new terminology closely follows the ASHA (1996, American Journal of Audiology, 5(2), 41-54) document, but provides some refinement based on recent research in CAPD. To support this recommendation, a confirmatory factor analysis (CFA) was applied to the findings of Domitz and Schow (2000, American Journal of Audiology), who proposed use of a battery of CAPD tests, the Multiple Auditory Processing Assessment (MAPA) for testing school children. The CFA was found to reinforce the four-factor model, which clearly emerged in the exploratory factor analysis of Domitz and Schow. The model was found to be reasonably consistent even when subtests from the SCAN were included in the analysis. Refinement and revision of ASHA (1996, American Journal of Audiology, 5(2), 41-54) is recommended to facilitate diagnosis, subclassification, and intervention for CAPD.

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 ...

Modulation of auditory temporal processing, speech in noise perception, auditory-verbal memory, and reading efficiency by anodal tDCS in children with dyslexia

Introduction Mismatch negativity (MMN) represents a negative component of event-related potentials, which is mentioned by guidelines as an important tool to provide measurable data regarding the functionality of the auditory system in acoustic processing. However, the literature still lacks reliable data that can support the clinical use of this potential in the complementary diagnosis of central auditory processing (CAP) disorder (CAPD).Objectives To analyze whether MMN assessment might be associated with the CAP behavioral test battery, as well as to assess the effects of auditory ability deficits on MMN responses in the pediatric population.Methods In total, 45 age-matched children participated in the study. They were submitted to the CAP behavior assessment and to MMN. The children were tested with a combination of speech contrast consisting of acoustic syllables [da] versus [ta], governed by the oddball paradigm.Results Mismatch negativity did not show a direct association with a single test but with the combination of the four tests used as a behavioral test battery to identify CAPD. The results also indicated that the auditory ability deficits influenced the measurement of MMN latency (p = 0.003*), but not the amplitude (p = 0.857) or the area (p = 0.577).Conclusion Mismatch negativity was shown to be statistically associated with the battery of tests used to identify deficits in auditory abilities in the studied sample rather than with a single behavioral test. The deficits in auditory abilities were observed in the MMN latency. Mismatch negativity can be used to assess children with CAPD.

Background: Subjects with (central) auditory processing disorder (C)APD may manifest a range of complaints including difficulty in spee­ch perception in noise, following directions, and discrimination of similar speech sounds. Other disorders may also have the same behavioral manifestations. The Case: Here we present an 8-year-old boy who was misdiagnosed and mismanaged as a child with learning disability. His speech, language and cognition problems at initial eva­luation included semantic problem, a short len­gth of speech, phonological sound disorder, and attention disorder. He showed abnormality in the dichotic digits test with free recall approach and monaural selective auditory attention test. Based on his performance and test results, he was suffering from (C)APD especially in dicho­tic listening and speech perception in com­petition. It was suggested that binaural hearing training with differential interaural intensity, informal localization training including loca­lization clock, and auditory training in noise be added to his classic auditory training program. Conclusion: Studying this subject was impor­tant because (C)APD diagnosis needs a team approach. Evidently, the parents, teacher and speech-language pathologist (SLP) did not seek a central auditory processing evaluations early enough but some of his behaviors could poten­tially be a red flag for (C)APD and could guide SLPs to refer him for central auditory testing. As we may not be able to evaluate central auditory processing in the early childhood, iden­tifying the possible (C)APD signs by a SLP may help them to plan a more suitable program even before reaching a definite diagnosis.

