Speech sound perception, neurophysiology, and plasticity

Mismatched response predicts behavioral speech discrimination outcomes in infants with hearing loss and normal hearing

Children with hearing loss (HL) remain at risk for poorer language abilities than normal hearing (NH) children despite targeted interventions; reasons for these differences remain unclear. In NH children, research suggests speech discrimination is related to language outcomes, yet we know little about it in children with HL under the age of 2 years. We utilized a vowel contrast, /a-i/, and a consonant-vowel contrast, /ba-da/, to examine speech discrimination in 47 NH infants and 40 infants with HL. At Mean age =3 months, EEG recorded from 11 scalp electrodes was used to compute the time-frequency mismatched response (TF-MMR_SE ) to the contrasts; at Mean age =9 months, behavioral discrimination was assessed using a head turn task. A machine learning (ML) classifier was used to predict behavioral discrimination when given an arbitrary TF-MMR_SE as input, achieving accuracies of 73% for exact classification and 92% for classification within a distance of one class. Linear fits revealed a robust relationship regardless of hearing status or speech contrast. TF-MMR_SE responses in the delta (1-3.5 Hz), theta (3.5-8 Hz), and alpha (8-12 Hz) bands explained the most variance in behavioral task performance. Our findings demonstrate the feasibility of using TF-MMR_SE to predict later behavioral speech discrimination.

Electrophysiological and phonological change detection measures of auditory word processing in normal Persian-speaking children

OBJECTIVE

Auditory phoneme discrimination is a basic and important prerequisite for acquiring speech, reading, and spelling skills. Children, who are unable to perceive auditory phoneme discrimination, cannot develop phonemic representations. Therefore, the early identification of these deficits and application of effective therapeutic approaches is a necessity. We need to assess appropriately word or sound discrimination in normal populations using an objective passive task such as mismatch negativity (MMN). Therefore, the aim of the present study was to investigate MMN responses using speech stimuli (words) in 6-7 year-old normal Persian-speaking children.

METHODS

Ten right-handed Persian-speaking children with normal visual and auditory acuity, aged from 6 to 7 years, participated in the study. Recording of electroencephalography (EEG) was done by 64 A g/AgCl electrodes. A new auditory paradigm was used with three deviant stimuli (/gam/,/jam/, and/tam/) which differed in the first consonant from a repeated standard word (/dam/). A total of 1500 stimuli, 750 standards and 750 deviants (250 each deviant), were presented by Cogent 2000 running in MATLAB software using two loud speakers.

RESULTS

MMN peaked over the fronto-central sites at around 380-424 ms after the onset of the stimulus. The comparison of the MMN amplitudes elicited by three deviants revealed a significant "initial phoneme type" effect in Fz and Cz (p < 0.05). This negativity was found to be larger for manner and voicing deviants compared with that of the place of articulation (p < 0.001) on midline scalps. The comparison of the MMN latencies revealed no significant main effect of all variables (p > 0.05). Also, the results revealed that only the MMN amplitude for the/gam/deviant correlated with the percentage of correct responses (R = -0.86, p < 0.01).

CONCLUSION

The current study showed that words can elicit MMN responses in ∼200 ms after the onset of changes. We can objectively evaluate children's neural speech sound discrimination using the developed paradigm in a natural word context. This paradigm can be useful objectively for investigating distinctive features of sounds and phonological discrimination development in normal children.

On the development of auditory distraction: A review

The present review focuses on the development of involuntary attention mechanisms in the context of the occurrence of unexpected events during childhood. We introduce a prevailing three-stage model of auditory involuntary attention describing the processes leading to, accompanying, and following the distraction of attention by prediction violations: (a) the automatic detection of prediction violations (associated with the event-related potential [ERP] component mismatch negativity [MMN]), (b) the involuntary orienting of attention processes towards the prediction violating sound (associated with the ERP component P3a), and (c) the reorienting back to task-relevant information (associated with the ERP components reorienting negativity [RON] or late discriminative negativity [LDN]). Within this framework we give an overview of studies investigating MMN, P3a, RON/LDN, and behavioral distraction effects in children. We discuss the development of the underlying involuntary attention mechanisms and highlight the relevance of and future perspectives for this important field of research.

A triagem auditiva neonatal antecipa o diagnóstico e a intervenção em crianças com perda auditiva?

