Contribution of psychoacoustics and neuroaudiology in revealing correlation of mental disorders with central auditory processing disorders

Development of auditory cognition in 5- to 10-year-old children: Focus on musical and verbal short-term memory

Developmental aspects of auditory cognition were investigated in 5-to-10-year-old children (n = 100). Musical and verbal short-term memory (STM) were assessed by means of delayed matching-to-sample tasks (DMST) (comparison of two four-item sequences separated by a silent retention delay), with two levels of difficulty. For musical and verbal materials, children's performance increased from 5 years to about 7 years of age, then remained stable up to 10 years of age, with performance remaining inferior to performance of young adults. Children and adults performed better with verbal material than with musical material. To investigate auditory cognition beyond STM, we assessed speech-in-noise perception with a four-alternative forced-choice task with two conditions of phonological difficulty and two levels of cocktail-party noise intensity. Partial correlations, factoring out the effect of age, showed a significant link between musical STM and speech-in-noise perception in the condition with increased noise intensity. Our findings reveal that auditory STM improves over development with a critical phase around 6-7 years of age, yet these abilities appear to be still immature at 10 years. Musical and verbal STM might in particular share procedural and serial order processes. Furthermore, musical STM and the ability to perceive relevant speech signals in cocktail-party noise might rely on shared cognitive resources, possibly related to pitch encoding. To the best of our knowledge, this is the first time that auditory STM is assessed with the same paradigm for musical and verbal material during childhood, providing perspectives regarding diagnosis and remediation in developmental learning disorders.

Recognizing and Reacting to Risk Signs for Patient Suicide

Evidence-based suggestions for developing an effective clinician-client relationship built upon trust and honesty will be shared, as well as a review of relevant scope of practice issues for audiologists. Audiologists need to be prepared if a patient threatens self-harm. Many patients do not spontaneously report their suicidal thoughts and intentions to their care providers, so we need to be alert to warning signs. Information about the strongest predictors of suicide, how to ask about suicidal intentions, and how to assess the risk of suicide will be presented. Although it is our responsibility to recognize suicidal tendencies and have a plan for preventive intervention, it is not our responsibility to conduct a suicide evaluation. Tips for collecting critical information to be provided to qualified professionals will be shared, as well as additional information about how and to whom to disclose this information. A list of suicide warning signs will be reviewed as well as some additional suggestions for how to react when a patient discloses his or her suicidal intent. A review of available resources (for both the patient and the clinician) will be provided, along with instructions for how and when it is appropriate to access them.

Practical guidelines to minimise language and cognitive confounds in the diagnosis of CAPD: a brief tutorial

OBJECTIVE

To provide audiologists with strategies to minimise confounding cognitive and language processing variables and accurately diagnose central auditory processing disorder (CAPD).

DESIGN

Tutorial.

STUDY SAMPLE

None.

RESULTS

Strategies are reviewed to minimise confounding cognitive and language processing variables and accurately diagnose CAPD.

CONCLUSIONS

Differential diagnosis is exceedingly important and can be quite challenging. Distinguishing between two or more conditions presenting with similar symptoms or attributes requires multidisciplinary, comprehensive assessment. To ensure appropriate interventions, the audiologist is a member of the multidisciplinary team responsible for determining whether there is an auditory component to other presenting deficits or whether one condition is responsible for the symptoms seen in another. Choice of tests should be guided both by the symptoms of the affected individual, as established in an in-depth interview and case history, the individual's age and primary language, and by the specific deficits reported to be associated with specific clinical presentations. Knowing which tests are available, their strengths and limitations, the processes assessed, task and response requirements, and the areas of the central auditory nervous system (CANS) to which each test is most sensitive provides the audiologist with critical information to assist in the differential diagnostic process.

Speech-Language Pathologists' Use of Hearing Screening for Clients With Aphasia: Challenges, Potential Solutions, and Future Directions

PURPOSE

The co-occurrence of aphasia and hearing loss can lead to compounded receptive communication impairment that is significantly worse than in either disorder alone. Therefore, identifying potential hearing loss is a critical part of communication assessment for clients with neurogenic communication disorders, many of whom have aphasia. This clinical focus article explores speech language pathologists' (SLPs') hearing-screening practices with this population, identifies patterns of concern, and presents potential solutions and future research needs.

METHOD

SLPs completed an online survey. Data were obtained from 102 SLPs who work with adults with aphasia.

