Heidelberg Phoneme Discrimination Test (HLAD): Normative Data for Children of the Third Grade and Correlation with Spelling Ability

from Folia Phoniatrica et Logopaedica

Objective: The Heidelberg Phoneme Discrimination Test (HLAD), developed and standardized in 1998, is widely used in the differential diagnosis of dyslexia. Normative data have only been available for children of the 2nd and 4th grades, while norms for the 3rd grade are still missing. Patients andMethods: We assessed three HLAD subtests [auditory phoneme discrimination, kinesthetic phoneme discrimination (repeating minimal pairs) and phoneme analysis] in 140 children of the 3rd grade from eight elementary schools. Writing capacity was tested via DRT3. Results: Comparing children of the 2nd, 3rd and 4th grades, we found a continuing increase in phoneme discrimination capacity with age. This increase was especially evident for the task of auditory comparison. For the 3rd grade, the correlation between HLAD and writing test (qualitative analysis) was 0.55, and 0.36 between HLAD and writing (quantitative analysis). The correlation with writing tasks was highest in the 2nd grade. Conclusion: The steady increase in phoneme discrimination capacity from the 2nd to 4th grade may indicate maturation and learning effects at least until the age of 10 years.

The influence of aphasia severity on how both members of a couple participate in an interview situation

from Aphasiology

Background: One of the major impacts of aphasia is the social isolation of spouses and their partners with aphasia over time. This consequence may be related to a couple’s discomfort in conversing with a third party. In an interview situation, spouses support their partner with aphasia in order to allow him/her to be included in the talk. It is likely that the participation of both members of couples depended on the degree to which the aphasia interfered.

Aims: The general aim of this research was to describe the influence of aphasia severity on the contributions of each member of a couple, one of them who had aphasia, in an interview situation.

Methods and Procedures: The twenty-six couples with a member with aphasia were divided into three groups of different aphasia severities. Five couples constituted the control group. All couples were filmed in an interview. Number and types of spouses’ contributions, their solicitation by the person with aphasia and their reaction and participation following the contributions were analyzed.

Outcomes and Results: Results showed that the severity of aphasia had a significant effect on both members of the couple participating in the interview. Groups of couples with aphasia and especially those with moderate and severe aphasia differed from groups of milder forms of aphasia and couples without communication limitations. The number of “speaking for” and “repair” behaviours produced by spouses and the reactions and participation of people with aphasia following these contributions also varied significantly with aphasia severity.

Conclusions: The results help us better understand how both couples with and without a member with aphasia engage in an interview. Moreover, these results may be clinically useful to support the development of treatment methods that include the spouse of people with aphasia.
This research was supported by grants from the Social Sciences and Humanities Research Council of Canada and the Fonds de la recherche en santé du Québec. The participants’ involvement is gratefully acknowledged. We would also like to thank the speech-language pathologists and the associations of people with aphasia who referred the participants to us. Claudia Morin carried out part of this research for her master’s research project in Speech and Language Pathology at the University of Montreal.

Visual attention in a multiple-choice task: Influences of image characteristics with and without presentation of a verbal stimulus

from Aphasiology

Background: Use of multiple-choice items is common in the assessment of language comprehension. Stimulus-driven aspects of multiple-choice images may interfere with valid assessment. Understanding the influences of stimulus-driven factors is crucial because individuals with neurological disorders have increased susceptibility to them.

Aims: The first goal of this study was to explore the influence of objectively measurable image characteristics in multiple-choice image sets that are otherwise well controlled in terms of physical stimulus features on individuals’ visual attention. The second goal was to explore viewers’ visual attention under the influence of a verbal stimulus.

Methods & Procedures: The effects of controlled manipulation of physical image characteristics on visual attention in 40 healthy adults were assessed. Eye movements were recorded while participants viewed 40 image sets with and without a verbal stimulus. Within each set, two images shared the same image characteristics (colour, orientation, size, and luminance) and one image differed in terms of one of those characteristics.

Outcomes & Results: All characteristics had a significant influence on visual attention in verbal and nonverbal conditions. The influence of verbal stimuli on visual attention did not override the tendency for physical stimulus characteristics to distract attention from target images.

Conclusions: Research and clinical relevance is highlighted in terms of the potential for assessment confounds to be greater in individuals with neurological impairments.
This study was supported in part by a grant (# DC 0015301 A1) from the National Institute on Deafness and other Communication Disorders of the National Institutes of Health, an Ohio University Graduate Student Senate Original Work grant, and an Ohio University Graduate Fellowship Award. The authors thank Dr Hans Kruse for stimulus presentation and analysis software design, Dr Helmut Zwahlen for technical assistance in physical stimulus control, and Anshula Odekar, Maria Ivanova, and Tae Asahina for assistance with data collection.