Objetivo Identificar a idade de diagnóstico, intervenção e amplificação pré e pós-implantação da Triagem Auditiva Neonatal (TAN) em um serviço de saúde auditiva e comparar aos indicadores propostos pelo Comitê Conjunto para Audição Infantil.Métodos Trezentos e treze prontuários de crianças atendidas no setor de reabilitação auditiva foram analisados, verificando se foi realizada a triagem auditiva e seu resultado, suspeita e idade de diagnóstico, intervenção e amplificação e se estas últimas atendiam aos indicadores preconizados: três meses para diagnóstico e seis meses para intervenção.Resultados Crianças identificadas pela TAN foram diagnosticadas e iniciaram a intervenção mais cedo do que as que não realizaram. Considerando-se a demanda institucional pré e pós a implantação da TAN, observou-se redução da idade de intervenção e amplificação após a implantação. Independentemente do resultado obtido na TAN (passa/falha), as crianças que passaram pela triagem apresentaram vantagem, quando comparadas às não triadas, uma vez que, dentre as triadas, antecipou-se o diagnóstico, a intervenção e a amplificação. Menos da metade das crianças que falharam na TAN concluíram o diagnóstico e iniciaram a intervenção no tempo preconizado.Conclusão A TAN antecipou o diagnóstico e a intervenção em crianças com perda auditiva. Contudo, fatores como a não adesão da família e as peculiaridades do diagnóstico retardaram os processos, impedindo que os indicadores preconizados fossem alcançados, na maior parte das crianças.

Auditory evoked potentials: predicting speech therapy outcomes in children with phonological disorders

OBJECTIVES

This study investigated whether neurophysiologic responses (auditory evoked potentials) differ between typically developed children and children with phonological disorders and whether these responses are modified in children with phonological disorders after speech therapy.

METHODS

The participants included 24 typically developing children (Control Group, mean age: eight years and ten months) and 23 children clinically diagnosed with phonological disorders (Study Group, mean age: eight years and eleven months). Additionally, 12 study group children were enrolled in speech therapy (Study Group 1), and 11 were not enrolled in speech therapy (Study Group 2). The subjects were submitted to the following procedures: conventional audiological, auditory brainstem response, auditory middle-latency response, and P300 assessments. All participants presented with normal hearing thresholds. The study group 1 subjects were reassessed after 12 speech therapy sessions, and the study group 2 subjects were reassessed 3 months after the initial assessment. Electrophysiological results were compared between the groups.

RESULTS

Latency differences were observed between the groups (the control and study groups) regarding the auditory brainstem response and the P300 tests. Additionally, the P300 responses improved in the study group 1 children after speech therapy.

CONCLUSION

The findings suggest that children with phonological disorders have impaired auditory brainstem and cortical region pathways that may benefit from speech therapy.

Temporal processing in children with phonological disorders submitted to auditory training: a pilot study

PURPOSE

This study compared the temporal processing performance of children with phonological disorders submitted to formal and informal auditory training.

METHODS

Fifteen subjects with phonological disorder (pure tone thresholds ≤20 dBHL from 0.50 to 4 kHz, and age between 7 years and 10 years and 11 months) were evaluated, divided into three groups:

CONTROL GROUP

five subjects (mean age 9.1 years) without auditory processing disorder, who passed through two evaluations of the auditory processing at intervals of six to eight weeks and without any intervention; Formal Training Group with five subjects (average 8.3 years) with auditory processing disorder submitted to eight sessions of formal training; and Informal Training Group, with five subjects (average 8.1 years) with auditory processing disorder submitted to eight sessions of informal training.

RESULTS

After eight sessions the formal training group showed an improvement of 8% and the informal training group of 22.5% in comparison with the pitch pattern sequence test. For the duration pattern sequence test, the average of the formal training group improved by 12.9% and the informal training group by 18.7%. There was no statistical difference between the means obtained by both groups after intervention, neither in the pitch pattern nor in the duration pattern sequence test.

CONCLUSION

Although the results did not present significant differences, this pilot study suggests that both formal and informal trainings provide improvement in the temporal processing abilities of children with phonological and auditory processing disorders.

Mismatch negativity and P300 to behaviorally perceptible and imperceptible temporal contrasts

The purpose of this study was to specify whether electrophysiological indices of behavioral discrimination of auditory duration could be demonstrated. Mismatch negativities and P300s were recorded to perceptible and imperceptible stimuli in 23 normal-hearing young adults. Behaviorally perceptible and imperceptible stimuli were demonstrated by measuring difference limens in a standard psychophysical procedure in a subset of participants (n = 8). Perceptibility was further demonstrated using a standard clinical pattern-perception test and modified-duration pattern tests created for this study. Mismatch negativities and P300s were recorded with an oddball paradigm using stimuli identical to those used in behavioral testing. All participants exhibited P300s in the perceptible contrast, while responses were absent for the imperceptible contrast. Mismatch negativities were found for 18 and 5 of 23 participants to the perceptible and imperceptible contrasts, respectively. The mismatch negativity did not correspond with behavioral discrimination and, as such, one could question its clinical feasibility. The P300 more accurately reflected behavioral discrimination performance in the current paradigm.