You have accessThe ASHA LeaderFeature1 Nov 2007Auditory Processing Disorder Evaluation: Using a Reinforcement Paradigm Raymond M. Hurley Raymond M. Hurley Google Scholar https://doi.org/10.1044/leader.FTR1.12152007.5 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Many issues associated with auditory processing disorders (APDs) have been debated and researched. For the most part, however, the issue of testee motivation/reinforcement has been ignored except for an article by Silman and colleagues (2000) that demonstrated changes in APD test performance through the use of reinforcement. During the last two years, I was asked to consult on the APD evaluation of two boys, ages 10 and 11. Each of these children had been diagnosed with a reading disorder, but had normal speech and language. The children's school system tested them for an APD with positive results. The testers' comments suggested poor motivation on the part of the two boys in performing the APD tests. The motivation issue was also noted in the teachers' comments, which characterized each child as not highly motivated. Recalling the article by Silman et al. (2000), I consulted with both sets of parents about the motivation issue and suggested that the two boys be retested using a reinforcement paradigm; the parents agreed. During discussion with the parents, I asked about suitable reinforcement. By coincidence, both sets of parents said their sons were highly motivated to save money—one wanted to purchase a new skateboard and the other wanted to purchase upgrades for his BMX bicycle. Further, the parents volunteered to provide the reinforcement money. The re-testing was conducted three to four weeks after the original testing, using the Filtered Speech Test (FST), the Dichotic Digits Test (DDT), and the Pitch Pattern Test (PPT), whose performance characteristics and norms I had previously investigated (Singer, Hurley & Preece, 1998). Each boy was told that he would receive 25 cents for each correct response. The results of these tests are presented in Figure 1, which compares the initial evaluation performance to the re-evaluation performance obtained using reinforcement. The test scores depicted in Figure 1 are composite scores, representing the average of the right and left ear scores, as the individual ear scores for each test were symmetrical. Each boy demonstrated enough improvement in each of the three APD tests using a reinforcement paradigm to move his performance from below normal to normal. These results suggest that the original test may have been influenced by these children's low motivation. If these children truly had an APD, their performance should not have moved from below normal to normal with increased motivation, i.e., reinforcement. Arguably, the improved test performance may have been the result of a learning effect; however, the time between testing was three to four weeks and the improved performance was across all three tests. After an intensive remedial reading experience, both boys are reading at near grade level with no other reported academic problems. The take-home messages from these case studies are: 1) motivation must be considered in APD evaluation, as children may be misdiagnosed as having an APD; and 2) motivation/reinforcement in APD assessment needs further study. ASHA Special Interest Division 6, Hearing and Hearing Disorders: Research and Diagnostics contributed this article. The division offers affiliates the opportunity to earn CEUs through self-study of its peer-reviewed publication, Perspectives; an exclusive e-mail list and Web forum; and other benefits. To learn more, visit Division 6's Web page. References Silman S., Silverman C. A., & Emmer M. B. (2000). Central auditory processing disorders and reduced motivation: three case studies.Journal of the American Academy of Audiology, 11, 57–63. Google Scholar Singer J., Hurley R. M., & Preece J. (1998). Effectiveness of central auditory processing (CAP) tests with children.American Journal of Audiology, 7, 73–84. LinkGoogle Scholar Author Notes Raymond M. Hurley, is an associate professor in the Department of Communication Sciences and Disorders, University of South Florida, Tampa. Contact him at [email protected]. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 12Issue 15November 2007 Get Permissions Add to your Mendeley library History Published in print: Nov 1, 2007 Metrics Downloaded 235 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2007 American Speech-Language-Hearing AssociationLoading ...

Objective Children with nonsyndromic cleft lip and/or palate often have a high prevalence of middle ear dysfunction. However, there are also indications that they may have a higher prevalence of (central) auditory processing disorder. This study used Fisher's Auditory Problems Checklist for caregivers to determine whether children with nonsyndromic cleft lip and/or palate have potentially more auditory processing difficulties compared with craniofacially normal children. Methods Caregivers of 147 school-aged children with nonsyndromic cleft lip and/or palate were recruited for the study. This group was divided into three subgroups: cleft lip, cleft palate, and cleft lip and palate. Caregivers of 60 craniofacially normal children were recruited as a control group. Hearing health tests were conducted to evaluate peripheral hearing. Caregivers of children who passed this assessment battery completed Fisher's Auditory Problems Checklist, which contains 25 questions related to behaviors linked to (central) auditory processing disorder. Results Children with cleft palate showed the lowest scores on the Fisher's Auditory Problems Checklist questionnaire, consistent with a higher index of suspicion for (central) auditory processing disorder. There was a significant difference in the manifestation of (central) auditory processing disorder-linked behaviors between the cleft palate and the control groups. The most common behaviors reported in the nonsyndromic cleft lip and/or palate group were short attention span and reduced learning motivation, along with hearing difficulties in noise. Conclusion A higher occurrence of (central) auditory processing disorder-linked behaviors were found in children with nonsyndromic cleft lip and/or palate, particularly cleft palate. Auditory processing abilities should not be ignored in children with nonsyndromic cleft lip and/or palate, and it is necessary to consider assessment tests for (central) auditory processing disorder when an auditory diagnosis is made for this population.

