Auditory pattern recognition and brief tone discrimination of children with reading disorders

Comorbidity of Auditory Processing, Attention, and Memory in Children With Word Reading Difficulties

OBJECTIVES

To document the auditory processing, visual attention, digit memory, phonological processing, and receptive language abilities of individual children with identified word reading difficulties.

DESIGN

Twenty-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.

RESULTS

When 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.

CONCLUSION

The 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.

Same or Different: The Overlap Between Children With Auditory Processing Disorders and Children With Other Developmental Disorders: A Systematic Review

Supplemental Digital Content is available in the text.

Objectives:

Children diagnosed with auditory processing disorders (APD) experience difficulties in auditory functioning and with memory, attention, language, and reading tasks. However, it is not clear whether the behavioral characteristics of these children are distinctive from the behavioral characteristics of children diagnosed with a different developmental disorder, such as specific language impairment (SLI), dyslexia, attention-deficit hyperactivity disorder (ADHD), learning disorder (LD), or autism spectrum disorder. This study describes the performance of children diagnosed with APD, SLI, dyslexia, ADHD, and LD to different outcome measurements. The aim of this study was to determine (1) which characteristics of APD overlap with the characteristics of children with SLI, dyslexia, ADHD, LD, or autism spectrum disorder; and (2) if there are characteristics that distinguish children diagnosed with APD from children diagnosed with other developmental disorders.

Design:

A systematic review. Six electronic databases (Pubmed, CINAHL, Eric, PsychINFO, Communication & Mass Media Complete, and EMBASE) were searched to find peer-reviewed studies from 1954 to May 2015. The authors included studies reporting behaviors and performance of children with (suspected) APD and children diagnosed with a different developmental disorder (SLI, Dyslexia, ADHD, and LD). Two researchers identified and screened the studies independently. Methodological quality of the included studies was assessed with the American Speech-Language-Hearing Association’s levels-of-evidence scheme.

Results:

In total, 13 studies of which the methodological quality was moderate were included in this systematic review. In five studies, the performance of children diagnosed with APD was compared with the performance of children diagnosed with SLI: in two with children diagnosed with dyslexia, one with children diagnosed with ADHD, and in another one with children diagnosed with LD. Ten of the studies included children who met the criteria for more than one diagnosis. In four studies, there was a comparison made between the performances of children with comorbid disorders. There were no studies found in which the performance of children diagnosed with APD was compared with the performance of children diagnosed with autism spectrum disorder. Children diagnosed with APD broadly share the same characteristics as children diagnosed with other developmental disorders, with only minor differences between them. Differences were determined with the auditory and visual Duration Pattern Test, the Children’s Auditory Processing Performance Scale questionnaire, and the subtests of the Listening in Spatialized Noise-Sentences test, in which noise is spatially separated from target sentences. However, these differences are not consistent between studies and are not found in comparison to all groups of children with other developmental disorders.

Conclusions:

Children diagnosed with APD perform equally to children diagnosed with SLI, dyslexia, ADHD, and LD on tests of intelligence, memory or attention, and language tests. Only small differences between groups were found for sensory and perceptual functioning tasks (auditory and visual). In addition, children diagnosed with dyslexia performed poorer in reading tasks compared with children diagnosed with APD. The result is possibly confounded by poor quality of the research studies and the low quality of the used outcome measures. More research with higher scientific rigor is required to better understand the differences and similarities in children with various neurodevelopmental disorders.

Evidence for a general auditory processing deficit in developmental dyslexia from a discrimination paradigm using speech versus nonspeech sounds matched in complexity

PURPOSE

It is unknown whether phonological deficits are the primary cause of developmental dyslexia or whether they represent a secondary symptom resulting from impairments in processing basic acoustic parameters of speech. This might be due, in part, to methodological difficulties. Our aim was to overcome two of these difficulties: the comparability of stimulus material and task in speech versus nonspeech conditions.

METHOD

In this study, the authors (a) assessed auditory processing of German vowel center stimuli, spectrally rotated versions of these stimuli, and bands of formants; (b) used the same task for linguistic and nonlinguistic conditions; and (c) varied systematically temporal and spectral parameters inherent in the German vowel system. Forty-two adolescents and adults with and without reading disabilities participated.

RESULTS

Group differences were found for all linguistic and nonlinguistic conditions for both temporal and spectral parameters. Auditory deficits were identified in most but not all participants with dyslexia. These deficits were not restricted to speech stimuli-they were also found for nonspeech stimuli with equal and lower complexity compared with the vowel stimuli. Temporal deficits were not observed in isolation.

CONCLUSION

These results support the existence of a general auditory processing impairment in developmental dyslexia.

