Temporal processing deficits of language-learning impaired children ameliorated by training

Perceptual organization of speech signals by children with and without dyslexia

Developmental dyslexia is a condition in which children encounter difficulty learning to read in spite of adequate instruction. Although considerable effort has been expended trying to identify the source of the problem, no single solution has been agreed upon. The current study explored a new hypothesis, that developmental dyslexia may be due to faulty perceptual organization of linguistically relevant sensory input. To test that idea, sentence-length speech signals were processed to create either sine-wave or noise-vocoded analogs. Seventy children between 8 and 11 years of age, with and without dyslexia participated. Children with dyslexia were selected to have phonological awareness deficits, although those without such deficits were retained in the study. The processed sentences were presented for recognition, and measures of reading, phonological awareness, and expressive vocabulary were collected. Results showed that children with dyslexia, regardless of phonological subtype, had poorer recognition scores than children without dyslexia for both kinds of degraded sentences. Older children with dyslexia recognized the sine-wave sentences better than younger children with dyslexia, but no such effect of age was found for the vocoded materials. Recognition scores were used as predictor variables in regression analyses with reading, phonological awareness, and vocabulary measures used as dependent variables. Scores for both sorts of sentence materials were strong predictors of performance on all three dependent measures when all children were included, but only performance for the sine-wave materials explained significant proportions of variance when only children with dyslexia were included. Finally, matching young, typical readers with older children with dyslexia on reading abilities did not mitigate the group difference in recognition of vocoded sentences. Conclusions were that children with dyslexia have difficulty organizing linguistically relevant sensory input, but learn to do so for the structure preserved by sine-wave signals before they do so for other sorts of signal structure. These perceptual organization deficits could account for difficulties acquiring refined linguistic representations, including those of a phonological nature, although ramifications are different across affected children.

Learning and cognitive disorders: multidiscipline treatment approaches

This article provides a select review of treatments for addressing reading disorder, mathematics disorder, disorder of written expression, auditory processing disorder, and poor working memory. This information will be valuable to practitioners in determining the suitability of certain treatments for these various disorders and problems, which has direct implications for providing comprehensive, multidisciplinary treatment for youth.

A case study of the changes in the speech-evoked auditory brainstem response associated with auditory training in children with auditory processing disorders

BACKGROUND

Studies related to plasticity and learning-related phenomena have primarily focused on higher-order processes of the auditory system, such as those in the auditory cortex and limited information is available on learning- and plasticity-related processes in the auditory brainstem.

DESIGN AND METHOD

A clinical electrophysiological test of speech-evoked ABR known as BioMARK has been developed to evaluate brainstem responses to speech sounds in children with language learning disorders. Fast ForWord (FFW) was used as an auditory intervention program in the current study and pre- intervention and post-intervention speech-evoked ABR (BioMARK) measures were compared in 2 school-aged children with auditory processing disorders (APD).

RESULTS AND CONCLUSIONS

Significant changes were noted from pre-intervention to post-intervention and reflect plasticity in the auditory brainstem's neural activity to speech stimuli.

Neuroplasticity-based cognitive and linguistic skills training improves reading and writing skills in college students

This study reports an evaluation of the effect of computer-based cognitive and linguistic training on college students' reading and writing skills. The computer-based training included a series of increasingly challenging software programs that were designed to strengthen students' foundational cognitive skills (memory, attention span, processing speed, and sequencing) in the context of listening and higher level reading tasks. Twenty-five college students (12 native English language; 13 English Second Language), who demonstrated poor writing skills, participated in the training group. The training group received daily training during the spring semester (11 weeks) with the Fast ForWord Literacy (FFW-L) and upper levels of the Fast ForWord Reading series (Levels 3-5). The comparison group (n = 28) selected from the general college population did not receive training. Both the training and comparison groups attended the same university. All students took the Gates MacGinitie Reading Test (GMRT) and the Oral and Written Language Scales (OWLS) Written Expression Scale at the beginning (Time 1) and end (Time 2) of the spring college semester. Results from this study showed that the training group made a statistically greater improvement from Time 1 to Time 2 in both their reading skills and their writing skills than the comparison group. The group who received training began with statistically lower writing skills before training, but exceeded the writing skills of the comparison group after training.

Speech perception in noise by children with cochlear implants

PURPOSE

Common wisdom suggests that listening in noise poses disproportionately greater difficulty for listeners with cochlear implants (CIs) than for peers with normal hearing (NH). The purpose of this study was to examine phonological, language, and cognitive skills that might help explain speech-in-noise abilities for children with CIs.

METHOD

Three groups of kindergartners (NH, hearing aid wearers, and CI users) were tested on speech recognition in quiet and noise and on tasks thought to underlie the abilities that fit into the domains of phonological awareness, general language, and cognitive skills. These last measures were used as predictor variables in regression analyses with speech-in-noise scores as dependent variables.

RESULTS

Compared to children with NH, children with CIs did not perform as well on speech recognition in noise or on most other measures, including recognition in quiet. Two surprising results were that (a) noise effects were consistent across groups and (b) scores on other measures did not explain any group differences in speech recognition.

CONCLUSIONS

Limitations of implant processing take their primary toll on recognition in quiet and account for poor speech recognition and language/phonological deficits in children with CIs. Implications are that teachers/clinicians need to teach language/phonology directly and maximize signal-to-noise levels in the classroom.

