Lack of systematic topographic difference between attention and reasoning beta correlates

Effects of otitis media with effusion on auditory temporal resolution

A popular hypothesis holds that specific reading disability (SRD) and specific language impairment (SLI) result from an impaired ability to process rapid and brief sounds. However, the results of experiments that have tested this hypothesis are incongruous. A number of factors could explain these contradictory findings, including the questionable reliability and validity of rapid auditory processing tasks, individual differences in the auditory processing abilities of SRD and SLI populations, the age of listeners, the quality of control groups, and the relationship between verbal and non-verbal auditory processing abilities. These issues highlight the need for future studies to (1) establish the reliability and validity of psychophysical tasks used to assess rapid auditory processing; (2) report the rapid auditory processing scores of individuals rather than just group means; (3) include a wide range of reading and spoken language tests to determine the literacy and oral language profile of people who demonstrate an auditory processing deficit; (4) include clinical comparison groups to determine whether a rapid auditory processing deficit is related specifically to written and spoken language impairments; and (5) examine the relationship between low-level non-verbal, verbal, and phonological processing abilities.

You have accessThe ASHA LeaderFeature1 Apr 2011Auditory Remediation for Patients With Landau-Kleffner Syndrome Annette HurleyPhD, CCC-A Annette Hurley Google Scholar More articles by this author , PhD, CCC-A https://doi.org/10.1044/leader.FTR5.16042011.5 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In http://www.asha.org/Publications/leader/2011/110405/Auditory-Remediation-for-Patients-With-Landau-Kleffner-Syndrome.htm Landau-Kleffner syndrome (LKS) is a rare neurological disorder that affects children and is characterized by aphasia that can develop suddenly or over a period of time. Often the deterioration in language is rapid, but it also may decline over several months (Miller et al, 1984). Although there is a body of evidence to support medical treatment for LKS, there is limited information about the clinical management for the language disorder or acquired (central) auditory processing disorder [(C)APD]. The prognosis of a child with LKS is unpredictable due to variability in the time and amount of recovery and the severity of the disorder. Speech-language pathologists are often challenged with the task of maximizing language recovery. Treatment techniques have relied on visual aids such as graphic symbols and visual language systems, as well as cued speech (for a review of language treatment options, see Alpern, 2010). Thomas Gibson listens to dichotic sentences during his treatment session with SLP Kristen Beckner. It also is important for clinicians to recognize auditory processing deficits associated with the acquired (C)APD that results from LKS and to offer a deficit-specific remediation plan to improve the patient’s auditory processing ability. Previous reports of auditory processing deficits in LKS patients have cited difficulty listening in background noise or other degraded environments, challenges with auditory discrimination, and problems with dichotic listening tasks (Bamiou, Musiek, & Luxon, 2001). An assistive listening device such as an FM system may be useful to improve the signal-to-noise ratio. Speech-in-noise training may also improve the patient’s listening ability. Dichotic listening treatment is one type of direct remediation for (C)APD that takes advantage of the brain’s lifelong capacity for plasticity and adaptive reorganization (Musiek, Chermak, & Weihing, 2007). LKS patients have an abnormal electroencephalogram (EEG) typified by abnormal spike activity in the temporal and/or parietal regions (Deonna, Beaumanoir, Gaillard, & Assal, 1991). The abnormal EEG activity occurs predominantly in the left temporal lobe, but may be present in both temporal lobes (Deonna et al., 1991). From anatomical and physiologic dichotic listening modeling, it is reasonable that the only way to isolate the damaged auditory pathway is to force this auditory pathway to work by direct auditory stimulation—dichotic listening. In normal listening conditions, auditory information is conducted to the auditory cortex by both ipsilateral and contralateral auditory pathways; however, during controlled dichotic listening, the ipsilateral pathway is suppressed by the dominant contralateral pathway. This dominant contralateral model was first proposed by Kimura (1961), whose data led her to hypothesize that the contralateral pathway must have greater neuronal innervation that enables it to be dominant over the ipsilateral pathway. Early work in the 19th century noted that most aphasia is the result of lesions in the left cerebral hemisphere, leading to the conclusion that most people are left-hemisphere-dominant for expressive and receptive language. Further, a language-related auditory signal presented to the right ear travels from the dominant contralateral right auditory pathway directly to the left hemisphere. Conversely, a language-related auditory signal directed to the left