Dimension-specific attention directs learning and listening on auditory training tasks

Central Auditory Processing Dysfunction in Service Members and Veterans: Treatment Considerations and Strategies

PURPOSE

Military risk factors such as blast exposure, noise exposure, head trauma, and neurotoxin exposure place Service members and Veterans at risk for deficits associated with auditory processing dysfunction. However, there is no clinical guidance specific to the treatment of auditory processing deficits in this unique population. We provide an overview of available treatments and their limited supporting evidence for use in adults, emphasizing the need for multidisciplinary case management and interdisciplinary research to support evidence-based solutions.

METHOD

We explored relevant literature to inform the treatment of auditory processing dysfunction in adults, with emphasis on findings involving active or former military personnel. We were able to identify a limited number of studies, pertaining primarily to the treatment of auditory processing deficits through the use of assistive technologies and training strategies. We assessed the current state of the science for knowledge gaps that warrant additional study.

CONCLUSIONS

Auditory processing deficits often co-occur with other military injuries and may pose significant risk in military operational and occupational settings. Research is needed to advance clinical diagnostic and rehabilitative capabilities, guide treatment planning, support effective multidisciplinary management, and inform fitness-for-duty standards. We emphasize the need for an inclusive approach to the assessment and treatment of auditory processing concerns in Service members and Veterans and for evidence-based solutions to address complex military risk factors and injuries.

The effectiveness of an auditory temporal training program in children who present voiceless/voiced-based orthographic errors

INTRODUCTION

Studies on children's written production of the Brazilian Portuguese have shown that one of the most frequent phonological-based orthographic errors is the one related to voiceless/voiced phonemes. Children who make this type of error may have auditory temporal processing disorders, which can harm the perception of phonemes with similar characteristics.

AIM

Verify the effectiveness of an auditory temporal training program based on activities adapted from the software Fast ForWord in the auditory temporal processing, i.e. the temporal ordering skill, and in reducing voiceless/voiced-based orthographic errors and the frequency of occurrence of these errors in the written production of the children.

METHOD

Twenty-five children participated on this study. They were divided in two groups: experimental group consisting of 16 participants, who engaged in the auditory temporal training activities; and a placebo group consisting of nine participants, who engaged in passive visual activities. The behavioral measures applied in the pre-training evaluation, post-training and placebo evaluations were: i) auditory skill of temporal ordering by the Pitch Pattern Sequence Test; and ii) analysis of the amount of voiceless/voiced-based orthographic errors and the frequency of occurrence of these errors by the use of dictation.

RESULTS

No statistically significant differences were found concerning the placebo group in the pre-training and post-training evaluations, in all evaluation measures. However, statistically significant differences were found in the pre-training and post-training evaluations for the pitch pattern sequence test concerning the experimental group. These differences were specifically related to a reduction of the errors regarding fricative graphemes, and the frequency of occurrence of plosive and fricative graphemes.

CONCLUSIONS

The auditory temporal training program was effective in improving the temporal ordering skill and reducing errors in the writing of children who made voiceless/voiced-based orthographic errors.

Auditory and cognitive performance in elderly musicians and nonmusicians

Musicians represent a model for examining brain and behavioral plasticity in terms of cognitive and auditory profile, but few studies have investigated whether elderly musicians have better auditory and cognitive abilities than nonmusicians. The aim of the present study was to examine whether being a professional musician attenuates the normal age-related changes in hearing and cognition. Elderly musicians still active in their profession were compared with nonmusicians on auditory performance (absolute threshold, frequency intensity, duration and spectral shape discrimination, gap and sinusoidal amplitude-modulation detection), and on simple (short-term memory) and more complex and higher-order (working memory [WM] and visuospatial abilities) cognitive tasks. The sample consisted of adults at least 65 years of age. The results showed that older musicians had similar absolute thresholds but better supra-threshold discrimination abilities than nonmusicians in four of the six auditory tasks administered. They also had a better WM performance, and stronger visuospatial abilities than nonmusicians. No differences were found between the two groups' short-term memory. Frequency discrimination and gap detection for the auditory measures, and WM complex span tasks and one of the visuospatial tasks for the cognitive ones proved to be very good classifiers of the musicians. These findings suggest that life-long music training may be associated with enhanced auditory and cognitive performance, including complex cognitive skills, in advanced age. However, whether this music training represents a protective factor or not needs further investigation.