Early gamma oscillations during rapid auditory processing in children with a language-learning impairment: changes in neural mass activity after training

Children with language-learning impairment (LLI) have consistently shown difficulty with tasks requiring precise, rapid auditory processing. Remediation based on neural plasticity assumes that the temporal precision of neural coding can be improved by intensive training protocols. Here, we examined the extent to which early oscillatory responses in auditory cortex change after audio-visual training, using combined source modeling and time-frequency analysis of the human electroencephalogram (EEG). Twenty-one elementary school students diagnosed with LLI underwent the intervention for an average of 32 days. Pre- and post-training assessments included standardized language/literacy tests and EEG recordings in response to fast-rate tone doublets. Twelve children with typical language development were also tested twice, with no intervention given. Behaviorally, improvements on measures of language were observed in the LLI group following completion of training. During the first EEG assessment, we found reduced amplitude and phase-locking of early (45-75 ms) oscillations in the gamma-band range (29-52 Hz), specifically in the LLI group, for the second stimulus of the tone doublet. Amplitude reduction for the second tone was no longer evident for the LLI children post-intervention, although these children still exhibited attenuated phase-locking. Our findings suggest that specific aspects of inefficient sensory cortical processing in LLI are ameliorated after training.

Dyslexia

Developmental dyslexia (DD) is a specific and persistent disability affecting the acquisition of written language. Prevalence is estimated to be between 5% and 17% of school-aged children; it therefore represents a major public health issue. Neurological in origin, its causes are unknown, although there is a clear genetic component. Diagnosis rests upon the use of standardized tests and tools to assess reading and spelling, as well as phonological skills. The importance of early diagnosis cannot be overemphasized and much current research is focusing on screening and prediction, particularly through use of objective imaging techniques (e.g., EEG/MEG), which have implicated cortical abnormalities in central auditory processing (Giraud et al., 2005, 2008). Remediation should be intensive, begin as early as possible, and be tailored to the individual. Phonics based treatments are most effective and several variants, incorporating temporal auditory, articulatory, or multisensory training exercises, have been developed or proposed. Clinical improvements in phonological skills and reading with such treatments have been shown to correlate with changes in the brains of dyslexic children in several functional imaging studies.

Fast ForWord®: the birth of the neurocognitive training revolution

In 1996, I cofounded Scientific Learning Corporation (SLC) with Drs Michael Merzenich, William Jenkins, and Steve Miller. I coined the term "Cogniceutical" to describe the new type of company we envisioned. SLC was the first company cofounded by academic scientists with the mission of building neurocognitive interventions. Fast ForWord® is the registered trade name of the platform SLC built to translate basic neuroplasticity-based training research into clinical and educational products. Fast ForWord® was the first cognitive neurotherapeutic intervention, the first to be individually adaptive in real time, the first "brain fitness" program that collected data over the Internet, and the first to use computer gaming technologies to change brains and enhance human potential. We included lofty goals in our first business plan for SLC. These included: using neuroplasticity-based training to improve language, literacy, and other academic skills; helping seniors maintain and recover function; helping people learn English as a second language; helping patient populations with neurological or mental disorders. SLC's first focus became improving language and literacy. Mike, Bill, Steve, and I began this journey together in 1994 with a laboratory-based research study that included seven children. To date, over two million children in 46 countries have used Fast ForWord® products. On any given school day, approximately 60,000 children log in to train on 1 of 10 Fast ForWord Language, Literacy, or Reading programs. We did not know at the time that we were creating what became a "disruptive innovation." This chapter chronicles this transformational journey.

Specific language impairment

The acquisition of language is one of the most important achievements in young children, in part because most children appear to acquire language with little effort. Some children are not so fortunate, however. There is a large group of children who also have difficulty learning language, but do not have obvious neurological, cognitive, sensory, emotional, or environmental deficits. Clinicians often refer to these children as language disordered or language impaired. Researchers tend to refer to these children as specific language impaired (SLI). Children with SLI have intrigued researchers for many years because there is no obvious reason for their language learning difficulties. SLI has been found to be an enduring condition that begins in early childhood and often persists into adolescence and adulthood. The language problems of children with SLI are not limited to spoken language; they also affect reading and writing and thus much of academic learning. Knowledge of the characteristics of SLI should aid physicians, pediatricians, and early childhood specialists to identify these children during the preschool years and ensure that they receive appropriate services. With high-quality language intervention and literacy instruction, most children with SLI should be able to perform and function adequately in school and beyond.

Effect of phonological training in French children with SLI: perspectives on voicing identification, discrimination and categorical perception

The aim of the present study was to investigate the effect of auditory training on voicing perception in French children with specific language impairment (SLI). We used an adaptive discrimination training that was centred across the French phonological boundary (0 ms voice onset time--VOT). One group of nine children with SLI attended eighteen twenty-minute training sessions with feedback, and a control group of nine children with SLI did not receive any training. Identification, discrimination and categorical perception were evaluated before, during and after training as well as one month following the final session. Phonological awareness and vocabulary were also assessed for both groups. The results showed that children with SLI experienced strong difficulties in the identification, discrimination and categorical perception of the voicing continuum prior to training. However, as early as after the first nine training sessions, their performance in the identification and discrimination tasks increased significantly. Moreover, phonological awareness scores improved during training, whereas vocabulary scores remained stable across sessions.

Assistive listening devices drive neuroplasticity in children with dyslexia

Children with dyslexia often exhibit increased variability in sensory and cognitive aspects of hearing relative to typically developing peers. Assistive listening devices (classroom FM systems) may reduce auditory processing variability by enhancing acoustic clarity and attention. We assessed the impact of classroom FM system use for 1 year on auditory neurophysiology and reading skills in children with dyslexia. FM system use reduced the variability of subcortical responses to sound, and this improvement was linked to concomitant increases in reading and phonological awareness. Moreover, response consistency before FM system use predicted gains in phonological awareness. A matched control group of children with dyslexia attending the same schools who did not use the FM system did not show these effects. Assistive listening devices can improve the neural representation of speech and impact reading-related skills by enhancing acoustic clarity and attention, reducing variability in auditory processing.