ear is conducted to the right cortex, but must be transferred to the left hemisphere via corpus callosum in order for the person to repeat what was heard in the left ear. Thus, it is not surprising that there is a slight right-ear advantage for neurologically normal listeners when listening to dichotic tasks (Kimura, 1961; Lowe, Cullen, Berlin, Thompson, & Willett, 1970; Berlin, Lowe-Bell, Cullen & Thompson, 1973). When there is damage or a lesion in the auditory temporal lobe, the ear contralateral to the lesion will be affected in dichotic listening tasks, as the contralateral pathway is the dominant pathway. Because lesions often are found in the left temporal lobe in LKS patients, a right-ear deficit on dichotic testing is expected. Dichotic listening training is an innovative treatment for the remediation of the compromised central auditory pathway (Musiek et al., 2007). Dichotic interaural intensity difference (DIID) training uses dichotic listening tasks in which the signal intensity presented to the unimpaired pathway is first decreased and then slowly increased over time as the weaker, impaired pathway grows stronger. DIID training purports to target the deficit ear specifically, thus activating brain regions that receive auditory sensory input on the side of the lesion. Previous investigations have shown behavioral and electrophysiological evidence of improvement of the central auditory nervous system after DIID training (Musiek, Baran, & Shinn, 2004; Hurley & Billiet, 2007; for a complete review of the DIID procedure, see Musiek et al., 2007). Improvement after auditory rehabilitative dichotic listening in dichotic scores and language scores also were shown in a group of children with language disorders. Until recently, dichotic listening programs could be completed only in a controlled laboratory environment; now dichotic stimuli are available on compact discs. Dichotic exercises directly stimulate areas of the cortex, which in turn forces the auditory pathways to these areas to exercise and recruit existing neuronal connections or build new neural connections and pathways. As the integrity of these areas pathways is improved, speech stimuli can reach the language processing temporal lobe more efficiently, resulting in improvement of dichotic skills. Dichotic Training: Case Studies Two patients participated in dichotic listening training. “Michael” participated in dichotic listening therapy for two clinic semesters. “Thomas” lives in another state and participated in dichotic listening therapy with his speech-language pathologist. In dichotic training, stimuli are presented at different interaural intensities with a higher intensity directed to the poorer (dichotic scoring) and lower intensity directed to better (dichotic scoring) ear. Initial presentation level is at a comfortable level to the poorer scoring ear, and a soft level to the better (dichotic scoring) ear. When the individual’s target ear’s score reaches >70%, the intensity level delivered to the poorer ear is increased by 1, 2, or 5 dB. This continues until there are equal intensities presented to both ears. Because of the limited amount of dichotic listening materials, available, new recordings of digits, words, sentences, CVs and short stories were created and used in the training sessions. Case One: Michael Michael was the product of a normal pregnancy and birth. All developmental milestones were developing appropriately until the age of three. At that time, Michael’s speech and language skills began to decline. Initially, this decline in speech and language was attributed to sibling jealousy as this decline coincided with the birth of a younger sibling. Michael was sent for a hearing evaluation which established normal peripheral hearing. As Michael had a history of otitis media, the lack of progression in speech and language was next related to his history of ear infections. Subsequently, autism and pervasive developmental disorder were also erroneously diagnosed. With the onset of seizure activity at the age of three and a half years, the diagnosis of LKS was made after a characteristic spiking EEG. Nocturnal seizure activity continued until Michael was eleven years old, even though anticonvulsants were prescribed. At age 11, Michael had his first normal EEG. Our involvement with Michael began when he was 12.5 years old, as he was a subject in a study examining pre and post behavioral and electrophysiological measures after Fast ForWord® training, provided by Michael’s local school system. Approximately four weeks after Michael completed the Fast ForWord® program, Dichotic listening therapy began weekly for a total of twenty one hour dichotic listening training sessions. Post-testing showed improvement in dichotic scores after dichotic listening training, as well as improvements in electrophysiologic responses (auditory late response). In addition, unsolicited parental reports were positive. Extended family member, as well as Michael’s teachers, commented that his speech was improving and that he was speaking in complete sentences and thoughts, rather than in a telegraphic-type speech. They also reported that he rarely used signs. This cannot be validated, as we did not measure pre and post mean length utterance. Case Two: Thomas Thomas was the product of a normal pregnancy and