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Educational evaluation. The first step toward understanding and remediation of central auditory disorders.

Of all the problems experienced by children with learning disabilities, a language disorder may be the most detrimental to school performance. Because the problems of a child with a language disorder are frequently not recognized until he begins school, it is important that the educational clinician, teacher, related professional, and parents understand what a central auditory disorder is, that it may manifest itself as language disorder, and the way it can academically and emotionally affect a child. Evaluation and identification of a child with a central auditory disorder is vital at an early stage of development; however, testing, while it appears simple, is an extremely complex process and is not always exact. Therefore, the educational clinician must be skilled and understand the frailties which exist in the test instrument and the testing situation. It must be remembered, also, that testing in only part of the diagnostic procedure. Organized, perceptive classroom observations are essential. These must be followed by multidisciplinary meetings that generate remedial procedures and directions to be taken by parents and teachers. Finally, parents must be accepted by professionals as reasonable, concerned, and able to offer knowledgeable insight into their child's learning problems. If a language disorder is suspected, professional help should be sought immediately. Truth is better than fiction or fantasy in helping a child become a happy, adjusted, productive human being.

Auditory Perceptual Disorders↗

Rate of information segregation in developmentally dyslexic children.

Slowed processing of sequential perceptual information is related to developmental dyslexia. We investigated this unimodally and crossmodally in developmentally dyslexic children and controls ages 8-12 years. The participants judged whether two spatially separate trains of brief stimuli, presented at various stimulus onset asynchronies (SOA) in one or two senses, were synchronous or not. The stimulus trains consisted of light flashes in vision, clicks in audition, and indentations of the skin in the tactile sense. The dyslexic readers required longer SOAs than controls for successful performance in all six comparisons. The crossmodal spatiotemporal resolution of the groups differed more than unimodal performance. The dyslexic readers' segregation performance was also less differentiated than that of the controls. Our results show that not only sensory but also polysensory nonverbal information processing is temporally impaired in dyslexic children.

Auditory Perceptual Disorders↗

Effects of imposed delay of response and item complexity on auditory comprehension by aphasics.

Ten aphasic and five control subjects were administered an auditory comprehension task similar to Levels I-IV of the Revised Token Test under conditions of 0, 5, 10, and 20 sec of imposed response delay. Responses were evaluated in terms of performance accuracy and response time. Aphasic subjects' response accuracy was significantly effected by an interaction between the length of delay imposed and the complexity of the stimulus. The aphasic group also demonstrated a significant main effect for item complexity. Control subjects' accuracy was not influenced by the treatment conditions. Latency measures indicated the aphasic subjects were slower to respond across all treatment conditions. Both groups' latency scores were significantly effected by item complexity. A comparison of mean latencies by condition did, however, suggest different patterns of response for the two groups. Results are discussed in terms of theoretical and clinical implications for the auditory comprehension deficits of aphasia.

Adult↗

Audio-spatial deficits in humans: differential effects associated with left versus right hemisphere parietal damage.

In order to study auditory spatial localization in subjects with posterior damage involving the parietal lobe, we investigated their manual pointing performances to linguistic and white noise signals distributed over six sound sources situated in the anterior auditory field at ear level. The results showed: (1) A striking difference between patterns of deficits associated with right and left damage. In subjects with right damage, auditory localization deficits occurred in the horizontal plane, were manifested as restrictions in the peripheral left auditory hemifield and tended to be related to left visual neglect. In subjects with left damage, auditory localization deficits occurred in the entire auditory field in the horizontal as well as vertical planes, and they were particularly strong in the antero-frontal region. (2) One subject with right damage and visual neglect but no left auditory spatial restriction, showed deficits in the right hemifield where sound source location tended to be overestimated. This subject also showed a better discrimination of the origin of a white noise than of a linguistic signal. Results are discussed in terms of hemispheric asymmetries of function.

Acoustic Stimulation↗

A case of receptive amusia with prominent timbre perception defect.

A patient with a right temporal lesion is described who, in recognising sounds and noises, complained of deficits which seemed to be most evident when sounds and noises could be recognised mainly by timbre whereas no deficit was noticed when pitch and rhythm were the main indicators. In addition, some global distortions in musical appreciation were complained of and described as "resonance" or "loss of aesthetic pleasure".

Auditory Perceptual Disorders↗

Binaural pitch-matching with interrupted tones.

The purpose of this paper was to ascertain and compare the binaural pitch-matching abilities of hearing and hearing-impaired people. Three groups of subjects, all adults ranging in age from 21 to 37 years, took part in this investigation. Group A consisted of 18 normal hearing people, Group B consisted of seven people with conductive hearing impairment and Group C consisted of nine people with sensorineural hearing impairment. Their mean binaural pitch-matching errors obtained at each one of the main speech frequencies (250-4000 Hz) were as follows: For the normal hearing group the mean pitch-matching errors varied from 1.57% at 2000 Hz to 2.31% at 4000 Hz. The corresponding values for the conductive group varied from 2.33% at 2000 Hz to 3.28% at 500 Hz. The sensorineural group exhibited mean binaural pitch-matching errors varying from 6.93% at 250 Hz to 14.62% at 1000 Hz. All mean error differences obtained between the sensorineural group and the other two groups of subjects were statistically significant at the 0.01 level. The differences between the normal hearing group and the conductive group did not prove to be statistically significant at the 0.01 level. The differences between the normal hearing group and the conductive group did not prove to be statistically significant.