A hierarchical model of temporal perception

Temporal perception comprises subjective phenomena such as simultaneity, successiveness, temporal order, subjective present, temporal continuity and subjective duration. These elementary temporal experiences are hierarchically related to each other. Functional system states with a duration of 30 ms are implemented by neuronal oscillations and they provide a mechanism to define successiveness. These system states are also responsible for the identification of basic events. For a sequential representation of several events time tags are allocated, resulting in an ordinal representation of such events. A mechanism of temporal integration binds successive events into perceptual units of 3 s duration. Such temporal integration, which is automatic and presemantic, is also operative in movement control and other cognitive activities. Because of the omnipresence of this integration mechanism it is used for a pragmatic definition of the subjective present. Temporal continuity is the result of a semantic connection between successive integration intervals. Subjective duration is known to depend on mental load and attentional demand, high load resulting in long time estimates. In the hierarchical model proposed, system states of 30 ms and integration intervals of 3 s, together with a memory store, provide an explanatory neuro-cognitive machinery for differential subjective duration.

Music and early language acquisition

Language is typically viewed as fundamental to human intelligence. Music, while recognized as a human universal, is often treated as an ancillary ability - one dependent on or derivative of language. In contrast, we argue that it is more productive from a developmental perspective to describe spoken language as a special type of music. A review of existing studies presents a compelling case that musical hearing and ability is essential to language acquisition. In addition, we challenge the prevailing view that music cognition matures more slowly than language and is more difficult; instead, we argue that music learning matches the speed and effort of language acquisition. We conclude that music merits a central place in our understanding of human development.

Transcranial direct current stimulation augments perceptual sensitivity and 24-hour retention in a complex threat detection task

We have previously shown that transcranial direct current stimulation (tDCS) improved performance of a complex visual perceptual learning task (Clark et al. 2012). However, it is not known whether tDCS can enhance perceptual sensitivity independently of non-specific, arousal-linked changes in response bias, nor whether any such sensitivity benefit can be retained over time. We examined the influence of stimulation of the right inferior frontal cortex using tDCS on perceptual learning and retention in 37 healthy participants, using signal detection theory to distinguish effects on perceptual sensitivity (d') from response bias (ß). Anodal stimulation with 2 mA increased d', compared to a 0.1 mA sham stimulation control, with no effect on ß. On completion of training, participants in the active stimulation group had more than double the perceptual sensitivity of the control group. Furthermore, the performance enhancement was maintained for 24 hours. The results show that tDCS augments both skill acquisition and retention in a complex detection task and that the benefits are rooted in an improvement in sensitivity (d'), rather than changes in response bias (ß). Stimulation-driven acceleration of learning and its retention over 24 hours may result from increased activation of prefrontal cortical regions that provide top-down attentional control signals to object recognition areas.

Training the brain: fact and fad in cognitive and behavioral remediation

Putatively safe and effective for improving cognitive performance in both health and disease, products purported to train the brain appeal to consumers and healthcare practitioners. In an increasingly health-centered society, these applications constitute a burgeoning commercial market. Sparse evidence coupled with lack of scientific rigor, however, leaves claims concerning the impact and duration of such brain training largely unsubstantiated. On the other hand, at least some scientific findings seem to support the effectiveness and sustainability of training for higher brain functions such as attention and working memory. In the present paper we provide a tectonic integration and synthesis of cognitive training approaches. Specifically, we sketch the relative merits and shortcomings of these programs, which often appeal to parents who must choose between side-effect-laden medication and other less conventional options. Here we examine how neuroplasticity allows the healthy as well the impaired to benefit from cognitive training programs. We evaluate the evidence and consider whether brain training can be a stand-alone treatment or an adjunct to pharmacotherapy, outline promising future prospects, and highlight what training outcomes are plausible in line with available data. Future research would determine whether the field of brain training realizes its potential to revolutionize education and rehabilitation or withers away engulfed in controversy.

Stroke recovery and sensory plasticity: common mechanisms?

Presentations in this symposium are considered in the context of mechanisms of sensory plasticity, particularly in the auditory system. The auditory nervous system has two discrete end organs that are separately vulnerable to clinical and experimental injury, and brainstem processing mechanisms that are highly specialized for temporal, spectral, and spatial coding. These include giant axo-somatic synapses and neurons with spatially segregated bipolar dendrites, each innervated exclusively from one ear. This architecture allows exquisite control of afferent-target interactions, including known excitatory and inhibitory couplings, and consequently enhanced interpretation of data from other brain systems. For example, deafening can silence the auditory nerve, but has surprisingly little impact on normal brain function, as evidenced by the success of cochlear implants. The observed amplification from one brain region to another of degeneration following stroke or discrete brain lesions may thus be due to secondary rather than primary afferent consequences of the lesion.

Sex differences in auditory subcortical function

OBJECTIVE

Sex differences have been demonstrated in the peripheral auditory system as well as in higher-level cognitive processing. Here, we aimed to determine if the subcortical response to a complex auditory stimulus is encoded differently between the sexes.

METHODS

Using electrophysiological techniques, we assessed the auditory brainstem response to a synthesized stop-consonant speech syllable [da] in 76 native-English speaking, young adults (38 female). Timing and frequency components of the response were compared between males and females to determine which aspects of the response are affected by sex.

RESULTS

A dissimilarity between males and females was seen in the neural response to the components of the speech stimulus that change rapidly over time; but not in the slower changing, lower frequency information in the stimulus. We demonstrate that, in agreement with the click-evoked brainstem response, females have earlier peaks relative to males in the subcomponents of the response representing the onset of the speech sound. In contrast, the response peaks comprising the frequency-following response, which encode the fundamental frequency (F(0)) of the stimulus, as well as the spectral amplitude of the response to the F(0), is not affected by sex. Notably, the higher-frequency elements of the speech syllable are encoded differently between males and females, with females having greater representation of spectrotemporal information for frequencies above the F(0).

CONCLUSIONS

Our results provide a baseline for interpreting the higher incidence of language impairment (e.g. dyslexia, autism, specific language impairment) in males, and the subcortical deficits associated with these disorders.