birth history was normal. Gross motor development milestones were achieved at appropriate times. At age 3, Thomas had a speech-language evaluation to address articulation concerns. This assessment yielded normal results. Sleep concerns were noted as early as age 3 ½; at age 5 ½, a tonsillectomy/ adenoidectomy was performed for sleep apnea. Early behavioral, attention, language and hearing were first noted when Thomas was in pre-school. A speech-language assessment at that time (age 6.25) indicated a severe receptive language delay. Language regression and concerns continued over the next few years. Thomas had an abnormal EEG at age 8 years, 2 months indicated bilateral abnormalities, but left temporal lobe activity greater on the left side. Approximately six months later, an EEG indicated abnormalities on the right side, as well. Thomas is currently managed medically for his abnormal nocturnal EEG. In July, 2009, Thomas was formally diagnosed with Landau-Kleffner Syndrome (LKS). Thomas began dichotic listening in October, 2009. He was seen at the LSU Health Sciences Center in July, 2010. Because of the geographical distance, Thomas has been working with his speech language pathologist on dichotic listening via recorded compact discs. Training began 20 minutes, twice per week, and is now listening weekly. Although we do not have comprehensive pre and post (C)APD test results, we have dichotic test scores from an assessment in July, 2009. Scores previously abnormal are now within normal limits. Reference Alpern C. A. (2010). Identification and Treatment of Landau-Kleffner Syndrome. ASHA Leader, September 21, 34–35. Google Scholar Bamiou D. E., Musiek F. M., & Luxon L. M. (2001). Aetiology and clinical presentations of auditory processing disorders—a review.Archives of Disease in Children, 85, 361–365. Google Scholar Berlin C. I., Lowe-Bell S. S., Culen J. K., & Thompson C. L. (1973). Dichotic speech perception: an interpretation of right-ear advantage and temporal offset effects.Journal of the Acoustical Society of America, 53, 699–709. Google Scholar Berlin C. I., Lowe-Bell S. S., Jannetta P. J., & Kline D. G. (1972). Central auditory deficits after temporal lobectomy.Archives of Otolaryngology, 96, 4–10. Google Scholar Deonna T., Beaumanoir A., Gaillard F., Assal G. (1977). Acquired aphasia in childhood with seizure disorder: a heterogeneous syndrome.Neuropadiatrie, 8, 263–273. Google Scholar Hurley A., & Billiet C. (2009). Dichotic interaural intensity difference (DIID) training; auditory remediation after CVA.Poster Presentation at the annual ASHA Convention, Chicago, IL. Google Scholar Kimura D. (1961). Cerebral dominance and the perception of verbal stimuli.Canadian Journal of Psychology, 15, 166–171. CrossrefGoogle Scholar Lowe S. S., Cullen J. K., Berlin C. I., Thompson C. L., & Willett M. E. (1970). Perception of simultaneous dichotic and monotic monosyllables.Journal of Speech and Hearing Research, 13, 812–822. LinkGoogle Scholar Miller J. F., Campbell T. F., Chapman R. S., & Weismer S. E. (1984). Language behavior in acquired childhood aphasia.In Holland A. (Ed.), Language disorders in childhood: Recent advances (pp. 57–99). San Diego: College Hill Press. Google Scholar Musiek F. E., Chermak G., & Weihing J. (2007). Auditory training.In In. Musiek F.E. and Chermak G. D. (Eds.), Handbook of (Central) Auditory Processing Disorder: Comprehensive Intervention, (Vol II, pp. 77-106). San Diego: Plural Publishing, 2007. Google Scholar Musiek F. E., Baran J. A., & Shinn J. (2004). Assessment and remediation of an auditory processing disorder associated with head trauma.Journal of the American Academy of Audiology, 15, 117–132. CrossrefGoogle Scholar Author Notes is an assistant professor in the Department of Communication Sciences at Louisiana State University Health Sciences Center in New Orleans, La. Contact her at [email protected]. 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ABSTRACTNumerous investigations have identified weaknesses in speech processing and language skills in children with dyslexia; however, little is known about these abilities in children with reading difficulties (RD). The primary objective of this investigation was to determine the utility of auditory speech processing tasks in differentiating children with RD from those with typical reading skills. It was hypothesized that children, who perform below grade level in reading, would also show poorer performance on both dichotic listening and sentence repetition tasks because of the reciprocal influences of deficient auditory speech processing and language abilities. A total of 180 Hungarian-speaking, monolingual 8-, 9- and 10-year-old children, with and without RD, participated in dichotic listening and sentence repetition (modified by noise and morphosyntactic complexity) tasks. Performances were compared across ability groups, age and gender. Children with RD evidenced significantly poorer performance than controls on both tasks. Effects for age and gender were more noticeable in students with RD. Our findings support the notion that reading deficiencies are also associated with poor auditory speech processing and language abilities in cases where dyslexia is not diagnosed. We suggest that these tasks may be used as easy and fast screening tests in the identification of RD.