Auditory Training for Central Auditory Processing Disorder

Auditory training (AT) is an important component of rehabilitation for patients with central auditory processing disorder (CAPD). The present article identifies and describes aspects of AT as they relate to applications in this population. A description of the types of auditory processes along with information on relevant AT protocols that can be used to address these specific deficits is included. Characteristics and principles of effective AT procedures also are detailed in light of research that reflects on their value. Finally, research investigating AT in populations who show CAPD or present with auditory complaints is reported. Although efficacy data in this area are still emerging, current findings support the use of AT for treatment of auditory difficulties.

Cognitive predictors of perceptual adaptation to accented speech

The present study investigated the effects of inhibition, vocabulary knowledge, and working memory on perceptual adaptation to accented speech. One hundred young, normal-hearing adults listened to sentences spoken in a constructed, unfamiliar accent presented in speech-shaped background noise. Speech Reception Thresholds (SRTs) corresponding to 50% speech recognition accuracy provided a measurement of adaptation to the accented speech. Stroop, vocabulary knowledge, and working memory tests were performed to measure cognitive ability. Participants adapted to the unfamiliar accent as revealed by a decrease in SRTs over time. Better inhibition (lower Stroop scores) predicted greater and faster adaptation to the unfamiliar accent. Vocabulary knowledge predicted better recognition of the unfamiliar accent, while working memory had a smaller, indirect effect on speech recognition mediated by vocabulary score. Results support a top-down model for successful adaptation to, and recognition of, accented speech; they add to recent theories that allocate a prominent role for executive function to effective speech comprehension in adverse listening conditions.

Musical ability and non-native speech-sound processing are linked through sensitivity to pitch and spectral information

Is the observed link between musical ability and non-native speech-sound processing due to enhanced sensitivity to acoustic features underlying both musical and linguistic processing? To address this question, native English speakers (N = 118) discriminated Norwegian tonal contrasts and Norwegian vowels. Short tones differing in temporal, pitch, and spectral characteristics were used to measure sensitivity to the various acoustic features implicated in musical and speech processing. Musical ability was measured using Gordon's Advanced Measures of Musical Audiation. Results showed that sensitivity to specific acoustic features played a role in non-native speech-sound processing: Controlling for non-verbal intelligence, prior foreign language-learning experience, and sex, sensitivity to pitch and spectral information partially mediated the link between musical ability and discrimination of non-native vowels and lexical tones. The findings suggest that while sensitivity to certain acoustic features partially mediates the relationship between musical ability and non-native speech-sound processing, complex tests of musical ability also tap into other shared mechanisms.

Perceptual learning: top to bottom

Perceptual learning has traditionally been portrayed as a bottom-up phenomenon that improves encoding or decoding of the trained stimulus. Cognitive skills such as attention and memory are thought to drive, guide and modulate learning but are, with notable exceptions, not generally considered to undergo changes themselves as a result of training with simple perceptual tasks. Moreover, shifts in threshold are interpreted as shifts in perceptual sensitivity, with no consideration for non-sensory factors (such as response bias) that may contribute to these changes. Accumulating evidence from our own research and others shows that perceptual learning is a conglomeration of effects, with training-induced changes ranging from the lowest (noise reduction in the phase locking of auditory signals) to the highest (working memory capacity) level of processing, and includes contributions from non-sensory factors that affect decision making even on a "simple" auditory task such as frequency discrimination. We discuss our emerging view of learning as a process that increases the signal-to-noise ratio associated with perceptual tasks by tackling noise sources and inefficiencies that cause performance bottlenecks, and present some implications for training populations other than young, smart, attentive and highly-motivated college students.

