Assistive listening devices drive neuroplasticity in children with dyslexia

Electrophysiological Measures of Listening-in-Noise With and Without Remote Microphone System Use in Autistic and Non-Autistic Youth

OBJECTIVES

This study examined the neural mechanisms by which remote microphone (RM) systems might lead to improved behavioral performance on listening-in-noise tasks in autistic and non-autistic youth.

DESIGN

Cortical auditory evoked potentials (CAEPs) were recorded in autistic (n = 25) and non-autistic (n = 22) youth who were matched at the group level on chronological age ( M = 14.21 ± 3.39 years) and biological sex. Potentials were recorded during an active syllable identification task completed in quiet and in multi-talker babble noise with and without the use of an RM system. The effects of noise and RM system use on speech-sound-evoked P1-N1-P2 responses and the associations between the cortical responses and behavioral performance on syllable identification were examined.

RESULTS

No group differences were observed for behavioral or CAEP measures of speech processing in quiet or in noise. In the combined sample, syllable identification in noise was less accurate and slower than in the quiet condition. The addition of the RM system to the noise condition restored accuracy, but not the response speed, to the levels observed in quiet. The CAEP analyses noted amplitude reductions and latency delays in the noise compared with the quiet condition. The RM system use increased the N1 amplitude as well as reduced and delayed the P2 response relative to the quiet and noise conditions. Exploratory brain-behavior correlations revealed that larger N1 amplitudes in the RM condition were associated with greater behavioral accuracy of syllable identification. Reduced N1 amplitude and accelerated P2 response were associated with shorter syllable identification response times when listening with the RM system.

CONCLUSIONS

Findings suggest that although listening-in-noise with an RM system might remain effortful, the improved signal to noise ratio facilitates attention to the sensory features of the stimuli and increases speech sound identification accuracy.

Remediation of Perceptual Deficits in Progressive Auditory Neuropathy: A Case Study

BACKGROUND

Auditory neuropathy (AN) is a hearing disorder that affects neural activity in the VIIIth cranial nerve and central auditory pathways. Progressive forms have been reported in a number of neurodegenerative diseases and may occur as a result of both the deafferentiation and desynchronisation of neuronal processes. The purpose of this study was to describe changes in auditory function over time in a patient with axonal neuropathy and to explore the effect of auditory intervention.

METHODS

We tracked auditory function in a child with progressive AN associated with Charcot-Marie-Tooth (Type 2C) disease, evaluating hearing levels, auditory-evoked potentials, and perceptual abilities over a 3-year period. Furthermore, we explored the effect of auditory intervention on everyday listening and neuroplastic development.

RESULTS

While sound detection thresholds remained constant throughout, both electrophysiologic and behavioural evidence suggested auditory neural degeneration over the course of the study. Auditory brainstem response amplitudes were reduced, and perception of auditory timing cues worsened over time. Functional hearing ability (speech perception in noise) also deteriorated through the first 1.5 years of study until the child was fitted with a "remote-microphone" listening device, which subsequently improved binaural processing and restored speech perception ability to normal levels.

CONCLUSIONS

Despite the deterioration of auditory neural function consistent with peripheral axonopathy, sustained experience with the remote-microphone listening system appeared to produce neuroplastic changes, which improved the patient's everyday listening ability-even when not wearing the device.

Hearing Assistive Technology Facilitates Sentence-in-Noise Recognition in Chinese Children With Autism Spectrum Disorder

PURPOSE

Hearing assistive technology (HAT) has been shown to be a viable solution to the speech-in-noise perception (SPIN) issue in children with autism spectrum disorder (ASD); however, little is known about its efficacy in tonal language speakers. This study compared sentence-level SPIN performance between Chinese children with ASD and neurotypical (NT) children and evaluated HAT use in improving SPIN performance and easing SPIN difficulty.

METHOD

Children with ASD (n = 26) and NT children (n = 19) aged 6-12 years performed two adaptive tests in steady-state noise and three fixed-level tests in quiet and steady-state noise with and without using HAT. Speech recognition thresholds (SRTs) and accuracy rates were assessed using adaptive and fixed-level tests, respectively. Parents or teachers of the ASD group completed a questionnaire regarding children's listening difficulty under six circumstances before and after a 10-day trial period of HAT use.

RESULTS

Although the two groups of children had comparable SRTs, the ASD group showed a significantly lower SPIN accuracy rate than the NT group. Also, a significant impact of noise was found in the ASD group's accuracy rate but not in that of the NT group. There was a general improvement in the ASD group's SPIN performance with HAT and a decrease in their listening difficulty ratings across all conditions after the device trial.

CONCLUSIONS

The findings indicated inadequate SPIN in the ASD group using a relatively sensitive measure to gauge SPIN performance among children. The markedly increased accuracy rate in noise during HAT-on sessions for the ASD group confirmed the feasibility of HAT for improving SPIN performance in controlled laboratory settings, and the reduced post-use ratings of listening difficulty further confirmed the benefits of HAT use in daily scenarios.

Plasticity Changes in Central Auditory Systems of School-Age Children Following a Brief Training With a Remote Microphone System

OBJECTIVES

The objective of this study was to investigate whether a brief speech-in-noise training with a remote microphone (RM) system (favorable listening condition) would contribute to enhanced post-training plasticity changes in the auditory system of school-age children.

DESIGN

Before training, event-related potentials (ERPs) were recorded from 49 typically developing children, who actively identified two syllables in quiet and in noise (+5 dB signal-to-noise ratio [SNR]). During training, children completed the same syllable identification task as in the pre-training noise condition, but received feedback on their performance. Following random assignment, half of the sample used an RM system during training (experimental group), while the other half did not (control group). That is, during training' children in the experimental group listened to a more favorable speech signal (+15 dB SNR) than children from the control group (+5 dB SNR). ERPs were collected after training at +5 dB SNR to evaluate the effects of training with and without the RM system. Electrical neuroimaging analyses quantified the effects of training in each group on ERP global field power (GFP) and topography, indexing response strength and network changes, respectively. Behavioral speech-perception-in-noise skills of children were also evaluated and compared before and after training. We hypothesized that training with the RM system (experimental group) would lead to greater enhancement of GFP and greater topographical changes post-training than training without the RM system (control group). We also expected greater behavioral improvement on the speech-perception-in-noise task when training with than without the RM system.

RESULTS

GFP was enhanced after training only in the experimental group. These effects were observed on early time-windows corresponding to traditional P1-N1 (100 to 200 msec) and P2-N2 (200 to 400 msec) ERP components. No training effects were observed on response topography. Finally, both groups increased their speech-perception-in-noise skills post-training.

CONCLUSIONS

Enhanced GFP after training with the RM system indicates plasticity changes in the neural representation of sound resulting from listening to an enriched auditory signal. Further investigation of longer training or auditory experiences with favorable listening conditions is needed to determine if that results in long-term speech-perception-in-noise benefits.