Phonological, temporal and spectral processing in vowel length discrimination is impaired in German primary school children with developmental dyslexia

It is still unclear whether phonological processing deficits are the underlying cause of developmental dyslexia, or rather a consequence of basic auditory processing impairments. To avoid methodological confounds, in the current study the same task and stimuli of comparable complexity were used to investigate both phonological and basic auditory (temporal and spectral) processing in dyslexia. German dyslexic children (Grades 3 and 4) were compared to age- and grade-matched controls in a vowel length discrimination task with three experimental conditions: In a phonological condition, natural vowels were used, differing both with respect to temporal and spectral information (in German, vowel length is phonemic, and vowel length differences are characterized by both temporal and spectral information). In a temporal condition, spectral information differentiating between the two vowels of a pair was eliminated, whereas in a spectral condition, temporal differences were removed. As performance measure, the sensitivity index d' was computed. At the group level, dyslexic children's performance was inferior to that of controls for phonological as well as temporal and spectral vowel length discrimination. At an individual level, nearly half of the dyslexic sample was characterized by deficits in all three conditions, but there were also some children showing no deficits at all. These results reveal on the one hand that phonological processing deficits in dyslexia may stem from impairments in processing temporal and spectral information in the speech signal. On the other hand they indicate, however, that not all dyslexic children might be characterized by phonological or auditory processing deficits.

Gaps-in-noise (GIN©) test results in children with and without reading disabilities and phonological processing deficits

OBJECTIVE

To determine if the gaps-in-noise (GIN(©)) test could differentiate children with dyslexia and significant phonological awareness deficits from a group of children with normal reading skills.

DESIGN

A prospective study of GIN test performance in two groups of children. Participants were administered routine audiological tests, a phonological processing test, and an auditory temporal resolution test (GIN test). Statistical testing was completed to determine if significant differences existed between groups on GIN test results and phonological processing measures, and to examine potential relationships between these test measures. Routine clinical analysis procedures examined the performance of the two groups from a clinical perspective.

STUDY SAMPLE

Participants included 61 children between the ages of 8 years, 1 month and 9 years, 11 months, separated into two groups: children with dyslexia and significant phonological deficits (Group I); normal-reading peers with age-appropriate phonological skills (Group II).

RESULTS

Children in Group I showed longer gap detection (GD) thresholds and lower gap identification scores than did the children in Group II. Results of statistical and clinical testing revealed significant differences between the groups.

CONCLUSION

An auditory temporal processing deficit is a factor to be considered in children presenting with dyslexia and phonological processing disorders.

Construct Validity and Measurement Invariance of the Peabody Picture Vocabulary Test-III Form A in the Performance of Struggling Adult Readers: Rasch Modeling

PURPOSE: The aim of this study was to apply the Rasch model to an analysis of the psychometric properties of the PPVT-III Form A items with struggling adult readers. METHODS: The PPVT-IIIA was administered to 229 African-American adults whose isolated word reading skills were between third and fifth grades. Conformity of the adults' performance on the PPVT-III items was evaluated using the Winsteps software. RESULTS: Analysis of all PPVT-IIIA items combined did not fully support its use as a useful measure of receptive vocabulary for struggling adult readers who were African Americans. To achieve an adequate model fit, items 73 through item 156 were analyzed. The items analyzed showed adequate internal consistency reliability, unidimensionality, and freedom from differential item functioning for ability, gender, and age, with a minor modification. DISCUSSION: With an appropriate treatment of misfit items, the results supported the measurement properties, internal consistency reliability, unidimensionality of the PPVT-IIIA items, and measurement invariance of the test across subgroups of ability, age, and gender.

The relationship between brainstem temporal processing and performance on tests of central auditory function in children with reading disorders

PURPOSE

Studies using speech stimuli to elicit electrophysiologic responses have found approximately 30% of children with language-based learning problems demonstrate abnormal brainstem timing. Research is needed regarding how these responses relate to performance on behavioral tests of central auditory function. The purpose of the study was to investigate performance of children with dyslexia with and without abnormal brainstem timing and children with no history of learning or related disorders on behavioral tests of central auditory function.

METHOD

Performance of 30 school-age children on behavioral central auditory tests in common clinical use was examined: Group 1 (n = 10): dyslexia, abnormal brainstem timing; Group 2 (n = 10): dyslexia, normal brainstem timing; Group 3 (n = 10): typical controls.

RESULTS

Results indicated that all participants in Group 2 met diagnostic criteria for (central) auditory processing disorder [(C)APD], whereas only 4 participants in Group 1 met criteria. The Biological Marker of Auditory Processing (BioMARK) identified 6 children in Group 1 who did not meet diagnostic criteria for (C)APD but displayed abnormal brainstem timing.

CONCLUSIONS

Results underscore the importance of central auditory assessment for children with dyslexia. Furthermore, the BioMARK may be useful in identifying children with central auditory dysfunction who would not have been identified using behavioral methods of (C)APD assessment.