Hearing preservation using combined monitoring of extra-tympanic electrocochleography and auditory brainstem responses during acoustic neuroma surgery

from the International Journal of Audiology

The aim of this study was to evaluate the efficacy of an intraoperative monitoring hearing preservation strategy that includes simultaneous recordings of an auditory brainstem response (ABR) and non-invasive electrocochleography (ECochG). The combined ABR and tympanic membrane (TM) ECochG testing was performed in 74 patients undergoing acoustic neuroma (AN) surgery. In addition, EMG recordings were conducted to monitor the facial nerve function. Hearing was preserved in 19 of the 30 patients with residual hearing prior to surgery (63%), and facial nerve function was maintained in 89% of the patients. In most cases, the presence of both auditory brainstem and TM-ECochG responses at the end of surgery was associated with preservation of postoperative functional hearing; however, eight patients had a TM-ECochG response with a complete loss of the ABR, pointing to deafferentation of the auditory nerve. Tumour size and preoperative hearing thresholds significantly affected the postoperative hearing. The TM-ECochG response yielded large reproducible responses, which, in some patients, was the only way to monitor the auditory function. This auditory monitoring approach offers a valuable auditory tool that helps to improve the hearing preservation during AN surgery.

Loudness and auditory steady-state responses in normal-hearing subjects

from the International Journal of Audiology

This study evaluated the use of multiple auditory steady-state responses (ASSRs) to estimate the growth of loudness in listeners with normal hearing. Individual intensity functions were obtained from measures of loudness growth using the contour test and from the electrophysiological amplitude measures of multiple amplitude-modulated (77-105Hz) tones (500, 1000, 2000, and 4000Hz) simultaneously presented to both ears and recorded over the scalp. Slope analyses for the behavioural and electrophysiological intensity functions were separately performed. Response amplitudes of the ASSRs and loudness sensation judgements increase as the stimulus intensity increases for the four frequencies studied. A significant relationship was obtained between loudness and the ASSRs. The results of this study suggest that the amplitude of the ASSRs may be used to estimate loudness growth at least for individuals with normal hearing.

Control mechanisms in bilingual language production: Neural evidence from language switching studies

from Language and Cognitive Processes

A key question in bilingual language production research is how bilingual individuals control the use of their two languages. The psycholinguistic literature concerning language control is unresolved. It is a matter of controversy whether (a) issues to do with control are central to understanding bilingual language processing; and (b) if they are, what is the site or sites of control; and (c) whether language control in bilinguals relies upon inhibitory mechanisms.

One way to deepen our understanding of language control is to consider the implications from research on functional neuroimaging. In the present paper, we illustrate that neuroimaging research shows that bilinguals engage cognitive control networks for achieving tasks such as language switching. The neural evidence points to multiple neural regions of control that may rely upon an inhibitory mechanism. These ‘brain data’ may, in turn, stimulate the development of neurocognitive accounts of bilingual language processing.

Nicotinic modulation of tone-evoked responses in auditory cortex reflects the strength of prior auditory learning

from Neurobiology of Learning and Memory

Nicotinic acetylcholine receptors (nAChRs) contribute to sensory-cognitive function, as demonstrated by evidence that nAChR activation enhances, and nAChR blockade impairs, neural processing of sensory stimuli and sensory-cognitive behavior. To better understand the relationship between nAChR function and behavior, here we compare the strength of nAChR-mediated physiology in individual animals to their prior auditory behavioral performance. Adult rats were trained on an auditory-cued, active avoidance task over 4 days and classified as “good,” “intermediate” or “poor” performers based on their initial rate of learning and eventual level of performance. Animals were then anesthetized, and tone-evoked local field potentials (LFPs) recorded in layer 4 of auditory cortex (ACx) before and after a test dose of nicotine (0.7mg/kg, s.c.) or saline. In “good” performers, nicotine enhanced LFP amplitude and decreased response threshold to characteristic frequency (CF) stimuli, yet had opposite effects (decreased amplitude, increased threshold) on responses to spectrally distant stimuli; i.e., cortical receptive fields became more selective for CF stimuli. In contrast, nicotine had little effect on LFP amplitude in “intermediate” or “poor” performing animals. Nicotine did, however, reduce LFP onset latency in all three groups, indicating that all received an effective dose of the drug. Our findings suggest that nicotinic regulation of cortical receptive fields may be a distinguishing feature of the best-performing animals, and may facilitate sensory-related learning by enhancing receptive field selectivity.