Impact of FM System Use on Acquisition of Phonological Awareness Skills for Children at Risk of Dyslexia: A Preliminary Classroom Study

PURPOSE

This study evaluated the effects of utilizing a frequency modulation (FM) system during phonological awareness intervention for students at risk for dyslexia in a classroom setting.

METHOD

Four first-grade students participated in an adapted-alternating single-case design study. Participants completed intervention targeting two phonological awareness skills and were assigned to wear an FM system during lessons targeting one skill and no FM system during lessons targeting the second skill. Performance was assessed using daily assessments on the skills targeted during intervention and one additional skill.

RESULTS

Two participants demonstrated quicker and more pronounced improvement on the skill learned while wearing the FM system. The other two participants did not show improvement on any skill.

CONCLUSIONS

For children who made gains as a result of phonological awareness intervention, the FM system was associated with quicker and greater improvement. FM systems show promise as a tool to use during phonological awareness training for at least some children at risk for dyslexia.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20540139.

Auditory Evoked Potentials in Communication Disorders: An Overview of Past, Present, and Future

This article provides a brief overview of auditory evoked potentials (AEPs) and their application in the areas of research and clinics within the field of communication disorders. The article begins with providing a historical perspective within the context of the key scientific developments that led to the emergence of numerous types of AEPs. Furthermore, the article discusses the different AEP techniques in the light of their feasibility in clinics. As AEPs, because of their versatility, find their use across disciplines, this article also discusses some of the research questions that are currently being addressed using AEP techniques in the field of communication disorders and beyond. At the end, this article summarizes the shortcomings of the existing AEP techniques and provides a general perspective toward the future directions. The article is aimed at a broad readership including (but not limited to) students, clinicians, and researchers. Overall, this article may act as a brief primer for the new AEP users, and as an overview of the progress in the field of AEPs along with future directions, for those who already use AEPs on a routine basis.

Altered brain network topology in children with auditory processing disorder: A resting-state multi-echo fMRI study

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A graph-theoretical approach was used to assess the functional topology in APD.

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Brain networks in APD are similarly integrated and segregated compared to HCs.

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Children with APD have different hub organization.

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Significant group differences were found in the PC measure in the bilateral STG.

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Regional differences observed within the DMN indicate multimodal roles in APD.

Children with auditory processing disorder (APD) experience hearing difficulties, particularly in the presence of competing sounds, despite having normal audiograms. There is considerable debate on whether APD symptoms originate from bottom-up (e.g., auditory sensory processing) and/or top-down processing (e.g., cognitive, language, memory). A related issue is that little is known about whether functional brain network topology is altered in APD. Therefore, we used resting-state functional magnetic resonance imaging data to investigate the functional brain network organization of 57 children from 8 to 14 years old, diagnosed with APD (n = 28) and without hearing difficulties (healthy control, HC; n = 29). We applied complex network analysis using graph theory to assess the whole-brain integration and segregation of functional networks and brain hub architecture. Our results showed children with APD and HC have similar global network properties –i.e., an average of all brain regions– and modular organization. Still, the APD group showed different hub architecture in default mode-ventral attention, somatomotor and frontoparietal-dorsal attention modules. At the nodal level –i.e., single-brain regions–, we observed decreased participation coefficient (PC – a measure quantifying the diversity of between-network connectivity) in auditory cortical regions in APD, including bilateral superior temporal gyrus and left middle temporal gyrus. Beyond auditory regions, PC was also decreased in APD in bilateral posterior temporo-occipital cortices, left intraparietal sulcus, and right posterior insular cortex. Correlation analysis suggested a positive association between PC in the left parahippocampal gyrus and the listening-in-spatialized-noise -sentences task where APD children were engaged in auditory perception. In conclusion, our findings provide evidence of altered brain network organization in children with APD, specific to auditory networks, and shed new light on the neural systems underlying children's listening difficulties.

Memory Specific to Temporal Features of Sound Is Formed by Cue-Selective Enhancements in Temporal Coding Enabled by Inhibition of an Epigenetic Regulator

Recent investigation of memory-related functions in the auditory system have capitalized on the use of memory-modulating molecules to probe the relationship between memory and substrates of memory in auditory system coding. For example, epigenetic mechanisms, which regulate gene expression necessary for memory consolidation, are powerful modulators of learning-induced neuroplasticity and long-term memory (LTM) formation. Inhibition of the epigenetic regulator histone deacetylase 3 (HDAC3) promotes LTM, which is highly specific for spectral features of sound. The present work demonstrates for the first time that HDAC3 inhibition also enables memory for temporal features of sound. Adult male rats trained in an amplitude modulation (AM) rate discrimination task and treated with a selective inhibitor of HDAC3 formed memory that was highly specific to the AM rate paired with reward. Sound-specific memory revealed behaviorally was associated with a signal-specific enhancement in temporal coding in the auditory system; stronger phase locking that was specific to the rewarded AM rate was revealed in both the surface-recorded frequency following response and auditory cortical multiunit activity in rats treated with the HDAC3 inhibitor. Furthermore, HDAC3 inhibition increased trial-to-trial cortical response consistency (relative to naive and trained vehicle-treated rats), which generalized across different AM rates. Stronger signal-specific phase locking correlated with individual behavioral differences in memory specificity for the AM signal. These findings support that epigenetic mechanisms regulate activity-dependent processes that enhance discriminability of sensory cues encoded into LTM in both spectral and temporal domains, which may be important for remembering spectrotemporal features of sounds, for example, as in human voices and speech.SIGNIFICANCE STATEMENT Epigenetic mechanisms have recently been implicated in memory and information processing. Here, we use a pharmacological inhibitor of HDAC3 in a sensory model of learning to reveal the ability of HDAC3 to enable precise memory for amplitude-modulated sound cues. In so doing, we uncover neural substrates for memory's specificity for temporal sound cues. Memory specificity was supported by auditory cortical changes in temporal coding, including greater response consistency and stronger phase locking. HDAC3 appears to regulate effects across domains that determine specific cue saliency for behavior. Thus, epigenetic players may gate how sensory information is stored in long-term memory and can be leveraged to reveal the neural substrates of sensory details stored in memory.

Auditory Cortical Changes Precede Brainstem Changes During Rapid Implicit Learning: Evidence From Human EEG

The auditory system is sensitive to stimulus regularities such as frequently occurring sounds and sound combinations. Evidence of regularity detection can be seen in how neurons across the auditory network, from brainstem to cortex, respond to the statistical properties of the soundscape, and in the rapid learning of recurring patterns in their environment by children and adults. Although rapid auditory learning is presumed to involve functional changes to the auditory network, the chronology and directionality of changes are not well understood. To study the mechanisms by which this learning occurs, auditory brainstem and cortical activity was simultaneously recorded via electroencephalogram (EEG) while young adults listened to novel sound streams containing recurring patterns. Neurophysiological responses were compared between easier and harder learning conditions. Collectively, the behavioral and neurophysiological findings suggest that cortical and subcortical structures each provide distinct contributions to auditory pattern learning, but that cortical sensitivity to stimulus patterns likely precedes subcortical sensitivity.