RESULTS

Most respondents indicated that they do some form of hearing screening, although few do them in a reliable, valid manner. Awareness of American Speech-Language-Hearing Association hearing-screening guidelines was low. The most common reasons given for not conducting screenings included cost and lack of proper equipment and time.

CONCLUSIONS

SLPs are an important resource for identifying potential hearing loss in individuals with aphasia. These data suggest that hearing screenings are being conducted only inconsistently with this population, often using nonstandardized methods. The results demonstrate a need to develop hearing-screening tools that are affordable, easily accessible, and validated for aphasia, and to raise awareness of currently available hearing-screening protocols and tools.

Is Central Auditory Processing Disorder Present in Psychosis?

Purpose

The scope of this study was to trace central auditory processing issues in patients with first-episode psychosis using a psychoacoustic test battery approach.

Method

Patients ( n = 17) and volunteer control subjects ( n = 17) with no personal or family history of schizophrenia were included in the study on the basis of normal hearing sensitivity. The authors implemented a central auditory processing battery consisting of monaural and binaural tests with verbal and nonverbal stimuli.

Results

Perceptual deficits in both nonverbal and verbal auditory stimuli are reported in this study, with temporal central auditory processing deficits and a mean left-ear advantage documented in the patient group.

Conclusion

This study points to the possibility of the existence of central auditory processing deficits in first-episode psychosis leading to schizophrenia. Audiologists should be aware of the psychiatric research pointing to enhanced verbal memory as a result of auditory training, linking bottom-up remediation with top-down improvement.

An examination of auditory processing and affective prosody in relatives of patients with auditory hallucinations

Research on auditory verbal hallucinations (AVHs) indicates that AVH schizophrenia patients show greater abnormalities on tasks requiring recognition of affective prosody (AP) than non-AVH patients. Detecting AP requires accurate perception of manipulations in pitch, amplitude and duration. Schizophrenia patients with AVHs also experience difficulty detecting these acoustic manipulations; with a number of theorists speculating that difficulties in pitch, amplitude and duration discrimination underlie AP abnormalities. This study examined whether both AP and these aspects of auditory processing are also impaired in first degree relatives of persons with AVHs. It also examined whether pitch, amplitude and duration discrimination were related to AP, and to hallucination proneness. Unaffected relatives of AVH schizophrenia patients (N = 19) and matched healthy controls (N = 33) were compared using tone discrimination tasks, an AP task, and clinical measures. Relatives were slower at identifying emotions on the AP task (p = 0.002), with secondary analysis showing this was especially so for happy (p = 0.014) and neutral (p = 0.001) sentences. There was a significant interaction effect for pitch between tone deviation level and group (p = 0.019), and relatives performed worse than controls on amplitude discrimination and duration discrimination. AP performance for happy and neutral sentences was significantly correlated with amplitude perception. Lastly, AVH proneness in the entire sample was significantly correlated with pitch discrimination (r = 0.44) and pitch perception was shown to predict AVH proneness in the sample (p = 0.005). These results suggest basic impairments in auditory processing are present in relatives of AVH patients; they potentially underlie processing speed in AP tasks, and predict AVH proneness. This indicates auditory processing deficits may be a core feature of AVHs in schizophrenia, and are worthy of further study as a potential endophenotype for AVHs.

Intact sensory function in anorexia nervosa

BACKGROUND

In anorexia nervosa (AN), taste and smell are believed to be anhedonic, hunger and pain are muted, and body-image distortion obscures wasting, which together facilitate self-starvation. However, the emphasis on these deficits may be biased because other sensory systems have been sparsely investigated.

OBJECTIVES

Objectives of the study were to clarify whether these dysfunctions are specific or part of a pattern of sensory-perceptual deficits in AN patients and to test the gustatory senses dissociated from ingestion to clarify whether any deficit is sensory or affective.

DESIGN

In 15 adolescent, first-episode, hospitalized, restrictive AN patients and 15 matched healthy controls who responded to gustatory stimuli (intensity and hedonics of 5 basic tastes and tastes and odors of foods and nonfoods), size estimation (manual and oral judgment of size and shape, kinesthesia, and body size and esthetics), cold pain, and auditory and visual processing were compared.

RESULTS

AN patients did not differ on most tests, were better at odor recognition, were less successful in central auditory processing and oral assessment of size and shape, and may have been more sensitive to cold. Body-image dissatisfaction in AN patients was not related to dysfunctional size estimation.

CONCLUSIONS

There is no systematic sensory-perceptual deficit in AN patients, and specifically, not in gustatory function. The few differences shown might be due to fear of food-related stimuli or comorbidity.