SIGNIFICANCE

These results parallel the subcortical encoding patterns that are documented for good and poor readers in that poor readers differ from good readers on encoding fast but not slow components of speech. This parallel may thus help to explain the higher incidence of reading impairment in males compared to females.

Auditory temporal-envelope processing in high-functioning children with Autism Spectrum Disorder

Individuals with Autism Spectrum Disorder (ASD) perform worse than controls when listening to speech in a temporally modulated noise (Alcántara, Weisblatt, Moore, & Bolton, 2004; Groen et al., 2009). The current study examined whether this is due to poor auditory temporal-envelope processing. Temporal modulation transfer functions were measured in 6 high-functioning children with ASD and 6 control listeners, using sinusoidal amplitude modulation of a broadband noise. Modulation-depth thresholds at low modulation rates were significantly higher for the ASD group than for the Control group, and generally higher at all modulation rates tested. Low-pass filter model estimates of temporal-envelope resolution and temporal-processing efficiency showed significant differences between the groups for modulation-depth threshold values at low modulation rates. Intensity increment-detection thresholds, measured on a subset of individuals in the ASD and Control groups, were not significantly different. The results are consistent with ASD individuals having reduced processing efficiency of temporal modulations. Possible neural mechanisms that might underlie these findings are discussed.

Lack of generalization of auditory learning in typically developing children

PURPOSE

To understand the components of auditory learning in typically developing children by assessing generalization across stimuli, across modalities (i.e., hearing, vision), and to higher level language tasks.

METHOD

Eighty-six 8- to 10-year-old typically developing children were quasi-randomly assigned to 4 groups. Three of the groups received twelve 30-min training sessions on multiple standards using either an auditory frequency discrimination task (AFD group), auditory phonetic discrimination task (PD group), or visual frequency discrimination task (VFD group) over 4 weeks. The 4th group, which was the no-intervention control (NI) group, did not receive any training. Thresholds on all tasks (AFD, PD, and VFD) were assessed immediately before and after training, along with performance on a battery of language assessments.

RESULTS

Relative to the other groups, both the AFD group and the PD group, but not the VFD group, showed significant learning on the stimuli upon which they were trained. However, in those instances where learning was observed, it did not generalize to the nontrained stimuli or to the language assessments.

CONCLUSIONS

Nonspeech (AFD) or speech (PD) discrimination training can lead to auditory learning in typically developing children of this age range. However, this learning does not always generalize across stimuli or tasks, across modalities, or to higher level measures of language ability.

Auditory processing theories of language disorders: past, present, and future

PURPOSE

The purpose of this article is to provide information that will assist readers in understanding and interpreting research literature on the role of auditory processing in communication disorders.

METHOD

A narrative review was used to summarize and synthesize the literature on auditory processing deficits in children with auditory processing disorder (APD), specific language impairment (SLI), and dyslexia. The history of auditory processing theories of these 3 disorders is described, points of convergence and controversy within and among the different branches of research literature are considered, and the influence of research on practice is discussed. The theoretical and clinical contributions of neurophysiological methods are also reviewed, and suggested approaches for critical reading of the research literature are provided.

CONCLUSION

Research on the role of auditory processing in communication disorders springs from a variety of theoretical perspectives and assumptions, and this variety, combined with controversies over the interpretation of research results, makes it difficult to draw clinical implications from the literature. Neurophysiological research methods are a promising route to better understanding of auditory processing. Progress in theory development and its clinical application is most likely to be made when researchers from different disciplines and theoretical perspectives communicate clearly and combine the strengths of their approaches.

Inverted-U function relating cortical plasticity and task difficulty

Many psychological and physiological studies with simple stimuli have suggested that perceptual learning specifically enhances the response of primary sensory cortex to task-relevant stimuli. The aim of this study was to determine whether auditory discrimination training on complex tasks enhances primary auditory cortex responses to a target sequence relative to non-target and novel sequences. We collected responses from more than 2000 sites in 31 rats trained on one of six discrimination tasks that differed primarily in the similarity of the target and distractor sequences. Unlike training with simple stimuli, long-term training with complex stimuli did not generate target-specific enhancement in any of the groups. Instead, cortical receptive field size decreased, latency decreased, and paired pulse depression decreased in rats trained on the tasks of intermediate difficulty, whereas tasks that were too easy or too difficult either did not alter or degraded cortical responses. These results suggest an inverted-U function relating neural plasticity and task difficulty.

Auditory processing in children and adolescents in situations of risk and vulnerability

CONTEXT AND OBJECTIVE

Children and adolescents who live in situations of social vulnerability present a series of health problems. Nonetheless, affirmations that sensory and cognitive abnormalities are present are a matter of controversy. The aim of this study was to investigate aspects to auditory processing, through applying the brainstem auditory evoked potential (BAEP) and behavioral auditory processing tests to children living on the streets, and comparison with a control group.

DESIGN AND SETTING

Cross-sectional study in the Laboratory of Auditory Processing, School of Medicine, Universidade de São Paulo.

METHODS

The auditory processing tests were applied to a group of 27 individuals, subdivided into 11 children (7 to 10 years old) and 16 adolescents (11 to 16 years old), of both sexes, in situations of social vulnerability, compared with an age-matched control group of 10 children and 11 adolescents without complaints. The BAEP test was also applied to investigate the integrity of the auditory pathway.

RESULTS

For both children and adolescents, there were significant differences between the study and control groups in most of the tests applied, with significantly worse performance in the study group, except in the pediatric speech intelligibility test. Only one child had an abnormal result in the BAEP test.

CONCLUSIONS

The results showed that the study group (children and adolescents) presented poor performance in the behavioral auditory processing tests, despite their unaltered auditory brainstem pathways, as shown by their normal results in the BAEP test.

