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Effects of the neonatal intensive care unit on auditory attention and distraction.

A theory is proposed that attention to acoustic signals is important for normal development and varies with background masking sounds. Specifically, the theory states that distractibility increases with decreasing predictability of the acoustic environment and with decreasing age. Literature from premature neonates, normal infants, preadolescent children, children with attention deficit disorders, and adults is reviewed. One conclusion is that an environment perceived by adults as predictable may be distracting for preterm infants. One recommendation for future research is to include measures of background acoustic predictability as independent variables or covariates in developmental studies.

Attention↗

Auditory masking experiments in schizophrenia.

Twelve schizophrenic subjects with acoustic hallucinations in their case histories were compared with 12 healthy reference subjects and eight subjects with panic disorder in a test of three auditory masking tasks, simultaneous masking (SM), forward masking (FM) and backward masking (BM). The schizophrenic subjects showed no differences from reference subjects on SM but had higher thresholds for the two other conditions (FM and BM). Schizophrenics with very increased thresholds (n=6) had a significantly higher need for residential treatment. Thresholds for SM and BM were not, as for reference subjects, related to age for schizophrenics. No statistically significant differences regarding any masking experiments were found between the panic disorder subjects and the reference subjects. Simultaneous masking, reflecting functions of the basilar membrane and those of elementary brainstem processing, showed no signs of dysfunction in schizophrenic subjects. Schizophrenics showed aberrations in FM and BM, possibly influenced by more central (cortical) processes.

Adult↗

Audiologic management of older adults with hearing loss and compromised cognitive/psychoacoustic auditory processing capabilities.

The number and proportion of older adults in the United States population is increasing, and more clinical audiologists will be called upon to deliver hearing care to the approximately 35% to 50% of them who experience hearing difficulties. In recent years, the characteristics and sources of receptive communication difficulties in older individuals have been investigated by hearing scientists, cognitive psychologists, and audiologists. It is becoming increasingly apparent that cognitive compromises and psychoacoustic auditory processing disorders associated with aging may contribute to communication difficulties in this population. This paper presents an overview of best practices, based on our current knowledge base, for clinical management of older individuals with limitations in cognitive or psychoacoustic auditory processing capabilities, or both, that accompany aging.

Age Factors↗

Neuropsychological evidence for "word-meaning deafness" in a Spanish-speaking patient.

In this paper we present a case of "word-meaning deafness," characterised by serious problems in the comprehension of spoken language, whilst repetition and writing words and non-words from dictation are preserved. This performance indicates the impossibility of correctly accessing phonological representation from the semantic representation of words. Neuropsychological evidence on specific alterations in word-meaning disorders is scarce, and this study contributes new findings with a Spanish-speaking patient. The nature of the processes involved in understanding language and the cerebral mechanisms that might be affected in each case were discussed, in accordance with current neuropsychological theories.

Aged↗

[Simplified auditory processing test and difficulties in reading and spelling].

BACKGROUND: Auditory processing disorders and difficulties in reading and spelling. AIM: To analyze the answers presented by children with reading and spelling disorders in a simplified auditory processing test and in a four sequential syllables memory test. METHOD: Participants of this study were 9 children who attended a special program at school, with no hearing impairments and with no history of neurologic and/or psyquiatric disorders. RESULTS: A significant relation was found between reading and spelling difficulties, and failing in the four sequential syllable memory test and instrumental sounds tasks, demonstrating that these tasks were efficient in detecting this type of difficulties. CONCLUSION: A relation exists between auditory processing and reading and spelling difficulties.

Agraphia↗

Can we differentially diagnose an attention deficit disorder without hyperactivity from a central auditory processing problem?

This article examines the dilemma involved in properly diagnosing children with Central Auditory Processing Deficits (CAPD) and children with Attention Deficit Disorders (without hyperactivity) (ADD) as they may not be mutually exclusive. With the help of a case illustration, the diagnostic difficulties are highlighted. There is a strong need for professionals in the speech/language and psychiatric communities to communicate to differentially diagnose a child who exhibits characteristics of both CAPD and ADD.

Auditory Perceptual Disorders↗

Primary progressive aphasia accompanied by environmental sound agnosia: a neuropsychological, MRI and PET study.

