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Purpose: Studies using speech stimuli to elicit electrophysiologic responses have found approximately 30% of children with language-based learning problems demonstrate abnormal brainstem timing. Research is needed regarding how these responses relate to performance on behavioral tests of central auditory function. The purpose of the study was to investigate performance of children with dyslexia with and without abnormal brainstem timing and children with no history of learning or related disorders on behavioral tests of central auditory function. Method: Performance of 30 school-age children on behavioral central auditory tests in common clinical use was examined: Group 1 (n = 10): dyslexia, abnormal brainstem timing; Group 2 (n = 10): dyslexia, normal brainstem timing; Group 3 (n = 10): typical controls. Results: Results indicated that all participants in Group 2 met diagnostic criteria for (central) auditory processing disorder [(C)APD], whereas only 4 participants in Group 1 met criteria. The Biological Marker of Auditory Processing (BioMARK) identified 6 children in Group 1 who did not meet diagnostic criteria for (C)APD but displayed abnormal brainstem timing. Conclusions: Results underscore the importance of central auditory assessment for children with dyslexia. Furthermore, the BioMARK may be useful in identifying children with central auditory dysfunction who would not have been identified using behavioral methods of (C)APD assessment.

The age-appropriate morphofunctional formation of the central parts of the auditory system determines the normal trajectory of a child’s auditory and speech development. Impairments can lead to the emergence of central auditory processing disorders (CAPD) and associated problems of psychoverbal and general development. Psychoacoustic testing is quite informative and is the most accessible diagnostic tool for detecting signs of CAPD, including in pediatric practice; it can be performed from age four years as long as normative data for the relevant age groups are available. The aim of the present work was to carry out audiological assessments of the functional state of the central components of the auditory system using psychoacoustic methods in healthy children of different ages. Materials and methods. A total of 125 healthy full-term children aged 4–17 years with normal peripheral auditory function without hearing, speech, language, cognitive, or academic problems were examined. The children were divided into five age groups(years:months): 4:00–5:11; 6:00–7:11; 8:00–9:11; 10:00–11:11; 12:00 years and older. Along with traditional audiological examination, all children were given tests to assess the functional state of the central parts of the auditory analyzer: assessment of the perception of rhythmic stimulus sequences; the Random Gap Detection Test (RGDT); a monaural low-redundancy speech test in silence and on the background of noise interference; a binaural interaction test using alternating binaural speech; dichotic testing; testing using a simplified version of the Russian matrix sentence test in noise (RUMatrix). Results. Data on the sensitivity of the tests used in these studies assessing the functional state of different structures of the central part of the auditory system indicated that signs of maturation developed in the bottom-up direction as children aged. The pace of ontogenetic processes, assessed from the results of the corresponding tests, depended on subjects’ age groups. The morphofunctional development of the central part of the auditory system was found not to be complete by adolescence. Conclusions. The results obtained here can be used for differential diagnosis between immaturity of the central auditory system, CAPD, and hearing disorders and language disabilities of different types in children of different age groups.

Purpose: To quantify how 9 different diagnostic criteria affected potential (central) auditory processing disorder ([C]APD) diagnoses in a large sample of children referred for (central) auditory processing ([C]AP) assessment. Method: A file review was conducted on 150 children (94 boys and 56 girls; ages 7.0-15.6 years) with normal peripheral hearing who had completed a (C)AP assessment involving low-pass filtered speech, competing sentences, 2-pair dichotic digits, and frequency patterns with linguistic and nonlinguistic report. Each child was classified as having or not having (C)APD based on 9 different sets of diagnostic criteria drawn from published technical reports, position statements, and selected research. Results: The rates of potential (C)APD diagnosis ranged from 7.3% for the strictest criteria to 96.0% for the most lenient criteria. Conclusions: Until greater consensus is reached, any diagnosis of (C)APD should be qualified by an explicit statement of the criteria used. Calls to abandon the use of (C)APD as a global label should also be supported.

The current study aimed to determine the criteria used for screening and diagnosing cases with central auditory processing disorders (CAPD) in India. A cross-sectional questionnaire-based survey design was used in the present study. A questionnaire was developed to determine the criteria used for screening and diagnosing CAPD across clinics in India. Responses were obtained from 83 participants from all over India. Results indicated that 78% of respondents were currently doing CAPD evaluation. In that, the majority of respondents (63%) had a predetermined minimum battery that was relatively adaptable depending on the case history and age of the patient. In screening, most respondents used a screening questionnaire (SCAP, 75%) and a screening test (STAP, 60%). In the diagnostic protocol, the most used tests by the respondents were masking level difference (MLD), repetition of words (RW), gap detection test (GDT), pitch pattern test (PPT), speech perception in noise (SPIN), digit span test (DST), dichotic digit test (DDT), binaural fusion test (BFT), auditory brainstem response (ABR), dichotic CV test (DCVT), and duration pattern test (DPT). The current study’s result will help professionals choose the minimum test battery for diagnosing CAPD.

