Auditory processing disorder evaluations and cognitive profiles of children with specific learning disorder

The Bender-Gestalt Test: A Systematic Review

The Bender-Gestalt test (Bender test), since its appearance, has been widely used to analyze visuomotor functions, perception and cognitive processes. However, it is often used in a variety of other contexts. The aim of this research is to study the use of the Bender test and the Bender-II, based on the results of studies conducted between 2013 and 2023. The search was carried out using inclusion and exclusion criteria and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The databases consulted were Medline, Embase and SciELO (Scientific Electronic Library Online), with no language restrictions. Study selection criteria included three steps: title, abstract and full text. The heterogeneity of study results precluded meta-analysis. Sixty-two articles were retrieved through the electronic search, and after reviewing abstracts and reading full texts, 25 articles were considered to meet our inclusion criteria. Among these, studies reveal that the Bender test is particularly useful for diagnosing neurodegenerative disorders such as dementia and Alzheimer's disease. In particular, several studies have demonstrated its effectiveness in assessing visuomotor functions and visual perception, with mixed results regarding its sensitivity and specificity. Key findings include improved detection of cognitive impairment in the early stages of Alzheimer's disease and a strong association between test performance and patients' neuropsychological status. In conclusion, although the Bender test is widely recognized and used in various clinical populations, its use remains subject to certain limitations. The main criticism concerns subjectivity in interpreting results and the variability of scores depending on cultural factors and the age of the individual.

Gonad-derived steroid hormones mediate a sex difference in the maturation of auditory encoding in the cochlea from adolescence to early adulthood in C57BL/6J mice

Sexually mature females of multiple mammalian species were previously reported to have increased peripheral auditory sensitivity, often measured as higher auditory brainstem response (ABR) wave I amplitude compared to males. Here, we determined potential hormonal and genetic (i.e., XX- vs. XY-linked genes) contributions to this sex difference by recording ABRs in gonadally intact and gonadectomized female and male wildtype (WT) and four core genotypes (FCG) C57BL/6J mice. WT females at postnatal day 38 (P38) and P65, and FCG mice with ovaries at P65 had higher wave I amplitude than males, and the difference was absent in gonadectomized mice. Furthermore, in WT mice, we addressed the initiation and duration of the sex difference in wave amplitude from pre-pubescence (P25) through maturation from post-pubescent late adolescence to early adulthood (P38, P65, and P95) in both the cochlea and cochlear nucleus. In both female and male mice, wave I amplitude decreased by 50 % from P25 to P95. However, the amplitude in females was 22 % and 11 % higher than males at P38 and P65, respectively. In gonadectomized mice, there was no sex difference in wave I amplitude at any age tested, due to a decrease in gonadectomized females. In contrast, we found that wave II amplitude remains relatively constant over these ages in both sham and gonadectomized WT female and male mice. Together, the data suggest that gonad-derived hormones differentially refine the maturation of wave I, but not wave II, amplitude between late adolescence and early adulthood.

Where do neurodevelopmental conditions fit in transdiagnostic psychiatric frameworks? Incorporating a new neurodevelopmental spectrum

Features of autism spectrum disorder, attention-deficit/hyperactivity disorder, learning disorders, intellectual disabilities, and communication and motor disorders usually emerge early in life and are associated with atypical neurodevelopment. These "neurodevelopmental conditions" are grouped together in the DSM-5 and ICD-11 to reflect their shared characteristics. Yet, reliance on categorical diagnoses poses significant challenges in both research and clinical settings (e.g., high co-occurrence, arbitrary diagnostic boundaries, high within-disorder heterogeneity). Taking a transdiagnostic dimensional approach provides a useful alternative for addressing these limitations, accounting for shared underpinnings across neurodevelopmental conditions, and characterizing their common co-occurrence and developmental continuity with other psychiatric conditions. Neurodevelopmental features have not been adequately considered in transdiagnostic psychiatric frameworks, although this would have fundamental implications for research and clinical practices. Growing evidence from studies on the structure of neurodevelopmental and other psychiatric conditions indicates that features of neurodevelopmental conditions cluster together, delineating a "neurodevelopmental spectrum" ranging from normative to impairing profiles. Studies on shared genetic underpinnings, overlapping cognitive and neural profiles, and similar developmental course and efficacy of support/treatment strategies indicate the validity of this neurodevelopmental spectrum. Further, characterizing this spectrum alongside other psychiatric dimensions has clinical utility, as it provides a fuller view of an individual's needs and strengths, and greater prognostic utility than diagnostic categories. Based on this compelling body of evidence, we argue that incorporating a new neurodevelopmental spectrum into transdiagnostic frameworks has considerable potential for transforming our understanding, classification, assessment, and clinical practices around neurodevelopmental and other psychiatric conditions.

