The effects of auditory information on 4-month-old infants' perception of trajectory continuity

Analysis of Health Disparities in the Screening and Diagnosis of Hearing Loss: Early Hearing Detection and Intervention Hearing Screening Follow-Up Survey

PURPOSE

The purpose of this study was to (a) provide introductory literature regarding cultural constructs, health disparities, and social determinants of health (SDoH); (b) summarize the literature regarding the Centers for Disease Control and Prevention (CDC) Early Hearing Detection and Intervention (EHDI) Hearing Screening Follow-Up Survey (HSFS) data; (c) explore the CDC EHDI HSFS data regarding the contribution of maternal demographics to loss-to-follow-up/loss-to-documentation (LTF/D) between hearing screening and audiologic diagnosis for 2016, 2017, and 2018; and (d) examine these health disparities within the context of potential ethnoracial biases.

METHOD

This is a comprehensive narrative literature review of cultural constructs, hearing health disparities, and SDoH as they relate to the CDC EHDI HSFS data. We explore the maternal demographic data reported on the CDC EHDI website and report disparities for maternal age, education, ethnicity, and race for 2016, 2017, and 2018. We focus on LTF/D for screening and diagnosis within the context of racial and cultural bias.

RESULTS

A literature review demonstrates the increase in quality of the CDC EHDI HSFS data over the past 2 decades. LTF/D rates for hearing screening and audiologic diagnostic testing have improved from higher than 60% to current rates of less than 30%. Comparisons of diagnostic completion rates reported on the CDC website for the EHDI HSFS 2016, 2017, and 2018 data show trends for maternal age, education, and race, but not for ethnicity. Trends were defined as changes more than 10% for variables averaged over a 3-year period (2016-2018).

CONCLUSIONS

Although there have been significant improvements in LTF/D over the past 2 decades, there continue to be opportunities for further improvement. Beyond neonatal screening, delays continue to be reported in the diagnosis of young children with hearing loss. Notwithstanding the extraordinarily diverse families within the United States, the imperative is to minimize such delays so that all children with hearing loss can, at the very least, have auditory accessibility to spoken language by 3 months of age. Conscious awareness is essential before developing a potentially effective plan of action that might remediate the problem.

Auditory information for spatial location and pitch-height correspondence support young infants' perception of object persistence

Perception of object persistence across occlusion emerges at around 4 months of age for objects moving horizontally or vertically. In addition, congruent auditory information for movement enhances perception of persistence of an object moving horizontally. In two experiments, we examined the effect of presenting bimodal (visual and auditory) sensory information, both congruently and incongruently, for a vertical moving object occlusion event. A total of 68 4-month-old infants (34 girls) were tested for perception of persistence of an object moving up and down, passing at each translation behind a centrally placed occluder. Infants were exposed to these visual events accompanied by no sound, spatially colocated sound, or congruent or incongruent pitch-height correspondence sounds. Both spatially colocated and congruent pitch-height auditory information enhanced perception of trajectory continuity. However, no impairment occurred when pitch-height sound information was presented incongruently. These results highlight the importance of taking a multisensory approach to infant perceptual development.

Temporal Audiovisual Motion Prediction in 2D- vs. 3D-Environments

Predicting motion is essential for many everyday life activities, e.g., in road traffic. Previous studies on motion prediction failed to find consistent results, which might be due to the use of very different stimulus material and behavioural tasks. Here, we directly tested the influence of task (detection, extrapolation) and stimulus features (visual vs. audiovisual and three-dimensional vs. non-three-dimensional) on temporal motion prediction in two psychophysical experiments. In both experiments a ball followed a trajectory toward the observer and temporarily disappeared behind an occluder. In audiovisual conditions a moving white noise (congruent or non-congruent to visual motion direction) was presented concurrently. In experiment 1 the ball reappeared on a predictable or a non-predictable trajectory and participants detected when the ball reappeared. In experiment 2 the ball did not reappear after occlusion and participants judged when the ball would reach a specified position at two possible distances from the occluder (extrapolation task). Both experiments were conducted in three-dimensional space (using stereoscopic screen and polarised glasses) and also without stereoscopic presentation. Participants benefitted from visually predictable trajectories and concurrent sounds during detection. Additionally, visual facilitation was more pronounced for non-3D stimulation during detection task. In contrast, for a more complex extrapolation task group mean results indicated that auditory information impaired motion prediction. However, a post hoc cross-validation procedure (split-half) revealed that participants varied in their ability to use sounds during motion extrapolation. Most participants selectively profited from either near or far extrapolation distances but were impaired for the other one. We propose that interindividual differences in extrapolation efficiency might be the mechanism governing this effect. Together, our results indicate that both a realistic experimental environment and subject-specific differences modulate the ability of audiovisual motion prediction and need to be considered in future research.

Audio Facilitates the Perception of Cinematic Continuity by First-Time Viewers

Previous studies concluded that first-time film viewers often had difficulty integrating shots into a coherent representation of the depicted events in the absence of a familiar action through the film cuts or a salient eye-gazing of a character in the film. In this study, we investigated whether diegetic sound (i.e., sound that seems to originate from the depicted cinematic space) could effectively bridge shots for first-time viewers. Across a range of films, both dialog, and salient environmental sound (e.g., barking dogs) helped first-time viewers connect shots. However, sound was not always successful in supporting first-time viewers' interpretations. While experienced viewers were able to understand less-familiar linking sounds and environments, first-time viewers found this difficult. Overall, a range of diegetic sounds helped first-time viewers understand spatiotemporal relations between shots, but these viewers still had difficulty integrating views of unfamiliar environments.

The impact of semantically congruent and incongruent visual information on auditory object recognition across development

The ability to use different sensory signals in conjunction confers numerous advantages on perception. Multisensory perception in adults is influenced by factors beyond low-level stimulus properties such as semantic congruency. Sensitivity to semantic relations has been shown to emerge early in development; however, less is known about whether implementation of these associations changes with development or whether development in the representations themselves might modulate their influence. Here, we used a Stroop-like paradigm that requires participants to identify an auditory stimulus while ignoring a visual stimulus. Prior research shows that in adults visual distractors have more impact on processing of auditory objects than vice versa; however, this pattern appears to be inverted early in development. We found that children from 8years of age (and adults) gain a speed advantage from semantically congruent visual information and are disadvantaged by semantically incongruent visual information. At 6years of age, children gain a speed advantage for semantically congruent visual information but are not disadvantaged by semantically incongruent visual information (as compared with semantically unrelated visual information). Both children and adults were influenced by associations between auditory and visual stimuli, which they had been exposed to on only 12 occasions during the learning phase of the study. Adults showed a significant speed advantage over children for well-established associations but showed no such advantage for newly acquired pairings. This suggests that the influence of semantic associations on multisensory processing does not change with age but rather these associations become more robust and, in turn, more influential.

Young infants' perception of the trajectories of two- and three-dimensional objects

We investigated oculomotor anticipations in 4-month-old infants as they viewed center-occluded object trajectories. In two experiments, we examined performance in two-dimensional (2D) and three-dimensional (3D) dynamic occlusion displays and in an additional 3D condition with a smiley face as the moving target stimulus. Rates of anticipatory eye movements were not facilitated by 3D displays or by the (presumably) more salient smiley face relative to the 2D condition. However, latencies of anticipations were reduced, implying that 3D visual information may have supported formation of more robust mental representations of the moving object. Results are interpreted in a context of perceptual constraints on developing cognitive capacities during early infancy.