Vestibular-evoked myogenic potentials and caloric stimulation in infants with congenital cytomegalovirus infection

from the Journal of Laryngology and Otology

Background: The influence of congenital cytomegalovirus infection on cochlear function has been well recognised; however, its impact on the vestibular system in infants has not been examined. The purpose of the present study was to evaluate vestibular function in a group of infants, using caloric stimulation tests and vestibular-evoked myogenic potential measurements.

Materials and methods: Vestibular-evoked myogenic potentials and auditory brainstem responses were recorded and caloric stimulation was performed in 66 infants aged three months, comprising 40 healthy controls and 26 infants with congenital cytomegalovirus infection.

Results: No reaction to caloric stimulation was elicited from 16 examined ears, no vestibular-evoked myogenic potentials were recorded from 12 ears, and profound sensorineural hearing loss was diagnosed in eight ears. Pathological results were observed predominantly in infants with symptoms of intrauterine congenital cytomegalovirus infection present at birth.

Conclusions: In infants with clinical symptoms of congenital CMV infection present at birth, abnormal vestibular test results occurred more frequently than abnormal auditory brainstem response results. Vestibular organs should be routinely examined in individuals with congenital cytomegalovirus infection.

(Accepted May 17 2007)

(Online publication September 21 2007)

Diagnostic tests for immunomediated hearing loss: a systematic review

from the Journal of Laryngology and Otology

Objective: To quantitatively evaluate the diagnostic accuracy of diagnostic tests for immunomediated hearing loss.

Data sources: We searched Medline and the Cochrane Database of Systematic Reviews for potentially relevant studies.

Study selection: Twenty-five studies met the inclusion criteria of this systematic review. The diagnosis of immunomediated hearing loss was based on the clinical presentation and the response to corticosteroid administration.

Data extraction: The following data were extracted from the selected studies and entered into a standardised database: population demographics; exclusion and inclusion criteria; diagnostic tests; sensitivity; specificity; the number of true positive, true negative, false positive and false negative values; therapy used, including dose and duration; and delay between symptom onset and therapy commencement.

Data synthesis: This systematic review combined data from 679 patients with immunomediated hearing loss, reported by 22 research teams. Substantial heterogeneity was found among the included studies; for this reason, summary sensitivity and specificity values were not computed.

Conclusions: The results of diagnostic tests for immunomediated hearing loss depend on many factors, and there is a risk of potential bias. This is the first time that such a systematic review has been presented; such a review is a more rigorous method of demonstrating the utility of the available diagnostic tests.

(Accepted June 04 2007)

(Online publication October 02 2007)

Functional contributions of the basal ganglia to emotional prosody: Evidence from ERPs

from Brain Research

The basal ganglia (BG) have been functionally linked to emotional processing [Pell, M.D., Leonard, C.L., 2003. Processing emotional tone form speech in Parkinson's Disease: a role for the basal ganglia. Cogn. Affec. Behav. Neurosci. 3, 275-288; Pell, M.D., 2006. Cerebral mechanisms for understanding emotional prosody in speech. Brain Lang. 97 (2), 221-234]. However, few studies have tried to specify the precise role of the BG during emotional prosodic processing. Therefore, the current study examined deviance detection in healthy listeners and patients with left focal BG lesions during implicit emotional prosodic processing in an event-related brain potential (ERP)-experiment. In order to compare these ERP responses with explicit judgments of emotional prosody, the same participants were tested in a follow-up recognition task. As previously reported [Kotz, S.A., Paulmann, S., 2007. When emotional prosody and semantics dance cheek to cheek: ERP evidence. Brain Res. 1151, 107-118; Paulmann, S. & Kotz, S.A., 2008. An ERP investigation on the temporal dynamics of emotional prosody and emotional semantics in pseudo- and lexical sentence context. Brain Lang. 105, 59-69], deviance of prosodic expectancy elicits a right lateralized positive ERP component in healthy listeners. Here we report a similar positive ERP correlate in BG-patients and healthy controls. In contrast, BG-patients are significantly impaired in explicit recognition of emotional prosody when compared to healthy controls. The current data serve as first evidence that focal lesions in left BG do not necessarily affect implicit emotional prosodic processing but evaluative emotional prosodic processes as demonstrated in the recognition task. The results suggest that the BG may not play a mandatory role in implicit emotional prosodic processing. Rather, executive processes underlying the recognition task may be dysfunctional during emotional prosodic processing.