The Interaction Between Somatosensory and Auditory Cognitive Processing Assessed With Event-Related Potentials

from the Journal of Clinical Neurophysiology

Event-related potentials induced by somatosensory and after auditory stimulation or bilateral somatosensory stimulation in young adults were studied, aiming to evaluate interactions of cognitive processing of somatosensory and auditory information. In experiment 1, event-related potentials were elicited by four stimulus conditions which were randomly presented with an interstimulus interval of 20 +/- 3 milliseconds: electric stimuli delivered to the right median nerve (Con 1), auditory stimuli delivered to both ears (Con 2), electric and subsequent auditory stimuli (Con 3), and electric stimuli delivered to the bilateral median nerve (Con 4). In experiment 2, Con 2 was changed to electric stimulation of the left median nerve. The subtraction of grand averaged event-related potentials of Con 1 and Con 2 from those of Con 3 demonstrated a positive-negative peak complex with a positive peak at approximately 165 to 170 milliseconds after stimuli and a negative peak with a mean latency of 372 milliseconds in experiment 1. In experiment 2, the subtraction of event-related potentials in Con 1 and 2 from those in Con 4 revealed positive and negative peaks resembling those in experiment 1, but the distribution or latencies of the peaks differed from those in experiment 1. We speculate that the subtracted positive and negative peaks reflect different cognitive processing of bimodal and bifocal sensory information.

Results of an assessment of information needs among speech-language pathologists and audiologists in Idaho

from Journal of the Medical Library Association

Objectives: The research assesses the information needs of speech-language pathologists (SLPs) and audiologists in Idaho and identifies specific needs for training in evidence-based practice (EBP) principles and searching EBP resources.
Methods: A survey was developed to assess knowledge and skills in accessing information. Questionnaires were distributed to 217 members of the Idaho Speech-Language-Hearing Association, who were given multiple options to return the assessment survey (web, email, mail). Data were analyzed descriptively and statistically.

Results: The total response rate was 38.7% (84/217). Of the respondents, 87.0% (73/84) indicated insufficient knowledge and skills to search PubMed. Further, 47.6% (40/84) indicated limited knowledge of EBP. Of professionals responding, 52.4% (44/84) reported interest in learning more about EBP and 47.6% (40/84) reported interest in learning to search PubMed. SLPs and audiologists who graduated within the last 10 years were more likely to respond online, while those graduating prior to that time preferred to respond via hard copy.

Discussions/Conclusion: More effort should be made to ensure that SLPs and audiologists develop skills in locating information to support their practice. Results from this information needs assessment were used to design a training and outreach program on EBP and EBP database searching for SLPs and audiologists in Idaho.

`Heard melodies are sweet, but those unheard are sweeter’: synaesthetic metaphors and cognition

from Language and Literature

Synaesthetic metaphors exhibit a robust, universal, tendency to use the `lower-tohigher’ structure more frequently than the inverse one. This robust pattern was found across genres (poetic and non-poetic discourse), language boundaries (e.g. English, Hebrew, Arabic, Chinese, Japanese and Indonesian) and historical periods. A cognitive account of this pattern is introduced, according to which this lower-to-higher mapping reflects a cognitively simpler and more basic directionality than the inverse one. Several predictions that follow from this account were tested, using various psychological measures (recall, difficulty in context generation, and naturalness judgments). In accordance with the present account, it was found that the lower-to-higher structure is judged as more natural than its inverse, is better recalled and is judged as easier to construct a context for.

Otitis media as a cause of significant hearing loss among Nigerians

from the International Journal of Pediatric Otorhinolaryngology

Summary
Mild or worse hearing loss, defined as pure tone average >25 decibel, is seen commonly with preventable etiologies.

Settings
A tertiary care, urban referral hospital.

Methods
Retrospective analysis of prospectively collected data of individuals attending the hearing loss clinic of National Hospital, Abuja, between May 2005 and April 2007. Data matching the diagnosis of acute otitis media (AOM), otitis media with effusion (OME) and chronic suppurative otitis media (CSOM) were extracted from the database and analyzed.

Result
A total of 298 cases with primary presenting complaints of hard of hearing were seen. A total of 77 cases had hearing loss due to otitis media. 44 (57.1%) had OME, 26 (33.8%) had CSOM, while 7 (9.1%) had AOM. The observed distribution of the OME was left OME (18.1%, n = 14), right OME (9.1%, n = 7) and bilateral OME (29.9%, n = 23), while the CSOM is distributed into left CSOM (15.5%, n = 12), bilateral CSOM (11.7%, n = 9) and right CSOM (6.4%, n = 5), and AOM is distributed into right AOM (2.6%, n = 2), left AOM (3.9%, n = 3), and bilateral AOM (2.6%, n = 2). The mean pure tone averages for the three groups are AOM (30.5 dB), OME (41.5 dB) and CSOM (56.9 dB).

Conclusion
Otitis media is an important cause of preventable hearing loss in developing countries, and the predominance of unilateral otitis media in the left ear observed in this study deserves further studies.

