Auditory processing deficits in children with reading and language impairments: Can they (and should they) be treated?

A novel paradigm for measuring prediction abilities in a rat model using a speech-sound discrimination task

The ability to predict and respond to upcoming stimuli is a critical skill for all animals, including humans. Prediction operates largely below conscious awareness to allow an individual to recall previously encountered stimuli and prepare an appropriate response, especially in language. The ability to predict upcoming words within typical speech patterns aids fluent comprehension, as conversational speech occurs quickly. Individuals with certain neurodevelopmental disorders such as autism and dyslexia have deficits in their ability to generate and use predictions. Rodent models are often used to investigate specific aspects of these disorders, but there is no existing behavioral paradigm that can assess prediction capabilities with complex stimuli like speech sounds. Thus, the present study modified an existing rapid speech sound discrimination paradigm to assess whether rats can form predictions of upcoming speech sound stimuli and utilize them to improve task performance. We replicated prior work showing that rats can discriminate between speech sounds presented at rapid rates. We also saw that rats responded exclusively to the target at slow speeds but began responding to the predictive cue in anticipation of the target as the speed increased, suggesting that they learned the predictive value of the cue and adjusted their behavior accordingly. This prediction task will be useful in assessing prediction deficits in rat models of various neurodevelopmental disorders through the manipulation of both genetic and environmental factors.

Music-Based and Auditory-Based Interventions for Reading Difficulties: A Literature Review

Remediation of reading difficulties through music and auditory-based interventions in children with impairments in reading (such as developmental dyslexia) has been suggested in light of the putative neural and cognitive overlaps between the music and language domains. Several studies had explored the effect of music training on reading development, showing mixed results. However, to date, the meta-analyses on this topic did not differentiate the studies on typical children from those on children with reading difficulties. To draw a clear picture of the remedial effects of music-based and auditory-based interventions, the present review of the literature included studies on struggling readers only. Eighteen studies have been categorized according to the type of the main training activity – either specific auditory training or more broad music training – and the combination with reading exercises. The reviewed studies showed that musical and auditory interventions yielded a positive, but not consistent, effect on reading. Nevertheless, significantly larger improvements of phonological abilities, relative to the control conditions, were overall reported. These findings support the hypothesis of a transfer effect of musical and auditory training on phonological and literacy skills in children with reading difficulties.

Speech Perception in Noise Predicts Oral Narrative Comprehension in Children With Developmental Language Disorder

We examined the relative contribution of auditory processing abilities (tone perception and speech perception in noise) after controlling for short-term memory capacity and vocabulary, to narrative language comprehension in children with developmental language disorder. Two hundred and sixteen children with developmental language disorder, ages 6 to 9 years (Mean = 7; 6), were administered multiple measures. The dependent variable was children's score on the narrative comprehension scale of the Test of Narrative Language. Predictors were auditory processing abilities, phonological short-term memory capacity, and language (vocabulary) factors, with age, speech perception in quiet, and non-verbal IQ as covariates. Results showed that narrative comprehension was positively correlated with the majority of the predictors. Regression analysis suggested that speech perception in noise contributed uniquely to narrative comprehension in children with developmental language disorder, over and above all other predictors; however, tone perception tasks failed to explain unique variance. The relative importance of speech perception in noise over tone-perception measures for language comprehension reinforces the need for the assessment and management of listening in noise deficits and makes a compelling case for the functional implications of complex listening situations for children with developmental language disorder.

A preliminary investigation of sound-field amplification as an inclusive classroom adjustment for children with and without Autism Spectrum Disorder

PURPOSE

This study aimed to determine if sound-field amplification (SFA) could be used as an inclusive classroom adjustment to support primary school students with and without Autism Spectrum Disorder (ASD).

METHODS

A two-group, randomised controlled trial (RCT) with crossover was conducted involving 13 students with ASD (9 males, aged 7.6 to 8.4 years) and 17 typically progressing students without ASD (7 males, aged 7.6 to 9.3 years) from 10 primary schools in and near to Brisbane, Australia. Eighteen of these children had an SFA system in their classrooms in semester one and 12 in semester two of their fourth year of formal schooling (Year 3). Potential proximate benefits were assessed using teacher questionnaire and video analysis of student listening behaviours. Potential distant benefits were assessed using measures of phonological processing in quiet and in noise, attention, memory, and educational achievement.