Changes in Auditory Evoked Potentials Increase the Chances of Adults Having Central Auditory Processing Disorder

Introduction  Auditory evoked potentials are widely used in clinical practice to complement the assessment of central auditory processing. However, it is necessary to understand whether these potentials are highly accurate, to assist in the diagnosis of auditory processing disorder. Objective  To measure the accuracy of middle and long latency auditory evoked potentials in the diagnosis of auditory processing disorder in adults. Methods  This is a case-control study, formed by a control group of 30 individuals with normal auditory processing assessment, and a case group composed of 43 individuals with altered auditory processing assessment. Their sensitivities, specificities, accuracies, positive and negative predictive values for the diagnosis of alterations were measured and compared between the potentials. Results  The accuracies of the middle and long latency potentials were 51% and 67%, respectively. The P1-N1-P2 and N2-P300 complexes had an accuracy of 57.5% and 58.9%, respectively. The cognitive potential P300 showed an accuracy of 55%. There was no significant result for the middle-latency potential (OR = 1.8; 95% CI: 0.6-5.4, p  > 0.42) and for P300 (OR = 2.63, 95% CI: 0.85-8.43, p  > 0.11). However, the result was significant for the long-latency potential (OR = 6.3; 95% CI: 2-19.6, p  < 0.01). There was a significant result for the P1-N1-P2 complexes (OR = 6.76, 95% CI:1.4-32.5, p  = < 0.010) and N2-P300 (OR = 3.60; 95% CI: 10.16-11.20, p  < 0.039). Conclusion  Individuals with altered long-latency auditory evoked potential are more likely to have auditory processing disorder and, as such, this test can be used as a complementary tool to confirm the diagnosis.

Long Latency Auditory Evoked Responses in the Identification of Children With Central Auditory Processing Disorders: A Scoping Review

PURPOSE

The long latency auditory evoked responses (LLAERs), originating in the auditory cortex, are often considered a biomarker for maturity in the central auditory system and may therefore be useful in the evaluation of children with central auditory processing disorder (CAPD). However, the characteristics of the LLAERs elicited in this population have not been widely described, and clinical applications remain unclear. The goal of this scoping review was to investigate if LLAERs can be used to identify children with CAPD.

METHOD

A systematic search strategy was used to identify studies that analyzed the latencies and amplitudes of P1, N1, P2, and N2 waveforms of the LLAERs. The online databases, including Embase, Web of Science, MEDLINE, PubMed, ProQuest, and CINAHL, as well as the gray literature were searched for papers published in English and French between January 1980 and May 2021.

RESULTS

Seventeen papers met the eligibility criteria and were included in the study. Four papers had pre- and posttraining study designs, and the remaining studies were cross-sectional. Several studies reported significant differences in LLAERs between children with CAPD and their normal-hearing peers, and the results tended toward longer latencies and smaller amplitudes regardless of LLAER waves considered. N1 and/or N2 results were most likely to reveal significant differences between children with CAPD and normal-hearing controls and could potentially be considered a biomarker for CAPD.

CONCLUSIONS

It seems that LLAER assessments, especially waves N1 and N2, might assist in better identification of CAPD children. However, considering heterogeneity in the methodology among the included studies, the results should be interpreted with caution. Well-designed studies on children with confirmed CAPD using standard diagnostic and assessment protocols are suggested.