Etiology and Treatment of Developmental Stuttering

from AAP Grand Rounds

The etiology and treatment of developmental stuttering in childhood (DS, also called idiopathic stammering or stuttering) are reviewed by a speech pathologist and psychologist from the University of Reading, UK. DS is a disorder of speech fluency that affects approximately 0.75% to 1% of the populations of Great Britain, Australia, and America.1

Effect of early onset otitis media on brainstem and cortical auditory processing

from Behavioral and Brain Functions

Otitis media (OM) leads to significant reduction in the hearing sensitivity. The reduced auditory input, if in the early years of life when the auditory neural system is still maturing, may adversely influence the structural as well as functional development of the system. Past research has reported abnormalities in both the structure and function of brainstem nuclei following auditory deprivation, but, it has not necessarily focused on children who had OM in their first year of life. It can also be said that if auditory processing is affected at the brainstem level because of early onset OM (reduced auditory input in the crucial periods of neural development), then, it may be said that auditory processing is also affected at the cortical level because it receives distorted input from the brainstem. Therefore, the purpose of this study was to document the effects of early onset OM on auditory processing, if any, at the brainstem as well as at cortical levels. A related purpose of the study was to investigate the persistence of the effects of early onset OM, if any, on auditory processing.

Methods
A cross sectional approach and a standard group comparison design was used in the study. Thirty children, who had OM between 6 and 12 months of age and who were in the age range of 3.1 – 5.6 years participated in the study. Children with OM were divided into 3 groups based on their age. Click evoked auditory brainstem responses (ABRs) and late latency responses (LLRs) were recorded from these children, and the responses were compared with those from age and gender matched normal children without any history of OM. The data from the 2 groups was statistically analyzed through independent t test. Pearsonas Product Moment correlation was computed to examine the relationship between results of ABR and LLR in children with early onset OM.

Results
The mean central conduction time was significantly increased and the mean amplitude of wave I and III of ABRs was significantly reduced in children with early onset OM compared to normal children. Also, the latency of all LLR waves was significantly less in children with early onset OM than in normal children. However, significant differences in mean values of either ABR or LLR (latencies or interwave intervals as the case may be) were observed only in 3-year old children. There was a significant, but negative association between central conduction time and latency of LLRs.

Conclusions
OM in the first year of life leads to negative effects on brainstem signal processing even if it has occurred only for a short duration (maximum of 3 months). In such a situation, auditory cortical structures probably show compensatory changes through central gain to offset the prolonged central conduction time. Although the results of the present study showed that the negative effects of early onset OM (occurring in the first year of life) on auditory processing disappeared by the time the children were 4.1 years, there is need for longitudinal studies on this to confirm the findings.

Electrophysiological Assessment following Newborn Hearing Screening

from the National Library for Health

Announcement of a conference Oct 6-8, 2008.

Electric to acoustic pitch matching: a possible way to improve individual cochlear implant fitting

from the European Archives of Oto-Rhino-Laryngology

Abstract Poor pitch resolution has been shown to have negative implications for speech and music perception in implanted patients. Surprisingly, works on the subject have not focused much on the impact that the non-correspondence between frequencies allocated to electrodes and perceived frequencies could have on speech and music perception. The aim of the present study is to investigate the correlation between pitch mismatch and speech performance with the implant, and to ascertain the effects of mismatch correction through a mapping function making a personalized frequency reallocation possible. We studied ten postlingually deaf adult patients with detectable bilateral residual hearing, implanted in our Clinic with Cochlear® Nucleus devices. In each test session, we asked the patients to find the best match between the pitch elicited by the residual ipsilateral and contralateral pure tones and the pitch elicited by stimulation of electrodes. We also assessed patients’ vowel and consonant recognition performance. Finally, in the only implanted patient in our clinic who had bilateral residual hearing and used a Digisonic DX10/C® device, which makes manual electrode-by-electrode frequency reallocation possible, we modified electrode-assigned frequency ranges on the basis of the pitch matching test results. We found that in none of the studied patients, the electric-to-acoustic pitch matching corresponds to the theoretical assignment pattern. A very strong correlation was detected between the electric-to-acoustic pitch mismatch and patient’s speech performance. In the Digisonic® patient, a remarkable improvement in all phoneme recognition scores was obtained 1 month after frequency reallocation. In the light of our results, we propose to assess, whenever possible, any frequency-to-electrode mismatch in all implanted patients, and correct it through mapping programs allowing manual frequency reallocation for the pitch-matched electrodes, and automated allocation of the non-tested electrodes. Cochlear implantation should therefore be proposed when residuals for all frequencies are still present, at least in one ear, so as to allow optimal alignment between allocated and subjectively perceived frequencies.