A Bridge over Troubled Listening: Improving Speech-in-Noise Perception by Children with Dyslexia

Developmental dyslexia is most commonly associated with phonological processing difficulties. However, children with dyslexia may experience poor speech-in-noise perception as well. Although there is an ongoing debate whether a speech perception deficit is inherent to dyslexia or acts as an aggravating risk factor compromising learning to read indirectly, improving speech perception might boost reading-related skills and reading acquisition. In the current study, we evaluated advanced speech technology as applied in auditory prostheses, to promote and eventually normalize speech perception of school-aged children with dyslexia, i.e., envelope enhancement (EE). The EE strategy automatically detects and emphasizes onset cues and consequently reinforces the temporal structure of the speech envelope. Our results confirmed speech-in-noise perception difficulties by children with dyslexia. However, we found that exaggerating temporal "landmarks" of the speech envelope (i.e., amplitude rise time and modulations)-by using EE-passively and instantaneously improved speech perception in noise for children with dyslexia. Moreover, the benefit derived from EE was large enough to completely bridge the initial gap between children with dyslexia and their typical reading peers. Taken together, the beneficial outcome of EE suggests an important contribution of the temporal structure of the envelope to speech perception in noise difficulties in dyslexia, providing an interesting foundation for future intervention studies based on auditory and speech rhythm training.

Remote Microphone System Use in Preschool Children With Autism Spectrum Disorder and Language Disorder in the Classroom: A Pilot Efficacy Study

Purpose The present pilot study aimed to provide estimates of the feasibility and efficacy of a remote microphone (RM) system as an augmentative intervention to improve the functional listening performance of preschool children with autism spectrum disorder (ASD) and language disorder. Method Eight children with ASD and language disorder participated. Efficacy of the RM system was determined by evaluating participants' functional listening performance, as measured by an observational measure in RM-off and RM-on conditions. Responses were evaluated at the individual level using an alternating conditions design. Results Adequate feasibility was demonstrated as all participants were able to complete tasks in the RM-on condition. A subset of participants showed significant improvements in their functional listening performance in the RM-on condition, as demonstrated by visual inspection and effect sizes (nonoverlapping data points and percentage of data points exceeding the mean), indicating that there may be important sources of individual differences in responses to RM use in children with ASD. Conclusion The results of this pilot study provide support for future research on RM systems to target functional listening performance in children with ASD and language disorder.

Remote Microphone Technology for Children with Hearing Loss or Auditory Processing Issues

School classrooms are noisy and reverberant environments, and the poor acoustics can be a barrier to successful learning in children, particularly those with multiple disabilities, auditory processing issues, and hearing loss. A new set of listening challenges have been imposed by the recent global pandemic and subsequent online learning requirements. The goal of this article is to review the impact of poor acoustics on the performance of children with auditory processing issues, mild hearing loss, and unilateral hearing loss. In addition, we will summarize the evidence in support of remote microphone technology by these populations.

Comparisons of Auditory Brainstem Responses Between a Laboratory and Simulated Home Environment

Purpose Miniaturization of digital technologies has created new opportunities for remote health care and neuroscientific fieldwork. The current study assesses comparisons between in-home auditory brainstem response (ABR) recordings and recordings obtained in a traditional lab setting. Method Click-evoked and speech-evoked ABRs were recorded in 12 normal-hearing, young adult participants over three test sessions in (a) a shielded sound booth within a research lab, (b) a simulated home environment, and (c) the research lab once more. The same single-family house was used for all home testing. Results Analyses of ABR latencies, a common clinical metric, showed high repeatability between the home and lab environments across both the click-evoked and speech-evoked ABRs. Like ABR latencies, response consistency and signal-to-noise ratio (SNR) were robust both in the lab and in the home and did not show significant differences between locations, although variability between the home and lab was higher than latencies, with two participants influencing this lower repeatability between locations. Response consistency and SNR also patterned together, with a trend for higher SNRs to pair with more consistent responses in both the home and lab environments. Conclusions Our findings demonstrate the feasibility of obtaining high-quality ABR recordings within a simulated home environment that closely approximate those recorded in a more traditional recording environment. This line of work may open doors to greater accessibility to underserved clinical and research populations.

Auditory brainstem measures and genotyping boost the prediction of literacy: A longitudinal study on early markers of dyslexia

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Multi-domain profiles advance retrospective prediction of emergent literacy.

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DCDC2 and KIAA0319 risk variants influence emergent spelling skills.

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Combined DYX2 and auditory brainstem measures enhance predictive model fits.

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Additional benefit of preliterate phonological awareness on predictive power.

Literacy acquisition is impaired in children with developmental dyslexia resulting in lifelong struggle to read and spell. Proper diagnosis is usually late and commonly achieved after structured schooling started, which causes delayed interventions. Legascreen set out to develop a preclinical screening to identify children at risk of developmental dyslexia. To this end we examined 93 preliterate German children, half of them with a family history of dyslexia and half of them without a family history. We assessed standard demographic and behavioral precursors of literacy, acquired saliva samples for genotyping, and recorded speech-evoked brainstem responses to add an objective physiological measure. Reading and spelling was assessed after two years of structured literacy instruction. Multifactorial regression analyses considering demographic information, genotypes, and auditory brainstem encoding, predicted children’s literacy skills to varying degrees. These predictions were improved by adding the standard psychometrics with a slightly higher impact on spelling compared to reading comprehension. Our findings suggest that gene-brain-behavior profiling has the potential to determine the risk of developmental dyslexia. At the same time our results imply the need for a more sophisticated assessment to fully account for the disparate cognitive profiles and the multifactorial basis of developmental dyslexia.

Sex differences in subcortical auditory processing only partially explain higher prevalence of language disorders in males

Males and females differ in their subcortical evoked responses to sound. For many evoked response measures, the sex difference is driven by a faster developmental decline of auditory processing in males. Using the frequency-following response (FFR), an evoked potential that reflects predominately midbrain processing of stimulus features, sex differences were identified in the response to the temporal envelope of speech. The pattern of later and smaller responses in males versus females is consistent with two of the three response features that track with language development and reading abilities. Therefore, here we analyzed subcortical response consistency, the third distinguishing feature of language ability. Furthermore, though the envelope is primarily a low-frequency response, the greatest sex differences were observed in harmonics encoding. To better understand these sex differences, we extended these findings to the temporal fine structure response, which is biased to high-frequency information. Using the same 516 participants as previously reported (Krizman et al., 2019), we analyzed the effect of sex across development on response consistency and the encoding of temporal fine structure, as indexed by the subtracted frequency-following response. We found that while males and females did not differ on response consistency, there was an effect of age on this measure. Moreover, while males still showed a faster decline in harmonic encoding, the magnitude and breadth of the sex differences were smaller (accounting for 2% variance) in the temporal fine structure response compared to the envelope response. These results suggest that sex differences are distinct, at least in part, from the differences that underlie language abilities and that developmental sex differences reflect subcortical auditory processing differences of both the temporal envelope and fine structure of sounds.