RESULTS

Potential proximate benefits were observed for all students with teachers rating student listening behaviours higher with SFA versus without SFA. Potential distant benefits were observed for students with ASD who showed greater improvements in one area of phonological processing (blending nonsense words in noise) following SFA versus no SFA. No other potential proximate or distant benefits following SFA were observed.

CONCLUSIONS

SFA could be used as an inclusive classroom adjustment to support some primary school students with and without ASD by potentially putting those students in a better position to learn, but their learning must still take place over time and realistic expectations of what can reasonably be achieved by SFA alone are needed.

[Effects of the Computer-Based Grapho-Phonological Training Lautarium in Children with Developmental Dyslexia]

Effects of the Computer-Based Grapho-Phonological Training Lautarium in Children with Developmental Dyslexia The effects of the computer-based training program Lautarium on phonological awareness and literacy skills were investigated in 41 third-grade children with developmental dyslexia who attended special dyslexia classes in a primary school in Saxony, Germany. Based on the proven efficacy of phonics-based instruction, Lautarium combines training of phoneme perception and phonological awareness with training of grapheme-phoneme-relationships and reading and spelling of transparent words. In addition, rapid access from written words to meaning is included. The children of the training group (N = 27) worked through the program during school lessons, 5 times per week for 30 minutes, for a period of 7 weeks. During the training period, the controls (N = 14) received traditional remedial reading instruction, 2-3 times per week, in small groups. Children's performance in phonological awareness, reading, and spelling was assessed at three time points (pretest, immediate posttest, and follow-up after 9 weeks). Pretest scores did not differ between groups. For spelling and subtests of phonological awareness, group comparisons of raw scores at posttest and follow-up including the respective pretest score as covariate confirmed stronger improvements in the training group when compared to the controls. Effect sizes were medium to strong. For reading, improvements did not differ between groups. In both groups, standard scores (T-scores) for reading and spelling increased significantly and substantially across the study period (from pretest to follow-up). The results confirm the efficacy of computer-based training with Lautarium in children with dyslexia, and the efficacy of school-based remedial instruction provided in the dyslexia classes.

Auditory Training to Improve Speech Perception and Self-Efficacy in Aging Adults

Purpose Difficulty in understanding spoken speech is a common complaint among aging adults, even when hearing impairment is absent. Correlational studies point to a relationship between age, auditory temporal processing (ATP), and speech perception but cannot demonstrate causality unlike training studies. In the current study, we test (a) the causal relationship between a spatial-temporal ATP task (temporal order judgment [TOJ]) and speech perception among aging adults using a training design and (b) whether improvement in aging adult speech perception is accompanied by improved self-efficacy. Method Eighty-two participants aged 60-83 years were randomly assigned to a group receiving (a) ATP training (TOJ) over 14 days, (b) non-ATP training (intensity discrimination) over 14 days, or (c) no training. Results The data showed that TOJ training elicited improvement in all speech perception tests, which was accompanied by increased self-efficacy. Neither improvement in speech perception nor self-efficacy was evident following non-ATP training or no training. Conclusions There was no generalization of the improvement resulting from TOJ training to intensity discrimination or generalization of improvement resulting from intensity discrimination training to speech perception. These findings imply that the effect of TOJ training on speech perception is specific and such improvement is not simply the product of generally improved auditory perception. It provides support for the idea that temporal properties of speech are indeed crucial for speech perception. Clinically, the findings suggest that aging adults can be trained to improve their speech perception, specifically through computer-based auditory training, and this may improve perceived self-efficacy.