Central auditory processing disorder (CAPD) in children with specific language impairment (SLI). Central auditory tests

The aim of this project is to use central auditory tests for diagnosis of central auditory processing disorder (CAPD) in children with specific language impairment (SLI), in order to confirm relationship between speech-language impairment and central auditory processing. We attempted to establish special dichotic binaural tests in Czech language modified for younger children. Tests are based on behavioral audiometry using dichotic listening (different auditory stimuli that presented to each ear simultaneously). The experimental tasks consisted of three auditory measures (test 1-3)-dichotic listening of two-syllable words presented like binaural interaction tests. Children with SLI are unable to create simple sentences from two words that are heard separately but simultaneously. Results in our group of 90 pre-school children (6-7 years old) confirmed integration deficit and problems with quality of short-term memory. Average rate of success of children with specific language impairment was 56% in test 1, 64% in test 2 and 63% in test 3. Results of control group: 92% in test 1, 93% in test 2 and 92% in test 3 (p<0.001). Our results indicate the relationship between disorders of speech-language perception and central auditory processing disorders.

Long-term exposure to occupational noise alters the cortical organization of sound processing

OBJECTIVE

Long-term exposure to noise may cause an altered hemispheric lateralization of speech processing even in silent conditions. We examined whether this lateralization shift is speech specific or occurs also for other sounds.

METHODS

Brain responses from 10 healthy noise-exposed workers (>5 years) and 10 matched controls were recorded with a 32-channel electroencephalogram in two conditions, one including standard and deviant speech sounds, the other non-speech sounds, with novel sounds in both.

RESULTS

The deviant-sound elicited mismatch negativity (MMN) was larger to non-speech than speech sounds in control subjects, while it did not differ between the sound types in the noise-exposed subjects. Moreover, the MMN to speech sounds was lateralized to the right hemisphere in exposed workers, while it was left-hemisphere predominant in control subjects. No group topography difference was found for non-speech sounds. The deviant sounds that were close in formant space to the standards elicited a longer MMN latency in both speech and non-speech conditions in exposed subjects than controls. No group differences were found for cortical responses to novel sounds.

CONCLUSIONS

Long-term noise exposure altered the strength and the hemispheric organization of speech-sound discrimination and decreased the speed of sound-change processing.

SIGNIFICANCE

Subpathological changes in cortical responses to sounds may occur even in subjects without a peripheral damage but continuously exposed to noisy auditory environments.

Clinical psychoacoustics in Alzheimer's disease central auditory processing disorders and speech deterioration

BACKGROUND: Difficulty in speech understanding in the presence of background noise or competing auditory signals is typically present in central auditory processing disorders. These disorders may be diagnosed in Alzheimer's disease as a result of degeneration in the central auditory system. In addition perception and processing of speech may be affected. MATERIAL AND METHODS: A MEDLINE research was conducted in order to answer the question whether there is a central auditory processing disorder involved in Alzheimer's disease. A second question to be investigated was what, if any is the connection, between central auditory processing disorders and speech deterioration?Articles were retrieved from the Medline to find relevance of Alzheimer's dis ease with central auditory processing disorders, they summed up to 34. Twelve papers were studied that contained testing for CAPD through psychoacoustic investigation. An additional search using the keywords 'speech production' and 'AD' produced a result of 33 articles, of them 14 are thoroughly discussed in this review as they have references concerning CAPD. The rest do not contain any relavent information on the central auditory system. RESULTS: Psychoacoustic tests reveal significantly lower scores in patients with Alzheimer's disease compared with normal subjects. Tests concerning sound localization and perception of tones as well as phoneme discrimination and tonal memory reveal deficits in Alzheimer's disease. Central auditory processing disorders may exist several years before the onset of clinical diagnosis of Alzheimer's disease. Segmental characteristics of speech are normal. Deficits exist concerning the supra-segmental components of speech. CONCLUSIONS: Central auditory processing disorders have been found in many cases when patients with Alzheimer's disease are tested. They may present as an early manifestation of Alzheimer's disease, preceding the disease by a minimum of 5 and a maximum of 10 years. During these years changes in the central auditory system, starting in the temporal lobe, may produce deficits in speech processing and production as hearing and speech are highly connected human functions. Another theory may be that spread of degeneration of the central nervous system has as a consequence, speech deterioration. Further research and central auditory processing disorders testing in the elderly population are needed to validate one theory over the other.