Post-Attentive Integration and Topographic Map Distribution During Audiovisual Processing in Dyslexia: A P300 Event-Related Component Analysis

Background

Research on audiovisual post-attentive integration has been carried out using a variety of experimental paradigms and experimental groups but not yet studied in dyslexia. We investigated post-attentive integration and topographic voltage distribution in children with dyslexia by analysing the P300 event-related potential (ERP) component.

Methods

We used a 128-child ERP net for the ERP experiment. Two types of stimuli were presented as either congruent or incongruent stimuli. Congruent stimuli included a matching auditory sound with an animal image, whereas incongruent stimuli included unmatched animal sounds. A total of 24 age-matched children were recruited in the control (n = 12) and dyslexia (n = 12) groups. Children pressed button ‘1’ or ‘2’ when presented with congruent or incongruent stimuli, respectively. The P300 amplitudes and latencies with topographic voltage distribution were analysed for both groups.

Results

The dyslexia group evoked significantly higher P300 amplitudes at the T4 area than the control group. No significant differences were found in cases of P300 latency. Moreover, the dyslexia group demonstrated a higher intensity of P300 voltage distribution in the right parietal and left occipital areas than the control group.

Conclusion

Post-attentive integration for children with dyslexia is higher and that this integration process implicated the parietal and occipital areas.

Remote Microphone Hearing Aid Use Improves Classroom Listening, Without Adverse Effects on Spatial Listening and Attention Skills, in Children With Auditory Processing Disorder: A Randomised Controlled Trial

BACKGROUND

Children with Auditory Processing Disorder (APD) often have poor auditory processing skills in the presence of normal peripheral hearing. These children have worse listening-in-noise skills compared to typically developing peers, while other commonly reported symptoms include poor attention and distractibility. One of the management strategies for children with APD is the use of Remote Microphone Hearing Aids (RMHAs), which can help improve the signal-to-noise ratio in the child's ears. The aim of this randomised controlled trial was to examine whether RMHAs improved classroom listening in children with APD, and to further test their effects on children's listening-in-noise and attention skills following a 6-month intervention.

METHODS

Twenty-six children diagnosed with APD, aged 7-12, in primary mainstream education, were randomised into the intervention (N = 13) and control group (N = 13). The primary outcome measure was the Listening Inventory for Education - Revised questionnaire, completed by children to assess their listening using RMHAs under several acoustically challenging situations in the classroom. Secondary outcome measures included the Listening in Spatialised Noise - Sentences test, assessing speech-in-noise perception and spatial listening, and the Test of Everyday Attention for Children, assessing different types of attention skills. Tests were conducted in unaided conditions. Mixed analysis of variance was used to analyse the data. The clinical trial was registered at clinicaltrials.gov (unique identifier: NCT02353091).

RESULTS

The questionnaire scores of self-reported listening skills in the classroom significantly improved in the intervention group after 3, MD = 7.31, SE = 2.113, p = 0.014, and after 6 months, M = 5.00, SE = 1.468, p = 0.016. The behavioural measures of listening-in-noise and attention did not significantly change.

CONCLUSION

Use of RMHAs improves classroom listening, evidenced by the results of the questionnaire analysis, while a 6-month use did not have adverse effects on unaided spatial listening or attention skills.

Stable auditory processing underlies phonological awareness in typically developing preschoolers

Sound processing is an important scaffold for early language acquisition. Here we investigate its relationship to three components of phonological processing in young children (∼age 3): Phonological Awareness (PA), Phonological Memory (PM), and Rapid Automatized Naming (RAN). While PA is believed to hinge upon consistency of sound processing to distinguish and manipulate word features, PM relies on an internal store of the sounds of language and RAN relies on fluid production of those sounds. Given the previously demonstrated link between PA and the auditory system, we hypothesized that only this component would be associated with auditory neural stability. Moreover, we expected relationships to manifest at early ages because additional factors may temper the association in older children. We measured across-trial stability of the frequency-following response, PA, PM, and RAN longitudinally in twenty-seven children. Auditory neural stability at age ∼3 years exclusively predicts PA, but this relationship vanishes in older children.

Instruments for augmentative and alternative communication for children with autism spectrum disorder: a systematic review

New technologies designed to improve the communication of autistic children can also help to promote interaction processes and cognitive and social development. The aim of this study was to analyze the instruments used to improve the communication skills of children with autism spectrum disorder. We searched the PubMed and Web of Science databases using the descriptors "autism", "Asperger", "education", "children" and "assistive technology" and selected articles that met the following inclusion criteria: (i) original research; (ii) written in English; (iii) based on participants with a primary diagnosis of autism spectrum disorder; and (iv) tested an instrument designed to promote communication in children with autism spectrum disorder. Our search retrieved 811 articles, of which 34 met the inclusion criteria. Data on 26 instruments were extracted, and the measurement properties of the instruments were combined with information about their outcomes and presentation. The most commonly used interventions were the Treatment and Education of Autistic and Related Communication Handicapped Children program and the Picture Exchange Communication System. The Treatment and Education of Autistic and Related Communication Handicapped Children program was shown to produce improvements in the communication skills, socialization and self-care skills of children with autism spectrum disorder. The Picture Exchange Communication System produced inconsistent results. The results of the identified studies confirm the significant importance of these instruments in improving the communicative process of autistic children.

Individual Differences in Human Auditory Processing: Insights From Single-Trial Auditory Midbrain Activity in an Animal Model

Auditory-evoked potentials are classically defined as the summations of synchronous firing along the auditory neuraxis. Converging evidence supports a model whereby timing jitter in neural coding compromises listening and causes variable scalp-recorded potentials. Yet the intrinsic noise of human scalp recordings precludes a full understanding of the biological origins of individual differences in listening skills. To delineate the mechanisms contributing to these phenomena, in vivo extracellular activity was recorded from inferior colliculus in guinea pigs to speech in quiet and noise. Here we show that trial-by-trial timing jitter is a mechanism contributing to auditory response variability. Identical variability patterns were observed in scalp recordings in human children, implicating jittered timing as a factor underlying reduced coding of dynamic speech features and speech in noise. Moreover, intertrial variability in human listeners is tied to language development. Together, these findings suggest that variable timing in inferior colliculus blurs the neural coding of speech in noise, and propose a consequence of this timing jitter for human behavior. These results hint both at the mechanisms underlying speech processing in general, and at what may go awry in individuals with listening difficulties.