Selectivity for the rate of frequency-modulated sweeps in the mouse auditory cortex

Frequency-modulated (FM) sweeps are common components of vocalizations, including human speech. Both sweep direction and rate influence discrimination of vocalizations. Across species, relatively less is known about FM rate selectivity compared with direction selectivity. In this study, FM rate selectivity was studied in the auditory cortex of anesthetized 1- to 3-mo-old C57bl/6 mice. Neurons were classified as fast pass, band pass, slow pass, or all pass depending on their selectivity for rates between 0.08 and 20 kHz/ms. Multiunit recordings were used to map FM rate selectivity at depths between 250 and 450 μm across both primary auditory cortex (A1) and the anterior auditory field (AAF). In terms of functional organization of rate selectivity, three patterns were found. First, in both A1 and AAF, neurons clustered according to rate selectivity. Second, most (∼60%) AAF neurons were either fast-pass or band-pass selective. Most A1 neurons (∼72%) were slow-pass selective. This distribution supports the hypothesis that AAF is specialized for faster temporal processing than A1. Single-unit recordings ( n = 223) from A1 and AAF show that the mouse auditory cortex is best poised to detect and discriminate a narrow range of sweep rates between 0.5 and 3 kHz/ms. Third, based on recordings obtained at different depths, neurons in the infragranular layers were less rate selective than neurons in the granular layers, suggesting FM processing undergoes changes within the cortical column. On average, there was very little direction selectivity in the mouse auditory cortex. There was also no correlation between characteristic frequency and direction selectivity. The narrow range of rate selectivity in the mouse cortex indicates that FM rate processing is a useful physiological marker for studying contributions of genetic and environmental factors in auditory system development, aging, and disease.

Cortical activity patterns predict robust speech discrimination ability in noise

The neural mechanisms that support speech discrimination in noisy conditions are poorly understood. In quiet conditions, spike timing information appears to be used in the discrimination of speech sounds. In this study, we evaluated the hypothesis that spike timing is also used to distinguish between speech sounds in noisy conditions that significantly degrade neural responses to speech sounds. We tested speech sound discrimination in rats and recorded primary auditory cortex (A1) responses to speech sounds in background noise of different intensities and spectral compositions. Our behavioral results indicate that rats, like humans, are able to accurately discriminate consonant sounds even in the presence of background noise that is as loud as the speech signal. Our neural recordings confirm that speech sounds evoke degraded but detectable responses in noise. Finally, we developed a novel neural classifier that mimics behavioral discrimination. The classifier discriminates between speech sounds by comparing the A1 spatiotemporal activity patterns evoked on single trials with the average spatiotemporal patterns evoked by known sounds. Unlike classifiers in most previous studies, this classifier is not provided with the stimulus onset time. Neural activity analyzed with the use of relative spike timing was well correlated with behavioral speech discrimination in quiet and in noise. Spike timing information integrated over longer intervals was required to accurately predict rat behavioral speech discrimination in noisy conditions. The similarity of neural and behavioral discrimination of speech in noise suggests that humans and rats may employ similar brain mechanisms to solve this problem.

Training speech-in-noise perception in mainstream school children

OBJECTIVE

Auditory training has been advocated as a management strategy for children with hearing, listening or language difficulties. Because poor speech-in-noise perception is commonly reported, previous research has focused on the use of complex (word/sentence) stimuli as auditory training material to improve sentence-in-noise perception. However, some evidence suggests that engagement with the training stimuli is more important than the type of stimuli used for training. The aim of this experiment was to assess if sentence-in-noise perception could be improved using simpler auditory training stimuli.

METHODS

We recruited 41 typically developing, normal-hearing children aged 8-10 years divided into four groups. Groups 1-3 trained over 4 weeks (12 × 30 min sessions) on either: (1) pure-tone frequency discrimination (FD), (2) FD in a modulated noise (FDN) or, (3) mono-syllabic words in a modulated noise (WN). Group 4 was an untrained Control. In the training tasks, either tone frequency (Group 1), or tone (Group 2) or speech (Group 3) level was varied adaptively. All children completed pre- and post-training tests of sentence perception in modulated (SMN) and unmodulated (SUN) noise and a probe measure of each training task.

RESULTS

All trained groups improved significantly on the trained tasks. Transfer of training occurred between FDN training and FD, WN and SMN testing, and between WN training and SMN testing. A significant performance suppression on the SUN test resulted from FD and FDN training.

CONCLUSION

The pattern of training-induced improvement, relative to Controls, suggests that transfer of training is more likely when some stimulus dimensions (tone frequency, speech, modulated noise) are shared between training tasks and outcomes. This and the finding of suppressed post-training performance, relative to Controls, between tasks not sharing a stimulus dimension both favour the use of outcome-specific material for auditory training.

Perception of speech in noise: neural correlates

The presence of irrelevant auditory information (other talkers, environmental noises) presents a major challenge to listening to speech. The fundamental frequency (F(0)) of the target speaker is thought to provide an important cue for the extraction of the speaker's voice from background noise, but little is known about the relationship between speech-in-noise (SIN) perceptual ability and neural encoding of the F(0). Motivated by recent findings that music and language experience enhance brainstem representation of sound, we examined the hypothesis that brainstem encoding of the F(0) is diminished to a greater degree by background noise in people with poorer perceptual abilities in noise. To this end, we measured speech-evoked auditory brainstem responses to /da/ in quiet and two multitalker babble conditions (two-talker and six-talker) in native English-speaking young adults who ranged in their ability to perceive and recall SIN. Listeners who were poorer performers on a standardized SIN measure demonstrated greater susceptibility to the degradative effects of noise on the neural encoding of the F(0). Particularly diminished was their phase-locked activity to the fundamental frequency in the portion of the syllable known to be most vulnerable to perceptual disruption (i.e., the formant transition period). Our findings suggest that the subcortical representation of the F(0) in noise contributes to the perception of speech in noisy conditions.

