Neural and behavioral consequences of prenatal exposure to diazepam.
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I have attempted to summarize the role of the psychologist and psychological evaluation in assessing a child with a suspected central auditory dysfunction. The reasons why a child may be referred for a psychological evaluation along with some of the exhibiting behaviors were discussed. The role of the psychological evaluation was examined. The indications for psychological evaluation in central auditory dysfunction were presented and alternative types of education were discussed.
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This article reviews the literature on auditory perceptual impairments in children with language disorders. It is suggested that, rather than a higher-order cognitive or "linguistic" deficit, the underlying deficit in childhood language disorders is a perceptual one. The perceptual impairment may consist of a deficiency in detecting acoustic features in the speech wave that normally cue certain phonemes. Support for this hypothesis comes from clinical observations and experimental studies of aphasic adults as well as language-disordered children. The most consistent finding of the studies with language-disordered children has been that they have difficulty making perceptual judgments of the order of rapid sequences of brief sounds, such as synthetic speech and non-speech stimuli. However, these children perceive the sequences more accurately if the duration of the stimuli or the inter-stimulus intervals are extended. This suggests a "rate-specific" auditory perceptual deficit in language-disordered children for rapid acoustic information, such as the distinctive acoustic features of speech sounds. Treatment and future research implications are discussed.
We describe a child who acquired a gradual sustained speech deficit for which no specific etiology was found, and who had an associated epileptogenic abnormality on EEG. Assessment of auditory perceptual skills and receptive language confirmed that gradual parallel improvement occurred with the EEG after therapeutic anticonvulsant blood levels were obtained. Prospective trials of anticonvulsant drugs in conjunction with serial measures of central auditory abilities are necessary to establish their value in the management of the linguistic deficit in children with auditory agnosia.
Alcoholic and non-alcoholic subjects received a test of the ability to identify speech presented against competing speech (Synthetic Sentence Identification) and a test of field dependence (Embedded-Figures Test (EFT). Performance on the speech task (which involved auditory figure-ground differentiation) bore no special relationship to performance on the field-dependence test. However, cross-sectional and longitudinal data suggested that recently-drinking alcoholics are temporarily impaired in their speech-processing ability, recovering this ability after several months of alcohol-abstinence. A relationship between chronicity of alcoholism and field dependence was also observed. The latter relationship, along with findings on auditory tests, were discussed in terms of their relevance to the issue of whether field dependence is an antecedent to or a consequence of alcoholism.
The incidence of perceptual-motor disorders arising from stroke is steadily increasing in the population of Europe and USA. This chapter sought to define the role that virtual environments may have in designing remedial programmes for rehabilitation following stroke in the areas of attentional retraining and the reacquisition of perceptuo-motor skills. Principles for the structure of guided learning were identified and emphasis placed on the need to identify when and how virtual environments technology can introduce added value to the therapy situation.
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Extinction to the simultaneous presentation of sounds to both ears was investigated in patients with acute cerebrovascular disease and found to be present in nearly half of the patients in the early stage of stroke. The occurrence of the symptom was not significantly different following damage to either hemisphere, but a higher percentage of right brain-damaged patients tended to show extinction for a longer time. However, this finding must be evaluated with caution since a greater number of left- than right-hemisphere patients had to be excluded from the investigation because aphasia precluded their understanding test instructions. The presence of auditory extinction was not related to that of visual extinction and there were patients with severe visual neglect who did not extinguish in the auditory modality. These findings and CT scan evidence, indicating that patients with long-lasting extinction had lesions encroaching upon the auditory pathways, suggest that in number of cases the phenomenon may have a sensory and not an attentional basis.
We report a case of auditory agnosia in which the initial clinical picture began with generalized auditory agnosia for verbal and non verbal sounds, but rapidly changed to a selective auditory agnosia confined to the perception of non verbal sounds. CT scanning and MRI did not demonstrate cortical or subcortical damage, except for bilateral ventricular enlargement. The patient was submitted to audiological investigations including physical and psychoacoustic studies. Deficits were revealed during the decay and loudness discrimination test, but no temporal auditory acuity deficit was observed. The results of these studies are discussed in relation to the clinical picture. Also the dissociation between verbal perception and non verbal perception is discussed.