Communicating common ground: How mutually shared knowledge influences speech and gesture in a narrative task

from Language and Cognitive Processes

Much research has been carried out into the effects of mutually shared knowledge (or common ground) on verbal language use. This present study investigates how common ground affects human communication when regarding language as consisting of both speech and gesture. A semantic feature approach was used to capture the range of information represented in speech and gesture. Overall, utterances were found to contain less semantic information when interlocutors had mutually shared knowledge, even when the information represented in both modalities, speech and gesture, was considered. However, when considering the gestures on their own, it was found that they represented only marginally less information. The findings also show that speakers gesture at a higher rate when common ground exists. It appears therefore that gestures play an important communicational function, even when speakers convey information which is already known to their addressee.

Learning-in-interaction: Resourceful work by people with aphasia and therapists in the course of language impairment therapy

from Aphasiology

Abstract
Background: “Learning” in aphasia language therapy has been studied in various ways. Empirical approaches to learning potential have been proposed, and attempts have been made to apply a range of concepts from learning theory. “Error” has been an important consideration and has received much recent attention through the application of “errorless learning” approaches. Errorless learning has been conceptualised in terms of error-elimination and error-reduction methods, with and without feedback. Authors have addressed questions of how “easy” and “difficult” may be embodied within the learning context. Key principles from adult learning models have also been espoused as relevant to aphasia language t’herapy. Therapist-client interactions in aphasia language therapy embody a range of features that are implicated in the learning process.

Aims: This study seeks to explore how detailed examination of situated and contextualised interactions can further our understanding of learning. It addresses three main themes—“error and effort”, “feedback”, and “mutuality and partnership”—entailed in the learning process.

Methods & Procedures: A qualitative study of therapy in day-to-day practice was carried out, applying Horton’s (2006) therapy process framework to audio/video data, focusing specifically on “doing therapy tasks”. Extracts from 15 sessions involving 10 therapist-client dyads were purposively selected. Analysis examines interactional aspects of “Task Introductions”, “Summary”, and “Task/response management” as relevant to the three learning themes.

Outcomes & Results: Key features of learning-in-interaction as a socially situated phenomenon emerge: “effort and error” is realised in therapist explanations, contingent enactment of accuracy/acceptability of responses, and mediated through the relative complexity of stimulus items; “feedback” functions flexibly, is calibrated responsively, and interfaces with and contributes to the ways in which “effort” is constructed in interaction; “mutuality and partnership” operates at levels that may be (quasi)conscious—through therapist/client control, or collaborative decision making for example—or unconscious, through clients asserting their processing needs or displaying their own standards.

Conclusions: Concepts associated with “learning” have been explored in interaction. Close scrutiny of therapy process has revealed subtle but powerful resources brought to bear by people with aphasia. Acknowledging these contributions and incorporating them into language therapy will help to develop a more comprehensive epistemology of therapy, and ensure that people with aphasia are active participants. Future research into error elimination/reduction approaches may benefit from these findings. Translational research may benefit from the insights of this study, enabling clinicians to apply novel therapies in day-to-day practice.
* The author would like to acknowledge the contributions of all participants—people with aphasia and therapists alike—who generously permitted collection and analysis of their therapy data. Great thanks are due to three reviewers of very early versions of this paper, and to two further reviewers of a more recent version for their very helpful comments. Many thanks to Paul Conroy for illuminating conversations about errorless learning.