On the Relationship Between General Auditory Sensitivity and Speech Perception: An Examination of Pitch and Lexical Tone Perception in 4- to 6-Year-Old Children

Purpose Theoretical models and substantial research have proposed that general auditory sensitivity is a developmental foundation for speech perception and language acquisition. Nonetheless, controversies exist about the effectiveness of general auditory training in improving speech and language skills. This research investigated the relationships among general auditory sensitivity, phonemic speech perception, and word-level speech perception via the examination of pitch and lexical tone perception in children. Method Forty-eight typically developing 4- to 6-year-old Cantonese-speaking children were tested on the discrimination of the pitch patterns of lexical tones in synthetic stimuli, discrimination of naturally produced lexical tones, and identification of lexical tone in familiar words. Results The findings revealed that accurate lexical tone discrimination and identification did not necessarily entail the accurate discrimination of nonlinguistic stimuli that followed the pitch levels and pitch shapes of lexical tones. Although pitch discrimination and tone discrimination abilities were strongly correlated, accuracy in pitch discrimination was lower than that in tone discrimination, and nonspeech pitch discrimination ability did not precede linguistic tone discrimination in the developmental trajectory. Conclusions Contradicting the theoretical models, the findings of this study suggest that general auditory sensitivity and speech perception may not be causally or hierarchically related. The finding that accuracy in pitch discrimination is lower than that in tone discrimination suggests that comparable nonlinguistic auditory perceptual ability may not be necessary for accurate speech perception and language learning. The results cast doubt on the use of nonlinguistic auditory perceptual training to improve children's speech, language, and literacy abilities.

Auditory frequency discrimination in developmental dyslexia: A meta-analysis

Auditory frequency discrimination has been used as an index of sensory processing in developmental language disorders such as dyslexia, where group differences have often been interpreted as evidence for a basic deficit in auditory processing that underpins and constrains individual variability in the development of phonological skills. Here, we conducted a meta-analysis to evaluate the cumulative evidence for group differences in frequency discrimination and to explore the impact of some potential moderator variables that could contribute to variability in effect-size estimations across studies. Our analyses revealed mean effect sizes for group differences on frequency discrimination tasks on the order of three-quarters of a standard deviation, but in the presence of substantial inter-study variability in their magnitude. Moderator variable analyses indicated that factors related both to participant variability on behavioural and cognitive variables associated with the dyslexia phenotype, and to variability in the task design, contributed to differences in the magnitude of effect size across studies. The apparently complex pattern of results was compounded by the lack of concurrent, standardised metrics of cognitive and reading component skills across the constituent studies. Differences on sensory processing tasks are often reported in studies of developmental disorders, but these need to be more carefully interpreted in the context of non-sensory factors, which may explain significant inter- and intra-group variance in the dependent measure of interest.

Comorbidity of Auditory Processing, Attention, and Memory in Children With Word Reading Difficulties

OBJECTIVES

To document the auditory processing, visual attention, digit memory, phonological processing, and receptive language abilities of individual children with identified word reading difficulties.

DESIGN

Twenty-five children with word reading difficulties and 28 control children with good word reading skills participated. All children were aged between 8 and 11 years, with normal hearing sensitivity and typical non-verbal intelligence. Both groups of children completed a test battery designed to assess their auditory processing, visual attention, digit memory, phonological processing, and receptive language.

RESULTS

When compared to children who were good readers, children with word reading difficulties obtained significantly lower average scores on tests of auditory processing, including the frequency pattern test, gaps in noise, frequency discrimination, Dichotic Digit difference Test, and Listening in Spatialized Noise. The two groups did not differ on the discrimination measures of sinusoidal amplitude modulation or iterated rippled noise. The results from children with word reading difficulties showed that 5 children (20%) had comorbid deficits in auditory processing, visual attention, and backward digit memory; whereas 12 children (48%) had comorbid auditory processing and visual attention deficits only, and 2 children (8%) had comorbid deficits in auditory processing and digit memory; the remaining children had only auditory processing, visual attention, or digit memory deficits.

CONCLUSION

The current study highlights the general co-existence of auditory processing, memory, and visual attention deficits in children with word reading difficulties. It is also noteworthy, however, that only one fifth of the current cohort had deficits across all measured tasks. Hence, our results also show the significant individual variability inherent in children with word reading difficulties.

Consequential differences in perspectives and practices concerning children with developmental language disorders: an integrative review

BACKGROUND

Inter-professional collaboration (IPC) has been recommended for many years as a means by which the needs of children with developmental language disorders (DLD) can be met at school. However, effective IPC remains difficult to achieve and our knowledge of how to support it is limited. A shared understanding between those involved has been identified as critical to IPC.

AIMS

To examine the literature, as one source of data, for evidence of a shared understanding between the fields of speech and language therapy (SLT) and education about children with DLD and how such needs can best be met at school.