The brain dynamics of rapid perceptual adaptation to adverse listening conditions

Listeners show a remarkable ability to quickly adjust to degraded speech input. Here, we aimed to identify the neural mechanisms of such short-term perceptual adaptation. In a sparse-sampling, cardiac-gated functional magnetic resonance imaging (fMRI) acquisition, human listeners heard and repeated back 4-band-vocoded sentences (in which the temporal envelope of the acoustic signal is preserved, while spectral information is highly degraded). Clear-speech trials were included as baseline. An additional fMRI experiment on amplitude modulation rate discrimination quantified the convergence of neural mechanisms that subserve coping with challenging listening conditions for speech and non-speech. First, the degraded speech task revealed an "executive" network (comprising the anterior insula and anterior cingulate cortex), parts of which were also activated in the non-speech discrimination task. Second, trial-by-trial fluctuations in successful comprehension of degraded speech drove hemodynamic signal change in classic "language" areas (bilateral temporal cortices). Third, as listeners perceptually adapted to degraded speech, downregulation in a cortico-striato-thalamo-cortical circuit was observable. The present data highlight differential upregulation and downregulation in auditory-language and executive networks, respectively, with important subcortical contributions when successfully adapting to a challenging listening situation.

Human decision making based on variations in internal noise: an EEG study

Perceptual decision making is prone to errors, especially near threshold. Physiological, behavioural and modeling studies suggest this is due to the intrinsic or ‘internal’ noise in neural systems, which derives from a mixture of bottom-up and top-down sources. We show here that internal noise can form the basis of perceptual decision making when the external signal lacks the required information for the decision. We recorded electroencephalographic (EEG) activity in listeners attempting to discriminate between identical tones. Since the acoustic signal was constant, bottom-up and top-down influences were under experimental control. We found that early cortical responses to the identical stimuli varied in global field power and topography according to the perceptual decision made, and activity preceding stimulus presentation could predict both later activity and behavioural decision. Our results suggest that activity variations induced by internal noise of both sensory and cognitive origin are sufficient to drive discrimination judgments.

Lack of generalization of auditory learning in typically developing children

PURPOSE

To understand the components of auditory learning in typically developing children by assessing generalization across stimuli, across modalities (i.e., hearing, vision), and to higher level language tasks.

METHOD

Eighty-six 8- to 10-year-old typically developing children were quasi-randomly assigned to 4 groups. Three of the groups received twelve 30-min training sessions on multiple standards using either an auditory frequency discrimination task (AFD group), auditory phonetic discrimination task (PD group), or visual frequency discrimination task (VFD group) over 4 weeks. The 4th group, which was the no-intervention control (NI) group, did not receive any training. Thresholds on all tasks (AFD, PD, and VFD) were assessed immediately before and after training, along with performance on a battery of language assessments.

RESULTS

Relative to the other groups, both the AFD group and the PD group, but not the VFD group, showed significant learning on the stimuli upon which they were trained. However, in those instances where learning was observed, it did not generalize to the nontrained stimuli or to the language assessments.

CONCLUSIONS

Nonspeech (AFD) or speech (PD) discrimination training can lead to auditory learning in typically developing children of this age range. However, this learning does not always generalize across stimuli or tasks, across modalities, or to higher level measures of language ability.

Stimulus uncertainty in auditory perceptual learning

Stimulus uncertainty produced by variations in a target stimulus to be detected or discriminated, impedes perceptual learning under some, but not all experimental conditions. To account for those discrepancies, it has been proposed that uncertainty is detrimental to learning when the interleaved stimuli or tasks are similar to each other but not when they are sufficiently distinct, or when it obstructs the downstream search required to gain access to fine-grained sensory information, as suggested by the Reverse Hierarchy Theory (RHT). The focus of the current review is on the effects of uncertainty on the perceptual learning of speech and non-speech auditory signals. Taken together, the findings from the auditory modality suggest that in addition to the accounts already described, uncertainty may contribute to learning when categorization of stimuli to phonological or acoustic categories is involved. Therefore, it appears that the differences reported between the learning of non-speech and speech-related parameters are not an outcome of inherent differences between those two domains, but rather due to the nature of the tasks often associated with those different stimuli.