Musical Experience, Sensorineural Auditory Processing, and Reading Subskills in Adults

Developmental research suggests that sensorineural auditory processing, reading subskills (e.g., phonological awareness and rapid naming), and musical experience are related during early periods of reading development. Interestingly, recent work suggests that these relations may extend into adulthood, with indices of sensorineural auditory processing relating to global reading ability. However, it is largely unknown whether sensorineural auditory processing relates to specific reading subskills, such as phonological awareness and rapid naming, as well as musical experience in mature readers. To address this question, we recorded electrophysiological responses to a repeating click (auditory stimulus) in a sample of adult readers. We then investigated relations between electrophysiological responses to sound, reading subskills, and musical experience in this same set of adult readers. Analyses suggest that sensorineural auditory processing, reading subskills, and musical experience are related in adulthood, with faster neural conduction times and greater musical experience associated with stronger rapid-naming skills. These results are similar to the developmental findings that suggest reading subskills are related to sensorineural auditory processing and musical experience in children.

On the Etiology of Listening Difficulties in Noise Despite Clinically Normal Audiograms

Many people with difficulties following conversations in noisy settings have “clinically normal” audiograms, that is, tone thresholds better than 20 dB HL from 0.1 to 8 kHz. This review summarizes the possible causes of such difficulties, and examines established as well as promising new psychoacoustic and electrophysiologic approaches to differentiate between them. Deficits at the level of the auditory periphery are possible even if thresholds remain around 0 dB HL, and become probable when they reach 10 to 20 dB HL. Extending the audiogram beyond 8 kHz can identify early signs of noise-induced trauma to the vulnerable basal turn of the cochlea, and might point to “hidden” losses at lower frequencies that could compromise speech reception in noise. Listening difficulties can also be a consequence of impaired central auditory processing, resulting from lesions affecting the auditory brainstem or cortex, or from abnormal patterns of sound input during developmental sensitive periods and even in adulthood. Such auditory processing disorders should be distinguished from (cognitive) linguistic deficits, and from problems with attention or working memory that may not be specific to the auditory modality. Improved diagnosis of the causes of listening difficulties in noise should lead to better treatment outcomes, by optimizing auditory training procedures to the specific deficits of individual patients, for example.

Speech-evoked auditory brainstem response with ipsilateral noise in adults with unilateral hearing loss

INTRODUCTION

Subjects with unilateral hearing loss (UHL) report difficulties in speech understanding in noise. Speech-evoked auditory brainstem response (S-ABR) provides cues for temporal and spectral encoding of speech in the brainstem. S-ABR recording in noise increases its sensitivity in evaluating the auditory processing and related disorders.

OBJECTIVES

Study speech encoding at the level of brainstem when the auditory system relies on one ear and to study the effect of noise on this encoding.

SUBJECTS AND METHOD

This study included two groups: control group consisted of 15 adults with normal hearing sensitivity and study group consisted of 30 adults with UHL. The study group was further subdivided into two subgroups: study subgroup A (SG A) consisted of 15 adults with right functioning ears and study subgroup B (SG B) consisted of 15 adults with left functioning ears. S-ABR in quiet and with ipsilateral noise was recorded in both the groups using complex ABR advanced auditory research module.

RESULTS

In UHL, there was a statistically significant delay in the S-ABR onset and offset in noise compared to quiet. Moreover, quiet-noise (+5 SNR) correlation was significantly low compared to NH. Furthermore, pitch representation (F0 amplitude) was significantly degraded with noise. In addition, there was a statistically significant noise-induced phase shift in the transition region of speech syllable in these subjects.

CONCLUSION

In monaural processing, pitch representation (F0 amplitude) and cross-phaseogram were the main affected domains. Speech phonemes of transient origin can be confused in subjects with UHL.

Monkeys share the neurophysiological basis for encoding sound periodicities captured by the frequency-following response with humans

The extraction and encoding of acoustical temporal regularities are fundamental for human cognitive auditory abilities such as speech or beat entrainment. Because the comparison of the neural sensitivity to temporal regularities between human and animals is fundamental to relate non-invasive measures of auditory processing to their neuronal basis, here we compared the neural representation of auditory periodicities between human and non-human primates by measuring scalp-recorded frequency-following response (FFR). We found that rhesus monkeys can resolve the spectrotemporal structure of periodic stimuli to a similar extent as humans by exhibiting a homologous FFR potential to the speech syllable /da/. The FFR in both species is robust and phase-locked to the fundamental frequency of the sound, reflecting an effective neural processing of the fast-periodic information of subsyllabic cues. Our results thus reveal a conserved neural ability to track acoustical regularities within the primate order. These findings open the possibility to study the neurophysiology of complex sound temporal processing in the macaque subcortical and cortical areas, as well as the associated experience-dependent plasticity across the auditory pathway in behaving monkeys.

Do prereaders' auditory processing and speech perception predict later literacy?

Developmental dyslexia has frequently been linked to deficits in auditory processing and speech perception. However, the presence and precise nature of these deficits and the direction of their relation with reading, remains debated. In this longitudinal study, 87 five-year-olds at high and low family risk for dyslexia were followed before and during different stages of reading acquisition. The processing of different auditory cues was investigated, together with performance on speech perception and phonology and reading. Results show no effect of family risk for dyslexia on prereading auditory processing and speech perception skills. However, a relation is present between the performance on these skills in kindergarten and later phonology and literacy. In particular, links are found with the auditory processing of cues characteristic for the temporal speech amplitude envelope, rather than with other auditory cues important for speech intelligibility. Hereby, cues embedded in the speech amplitude envelope show to be related to a broad range of phonological precursors for reading. In addition, speech-in-noise perception demonstrates to operate as the most contributing factor for later phonological awareness and to be a predictor for reading mediated by the association with phonology. This study provides behavioral support for the link between prereading speech amplitude envelope processing and speech perception for future phonology and reading.

(Central) Auditory Processing Disorder Grand Rounds: Multiple Cases, Multiple Causes, Multiple Outcomes

PURPOSE

The purpose of this article was to provide multiple examples of how (central) auditory processing disorder ([C]APD) is being evaluated and treated at various audiology clinics throughout the United States.

METHOD

The authors present 5 cases highlighting the diagnosis and treatment of (C)APD in children and adults. Similarities and differences between these cases have been showcased through detailed histories, evaluation protocol, and treatment options. When possible, the rationale for evaluation procedures and intervention processes were described and compared with guidelines and findings within the literature.

RESULTS AND CONCLUSIONS

These cases illustrate the varied processes and clinical protocols by which children and adults are evaluated, diagnosed, counseled, and treated for (C)APD. In addition, similarities and differences between the referral source, evaluation team, developmental history, comorbidities, test battery, recommendations, and remediations were described. The multiple clinic sites, diversity of clinical philosophies, variety of test measures, and diversity of patient populations make these cases ideal for showcasing the assortment of methodologies used with patients who present with histories and characteristics consistent with (C)APD.