Antecedentes: la esquizofrenia es una enfermedad crónica que genera gran discapacidad, para la cual se han reportado biomarcadores potenciales, pero sin suficiente validez clínica. El mismatch negativity (MMN) y el P3a son potenciales relacionados con eventos que han demostrado ser indicadores neurofisiológicos del procesamiento auditivo pre-atencional y potenciales biomarcadores. Objetivo: evaluar el MMN y P3a en pacientes con diagnóstico de esquizofrenia y su relación con variables sociodemográficas y clínicas. Método: estudio cuantitativo transversal de 23 sujetos con esquizofrenia (ESQ) y 22 controles sanos (SN). Las amplitudes promedio y latencias del MMN/P3a para la condición infrecuente en duración y frecuencia fueron obtenidas mediante un paradigma oddball auditivo en un EEG de 32 canales. Resultados: se encontraron diferencias para la condición frecuencia en la amplitud del MMN (p=0.046; CI 95% 0.009; 0.87) y la amplitud del P3a (p=0.042; CI 95% 0.025; 1.24) entre los grupos; la amplitud del MMN fue menor en el grupo ESQ (-0.36 DE 0.51 µV) en comparación con los participantes del grupo de SN (-0.81 DE 0.89 µV), mientras que la amplitud del P3a fue menor en el grupo SN (0.18 DE 0.97 µV) versus el grupo ESQ (0.82 DE 1.05 µV). En relación con las variables sociodemográficas y clínicas, las asociaciones con el P3a fueron moderadas y con el MMN débiles. Conclusiones: la reducción de la amplitud del MMN a la condición frecuencia exhibe mayor utilidad que el P3a como medida de alta estabilidad en pacientes con esquizofrenia, lo que reitera su posible uso como biomarcador. Background: schizophrenia is a chronic disease that generates great disability, which currently has potential biomarkers but without sufficient clinical validity. Mismatch negativity (MMN) and P3a are event-related potentials that have been shown to be neurophysiological indicators of pre-attentional auditory processing and potential biomarkers. Objective: to evaluate MMN and P3a in patients with a diagnosis of schizophrenia and their relationship with sociodemographic and clinical variables. Method: a quantitative cross-sectional study of 23 subjects with schizophrenia and 22 healthy controls was performed. The average amplitudes and latencies of the MMN/P3a for the condition infrequent in duration and infrequent in frequency were obtained using an auditory oddball paradigm on a 32-channel EEG. Results: differences were found for the frequency condition in the amplitude of the MMN (p=0.046; 95% CI 0.009; 0.87) and the amplitude of the P3a (p=0.042; 95% CI 0.025; 1.24) between the groups; MMN amplitude was lower in schizophrenia (-0.36 SD 0.51 µV) compared to healthy controls (-0.81 SD 0.89 µV), while P3a amplitude was lower in healthy controls (0.18 SD 0.97 µV) versus the group with schizophrenia (0.82 SD 1.05 µV). In regard to sociodemographic and clinical variables, the associations with P3a were moderate, and showed weak MMN. Conclusions: MMN amplitude reduction to the frequency condition exhibits greater utility than P3a as a measure of high stability in schizophrenia, restating its potential use as a biomarker.

The Masking Level Difference (MLD) test is one of the main instruments for investigating binaural interaction. Studies with children aged 7–12 years still disagree about the influence of age on test performance and present discordant reference values. This study aimed to verify the effect of age on the performance of children aged 7–12 years in the MLD test and to establish reference values and cutoff criteria for this age group. Fifty-nine children with normal hearing were organized in three groups according to their age: 7–8 (n = 20), 9–10 (n = 20), and 11–12 (n = 19) years. The participants completed the MLD test by Auditec®. The Kruskal–Wallis statistical test was used to compare groups. Reference values were obtained by calculating mean, standard deviation, median, mode, and percentiles, while the cutoff criterion was obtained by subtracting two standard deviations from the mean. No statistically significant differences were observed between the groups regarding the MLD test measures. The mean MLD was 10.51 ± 1.84 dB and the cutoff point was set at 7 dB. Thus, reference values for the MLD test were established for children aged 7–12 years, who presented no effect of age on test performance.