Resolving ambiguity: A psycholinguistic approach to understanding prosody processing in high-functioning autism

from Brain and Language

Individuals with autism exhibit significant impairments in prosody production, yet there is a paucity of research on prosody comprehension in this population. The current study adapted a psycholinguistic paradigm to examine whether individuals with autism are able to use prosody to resolve syntactically ambiguous sentences. Participants were 21 adolescents with high-functioning autism (HFA), and 22 typically developing controls matched on age, IQ, receptive language, and gender. The HFA group was significantly less likely to use prosody to disambiguate syntax, but scored comparably to controls when syntax alone or both prosody and syntax indicated the correct response. These findings indicate that adolescents with HFA have difficulty using prosody to disambiguate syntax in comparison to typically developing controls, even when matched on chronological age, IQ, and receptive language. The implications of these findings for how individuals with autism process language are discussed.

Current focusing and steering: Modeling, physiology, and psychophysics

from Hearing Research

Current steering and current focusing are stimulation techniques designed to increase the number of distinct perceptual channels available to cochlear implant (CI) users by adjusting currents applied simultaneously to multiple CI electrodes. Previous studies exploring current steering and current focusing stimulation strategies are reviewed, including results of research using computational models, animal neurophysiology, and human psychophysics. Preliminary results of additional neurophysiological and human psychophysical studies are presented that demonstrate the success of current steering strategies in stimulating auditory nerve regions lying between physical CI electrodes, as well as current focusing strategies that excite regions narrower than those stimulated using monopolar configurations. These results are interpreted in the context of perception and speech reception by CI users. Disparities between results of physiological and psychophysical studies are discussed. The differences in stimulation used for physiological and psychophysical studies are hypothesized to contribute to these disparities. Finally, application of current steering and focusing strategies to other types of auditory prostheses is also discussed.

Keywords: Cochlear implant; Tripolar focusing; Steering; Psychophysics; Physiology; Inferior colliculus

Auditory neuropathy: Endocochlear lesion or temporal processing impairment? Implications for diagnosis and management

from the International Journal of Pediatric Otorhinolaryngology

BACKGROUND/OBJECTIVE: Auditory neuropathy/dys-synchrony, characterized by absent auditory brainstem responses, normal otoacoustic emissions or cochlear microphonics, and word discrimination disproportional to the pure-tone audiogram, may be accompanied by perceptual consequences that could jeopardize language acquisition in affected children. However, the related evidence is constantly changing leading to a serious debate. The aim of the present paper is to review the current knowledge on auditory neuropathy/dys-synchrony, and to present the therapeutic strategies that can be employed in its management, taking into account the potentially underlying pathophysiology. MATERIALS/METHODS: Literature review from Medline and database sources. Related books were also included. STUDY SELECTION: Controlled clinical trials, prospective and retrospective cohort studies, nested-based case-control and analytical family studies, laboratory and electrophysiological studies, animal models, case-reports, joint statements and review articles. DATA SYNTHESIS: Auditory neuropathy/dys-synchrony, in contrast to what is widely believed, is a very frequent disease, responsible for approximately 8% of newly diagnosed cases of hearing loss in children per year. Hyperbilirubinemia and hypoxia represent major risk factors, whereas generalized neuropathic disorders, or a genetic substrate involving the otoferlin gene, are responsible for the phenotype of auditory neuropathy/dys-synchrony in certain cases. Auditory nerve myelinopathy and/or desynchrony of neural discharges are the most probable underlying pathophysiologic mechanisms. Genetic testing may be helpful in cases of non-syndromic prelingual children. Auditory neuropathy/dys-synchrony management aims at restoring the compromised processing of auditory information, either through conventional amplification and/or alternative forms of communication, or by cochlear implantation (combined with intensive speech and language therapy). CONCLUSION: Auditory neuropathy/dys-synchrony is more frequent than considered in the past, especially amongst hearing-impaired children. Accurate diagnosis, based on subjective and objective hearing assessment techniques (including the various electrophysiological assessment measures), and timely treatment of the affected children is of paramount importance, with hearing aids, intensive speech and language therapy (and sign language when indicated) providing the mainstay of habilitation, and cochlear implantation representing a valid therapeutic alternative.