As part of the frontotemporal dementias, primary progressive aphasia (PPA) is typically characterized by nonfluent speech with paraphasias, but there is growing evidence that also a fluent variant of PPA exists. We describe a patient suffering from PPA who adds to the broad clinical spectrum of this disorder. Moreover, we report for the first time that PPA may be associated with severe impairment in meaningful nonverbal sound recognition (environmental sound agnosia). These neuropsychological findings were found to be associated with distinct focal alterations in functional and structural neuroimaging.

Aged↗

"Pure word deafness": implications for assessment and management in communication disorder--a report of two cases.

In "pure word deafness" after acquired brain injury, the auditory comprehension of words is much more impaired than other aspects of communication or cognition. Two cases are presented, one early and one late presentation. The key to diagnosis of communication disorders is to remember to assess all six basic aspects of language function and to be vigilant for coexisting diagnoses that can complicate such assessment (especially psychiatric diagnoses). Rehabilitation management of impaired communication should emphasize the teaching of specific coping mechanisms to the patient and to all others who are involved.

Aged↗

The clinical management of perceptual skills disorders in a primary care practice.

This paper offers guidelines that will assist the primary-care optometrist formulate effective treatment recommendations for patients who display perceptual skills dysfunction in association with school learning difficulties. It suggests that long, multifaceted diagnostic protocols are unnecessary and, further, that only certain children are aided significantly by perceptual skills remedial training programs. Others are better served by properly designed compensatory education programs that may or may not include a perceptual skills training component. Two case reports are included to illustrate these concepts.

Auditory Perceptual Disorders↗

Congenital amusia: a group study of adults afflicted with a music-specific disorder.

The condition of congenital amusia, commonly known as tone-deafness, has been described for more than a century, but has received little empirical attention. In the present study, a research effort has been made to document in detail the behavioural manifestations of congenital amusia. A group of 11 adults, fitting stringent criteria of musical disabilities, were examined in a series of tests originally designed to assess the presence and specificity of musical disorders in brain-damaged patients. The results show that congenital amusia is related to severe deficiencies in processing pitch variations. The deficit extends to impairments in music memory and recognition as well as in singing and the ability to tap in time to music. Interestingly, the disorder appears specific to the musical domain. Congenital amusical individuals process and recognize speech, including speech prosody, common environmental sounds and human voices, as well as control subjects. Thus, the present study convincingly demonstrates the existence of congenital amusia as a new class of learning disabilities that affect musical abilities.

Adult↗

Revisiting the factor structure for positive and negative symptoms: evidence from a large heterogeneous group of psychiatric patients.

OBJECTIVE: The factor structures of individual positive and negative symptoms as well as global ratings were examined in a diagnostically heterogeneous group of subjects. METHOD: Subjects were identified through a clinical and family study of patients with major psychoses at a VA medical center and evaluated with the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms. For the examination of global-level factor structures (N = 630), both principal-component analysis and factor analysis with orthogonal rotation were used. Factor analysis was used for the examination of item-level factor structures as well (N = 549). RESULTS: The principal-component analysis of global ratings revealed three factors: negative symptoms, positive symptoms, and disorganization. The factor analysis of global ratings revealed a negative symptom factor and a positive symptom factor. The item-level factor analysis revealed two negative symptom factors (diminished expression and disordered relating), two positive symptom factors (bizarre delusions and auditory hallucinations), and a disorganization factor. CONCLUSIONS: The generation of additional meaningful factors at the item level suggests that important information about symptoms is lost when only global ratings are viewed. Future work should explore clinical and pathological correlates of the more differentiated item-level symptom dimensions.

Adult↗

[Dychotomic tests in Polish for speech audiometry part 1: preparing material for the tests].

INTRODUCTION: Dychotomic tests in speech audiometry are extremely beneficial, especially in diagnosing central auditory processing disorders. MATERIALS AND METHODS: Basing on new articulatory lists (NLA-93), the authors have prepared a new set of language tests, including filtered speech test, numeral and verbal dichotic tests and Calearo test. CONCLUSIONS: The phonetic characteristics of the tests are presented, with special attention paid to their phonetic balance.

Audiometry↗

Lead exposure and the central auditory processing abilities and cognitive development of urban children: the Cincinnati Lead Study cohort at age 5 years.