Neural stability: A reflection of automaticity in reading

Automaticity, the ability to perform a task rapidly with minimal effort, plays a key role in reading fluency and is indexed by rapid automatized naming (RAN) and processing speed. Yet little is known about automaticity's neurophysiologic underpinnings. The more efficiently sound is encoded, the more automatic sound processing can be. In turn, this automaticity could free up cognitive resources such as attention and working memory to help build an integrative reading network. Therefore, we hypothesized that automaticity and reading fluency correlate with stable neural representation of sounds, given a larger body of literature suggesting the close relationship between neural stability and the integrative function in the central auditory system. To test this hypothesis, we recorded the frequency-following responses (FFR) to speech syllables and administered cognitive and reading measures to school-aged children. We show that the stability of neural responses to speech correlates with RAN and processing speed, but not phonological awareness. Moreover, the link between neural stability and RAN mediates the previously-determined link between neural stability and reading ability. Children with a RAN deficit have especially unstable neural responses. Our neurophysiological approach illuminates a potential neural mechanism specific to RAN, which in turn indicates a relationship between synchronous neural firing in the auditory system and automaticity critical for reading fluency.

Vowel decoding from single-trial speech-evoked electrophysiological responses: A feature-based machine learning approach

INTRODUCTION

Scalp-recorded electrophysiological responses to complex, periodic auditory signals reflect phase-locked activity from neural ensembles within the auditory system. These responses, referred to as frequency-following responses (FFRs), have been widely utilized to index typical and atypical representation of speech signals in the auditory system. One of the major limitations in FFR is the low signal-to-noise ratio at the level of single trials. For this reason, the analysis relies on averaging across thousands of trials. The ability to examine the quality of single-trial FFRs will allow investigation of trial-by-trial dynamics of the FFR, which has been impossible due to the averaging approach.

METHODS

In a novel, data-driven approach, we used machine learning principles to decode information related to the speech signal from single trial FFRs. FFRs were collected from participants while they listened to two vowels produced by two speakers. Scalp-recorded electrophysiological responses were projected onto a low-dimensional spectral feature space independently derived from the same two vowels produced by 40 speakers, which were not presented to the participants. A novel supervised machine learning classifier was trained to discriminate vowel tokens on a subset of FFRs from each participant, and tested on the remaining subset.

RESULTS

We demonstrate reliable decoding of speech signals at the level of single-trials by decomposing the raw FFR based on information-bearing spectral features in the speech signal that were independently derived.

CONCLUSIONS

Taken together, the ability to extract interpretable features at the level of single-trials in a data-driven manner offers unchartered possibilities in the noninvasive assessment of human auditory function.

Positive impacts of early auditory training on cortical processing at an older age

Progressive negative behavioral changes in normal aging are paralleled by a complex series of physical and functional declines expressed in the cerebral cortex. In studies conducted in the auditory domain, these degrading physical and functional cortical changes have been shown to be broadly reversed by intensive progressive training that improves the spectral and temporal resolution of acoustic inputs and suppresses behavioral distractors. Here we found older rats that were intensively trained on an attentionally demanding modulation-rate recognition task in young adulthood substantially retained training-driven improvements in temporal rate discrimination abilities over a subsequent 18-mo epoch-that is, forward into their older age. In parallel, this young-adult auditory training enduringly enhanced temporal and spectral information processing in their primary auditory cortices (A1). Substantially greater numbers of parvalbumin- and somatostatin-labeled inhibitory neurons (closer to the numbers recorded in young vigorous adults) were recorded in the A1 and hippocampus in old trained versus untrained age-matched rats. These results show that a simple form of training in young adulthood in this rat model enduringly delays the otherwise expected deterioration of the physical status and functional operations of the auditory nervous system, with evident training impacts generalized to the hippocampus.

Long-term use benefits of personal frequency-modulated systems for speech in noise perception in patients with stroke with auditory processing deficits: a non-randomised controlled trial study

OBJECTIVES

Approximately one in five stroke survivors suffer from difficulties with speech reception in noise, despite normal audiometry. These deficits are treatable with personal frequency-modulated systems (FMs). This study aimed to evaluate long-term benefits in speech reception in noise, after daily 10-week use of personal FMs, in non-aphasic patients with stroke with auditory processing deficits.

DESIGN

This was a prospective non-randomised controlled trial study. Patients were allocated to an intervention care group or standard care subjects group according to their willingness to use the intervention or not.

SETTING

Tertiary care setting.

PARTICIPANTS

Nine non-aphasic subjects with ischaemic stroke, normal/near-normal audiometry and auditory processing deficits and with reported difficulties understanding speech in background noise were recruited in the subacute stroke stage (3-12 months after stroke).

INTERVENTIONS

Four patients (intervention care subjects) used the FMs in their daily life over 10 weeks. Five patients (standard care subjects) received standard care.

PRIMARY OUTCOME MEASURES

All subjects were tested at baseline (visit 1) and 10 weeks later (visit 2) on a sentences in noise test with the FMs (aided) and without the FMs (unaided).

RESULTS

Speech reception thresholds showed clinically and statistically significant improvements in intervention but not in standard care subjects at 10 weeks in aided and unaided conditions.

CONCLUSIONS

10-week use of FMs by adult patients with stroke may lead to benefits in unaided speech in noise perception. Our findings may indicate auditory plasticity type changes and require further investigation.

TRIAL REGISTRATION NUMBER

Pre-results; NCT02889107.

Incorporation of feedback during beat synchronization is an index of neural maturation and reading skills

Speech communication involves integration and coordination of sensory perception and motor production, requiring precise temporal coupling. Beat synchronization, the coordination of movement with a pacing sound, can be used as an index of this sensorimotor timing. We assessed adolescents' synchronization and capacity to correct asynchronies when given online visual feedback. Variability of synchronization while receiving feedback predicted phonological memory and reading sub-skills, as well as maturation of cortical auditory processing; less variable synchronization during the presence of feedback tracked with maturation of cortical processing of sound onsets and resting gamma activity. We suggest the ability to incorporate feedback during synchronization is an index of intentional, multimodal timing-based integration in the maturing adolescent brain. Precision of temporal coding across modalities is important for speech processing and literacy skills that rely on dynamic interactions with sound. Synchronization employing feedback may prove useful as a remedial strategy for individuals who struggle with timing-based language learning impairments.

Assistive technology evaluations: Remote-microphone technology for children with Autism Spectrum Disorder

The goal of this study was to conduct assistive technology evaluations on 12 children diagnosed with Autism Spectrum Disorder (ASD) to evaluate the potential benefits of remote-microphone (RM) technology. A single group, within-subjects design was utilized to explore individual and group data from functional questionnaires and behavioral test measures administered, designed to assess school- and home-based listening abilities, once with and once without RM technology. Because some of the children were unable to complete the behavioral test measures, particular focus was given to the functional questionnaires completed by primary teachers, participants, and parents. Behavioral test measures with and without the RM technology included speech recognition in noise, auditory comprehension, and acceptable noise levels. The individual and group teacher (n=8-9), parent (n=8-9), and participant (n=9) questionnaire ratings revealed substantially less listening difficulty when RM technology was used compared to the no-device ratings. On the behavioral measures, individual data revealed varied findings, which will be discussed in detail in the results section. However, on average, the use of the RM technology resulted in improvements in speech recognition in noise (4.6dB improvement) in eight children, higher auditory working memory and comprehension scores (12-13 point improvement) in seven children, and acceptance of poorer signal-to-noise ratios (8.6dB improvement) in five children. The individual and group data from this study suggest that RM technology may improve auditory function in children with ASD in the classroom, at home, and in social situations. However, variability in the data and the inability of some children to complete the behavioral measures indicates that individualized assistive technology evaluations including functional questionnaires will be necessary to determine if the RM technology will be of benefit to a particular child who has ASD.