Self-esteem and social well-being of children with cochlear implant compared to normal-hearing children

from the International Journal of Pediatric Otorhinolaryngology

Objective
The purpose of this study was to make a quantitative comparison of parameters of self-esteem and social well-being between children with cochlear implants and normal-hearing children.

Material and methods
Data were obtained from 164 children with cochlear implant (CI) and 2169 normal-hearing children (NH). Parental questionnaires, used in a national survey assessing the self-esteem and well-being of normal-hearing children, were applied to the cochlear implanted group, in order to allow direct comparisons.

Results
The children in the CI group rated significantly higher on questions about well-being in kindergarten/school and the CI boys appeared to manage school work better than normal-hearing boys. CI children were significantly more active and bullied other children less than normal-hearing peers, whereas no difference existed as to being bullied by other children. No difference was obtained regarding overall self-esteem or number of friends. The two groups of children scored similarly on being confident, independent, social, not worried and happy.

Conclusion
Children with cochlear implant score equal to or better than their normal-hearing peers on matters of self-esteem and social well-being.

Pope Benedict XVI urged to provide guidelines after Autism Church Ban

from Topix.net

Campaigners have urged Pope Benedict XVI to provide guidelines to the Roman Catholic Church on how to deal with children and adults with autism and Asperger’s syndrome in the light of the banning of a 13 year old boy with autism, Adam Race from the Church of St.Joseph in Bertha, Minnesota.

Darwin’s last word: How words changed cognition

from Behavioral and Brain Sciences

Although Penn et al. make a good case for the existence of deep cognitive discontinuity between humans and animals, they fail to explain how such a discontinuity could have evolved. It is proposed that until the advent of words, no species had mental representations over which higher-order relations could be computed.

Explaining human cognitive autapomorphies

from Behavioral and Brain Sciences

The real reason for the apparent discontinuity between human and nonhuman minds is that all closely related hominids have become extinct. Nonetheless, I agree with Penn et al. that comparative psychology should aim to establish what cognitive traits humans share with other animals and what traits they do not share, because this could make profound contributions to genetics and neuroscience. There is, however, no consensus yet, and Penn et al.’s conclusion that it all comes down to one trait is premature.

Language as a consequence and an enabler of the exercise of higher-order relational capabilities: Evidence from toddlers

from Behavioral and Brain Sciences

Data on toddler language acquisition and use support the idea of a cognitive “supermodule” that can resolve contradictory claims about human-animal similarities. Examples of imagination, aesthetic evaluation, theory of mind (ToM), and language learning reveal higher-order, relational, abstract capabilities early on. Although language itself may be a consequence of exercising this supermodule, it enables further cognitive operations on indirect experience to go far beyond animal accomplishments.

Languages of thought need to be distinguished from learning mechanisms, and nothing yet rules out multiple distinctively human learning systems

from Behavioral and Brain Sciences

We distinguish the question whether only human minds are equipped with a language of thought (LoT) from the question whether human minds employ a single uniquely human learning mechanism. Thus separated, our answer to both questions is negative. Even very simple minds employ a LoT. And the comparative data reviewed by Penn et al. actually suggest that there are many distinctively human learning mechanisms.

Relational language supports relational cognition in humans and apes

from Behavioral and Brain Sciences

We agree with Penn et al. that our human cognitive superiority derives from our exceptional relational ability. We far exceed other species in our ability to grasp analogies and to combine relations into higher-order structures (Gentner 2003). However, we argue here that possession of an elaborated symbol system – such as human language – is necessary to make our relational capacity operational.