AudBility: test-retest reliability in typically developing children aged 6 to 7 years

PURPOSE

to investigate the test-retest reliability of the AudBility program in typically developing children aged six-seven years.

METHODS

29 children, male and female, right-handed, native Portuguese speakers and adequate school performance for the age group studied, underwent previous meatoscopy, immittance measurements and the AudBility program was applied, composed of a self-perception questionnaire and auditory tasks, being analyzed the abilities of sound localization, auditory closure, figure-ground, dichotic digits test, temporal resolution, and temporal ordering of frequency and duration. The program was designed and reapplied with an interval of one week under the same conditions. The performance in each task was presented from central tendency and dispersion data and was conducted using the Intraclass Correlation Coefficient (ICC), based on the 95% confidence interval (CI).

RESULTS

The analyses showed a positive and significant ICC (p<0.01) for the questionnaire and auditory tasks, except for auditory closure, in the right and left ears and figure-ground in the left ear. The questionnaire mean ICC was 0.742 and ranged from -0.012 to 0.698 for the auditory tasks.

CONCLUSION

Based on mean results and upper limit of the CI, the findings showed agreement between moments, classified as good for the questionnaire and moderate to good for five of the seven auditory analyzed tasks (ICC>0.05 and <0.9). The results of the reliability study represent an important parameter for validating the program for the studied age group.

AudBility: test-retest reliability in typically developing children aged 6 to 7 years

ABSTRACT Purpose to investigate the test-retest reliability of the AudBility program in typically developing children aged six-seven years. Methods 29 children, male and female, right-handed, native Portuguese speakers and adequate school performance for the age group studied, underwent previous meatoscopy, immittance measurements and the AudBility program was applied, composed of a self-perception questionnaire and auditory tasks, being analyzed the abilities of sound localization, auditory closure, figure-ground, dichotic digits test, temporal resolution, and temporal ordering of frequency and duration. The program was designed and reapplied with an interval of one week under the same conditions. The performance in each task was presented from central tendency and dispersion data and was conducted using the Intraclass Correlation Coefficient (ICC), based on the 95% confidence interval (CI). Results The analyses showed a positive and significant ICC (p<0.01) for the questionnaire and auditory tasks, except for auditory closure, in the right and left ears and figure-ground in the left ear. The questionnaire mean ICC was 0.742 and ranged from −0.012 to 0.698 for the auditory tasks. Conclusion Based on mean results and upper limit of the CI, the findings showed agreement between moments, classified as good for the questionnaire and moderate to good for five of the seven auditory analyzed tasks (ICC>0.05 and <0.9). The results of the reliability study represent an important parameter for validating the program for the studied age group.

Cortical auditory evoked potentials with different acoustic stimuli: Evidence of differences and similarities in coding in auditory processing disorders

OBJECTIVES

The use of cortical auditory evoked potentials allows for the study of the processing of acoustic signals at the cortical level, an important step in the diagnostic evaluation process, and for the monitoring of the therapeutic process associated with auditory processing disorders (APD). The differences and similarities in the acoustic coding between different types of stimuli in the context of APD remain unknown to this date.

METHODS

A total of 37 children aged between 7 and 11 years, with and without APDs (identified based on verbal and non-verbal tests), all with a suitable intelligence quotient with respect to their chronological age, were assessed. Components P1 and N1 were studied using verbal and non-verbal stimuli.

RESULTS

The comparison between stimuli in each group revealed that the control group had higher latency and amplitude values for speech stimuli, except for the P1 amplitude, while the group with APDs had different results with respect to the amplitudes of P1 and N1, yielding higher values for speech sounds. The differences between the groups varied according to the type of stimulus: the difference was in amplitude for the verbal stimulus and latency for the non-verbal stimulus.

CONCLUSION

The records of components P1 and N1 revealed that the children with APDs performed the coding underlying the detection and identification of acoustic signals, whether verbal and non-verbal, according to a different pattern than the children in the control group.