Phonetic processing in children with cochlear implants: an auditory event-related potentials study

OBJECTIVES

To investigate the effect of increasing acoustic-phonetic difficulty in children with cochlear implants (CI) by means of auditory event-related potentials (AERPs).

DESIGN

AERPs were recorded from a group of ten 9- to 14-year-old prelingually deafened children who exhibited open-set speech recognition, using the Nucleus 22 CI for at least 5 years. AERPs were recorded in sound field while children were performing oddball discrimination tasks with increasing acoustic-phonetic demand. The tasks consisted pairs of naturally produced stimuli that differed by one phonetic feature: vowel place (/ki/ versus/ku/), vowel height (/ki/ versus /ke/), voicing (/ka/ versus /ga/), and place of articulation (/ka/ versus /ta/). Using a repeated measure design, the effect of increasing acoustic-phonetic difficulty on P3 latency, amplitude, and scalp distribution as well as on the simultaneously obtained behavioral measures, performance accuracy, and reaction time was evaluated.

RESULTS

AERPs elicited in the range of 350 msec poststimulus onset were contaminated by the CI stimulus artifact, thus enabling reliable identification of the P3 component only. Increasing acoustic-phonetic difficulty was manifested in all measures in a hierarchical manner: P3 latency and reaction time increased, whereas P3 amplitude and performance accuracy decreased. The correlations, however, between behavioral and electrophysiological measures were not significant. Further support for P3 sensitivity to increasing acoustic-phonetic demand was its absence in four of the 10 children, but only in the most difficult place of articulation task. P3 amplitude was maximal at the midline parietal cite, with equal amplitudes over the right and left scalp regardless of side of implant.

CONCLUSIONS

The results underscore the significant value of the P3 potential as a sensitive neural index of speech-sound processing in children with CI. The similar hierarchy of acoustic-phonetic demand manifested in both behavioral and electrophysiological measures suggests that speech perception performance relates to neurophysiologic responses at cortical levels of the auditory system. Thus, recording the P3 potential to distinct phonetic contrasts may be useful for studying accessibility and neural encoding at the cortical level in CI recipients.

The maturation of human evoked brain potentials to sounds presented at different stimulus rates

The current study assessed the normal development of cortical auditory evoked potentials (CAEPs) in humans presented with pure tone stimuli at relatively fast stimulus rates. Traditionally, maturation of sound processing indexed by CAEPs has been studied in paradigms using inter-stimulus intervals (ISIs) generally slower than 1 Hz. While long ISIs may enhance the amplitude of CAEP components, speech information generally occurs at more rapid rates. These slower rates of sound presentation may not accurately assess auditory cortical functions in more realistic sound environments. We examined the effect of temporal rate on the elicitation of the P1-N1-P2-N2 components to unattended sounds at four levels of stimulus onset asynchrony (SOA, onset to onset, 200, 400, 600, and 800 ms) in children grouped separately by year (ages 8, 9, 10, 11 years), in adolescents (age 16 years) and in one group of young adults (ages 22-40 years). We found that both age and stimulus rate produced profound changes in CAEP morphology. Between the ages of 8-11 years, the P1 and N2 components dominated the ERP waveform at all stimulus rates. N1, the dominant CAEP component in adults, appeared as a bifurcation in a broad positive peak at earlier ages, and did not emerge as a separate component until adolescence. While the P1-N1-P2 components are more "adult-like" than "child-like" in the adolescent subjects, the N2 component, a hallmark of the child obligatory response, was still present. Faster rates resulted in the suppression of discrete components such that by 200 ms, only P1 in the adults and adolescents, and both P1 and N2 in the youngest children were discernable. We conclude that both age and ISI are important variables in the assessment of auditory cortex function and maturation. The presence of N2 in adolescents indicates that auditory cortical maturation persists into teen years.

The development of involuntary and voluntary attention from childhood to adulthood: A combined behavioral and event-related potential study

OBJECTIVE

This study investigated auditory involuntary and voluntary attention in children aged 6-8, 10-12 and young adults. The strength of distracting stimuli (20% and 5% pitch changes) and the amount of allocation of attention were varied.