The effects of chronic otitis media during the first three years of life on developing auditory processing skills were examined. Two groups of children with auditory processing deficits were compared in areas of language development, intellectual factors, auditory processing skills, and academic capabilities. One group of children with auditory processing deficits had a history of severe chronic otitis media during the first three years of life, whereas a second group had auditory processing deficits but no history of early middle ear infections. The results indicate that subjects who had a history of chronic otitis media were slower in developing word combinations, had depressed verbal intelligence scores, manifested pervasive auditory processing deficits, and were significantly poorer in reading. A profile has been constructed that permits early detection of the child at risk.
Visual imperception denotes the disorders of perceptual functioning commonly associated with unilateral brain injury. Typically the same half of the visual fields of both eyes are affected on the side opposite to that of the brain injury. The disorder may have a sensory or an attentional basis or both, moreover, the patient is often not aware of the problem. The condition interferes with daily activities including reading and navigating abilities, and it increases the likelihood that a person will have accidents. Thus, it becomes an obstacle to rehabilitation. Two comprehensive tests for visual imperception, Search-A-Word (SAW) and Speeded Reading of Word Lists (SRWL), were administered to a large sample of brain-injured and nonbrain-injured adult rehabilitation patients. Measures included: search times for left- and right-side targets, words missed at either margin, completion rates, errors on displaced words, and within-span errors. Right hemisphere brain injury was reliably associated with errors on the left side; left hemisphere brain injury was associated with overall poor performance. A factor analysis of performance measures revealed three major independent factors: (1) left spatial hemi-imperception, (2) lateral scanning dysfunction, and (3) left foveal hemi-imperception. These findings support a neurosensory-based view of imperception, especially in brain-injured persons. Finally, differential assessment of these problems is essential for comprehensive rehabilitation.
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Seventy-four patients with focal epilepsy were examined by means of a specially devised complex of experimental techniques. It was shown that epileptic involvement of the temporal lobes (in particular the anterior and mediobasal regions) of both hemispheres was associated with disorders of recognition of the emotional coloring of speech and non-speech sound complexes. Maximum disorders in the comparison of unorganized sound rows were observed when the right temporal lobe was involved, in the comparison of emotions when the left lobe was affected. Difficulties in recognizing melodies and emotions were observed in patients with temporal foci in the left and the right hemisphere but it was especially marked after surgery on the structures of the left temporal lobe. The degree of the disorders was primarily due to the severity of the organic damage of the brain rather than to the localization of the epileptic focus.
Amusia is a condition in which musical capacity is impaired by organic brain disease. Music is in a sense a language and closely resembles speech, both executively and receptively. For musical functioning, rhythmic sense and sense of sounds are essential. Musical ability resides largely in the right (non-dominant) hemisphere. Tests have been devised for the assessment of musical capabilities by Dorgeuille, Grison and Wertheim. Classification of amusia includes vocal amusia, instrumental amnesia, musical agraphia, musical amnesia, disorders of rhythm, and receptive amusia. Amusia like aphasia has clinical significance, and the two show remarkable similarities and often co-exist. Usually executive amusia occurs with executive aphasia and receptive amusia with receptive aphasia, but amusias can exist without aphasia. Severely executive aphasics can sometimes sing with text (words), and this ability is used in the treatment of aphasia. As with aphasia, there is correlation between type of amusia and site of lesion. Thus in executive amusia, the lesion generally occurs in the frontal lobe. In receptive amusia, the lesion is mainly in the temporal lobe. If aphasia is also present the lesion will be in the left (dominant) hemisphere.
Central auditory processing disorders in children are introduced and defined. The article explains who should be evaluated and for what reasons. The evaluation process, test stimuli, and use of assessment findings are presented.
We report a 53-year-old patient (AWF) who has an acquired deficit of audiovisual speech integration, characterized by a perceived temporal mismatch between speech sounds and the sight of moving lips. AWF was less accurate on an auditory digit span task with vision of a speaker's face as compared to a condition in which no visual information from the lower face was available. He was slower in matching words to pictures when he saw congruent lip movements compared to no lip movements or non-speech lip movements. Unlike normal controls, he showed no McGurk effect. We propose that multisensory binding of audiovisual language cues can be selectively disrupted.