Rapid auditory processing and learning deficits in rats with P1 versus P7 neonatal hypoxic-ischemic injury

ObjectivesTo document the auditory processing, visual attention, digit memory, phonological processing, and receptive language abilities of individual children with identified word reading difficulties.DesignTwenty-five children with word reading difficulties and 28 control children with good word reading skills participated. All children were aged between 8 and 11 years, with normal hearing sensitivity and typical non-verbal intelligence. Both groups of children completed a test battery designed to assess their auditory processing, visual attention, digit memory, phonological processing, and receptive language.ResultsWhen compared to children who were good readers, children with word reading difficulties obtained significantly lower average scores on tests of auditory processing, including the frequency pattern test, gaps in noise, frequency discrimination, Dichotic Digit difference Test, and Listening in Spatialized Noise. The two groups did not differ on the discrimination measures of sinusoidal amplitude modulation or iterated rippled noise. The results from children with word reading difficulties showed that 5 children (20%) had comorbid deficits in auditory processing, visual attention, and backward digit memory; whereas 12 children (48%) had comorbid auditory processing and visual attention deficits only, and 2 children (8%) had comorbid deficits in auditory processing and digit memory; the remaining children had only auditory processing, visual attention, or digit memory deficits.ConclusionThe current study highlights the general co-existence of auditory processing, memory, and visual attention deficits in children with word reading difficulties. It is also noteworthy, however, that only one fifth of the current cohort had deficits across all measured tasks. Hence, our results also show the significant individual variability inherent in children with word reading difficulties.

Auditory processing in dyslexia and specific language impairment: is there a deficit? What is its nature? Does it explain anything?

The effects of chronic otitis media during the first three years of life on developing auditory processing skills were examined. Two groups of children with auditory processing deficits were compared in areas of language development, intellectual factors, auditory processing skills, and academic capabilities. One group of children with auditory processing deficits had a history of severe chronic otitis media during the first three years of life, whereas a second group had auditory processing deficits but no history of early middle ear infections. The results indicate that subjects who had a history of chronic otitis media were slower in developing word combinations, had depressed verbal intelligence scores, manifested pervasive auditory processing deficits, and were significantly poorer in reading. A profile has been constructed that permits early detection of the child at risk.

Normal-hearing older adults often experience increased difficulties understanding speech in noise. In addition, they benefit less from amplitude fluctuations in the masker. These difficulties may be attributed to an age-related auditory temporal processing deficit. However, a decline in cognitive processing likely also plays an important role. This study examined the relative contribution of declines in both auditory and cognitive processing to the speech in noise performance in older adults. Participants included older (60–72 years) and younger (19–29 years) adults with normal hearing. Speech reception thresholds (SRTs) were measured for sentences in steady-state speech-shaped noise (SS), 10-Hz sinusoidally amplitude-modulated speech-shaped noise (AM), and two-talker babble. In addition, auditory temporal processing abilities were assessed by measuring thresholds for gap, amplitude-modulation, and frequency-modulation detection. Measures of processing speed, attention, working memory, Text Reception Threshold (a visual analog of the SRT), and reading ability were also obtained. Of primary interest was the extent to which the various measures correlate with listeners' abilities to perceive speech in noise. SRTs were significantly worse for older adults in the presence of two-talker babble but not SS and AM noise. In addition, older adults showed some cognitive processing declines (working memory and processing speed) although no declines in auditory temporal processing. However, working memory and processing speed did not correlate significantly with SRTs in babble. Despite declines in cognitive processing, normal-hearing older adults do not necessarily have problems understanding speech in noise as SRTs in SS and AM noise did not differ significantly between the two groups. Moreover, while older adults had higher SRTs in two-talker babble, this could not be explained by age-related cognitive declines in working memory or processing speed.

It is indicated that auditory perception deficits are present in schizophrenia and related to formal thought disorder. The purpose of the present study was to investigate the association of auditory deficits with cognitive impairment in schizophrenia. An experimental group of 50 schizophrenia patients completed a battery of auditory processing evaluation and a neuropsychological battery of tests. Correlations between neuropsychological battery scores and auditory processing scores were examined. Cognitive impairment was correlated with auditory processing deficits in schizophrenia patients. All neuropsychological test scores were significantly correlated with at least one auditory processing test score. Our findings support the coexistence of auditory processing disorder, severe cognitive impairment, and formal thought disorder in a subgroup of schizophrenia patients. This may have important implications in schizophrenia research, as well as in early diagnosis and nonpharmacological treatment of the disorder.