Behavioral training restores temporal processing in auditory cortex of long-deaf cats

Temporal auditory processing is poor in prelingually hearing-impaired patients fitted with cochlear prostheses as adults. In an animal model of prelingual long-term deafness, we investigated the effects of behavioral training on temporal processing in the adult primary auditory cortex (AI). Neuronal responses to pulse trains of increasing frequencies were recorded in three groups of neonatally deafened cats that received a cochlear prosthesis after >3 yr of deafness: 1) acutely implanted animals that received no electric stimulation before study, 2) animals that received chronic-passive stimulation for several weeks to months before study, and 3) animals that received chronic-passive stimulation and additional behavioral training (signal detection). A fourth group of normal adult cats that was deafened acutely and implanted served as controls. The neuronal temporal response parameters of interest included the stimulus rate that evoked the maximum number of phase-locked spikes [best repetition rate (BRR)], the stimulus rate that produced 50% of the spike count at BRR (cutoff rate), the peak-response latency, and the first spike latency and timing-jitter. All long-deaf animals demonstrated a severe reduction in spiral ganglion cell density (mean, <6% of normal). Long-term deafness resulted in a significantly reduced temporal following capacity and spike-timing precision of cortical neurons in all parameters tested. Neurons in deaf animals that received only chronic-passive stimulation showed a gain in BRR but otherwise were similar to deaf cats that received no stimulation. In contrast, training with behaviorally relevant stimulation significantly enhanced all temporal processing parameters to normal levels with the exception of minimum latencies. These results demonstrate the high efficacy of learning-based remodeling of fundamental timing properties in cortical processing even in the adult, long-deaf auditory system, suggesting rehabilitative strategies for patients with long-term hearing loss.

Diverse excitatory and inhibitory synaptic plasticity outcomes in complex horizontal circuits near a functional border of adult neocortex

The primary somatosensory cortex (SI) is topographically organized into a map of the body. This organization is dynamic, undergoing experience-dependent modifications throughout life. It has been hypothesized that excitatory and inhibitory synaptic plasticity of horizontal intracortical connections contributes to functional reorganization. However, very little is known about synaptic plasticity of these connections; particularly the characteristics of inhibitory synaptic plasticity, its relationship to excitatory synaptic plasticity, and their relationship to the functional organization of the cortex. To investigate this, we located the border between the forepaw and lower jaw representation of SI in vivo, and used whole cell-patch electrophysiology to record post-synaptic excitatory and inhibitory currents in complex horizontal connections in vitro. Connections that remained within the representation (continuous) and those that crossed from one representation to another (discontinuous) were stimulated differentially, allowing us to examine differences associated with the border. To induce synaptic plasticity, tetanic stimulation was applied to either continuous or discontinuous pathways. Tetanic stimulation induced diverse forms of excitatory and inhibitory synaptic plasticity, with LTP dominating for excitation and LTD dominating for inhibition. The border did not restrict plasticity in either case. In contrast, tetanization elicited LTP of monosynaptic inhibitory responses in continuous, but not discontinuous connections. These results demonstrate that continuous and discontinuous pathways are capable of diverse synaptic plasticity responses that are differentially inducible. Furthermore, continuous connections can undergo monosynaptic inhibitory LTP, independent of excitatory drive onto interneurons. Thus, coordinated excitatory and inhibitory synaptic plasticity of horizontal connections are capable of contributing to functional reorganization.

Training to improve hearing speech in noise: biological mechanisms

We investigated training-related improvements in listening in noise and the biological mechanisms mediating these improvements. Training-related malleability was examined using a program that incorporates cognitively based listening exercises to improve speech-in-noise perception. Before and after training, auditory brainstem responses to a speech syllable were recorded in quiet and multitalker noise from adults who ranged in their speech-in-noise perceptual ability. Controls did not undergo training but were tested at intervals equivalent to the trained subjects. Trained subjects exhibited significant improvements in speech-in-noise perception that were retained 6 months later. Subcortical responses in noise demonstrated training-related enhancements in the encoding of pitch-related cues (the fundamental frequency and the second harmonic), particularly for the time-varying portion of the syllable that is most vulnerable to perceptual disruption (the formant transition region). Subjects with the largest strength of pitch encoding at pretest showed the greatest perceptual improvement. Controls exhibited neither neurophysiological nor perceptual changes. We provide the first demonstration that short-term training can improve the neural representation of cues important for speech-in-noise perception. These results implicate and delineate biological mechanisms contributing to learning success, and they provide a conceptual advance to our understanding of the kind of training experiences that can influence sensory processing in adulthood.

Auditory Processing Disorder and Auditory/Language Interventions: An Evidence-Based Systematic Review

Purpose

In this systematic review, the peer-reviewed literature on the efficacy of interventions for school-age children with auditory processing disorder (APD) is critically evaluated.

Method

Searches of 28 electronic databases yielded 25 studies for analysis. These studies were categorized by research phase (e.g., exploratory, efficacy) and ranked on a standard set of quality features related to methodology and reporting.

Results

Some support exists for the claim that auditory and language interventions can improve auditory functioning in children with APD and those with primary spoken language disorder. There is little indication, however, that observed improvements are due to the auditory features of these programs. Similarly, evidence supporting the effects of these programs on spoken and written language functioning is limited.

Conclusion

The evidence base is too small and weak to provide clear guidance to speech-language pathologists faced with treating children with diagnosed APD, but some cautious skepticism is warranted until the record of evidence is more complete. Clinicians who decide to use auditory interventions should be aware of the limitations in the evidence and take special care to monitor the spoken and written language status of their young clients.

Auditory evoked response to gaps in noise: older adults

OBJECTIVE

The objective of this study was to describe the auditory evoked response to silent gaps for a group of older adults using stimulus conditions identical to those used in psychophysical studies of gap detection.

DESIGN

The P1-N1-P2 response to the onsets of stimuli (markers) defining a silent gap for within-channel (spectrally identical markers) and across-channel (spectrally different markers) conditions was examined using four perceptually-equated gap durations.