Systematic Review of the Effectiveness of Frequency Modulation Devices in Improving Academic Outcomes in Children With Auditory Processing Difficulties

This systematic review describes the published evidence related to the effectiveness of frequency modulation (FM) devices in improving academic outcomes in children with auditory processing difficulties. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards were used to identify articles published between January 2003 and March 2014. The Cochrane Population, Intervention, Control, Outcome, Study Design approach and the American Occupational Therapy Association process forms were used to guide the article selection and evaluation process. Of the 83 articles screened, 7 matched the systematic review inclusion criteria. Findings were consistently positive, although limitations were identified. Results of this review indicate moderate support for the use of FM devices to improve children's ability to listen and attend in the classroom and mixed evidence to improve specific academic performance areas. FM technology should be considered for school-age children with auditory processing impairments who are receiving occupational therapy services to improve functioning in the school setting.

Impact of Educational Level on Performance on Auditory Processing Tests

Research has demonstrated that a higher level of education is associated with better performance on cognitive tests among middle-aged and elderly people. However, the effects of education on auditory processing skills have not yet been evaluated. Previous demonstrations of sensory-cognitive interactions in the aging process indicate the potential importance of this topic. Therefore, the primary purpose of this study was to investigate the performance of middle-aged and elderly people with different levels of formal education on auditory processing tests. A total of 177 adults with no evidence of cognitive, psychological or neurological conditions took part in the research. The participants completed a series of auditory assessments, including dichotic digit, frequency pattern and speech-in-noise tests. A working memory test was also performed to investigate the extent to which auditory processing and cognitive performance were associated. The results demonstrated positive but weak correlations between years of schooling and performance on all of the tests applied. The factor “years of schooling” was also one of the best predictors of frequency pattern and speech-in-noise test performance. Additionally, performance on the working memory, frequency pattern and dichotic digit tests was also correlated, suggesting that the influence of educational level on auditory processing performance might be associated with the cognitive demand of the auditory processing tests rather than auditory sensory aspects itself. Longitudinal research is required to investigate the causal relationship between educational level and auditory processing skills.

Intertrial auditory neural stability supports beat synchronization in preschoolers

The ability to synchronize motor movements along with an auditory beat places stringent demands on the temporal processing and sensorimotor integration capabilities of the nervous system. Links between millisecond-level precision of auditory processing and the consistency of sensorimotor beat synchronization implicate fine auditory neural timing as a mechanism for forming stable internal representations of, and behavioral reactions to, sound. Here, for the first time, we demonstrate a systematic relationship between consistency of beat synchronization and trial-by-trial stability of subcortical speech processing in preschoolers (ages 3 and 4 years old). We conclude that beat synchronization might provide a useful window into millisecond-level neural precision for encoding sound in early childhood, when speech processing is especially important for language acquisition and development.

Relation between Phonological Processing, Auditory Processing and Speech Perception among Bilingual Poor Readers

BACKGROUND AND OBJECTIVES

A deficit in phonological processing abilities has been hypothesized as a cause of reading deficits among poor readers, but the precise etiology of this deficit is still unknown. Many studies have investigated the relation of auditory processing and speech perception with phonological processing, while the relation between these are not well understood. Thus, the present study was carried out to investigate the relation between these abilities among poor readers.

SUBJECTS AND METHODS

A total of 20 children between 7-12 years of age participated in the study. Among these 10 were typically developing children and 10 were poor readers. Auditory processing, speech perception in noise and phonological processing skills were assessed in both the groups.

RESULTS

Auditory processing was not significantly different between children in both the groups. In contrast, phonological awareness, verbal short-term memory and rapid automatized naming, which reflect phonological processing, and speech perception in noise were found to be significantly affected in poor readers. In addition, the results showed a significant correlation between phonological processing and speech perception in noise.

CONCLUSIONS

The present study found a significant relationship between speech perception in noise and phonological processing, while there was no relationship between auditory processing and phonological processing. This finding suggests that poor speech perception among poor readers may be one of the contributing factors for phonological processing deficits, which in turn leads to reading difficulties.

Bilingual enhancements have no socioeconomic boundaries

To understand how socioeconomic status (SES) and bilingualism simultaneously operate on cognitive and sensory function, we examined executive control, language skills, and neural processing of sound in adolescents who differed in language experience (i.e. English monolingual or Spanish-English bilingual) and level of maternal education (a proxy for SES). We hypothesized that experience communicating in two languages provides an enriched linguistic environment that can bolster neural precision in subcortical auditory processing which, in turn, enhances cognitive and linguistic function, regardless of the adolescent's socioeconomic standing. Consistent with this, we report that adolescent bilinguals of both low and high SES demonstrate more stable neural responses, stronger phonemic decoding skills, and heightened executive control, relative to their monolingual peers. These results support the argument that bilingualism can bolster cognitive and neural function in low-SES children and suggest that strengthened neural response consistency provides a biological mechanism through which these enhancements occur.

Results from a National Central Auditory Processing Disorder Service: A Real-World Assessment of Diagnostic Practices and Remediation for Central Auditory Processing Disorder

This article describes the development and evaluation of a national service to diagnose and remediate central auditory processing disorder (CAPD). Data were gathered from 38 participating Australian Hearing centers over an 18-month period from 666 individuals age 6, 0 (years, months) to 24, 8 (median 9, 0). A total of 408 clients were diagnosed with either a spatial processing disorder (n = 130), a verbal memory deficit (n = 174), or a binaural integration deficit (n = 104). A hierarchical test protocol was used so not all children were assessed on all tests in the battery. One hundred fifty clients decided to proceed with deficit-specific training (LiSN & Learn or Memory Booster) and/or be fitted with a frequency modulation system. Families were provided with communication strategies targeted to a child's specific listening difficulties and goals. Outcomes were measured using repeat assessment of the relevant diagnostic test, as well as the Client Oriented Scale of Improvement measure and Listening Inventories for Education teacher questionnaire. Group analyses revealed significant improvements postremediation for all training/management options. Individual posttraining performance and results of outcome measures also are discussed.