This analysis examined the relationship between lead exposure as registered in whole blood (PbB) and the central auditory processing abilities and cognitive developmental status of the Cincinnati cohort (N = 259) at age 5 years. Although the effects were small, higher prenatal, neonatal, and postnatal PbB levels were associated with poorer central auditory processing abilities on the Filtered Word Subtest of the SCAN (a screening test for auditory processing disorders). Higher postnatal PbB levels were associated with poorer performance on all cognitive developmental subscales of the Kaufman Assessment Battery for Children (K-ABC). However, following adjustment for measures of the home environment and maternal intelligence, few statistically or near statistically significant associations remained. Our findings are discussed in the context of the related issues of confounding and the detection of weak associations in high risk populations.

Auditory Perceptual Disorders↗

Learning disabilities and central auditory dysfunction.

Hearing loss, whether peripheral or central, compounds the communication and educational problems of the learning disabled student. A central auditory processing disorder uniquely interferes with both the input and integration of verbal information, further resulting in a potentially permanent cognitive dysfunction during the developmental period of acquisition of language. Illustrative cases are presented that indicate the panorama of cognitive dysfunction associated with the learning disabled status. Methods of evaluation and identification and diagnostic criteria are correlated with auditory, visual, and academic performance. Comments regarding clinical awareness, prompt recognition, and ensuing individualized remediation are submitted.

Adult↗

Carbamazepine-induced transient auditory pitch-perception deficit.

This report presents six cases of transient auditory disturbance caused by carbamazepine, with a particular focus on pitch-perception deficit. Basic disorders in the six cases included epilepsy (cryptogenic localization-related epilepsy and benign childhood epilepsy) and glossopharyngeal neuralgia. Since 1993, in which we reported the first description of transient pitch-perception deficit associated with carbamazepine, a further 26 cases have been reported. However, this carbamazepine-induced transient pitch-perception deficit may be more frequent than previously suspected. Moreover, because auditory disturbance occurs at therapeutic serum levels of carbamazepine, patient awareness of reversible hearing impairment on initiating carbamazepine therapy is important.

Adult↗

A new CAPD battery--multiple auditory processing assessment: factor analysis and comparisons with SCAN.

Based on recommendations by Musiek & Chermak (1994, American Journal of Audiology, 3, 23-27) and ASHA (1996, American Journal of Audiology, 5(2), 41-54), a battery of four commonly used tests was selected and recorded for use in assessing school children. These tests were labeled the Multiple Auditory Processing Assessment (MAPA) and then administered to an initial sample of 81 third grade children, along with the SCAN screening test for auditory processing disorders. Afterward, several exploratory factor analyses were performed on the findings, and comparisons were made between the results for the MAPA and SCAN. Four separate factors emerged from the four MAPA tests, which were linked closely to the components of central auditory processing disorders (CAPDs) defined by ASHA (1996, American Journal of Audiology, 5(2), 41-54). These factors were labeled monaural separation/closure (MSC), auditory pattern/temporal ordering, binaural integration, and binaural separation (BS). SCAN appears to measure two of these factors, MSC and BS. Use of MAPA is encouraging. Our findings suggest it may provide an appropriate multiple-test, CAPD battery for third grade children, and it meets at least some of the objectives described in the consensus document proposed by ASHA (1996, American Journal of Audiology, 5(2), 41-54).

Auditory Perceptual Disorders↗

Identification and discrimination disorders in auditory perception: a report on two cases.

Auditory perception was investigated in two brain-damaged subjects. The first patient had a left temporoparietal ischaemic lesion. He presented a right-ear extinction in dichotic tasks, as well as difficulties in understanding and repeating verbal material and impaired identification of melodies. All discrimination tests were well performed. The second patient had a right capsulolenticular and frontal ischaemic lesion. He presented a left ear dichotic extinction and severe difficulties in discrimination of environmental sounds and melodies but no major difficulty in naming and identification. From these results, it is hypothesized that identification and discrimination involve distinct mechanisms within the processing of auditory stimuli, and that they may be selectively disrupted in brain-damaged subjects.

Adult↗

Auditory agnosia: apperceptive or associative disorder?

Neuropsychological testing of a patient with auditory agnosia showed that certain difficulties in the initial analysis of sounds may be the cause of his inability to understand spoken words and other sounds. Abnormalities included a slow reaction time to brief auditory stimuli (but not to equally brief visual stimuli or to longer auditory stimuli) and the need for approximately 1/4 sec of silence between two tones before the patient was able to hear them as separate. He could identify words and word associations if he was able to view the object whose name or word associate he was hearing. The findings imply that this patient's deficit in comprehending speech was probably apperceptive rather than associative in origin.

Agnosia↗