A avaliação do Processamento Auditivo (PA) é um procedimento audiológico que fornece informações importantes relacionadas ao processo de compreensão do material linguístico. Com o objetivo de investigar as pesquisas que abordam a interface PA – Afasia foi realizada uma revisão sistemática tomando por referência os seguintes descritores e seus correlatos em língua inglesa: Afasia, Dicótico, Monótico, Processamento auditivo e Habilidades auditivas; a busca foi realizada no formato intersecção com o conectivo and. Os cinco estudos incluídos nesta pesquisa diferem em aspectos diversos nos seus objetivos, tais como localização da lesão, mudança da dominância hemisférica para linguagem, presença de vantagem da orelha esquerda em quadros de afasia, relação entre habilidades auditivas e linguagem e a extinção auditiva. Os trabalhos analisados sugerem que as abordagens acerca do processamento auditivo e afasia ocorreram sob duas perspectivas de funcionamento cortical: teoria localizacionista e teoria distribucionista, estando a maioria dos artigos (três), em consonância com a primeira corrente (localizacionista).

Background/Aims: Specific language impairment (SLI) is believed to be associated with nonverbal auditory (NVA) deficits. It remains unclear, however, whether children with SLI show deficits in auditory time processing, time processing in general, frequency discrimination (FD), or NVA processing in general. Patients and Methods: Twenty-seven children (aged 8–11) with SLI and 27 control children (CG), matched for age and gender, were retrospectively compared with regard to their performance on five NVA skills in terms of just noticeable differences (JND) and time order judgments (TOJ). JND was used for FD, intensity discrimination, and gap detection, while TOJ was used for FD and clicks. Results: Children with SLI performed significantly worse than the CG only on the FD tasks (JND and TOJ). The other nonverbal tasks showed no significant intergroup differences. Additionally, moderate associations were found between the FD tasks and phonological skills, as well as between FD tasks and language scores. Conclusion: Children with SLI appear to have restricted FD skills compared to controls, but there was no evidence for a common NVA deficit or reduced temporal auditory abilities.

Neural processing of speech in noise recognition in preschool children with different auditory processing abilities: a fNIRS study.

This study investigated the self-reported listening abilities of older adults with clinically normal hearing and examined the role of auditory processing abilities and extended high-frequency thresholds in perceived challenges. This cross-sectional study used self-report questionnaires and objective measures, such as the dichotic digit test, gaps-in-noise test, and extended high-frequency audiometry. Fifty adults, including 25 younger adults (<30 years) and 25 older adults (≥50 years) with normal hearing thresholds, were included. Older adults reported significantly more difficulties in spatial hearing, intelligibility in quiet and sound identification tasks compared to younger adults. Objective assessments revealed deficits in temporal resolution, binaural separation, and extended high-frequency thresholds in older individuals. Significant correlations were observed between extended high-frequency thresholds and auditory processing abilities. However, no correlation was found between extended high-frequency thresholds and self-reported listening difficulties. Older adults with clinically normal hearing reported more listening difficulties and performed worse in auditory processing tasks than younger adults. Extended high-frequency thresholds were correlated with auditory processing abilities but not with self-reported difficulties. These findings indicate a relationship between age-related auditory changes and perceived listening difficulties, emphasizing the need for a comprehensive auditory assessment in older adults.

Discriminant analysis (DA) and self-organizing feature maps (SOFM) were used to classify passively evoked auditory event-related potentials (ERP) P₁, N₁, P₂ and N₂. Responses from 16 children with severe behavioral auditory perception deficits, 16 children with marked behavioral auditory perception deficits, and 14 controls were examined. Eighteen ERP amplitude parameters were selected for examination of statistical differences between the groups. Different DA methods and SOFM configurations were trained to the values. SOFM had better classification results than DA methods. Subsequently, measures on another 37 subjects that were unknown for the trained SOFM were used to test the reliability of the system. With 10-dimensional vectors, reliable classifications were obtained that matched behavioral auditory perception deficits in 96%, implying central auditory processing disorder (CAPD). The results also support the assumption that CAPD includes a ‘non-peripheral’ auditory processing deficit.