There are still no valid, clinically feasible instruments to assess backward masking (BM), an auditory temporal processing (ATP) phenomenon. The aim of this study was to develop, standardize and present evidence of validity for a behavioral test for BM assessment. Young adults were submitted to a BM test (BMT), where they were asked to identify a 1000 Hz pure tone followed by a narrowband noise with interstimulus intervals of 0 to 400 ms and signal-to-noise ratio (SNR) between −20 and −30 dB. The correct response rate and target sound detection threshold were calculated, and the results compared with those of young adults with abnormal ATP tests and older adults. Diagnostic accuracy analyses were carried out. Young adults with normal ATP obtained an average correct response rate of 89 and 87% for SNR −20 and −30 dB, respectively, with average thresholds between 10 and 15 ms and no difference between the left and right ears. Results were more consistent at SNR −20 dB, and the best diagnostic accuracy was obtained for SNR −20 dB, with good specificity, but low sensitivity. Normative values were obtained for the BMT, which proved to be clinically feasible, with preliminary evidence of validity.

Purpose: In this study, the authors investigated the relationships between 3 tests used to screen for (central) auditory processing disorder ([C]APD)--the Children's Auditory Performance Scale (CHAPS; W. J. Smoski, M. A. Brunt, & J. C. Tannahill, 1998), the Screening Instrument for Targeting Educational Risk (SIFTER; K. Anderson, 1989), and the Test of Auditory Perceptual Skills--Revised (TAPS-R; M. Y. Gardner, 1997)--and 4 tests used to diagnostically assess for (C)APD: Low-Pass Filtered Speech (LPFS), Competing Sentences (CS), Two-Pair Dichotic Digits (DD), and Frequency Patterns With Linguistic Report (FP). Method: The screening and diagnostic (C)APD tests results of 104 children (71 boys, 33 girls) aged 6.9-14.3 years were reviewed following their attendance at a university clinic in Brisbane, Australia. Results: Pearson's product-moment correlation coefficient analysis showed weak (r = 0.22, p less than 0.05) to moderate (r = 0.47, p less than 0.01) correlations predominantly between the short-term and working memory test results of the TAPS-R and the DD and FP test results of the (C)AP test battery. Linear and binary logistic regression analyses showed a poor ability of the CHAPS, SIFTER, and TAPS-R test results to predict the individual LPFS, CS, DD, or FP test results or the overall risk for (C)APD. Conclusion: The CHAPS, SIFTER, and TAPS-R should be used to highlight concerns about a child but not to determine whether a diagnostic (C)AP assessment is particularly warranted.

The mismatch negativity (MMN) is a key biomarker of automatic deviance detection thought to emerge from 2 cortical sources. First, the auditory cortex (AC) encodes spectral regularities and reports frequency-specific deviances. Then, more abstract representations in the prefrontal cortex (PFC) allow to detect contextual changes of potential behavioral relevance. However, the precise location and time asynchronies between neuronal correlates underlying this frontotemporal network remain unclear and elusive. Our study presented auditory oddball paradigms along with “no-repetition” controls to record mismatch responses in neuronal spiking activity and local field potentials at the rat medial PFC. Whereas mismatch responses in the auditory system are mainly induced by stimulus-dependent effects, we found that auditory responsiveness in the PFC was driven by unpredictability, yielding context-dependent, comparatively delayed, more robust and longer-lasting mismatch responses mostly comprised of prediction error signaling activity. This characteristically different composition discarded that mismatch responses in the PFC could be simply inherited or amplified downstream from the auditory system. Conversely, it is more plausible for the PFC to exert top-down influences on the AC, since the PFC exhibited flexible and potent predictive processing, capable of suppressing redundant input more efficiently than the AC. Remarkably, the time course of the mismatch responses we observed in the spiking activity and local field potentials of the AC and the PFC combined coincided with the time course of the large-scale MMN-like signals reported in the rat brain, thereby linking the microscopic, mesoscopic, and macroscopic levels of automatic deviance detection.

Purpose: Eight English-language, student- or parent proxy-administered questionnaires for (central) auditory processing disorders, or (C)APD, were analyzed for readability. For student questionnaires, readability levels were checked against the approximate reading grade levels by intended administration age per the questionnaires' developers. For proxy questionnaires, results were compared to the reading grade level for the average U.S. adult and the minimum 5th- to 6th-grade reading level for health materials as recommended by adult health literacy experts. Method: This was a descriptive study that was based on the results of a commercially available readability calculations software package. Text-based files of the 8 questionnaires were analyzed using 3 readability formulas: FORCAST (Caylor & Sticht, 1973), Flesch Reading Ease (FRE; Flesch, 1948), and Gunning's Fog index (FOG; Gunning, 1952). Results: The FORCAST formula, the most appropriate for nonnarrative-type materials, indicated that all 8 questionnaires were written at reading levels between the 8th and 10th grades. The FRE and FOG formulas, designed for narrative-type materials, were generally in good agreement with one another but varied widely between the upper 4th- and 12th-grade levels. Conclusion: In an effort to decrease respondent burden, developers should consider readability as another testable psychometric construct. Clinicians should take into account the functional health literacy skills of adult proxy respondents when giving self-administered questionnaires.