Auditory event related potentials in children with peripheral hearing loss

Central auditory processing refers to the individual's ability to process auditory information within the central auditory nervous system and involves a set of auditory skills. Deficits in one or more of these skills characterize central auditory processing disorder. Given the presence of this disorder, auditory training is indicated as a set of strategies designed to activate the auditory system and improve the processing of acoustic signals. Electrophysiological measures such as cortical auditory evoked potential may serve as a valuable supplement to the behavioral assessment of auditory processing. When associated with noise, temporal masking is assessed. It is characterized as an alteration in the perception of a sound in the presence of another auditory stimulus. Individuals with this disorder are more susceptible to post-masking effects due to difficulties in understanding speech in noisy environments. This study reports the case of a 25-year-old adult diagnosed with central auditory processing disorder who underwent cortical auditory evoked potentials using speech stimulus preceded by noise. The acoustically controlled auditory training was conducted over 10 sessions, using the "Afinando o Cérebro" platform. Following intervention, improvements were observed in the participant's auditory skills, along with reductions in the latencies of the P1, N1 and P2 waves and in the N1-P1 and N1-P2 peak-to-peak amplitudes. These findings highlight the effects of acoustically controlled auditory training and contribute to a better understanding of the neurophysiological mechanisms involved in speech perception in noise among individuals with central auditory processing disorder.

The long latency auditory evoked responses (LLAERs), originating in the auditory cortex, are often considered a biomarker for maturity in the central auditory system and may therefore be useful in the evaluation of children with central auditory processing disorder (CAPD). However, the characteristics of the LLAERs elicited in this population have not been widely described, and clinical applications remain unclear. The goal of this scoping review was to investigate if LLAERs can be used to identify children with CAPD. A systematic search strategy was used to identify studies that analyzed the latencies and amplitudes of P1, N1, P2, and N2 waveforms of the LLAERs. The online databases, including Embase, Web of Science, MEDLINE, PubMed, ProQuest, and CINAHL, as well as the gray literature were searched for papers published in English and French between January 1980 and May 2021. Seventeen papers met the eligibility criteria and were included in the study. Four papers had pre- and posttraining study designs, and the remaining studies were cross-sectional. Several studies reported significant differences in LLAERs between children with CAPD and their normal-hearing peers, and the results tended toward longer latencies and smaller amplitudes regardless of LLAER waves considered. N1 and/or N2 results were most likely to reveal significant differences between children with CAPD and normal-hearing controls and could potentially be considered a biomarker for CAPD. It seems that LLAER assessments, especially waves N1 and N2, might assist in better identification of CAPD children. However, considering heterogeneity in the methodology among the included studies, the results should be interpreted with caution. Well-designed studies on children with confirmed CAPD using standard diagnostic and assessment protocols are suggested.

Although central auditory processing disorder (CAPD) test battery performance has been examined in adults with neurologic lesions of the central auditory nervous system (CANS), similar data on children being referred for CAPD evaluations are sparse. This study characterizes CAPD test battery performance in children using tests commonly administered to diagnose the disorder. Specifically, this study describes failure rates for various test combinations, relationships between CAPD tests used in the battery, and the influence of cognitive function on CAPD test performance and CAPD diagnosis. A comparison is also made between the performance of children with CAPD and data from patients with neurologic lesions of the CANS. A retrospective study. Fifty-six pediatric patients were referred for CAPD testing. Participants were administered four CAPD tests, including frequency patterns (FP), low-pass filtered speech (LPFS), dichotic digits (DD), and competing sentences (CS). In addition, they were given the Wechsler Intelligence Scale for Children (WISC). Descriptive analyses examined the failure rates of various test combinations, as well as how often children with CAPD failed certain combinations when compared with adults with CANS lesions. A principal components analysis was performed to examine interrelationships between tests. Correlations and regressions were conducted to determine the relationship between CAPD test performance and the WISC. Results showed that the FP and LPFS tests were most commonly failed by children with CAPD. Two-test combinations that included one or both of these two tests and excluded DD tended to be failed more often. Including the DD and CS test in a battery benefited specificity. Tests thought to measure interhemispheric transfer tended to be correlated. Compared with adult patients with neurologic lesions, children with CAPD tended to fail LPFS more frequently and DD less frequently. Both groups failed FP with relatively equal frequency. The two-test combination that showed the highest failure rate for children with CAPD was LPFS-FP. Comparison with adults with CANS lesions, however, suggests that the mechanisms underlying LPFS performance in children need to be better understood. The two-test combination that showed the next highest failure rates among children with CAPD and did not include LPFS was CS-FP. If it is desirable to use a dichotic measure that has a lower linguistic load than CS then DD can be substituted for CS despite the slightly lower failure rate of the DD-FP battery.