Adult↗

Observation on the curative effect of 120 cases of auditory hallucination treated with auricular acupuncture.

Auditory hallucination often affects the thinking and emotion of the patients leading to dangerous behaviour of injuring themselves or others. We have treated auditory hallucination with different kinds of psychosis, mainly using auricular acupuncture and yielding certain curative effect. In our series, we found that there is no obvious correlation between number of attacks and the curative effect; however the duration of each attack may affect the curative effect. We also noticed that there is no significant difference in curative effects among the groups of simple auricular acupuncture, auricular plus body acupuncture and auricular acupuncture plus chlorpromazine. Therefore, we recommend auricular acupuncture for treating auditory hallucination.

Acupuncture Therapy↗

Procedural influences on auditory comprehension: a second look at the Revised Token Test.

The purpose of this report is to demonstrate how methodologic procedures used in the standardization of certain subtests of the Revised Token Test ( RTT ) ( McNeil and Prescott , 1978) may have affected the nature of the data collected and, subsequently the interpretation of auditory comprehension abilities shown by clinical populations tested with the RTT .

Adult↗

[Effect of pathologic gaze deviation caused by brain stem lesion on interhemispheric equilibrium. Study using a non-verbal dichotic listening test].

Three cases of patients with lateral gaze palsy due to brainstem lesion were studied. They underwent a non-verbal dichotic listening test which evidenced a significant decrease of performance in the ear located on the same side as the lesion. This result can be interpreted as an inter-hemispheric imbalance linked to the pathological gaze deviation.

Abducens Nerve↗

Temporal and speech processing deficits in auditory neuropathy.

Auditory neuropathy affects the normal synchronous activity in the auditory nerve, without affecting the amplification function in the inner ear. Patients with auditory neuropathy often complain that they can hear sounds, but cannot understand speech. Here we report psychophysical tests indicating that these patients' poor speech recognition is due to a severe impairment in their temporal processing abilities. We also simulate this temporal processing impairment in normally hearing listeners and produce similar speech recognition deficits. This study demonstrates the importance of neural synchrony for auditory perceptions including speech recognition in humans. The results should contribute to better diagnosis and treatment of auditory neuropathy.

Acoustic Stimulation↗

Backward masking performance as an indicator of vulnerability to schizophrenia.

Several types of design have been used to identify neurocognitive measures that indicate vulnerability to schizophrenia rather than the presence of the illness. These designs include studies of first-degree relatives of patients, studies of patients in symptomatic remission, and studies of subjects who are considered to be prone to psychosis. The backward masking procedure is one promising indicator of vulnerability to schizophrenia. Backward masking is a procedure in which identification of an initial stimulus (the target) is disrupted by a later stimulus (the mask). Schizophrenic patients show performance deficits on backward masking. Unaffected siblings of patients, remitted patients, and individuals prone to psychosis also show performance deficits on backward masking. This pattern of results suggests that backward masking is a promising indicator of vulnerability to schizophrenia. It provides an alternative phenotype for schizophrenia that is separate from the disorder. The composite nature of masking procedures helps investigators to parse a performance deficit into its smallest meaningful elements and relate them to vulnerability to schizophrenia.

Attention↗

Cortical, subcortical, and brainstem dysfunction: a correlation in dyslexic children.

A group of dyslexic students was examined by a central auditory test (CAT) battery including competing sentences, binaural fusion, filtered speech, and compressed speech. Auditory evoked brainstem responses (BSER) were measured in conjunction with the CAT data. The auditory tests indicate a high degree of failure in those areas requiring sophisticated integration, coordination, and identification of the modified speech stimuli. The BSER did not identify a significant abnormality. The cortical and subcortical areas of integration are proposed as the multicentric sites of impairment in the hearing function found in dyslexic students.

Adolescent↗

Autophony and the patulous eustachian tube.

Autophony and the patulous Eustachian tube is a real but rare clinical entity often misdiagnosed because the symptoms so mimic those of middle ear effusion. The diagnosis is made by the history of fullness or blockage and hearing ones own voice and breath sounds in the ear. The drum is usually atrophic and moves with respiration but this may not be visible. The usual past history is of weight loss. The diagnostic test is to observe a regular increase or decrease in middle ear pressure when increasing or decreasing the ambient pressure while measuring the impedance in a pressure chamber. The usual variations in pressure with opening and closing of the tube are not seen because the tube remains open all the time. Few patients need operative intervention and explanation is all that is usually required. When surgical treatment is necessary the application of 20% silver nitrate to the lumen of the tube on a wire covered by cotton has given results with few complications. Injection of Teflon paste anterior to the mouth of the Eustachian tube has been stopped by the manufacturer of the paste because of serious complications caused by the Teflon paste being accidentally injected into the internal carotid artery. Why some patients with a patulous tube and movement of the drug with respiration have no symptoms and other patients with very bothersome symptoms have so few objective signs and no movement of the drum, that can be observed with respiration, remains a mystery that needs further study.

Acoustic Impedance Tests↗