STUDY SAMPLE

A group of 24 older adults (mean age = 63 years) with normal hearing or minimal hearing loss participated.

RESULTS

Older adults exhibited neural activation patterns that were qualitatively different and more frontally oriented than those observed in a previous study (Lister et al., 2007) of younger listeners. Older adults showed longer P2 latencies and larger P1 amplitudes than younger adults, suggesting relatively slower neural travel time and altered auditory inhibition/arousal by irrelevant stimuli.

CONCLUSION

Older adults appeared to recruit later-occurring T-complex-like generators for gap processing, compared to earlier-occurring T-complex-like generators by the younger group. Early and continued processing of channel cues with later processing of gap cues may represent the inefficiency of the aging auditory system and may contribute to poor speech understanding in noisy, real-world listening environments.

Noise on, voicing off: Speech perception deficits in children with specific language impairment

Speech perception of four phonetic categories (voicing, place, manner, and nasality) was investigated in children with specific language impairment (SLI) (n=20) and age-matched controls (n=19) in quiet and various noise conditions using an AXB two-alternative forced-choice paradigm. Children with SLI exhibited robust speech perception deficits in silence, stationary noise, and amplitude-modulated noise. Comparable deficits were obtained for fast, intermediate, and slow modulation rates, and this speaks against the various temporal processing accounts of SLI. Children with SLI exhibited normal "masking release" effects (i.e., better performance in fluctuating noise than in stationary noise), again suggesting relatively spared spectral and temporal auditory resolution. In terms of phonetic categories, voicing was more affected than place, manner, or nasality. The specific nature of this voicing deficit is hard to explain with general processing impairments in attention or memory. Finally, speech perception in noise correlated with an oral language component but not with either a memory or IQ component, and it accounted for unique variance beyond IQ and low-level auditory perception. In sum, poor speech perception seems to be one of the primary deficits in children with SLI that might explain poor phonological development, impaired word production, and poor word comprehension.

Relating pitch awareness to phonemic awareness in children: implications for tone-deafness and dyslexia

Language and music are complex cognitive and neural functions that rely on awareness of one's own sound productions. Information on the awareness of vocal pitch, and its relation to phonemic awareness which is crucial for learning to read, will be important for understanding the relationship between tone-deafness and developmental language disorders such as dyslexia. Here we show that phonemic awareness skills are positively correlated with pitch perception–production skills in children. Children between the ages of seven and nine were tested on pitch perception and production, phonemic awareness, and IQ. Results showed a significant positive correlation between pitch perception–production and phonemic awareness, suggesting that the relationship between musical and linguistic sound processing is intimately linked to awareness at the level of pitch and phonemes. Since tone-deafness is a pitch-related impairment and dyslexia is a deficit of phonemic awareness, we suggest that dyslexia and tone-deafness may have a shared and/or common neural basis.

Late maturation of auditory perceptual learning

Adults can improve their performance on many perceptual tasks with training, but when does the response to training become mature? To investigate this question, we trained 11-year-olds, 14-year-olds and adults on a basic auditory task (temporal-interval discrimination) using a multiple-session training regimen known to be effective for adults. The adolescents all began with performance in the adult range. However, while all of the adults improved across sessions, none of the 11-year-olds and only half of the 14-year-olds did. The adolescents who failed to learn did so even though the 10-session training regimen provided twice the number of sessions required by adults to reach asymptotic performance. Further, over the course of each session, the performance of the adults was stable but that of the adolescents, including those who learned, deteriorated. These results demonstrate that the processes that underlie perceptual learning can continue to develop well into adolescence.

Bidirectional axonal plasticity during reorganization of adult rat primary somatosensory cortex

Cortical sensory maps contain discrete functional subregions that are separated by borders that restrict tangential activity flow. Interestingly, the functional organization of border regions remains labile in adults, changing in an activity-dependent manner. Here, we investigated if axon remodeling contributes to this reorganization. We located the border between the forepaw and lower jaw representation (forepaw/lower jaw border,(1) FP/LJ border) in SI of adult rats, and used a retrograde axonal tracer (cholera toxin subunit B(2), Ctb) to determine if horizontal axonal projections change after different durations of forelimb denervation or sham-denervation. In sham-denervated animals, neurons close to the border had axonal projections oriented away from the border (axonal bias). Forelimb denervation resulted in a sustained change in border location and a significant reduction in the axonal bias at the original border after 6 weeks of denervation, but not after 4 or 12 weeks. The change in axonal bias was due to an increase in axons that cross the border at 6 weeks, followed by an apparent loss of these axons by 12 weeks. This suggests that bidirectional axonal rearrangements are associated with relatively long durations of reorganization and could contribute transiently to the maintenance of cortical reorganization.

A systematic meta-analytic review of evidence for the effectiveness of the 'Fast ForWord' language intervention program

BACKGROUND

Fast ForWord is a suite of computer-based language intervention programs designed to improve children's reading and oral language skills. The programs are based on the hypothesis that oral language difficulties often arise from a rapid auditory temporal processing deficit that compromises the development of phonological representations.

METHODS

A systematic review was designed, undertaken and reported using items from the PRISMA statement. A literature search was conducted using the terms 'Fast ForWord''Fast For Word''Fastforword' with no restriction on dates of publication. Following screening of (a) titles and abstracts and (b) full papers, using pre-established inclusion and exclusion criteria, six papers were identified as meeting the criteria for inclusion (randomised controlled trial (RCT) or matched group comparison studies with baseline equivalence published in refereed journals). Data extraction and analyses were carried out on reading and language outcome measures comparing the Fast ForWord intervention groups to both active and untreated control groups.

RESULTS

Meta-analyses indicated that there was no significant effect of Fast ForWord on any outcome measure in comparison to active or untreated control groups.

CONCLUSIONS

There is no evidence from the analysis carried out that Fast ForWord is effective as a treatment for children's oral language or reading difficulties.