METHODS

In an auditory distraction paradigm event-related potentials (ERPs) and behavioral data were measured from subjects either performing a sound duration discrimination task or watching a silent video.

RESULTS

Pitch changed sounds caused prolonged reaction times and decreased hit rates in all age groups. Larger distractors (20%) caused stronger distraction in children, but not in adults. The amplitudes of mismatch negativity (MMN), P3a, and reorienting negativity (RON) were modulated by age and by voluntary attention. P3a was additionally affected by distractor strength. Maturational changes were also observed in the amplitudes of P1 (decreasing with age) and N1 (increasing with age). P2-modulation by voluntary attention was opposite in young children and adults.

CONCLUSIONS

Results suggest quantitative and qualitative changes in auditory voluntary and involuntary attention and distraction during development. The processing steps involved in distraction (pre-attentive change detection, attention switch, reorienting) are functional in children aged 6-8 but reveal characteristic differences to those of young adults. In general, distractibility as indicated by behavioral and ERP measures decreases from childhood to adulthood.

SIGNIFICANCE

Behavioral and ERP markers for different processing stages involved in voluntary and involuntary attention reveal characteristic developmental changes from childhood to young adulthood.

Sensitividade e especificidade do potencial de média latência

O Potencial Evocado Auditivo de Média Latência (PEAML) foi primeiramente descrito por Geisler, Frishkopf, Rosenblith em 1958.¹ É caracterizado por uma série de ondas/respostas neuroelétricas gravadas no cérebro através de eletrodos de superfície. Atualmente, tem sido visto como um dos testes eletrofisiológicos mais promissores para a avaliação das disfunções e/ou alterações do Sistema Nervoso Auditivo Central. Suas ondas aparecem no intervalo entre 10 e 80 milissegundos (ms) após o início do estímulo auditivo. A onda Pa é a mais estudada por ser a mais visível e robusta deste potencial. Esse teste ainda é pouco utilizado na prática clínica pelo fato de existir uma grande variabilidade nos resultados encontrados intersujeitos, o que torna difícil o estabelecimento de medidas de normalidade. OBJETIVO: O objetivo desse trabalho foi estabelecer a efetividade - sensitividade e especificidade do PEAML para que este potencial possa ser mais utilizado com maior fidedignidade. FORMA DE ESTUDO: Caso-controle. MATERIAL E MÉTODO: Fizeram parte desse estudo indivíduos com idade entre 15 e 55 anos, portadores de lesões de Sistema Nervoso Auditivo Central, comprovada através de diagnóstico por imagem ou que tenham sido submetidos a cirurgias crânio-encefálicas, indivíduos portadores de Transtornos do Processamento Auditivo (TPA) comprovadas através de avaliação comportamental e indivíduos normais (Grupo Controle). RESULTADOS: Os resultados mostram que o corte de 30% apresentou melhores resultados, tanto para o efeito de eletrodo quanto para o efeito de orelha. O efeito de orelha foi mais fidedigno para evidenciar Transtornos de Processamento Auditivo, enquanto o efeito de eletrodo foi mais efetivo para evidenciar lesão.

Neurophysiologic correlates of deficient phonological representations and object naming in prematurely born children

OBJECTIVE

The aim of this follow-up study was to evaluate the development of object naming ability and auditory processing in prematurely born children. Furthermore, we investigated whether the mismatch negativity (MMN) parameters at the age of 4 years correlate with the MMN parameters and naming ability at the age of 6 years.

METHODS

Twelve very low birth weight (VLBW) preterm children (mean age 5 years 7 months) and matched controls were studied. Object naming was measured by the Boston naming test. Auditory event-related potentials (ERPs), especially the MMN, were recorded for Finnish syllables (standard /taa/; deviants /ta/ and /kaa/) in an oddball paradigm.

RESULTS

VLBW preterm children scored significantly lower in the object naming test than their controls. The MMN amplitude for consonant change was significantly smaller in the preterm group compared to the controls. The MMN amplitude at the age of 4 years correlated with the MMN amplitude at the age of 6 years. Furthermore, absence of the MMN at the age of 4 years predicted naming difficulties at the age of 6 years.

CONCLUSIONS

VLBW preterm children with a difficulty to preattentively discriminate changes in syllables, as indexed by the diminished change detection response, MMN, seem to have sustained naming difficulty. Therefore, it is reasonable to record the MMN along with the language development from infancy, in order to identify the children at risk for language deficiencies and to provide appropriate rehabilitation.