The purpose of this study was to quantify how the use of two different cutoff criteria affects the test failure rate and potential diagnosis of central auditory processing disorder ([C]APD) in a sample of children subjected to central auditory processing ([C]AP) assessment.Test failure rates for the central test battery (CTB) using two different cutoff criteria (1 and 2 SDs below the mean) were measured retrospectively for 98 children who completed (C)AP assessment. The rates of potential (C)APD diagnosis ranged from 86.8% [when a 1 standard deviation (SD) cutoff was used] to 66.2% (when a 2 SD cutoff was used). The current use of two different cutoffs for the CTB has a large impact on the diagnostic rate for (C)APD. These findings have clinical implications for the diagnosis of (C)APD due to the widespread use of the CTB in the United States for the assessment of (C)APD in children. Thus, it is important to create awareness among audiologists that use of the 2 SDs cutoff criterion is recommended for reducing false positives (error).

Introduction Auditory evoked potentials are widely used in clinical practice to complement the assessment of central auditory processing. However, it is necessary to understand whether these potentials are highly accurate, to assist in the diagnosis of auditory processing disorder.Objective To measure the accuracy of middle and long latency auditory evoked potentials in the diagnosis of auditory processing disorder in adults.Methods This is a case-control study, formed by a control group of 30 individuals with normal auditory processing assessment, and a case group composed of 43 individuals with altered auditory processing assessment. Their sensitivities, specificities, accuracies, positive and negative predictive values for the diagnosis of alterations were measured and compared between the potentials.Results The accuracies of the middle and long latency potentials were 51% and 67%, respectively. The P1-N1-P2 and N2-P300 complexes had an accuracy of 57.5% and 58.9%, respectively. The cognitive potential P300 showed an accuracy of 55%. There was no significant result for the middle-latency potential (OR = 1.8; 95% CI: 0.6–5.4,p > 0.42) and for P300 (OR = 2.63, 95% CI: 0.85–8.43,p > 0.11). However, the result was significant for the long-latency potential (OR = 6.3; 95% CI: 2–19.6,p < 0.01). There was a significant result for the P1-N1-P2 complexes (OR = 6.76, 95% CI:1.4–32.5,p = < 0.010) and N2-P300 (OR = 3.60; 95% CI: 10.16–11.20,p < 0.039).Conclusion Individuals with altered long-latency auditory evoked potential are more likely to have auditory processing disorder and, as such, this test can be used as a complementary tool to confirm the diagnosis.

Stroke survivors may suffer from a range of hearing impairments that may restrict their participation in postacute rehabilitation programs. Hearing impairment may have a significant impact on listening, linguistic skills, and overall communication of the affected stroke patient. However, no studies sought to systematically characterize auditory function of stroke patients in detail, to establish the different types of hearing impairments in this cohort of patients. Such information would be clinically useful in understanding and addressing the hearing needs of stroke survivors. The present study aimed to characterize and classify the hearing impairments, using a detailed audiological assessment test battery, in order to determine the level of clinical need and inform appropriate rehabilitation for this patient population. A case-control study. Forty-two recruited stroke patients who were discharged from a stroke unit and 40 control participants matched for age. All participants underwent pure-tone audiometry and immittance measurements including acoustic reflex threshold, transient-evoked otoacoustic emissions, auditory-evoked brainstem response, and a central auditory processing assessment battery, performed in a single session. Hearing impairments were classified as peripheral hearing loss (cochlear and neural type), central auditory processing disorder (CAPD), and as a combination of CAPD and peripheral hearing loss. Overall mean hearing thresholds were not significantly different between the control and stroke groups. The most common type of hearing impairment in stroke patients was the combination type, "peripheral and CAPD," in the 61- to 80-yr-old subgroup (in 55%), and auditory processing deficits in 18- to 60-yr-olds (in 40%), which were both significantly higher than in controls. This is the first study to examine hearing function in detail in stroke patients. Given the importance of hearing for the efficiency of communication, it is essential to identify hearing impairments and differentiate peripheral and central deficits to define an appropriate intervention plan.