METHODS & PROCEDURES

An integrative review of the literature was undertaken. A systematic search of the published, peer-reviewed literature (between 2006 and 2016) was conducted for empirical and theoretical papers and a manual search was undertaken to obtain a representative sample of policy/professional guidelines. A total of 81 papers across SLT and education were included in the review. The papers were scrutinized using a qualitative content analysis.

MAIN CONTRIBUTION

Although some commonality between perspectives in the literature was identified, differences between the fields dominated. These differences related to how DLD is conceptualized; how children's needs are assessed; which outcomes are prioritized and how best these outcomes can be achieved. We also found differences about what constitutes useful knowledge to guide practice. We suggest that the nature of the differences we identified in the literature may have negative implications for practitioners wishing to collaborate to meet the needs of children with DLD in school. The perspectives of practising SLTs and teachers need to be sought to determine whether the findings from the literature reflect dilemmas in practice.

CONCLUSIONS

Effective IPC is essential to meet the needs of children with DLD in school; yet, it remains difficult to achieve. Our review of the literature across SLT and education indicates evidence of a lack of shared understanding about DLD. If these differences are also evident in practice, then a conceptual model to support IPC may be warranted.

Language Skills, but Not Frequency Discrimination, Predict Reading Skills in Children at Risk of Dyslexia

This study evaluated the claim that auditory processing deficits are a cause of reading and language difficulties. We report a longitudinal study of 245 children at family risk of dyslexia, children with preschool language impairments, and control children. Children with language impairments had poorer frequency-discrimination thresholds than controls at 5.5 years, but children at family risk of dyslexia did not. A model assessing longitudinal relationships among frequency discrimination, reading, language, and executive function skills showed that frequency discrimination was predicted by executive skills but was not a longitudinal predictor of reading or language skills. Our findings contradict the hypothesis that frequency discrimination is causally related to dyslexia or language impairment and suggest that individuals at risk for dyslexia or who have language impairments may perform poorly on auditory processing tasks because of comorbid attentional difficulties.

Language Development and Impairment in Children With Mild to Moderate Sensorineural Hearing Loss

PURPOSE

The goal of this study was to examine language development and factors related to language impairments in children with mild to moderate sensorineural hearing loss (MMHL).

METHOD

Ninety children, aged 8-16 years (46 children with MMHL; 44 aged-matched controls), were administered a battery of standardized language assessments, including measures of phonological processing, receptive and expressive vocabulary and grammar, word and nonword reading, and parental report of communication skills. Group differences were examined after controlling for nonverbal ability.

RESULTS

Children with MMHL performed as well as controls on receptive vocabulary and word and nonword reading. They also performed within normal limits, albeit significantly worse than controls, on expressive vocabulary, and on receptive and expressive grammar, and worse than both controls and standardized norms on phonological processing and parental report of communication skills. However, there was considerable variation in performance, with 26% showing evidence of clinically significant oral or written language impairments. Poor performance was not linked to severity of hearing loss nor age of diagnosis. Rather, outcomes were related to nonverbal ability, maternal education, and presence/absence of family history of language problems.

CONCLUSIONS

Clinically significant language impairments are not an inevitable consequence of MMHL. Risk factors appear to include lower maternal education and family history of language problems, whereas nonverbal ability may constitute a protective factor.

Auditory perception and word recognition in Cantonese-Chinese speaking children with and without Specific Language Impairment

Auditory processing and spoken word recognition difficulties have been observed in Specific Language Impairment (SLI), raising the possibility that auditory perceptual deficits disrupt word recognition and, in turn, phonological processing and oral language. In this study, fifty-seven kindergarten children with SLI and fifty-three language-typical age-matched controls were assessed with a speech-gating task to measure spoken word recognition, psychophysical tasks to measure auditory Frequency Modulation (FM) detection and Frequency Discrimination (FD), and standardized psychometric tests of phonological processing and oral language. As a group, children with SLI took significantly longer than language-typical controls to recognize words with high neighborhood density, perhaps reflecting subpar phonological representations. FM, but not FD, was significantly worse in SLI. However, while both poorer speech-gating performance and poorer auditory thresholds (FM) were evident in SLI, spoken word recognition did not mediate any relation between auditory perception and either phonological processing or oral language.