Neuroscience insights improve neurorehabilitation of poststroke aphasia

The treatment of aphasias-acquired language disorders-caused by stroke and other neurological conditions has benefitted from insights from neuroscience and neuropsychology. Hebbian mechanisms suggest that massed practice and exploitation of residual neurological capacities can aid neurorehabilitation of patients with poststroke aphasia, and progress in basic neuroscience research indicates that the language system of the human brain is functionally interwoven with perceptual and motor systems. Intensive speech and language therapies, including constraint-induced aphasia therapy, that activate both the linguistic and concordant motor circuits utilize the knowledge gained from these advances in neuroscience research and can lead to surprisingly rapid improvements in language performance, even in patients with chronic aphasia. Drug-based therapies alone and in conjunction with behavioral language therapies also increase language performance in patients with aphasia. Furthermore, noninvasive transcranial magnetic stimulation and electrical stimulation techniques that target neuronal activity within perilesional areas might help patients with aphasia to regain lost language functions. Intensive language-action therapies that lead to rapid improvements in language skills might provide a new opportunity for investigating fast plastic neuronal changes in the areas of the brain associated with language processing. Here, we review progress in basic neuroscience research and its translational impact on the neurorehabilitation of language disorders after stroke.

Enhanced physiologic discriminability of stop consonants with prolonged formant transitions in awake monkeys based on the tonotopic organization of primary auditory cortex

Many children with specific language impairment (SLI) have difficulty in perceiving stop consonant-vowel syllables (e.g., /ba/, /ga/, /da/) with rapid formant transitions, but perform normally when formant transitions are extended in time. This influential observation has helped lead to the development of the auditory temporal processing hypothesis, which posits that SLI is causally related to the processing of rapidly changing sounds in aberrantly expanded windows of temporal integration. We tested a potential physiological basis for this observation by examining whether syllables varying in their consonant place of articulation (POA) with prolonged formant transitions would evoke better differentiated patterns of activation along the tonotopic axis of A1 in awake monkeys when compared to syllables with short formant transitions, especially for more prolonged windows of temporal integration. Amplitudes of multi-unit activity evoked by /ba/, /ga/, and /da/ were ranked according to predictions based on responses to tones centered at the spectral maxima of frication at syllable onset. Population responses representing consonant POA were predicted by the tone responses. Predictions were stronger for syllables with prolonged formant transitions, especially for longer windows of temporal integration. Relevance of findings to normal perception and that occurring in SLI are discussed.

Speech perception, rapid temporal processing, and the left hemisphere: a case study of unilateral pure word deafness

The mechanisms and functional anatomy underlying the early stages of speech perception are still not well understood. One way to investigate the cognitive and neural underpinnings of speech perception is by investigating patients with speech perception deficits but with preserved ability in other domains of language. One such case is reported here: patient NL shows highly impaired speech perception despite normal hearing ability and preserved semantic knowledge, speaking, and reading ability, and is thus classified as a case of pure word deafness (PWD). NL has a left temporoparietal lesion without right hemisphere damage and DTI imaging suggests that he has preserved cross-hemispheric connectivity, arguing against an account of PWD as a disconnection of left lateralized language areas from auditory input. Two experiments investigated whether NL's speech perception deficit could instead result from an underlying problem with rapid temporal processing. Experiment 1 showed that NL has particular difficulty discriminating sounds that differ in terms of rapid temporal changes, be they speech or non-speech sounds. Experiment 2 employed an intensive training program designed to improve rapid temporal processing in language impaired children (Fast ForWord; Scientific Learning Corporation, Oakland, CA) and found that NL was able to improve his ability to discriminate rapid temporal differences in non-speech sounds, but not in speech sounds. Overall, these data suggest that patients with unilateral PWD may, in fact, have a deficit in (left lateralized) temporal processing ability, however they also show that a rapid temporal processing deficit is, by itself, unable to account for this patient's speech perception deficit.

Explaining lexical-semantic deficits in specific language impairment: the role of phonological similarity, phonological working memory, and lexical competition

PURPOSE

In this study, the authors investigated potential explanations for sparse lexical-semantic representations in children with specific language impairment (SLI) and typically developing peers. The role of auditory perception, phonological working memory, and lexical competition were investigated.

METHOD

Participants included 32 children (ages 8;5-12;3 [years;months]): Sixteen children with SLI and 16 typically developing age- and nonverbal IQ-matched peers (CA). Children's word definitions were investigated. The words to be defined were manipulated for phonological neighborhood density. Nonword repetition and two lexical competition measures were tested as predictors of word definition abilities.

RESULTS

Children with SLI gave word definitions with fewer content details than children in the CA group. Compared with the CA group, the definitions of children in the SLI group were not disproportionately impacted by phonological neighborhood density. Lexical competition was a significant unique predictor of children's word definitions, but nonword repetition was not.

CONCLUSIONS

Individual differences in richness of lexical semantic representations as well as differences between children with SLI and typically developing peers may-at least, in part-be explained by processes of competition. However, difficulty with auditory perception or phonological working memory does not fully explain difficulties in lexical semantics.

Speech perception among school-aged skilled and less skilled readers

This study investigated the relationship between speech perception, phonological processing and reading skills among school-aged children classified as 'skilled' and 'less skilled' readers based on their ability to read words, decode non-words, and comprehend short passages. Three speech perception tasks involving categorization of speech continua differing in voicing, place and manner of articulation were administered and compared to phonological processing skills in phonological awareness, speeded naming and verbal short-term memory. The results obtained suggested that (a) speech categorization among skilled readers differed from that of less skilled readers, (b) speech perception skills were associated with both reading and phonological processing skills among both skilled and less skilled readers, however, (c) a strong association between speeded naming and both word and passage reading skills found among skilled readers was absent among less skilled readers. These results suggested that phonological representations and/or activation may not be as well developed in less skilled readers.