Music training alters the course of adolescent auditory development

Fundamental changes in brain structure and function during adolescence are well-characterized, but the extent to which experience modulates adolescent neurodevelopment is not. Musical experience provides an ideal case for examining this question because the influence of music training begun early in life is well-known. We investigated the effects of in-school music training, previously shown to enhance auditory skills, versus another in-school training program that did not focus on development of auditory skills (active control). We tested adolescents on neural responses to sound and language skills before they entered high school (pretraining) and again 3 y later. Here, we show that in-school music training begun in high school prolongs the stability of subcortical sound processing and accelerates maturation of cortical auditory responses. Although phonological processing improved in both the music training and active control groups, the enhancement was greater in adolescents who underwent music training. Thus, music training initiated as late as adolescence can enhance neural processing of sound and confer benefits for language skills. These results establish the potential for experience-driven brain plasticity during adolescence and demonstrate that in-school programs can engender these changes.

Development of subcortical speech representation in human infants

Previous studies have evaluated representation of the fundamental frequency (F0) in the frequency following response (FFR) of infants, but the development of other aspects of the FFR, such as timing and harmonics, has not yet been examined. Here, FFRs were recorded to a speech syllable in 28 infants, ages three to ten months. The F0 amplitude of the response was variable among individuals but was strongly represented in some infants as young as three months of age. The harmonics, however, showed a systematic increase in amplitude with age. In the time domain, onset, offset, and inter-peak latencies decreased with age. These results are consistent with neurophysiological studies indicating that (1) phase locking to lower frequency sounds emerges earlier in life than phase locking to higher frequency sounds and (2) myelination continues to increase in the first year of life. Early representation of low frequencies may reflect greater exposure to low frequency stimulation in utero. The improvement in temporal precision likely parallels an increase in the efficiency of neural transmission accompanied by exposure to speech during the first year of life.

Infant cortical electrophysiology and perception of vowel contrasts

Cortical auditory evoked potentials (CAEPs) were obtained for vowel tokens presented in an oddball stimulus paradigm. Perceptual measures of vowel discrimination were obtained using a visually-reinforced head-turn paradigm. The hypothesis was that CAEP latencies and amplitudes would differ as a function of vowel type and be correlated with perceptual performance. Twenty normally hearing infants aged 4-12 months were evaluated. CAEP component amplitudes and latencies were measured in response to the standard, frequent token /a/ and for infrequent, deviant tokens /i/, /o/ and /u/, presented at rates of 1 and 2 tokens/s. The perceptual task required infants to make a behavioral response for trials that contained two different vowel tokens, and ignore those in which the tokens were the same. CAEP amplitudes were larger in response to the deviant tokens, when compared to the control condition in which /a/ served as both standard and deviant. This was also seen in waveforms derived by subtracting the response to standard /a/ from the responses to deviant tokens. CAEP component latencies in derived responses at 2/s also demonstrated some sensitivity to vowel contrast type. The average hit rate for the perceptual task was 68.5%, with a 25.7% false alarm rate. There were modest correlations of CAEP amplitudes and latencies with perceptual performance. The CAEP amplitude differences for vowel contrasts could be used as an indicator of the underlying neural capacity to encode spectro-temporal differences in vowel sounds. This technique holds promise for translation to clinical methods for evaluating speech perception.

Plasticity in developing brain: active auditory exposure impacts prelinguistic acoustic mapping

A major task across infancy is the creation and tuning of the acoustic maps that allow efficient native language processing. This process crucially depends on ongoing neural plasticity and keen sensitivity to environmental cues. Development of sensory mapping has been widely studied in animal models, demonstrating that cortical representations of the sensory environment are continuously modified by experience. One critical period for optimizing human language mapping is early in the first year; however, the neural processes involved and the influence of passive compared with active experience are as yet incompletely understood. Here we demonstrate that, while both active and passive acoustic experience from 4 to 7 months of age, using temporally modulated nonspeech stimuli, impacts acoustic mapping, active experience confers a significant advantage. Using event-related potentials (ERPs), we show that active experience increases perceptual vigilance/attention to environmental acoustic stimuli (e.g., larger and faster P2 peaks) when compared with passive experience or maturation alone. Faster latencies are also seen for the change discrimination peak (N2*) that has been shown to be a robust infant predictor of later language through age 4 years. Sharpening is evident for both trained and untrained stimuli over and above that seen for maturation alone. Effects were also seen on ERP morphology for the active experience group with development of more complex waveforms more often seen in typically developing 12- to 24-month-old children. The promise of selectively "fine-tuning" acoustic mapping as it emerges has far-reaching implications for the amelioration and/or prevention of developmental language disorders.

Central auditory processing disorders in children and adults

Central auditory processing disorders (CAPD) can affect children and adults of all ages due to a wide variety of causes. CAPD is a neurobiologic deficit in the central auditory nervous system (CANS) that affects those mechanisms that underlie fundamental auditory perception, including localization and lateralization; discrimination of speech and non-speech sounds; auditory pattern recognition; temporal aspects of audition, including integration, resolution, ordering, and masking; and auditory performance with competing and/or degraded acoustic signals (American Speech-Language-Hearing Association, 2005a, b). Although it is recognized that central auditory dysfunction may coexist with other disorders, CAPD is conceptualized as a sensory-based auditory disorder. Administration of behavioral and/or electrophysiologic audiologic tests that have been shown to be sensitive and specific to dysfunction of the CANS is critical for a proper diagnosis of CAPD, in addition to assessments and collaboration with a multidisciplinary team. Intervention recommendations for CAPD diagnosis are based on the demonstrated auditory processing deficits and related listening and related complaints. This chapter provides an overview of current definitions and conceptualizations, methods of diagnosis of, and intervention for, CAPD. The chapter culminates with a case study illustrating pre- and posttreatment behavioral and electrophysiologic diagnostic findings.

Engagement in community music classes sparks neuroplasticity and language development in children from disadvantaged backgrounds

Children from disadvantaged backgrounds often face impoverished auditory environments, such as greater exposure to ambient noise and fewer opportunities to participate in complex language interactions during development. These circumstances increase their risk for academic failure and dropout. Given the academic and neural benefits associated with musicianship, music training may be one method for providing auditory enrichment to children from disadvantaged backgrounds. We followed a group of primary-school students from gang reduction zones in Los Angeles, CA, USA for 2 years as they participated in Harmony Project. By providing free community music instruction for disadvantaged children, Harmony Project promotes the healthy development of children as learners, the development of children as ambassadors of peace and understanding, and the development of stronger communities. Children who were more engaged in the music program-as defined by better attendance and classroom participation-developed stronger brain encoding of speech after 2 years than their less-engaged peers in the program. Additionally, children who were more engaged in the program showed increases in reading scores, while those less engaged did not show improvements. The neural gains accompanying music engagement were seen in the very measures of neural speech processing that are weaker in children from disadvantaged backgrounds. Our results suggest that community music programs such as Harmony Project provide a form of auditory enrichment that counteracts some of the biological adversities of growing up in poverty, and can further support community-based interventions aimed at improving child health and wellness.