Predicting dyslexia using prereading skills: the role of sensorimotor and cognitive abilities

BACKGROUND

It is well established that phonological awareness, print knowledge and rapid naming predict later reading difficulties. However, additional auditory, visual and motor difficulties have also been observed in dyslexic children. It is examined to what extent these difficulties can be used to predict later literacy difficulties.

METHOD

An unselected sample of 267 children at school entry completed a wide battery of tasks associated with dyslexia. Their reading was tested 2, 3 and 4 years later and poor readers were identified (n = 42). Logistic regression and multiple case study approaches were used to examine the predictive validity of different tasks.

RESULTS

As expected, print knowledge, verbal short-term memory, phonological awareness and rapid naming were good predictors of later poor reading. Deficits in visual search and in auditory processing were also present in a large minority of the poor readers. Almost all poor readers showed deficits in at least one area at school entry, but there was no single deficit that characterised the majority of poor readers.

CONCLUSIONS

Results are in line with Pennington's () multiple deficits view of dyslexia. They indicate that the causes of poor reading outcome are multiple, interacting and probabilistic, rather than deterministic.

Auditory Training for Central Auditory Processing Disorder

Auditory training (AT) is an important component of rehabilitation for patients with central auditory processing disorder (CAPD). The present article identifies and describes aspects of AT as they relate to applications in this population. A description of the types of auditory processes along with information on relevant AT protocols that can be used to address these specific deficits is included. Characteristics and principles of effective AT procedures also are detailed in light of research that reflects on their value. Finally, research investigating AT in populations who show CAPD or present with auditory complaints is reported. Although efficacy data in this area are still emerging, current findings support the use of AT for treatment of auditory difficulties.

Sight Word and Phonics Training in Children With Dyslexia

The aims of this study were to (a) compare sight word training and phonics training in children with dyslexia, and (b) determine if different orders of sight word and phonics training have different effects on the reading skills of children with dyslexia. One group of children (n = 36) did 8 weeks of phonics training (reading via grapheme-phoneme correspondence rules) and then 8 weeks of sight word training (reading irregular words as a whole), one group did the reverse (n = 36), and one group did phonics and sight word training simultaneously for two 8-week periods (n = 32). We measured the effects of phonics and sight word training on sight word reading (trained irregular word reading accuracy, untrained irregular word reading accuracy), phonics reading (nonword reading accuracy, nonword reading fluency), and general reading (word reading fluency, reading comprehension). Sight word training led to significant gains in sight word reading measures that were larger than gains made from phonics training, phonics training led to statistically significant gains in a phonics reading measure that were larger than gains made from sight word training, and both types of training led to significant gains in general reading that were similar in size. Training phonics before sight words had a slight advantage over the reverse order. We discuss the clinical implications of these findings for improving the treatment and assessment of children with dyslexia.

Reading disabilities in children: A selective meta-analysis of the cognitive literature

This article synthesizes literature that compares the academic, cognitive, and behavioral performance of children with and without reading disabilities (RD). Forty-eight studies met the criteria for the meta-analysis, yielding 735 effect sizes (ESs) with an overall weighted ES of 0.98. Small to high ESs in favor of children without RD emerged on measures of cognition (rapid naming [ES = 0.89], phonological awareness [ES = 1.00], verbal working memory [ES = 0.79], short-term memory [ES = 0.56], visual-spatial memory [ES = 0.48], and executive processing [ES = 0.67]), academic achievement (pseudoword reading [ES = 1.85], math [ES = 1.20], vocabulary [ES = 0.83], spelling [ES = 1.25], and writing [ES = 1.20]), and behavior skills (ES = 0.80). Hierarchical linear modeling indicated that specific cognitive process measures (verbal working memory, visual-spatial memory, executive processing, and short-term memory) and intelligence measures (general and verbal intelligence) significantly moderated overall group effect size differences. Overall, the results supported the assumption that cognitive deficits in children with RD are persistent.

Central auditory processing disorders in children and adults

Central auditory processing disorders (CAPD) can affect children and adults of all ages due to a wide variety of causes. CAPD is a neurobiologic deficit in the central auditory nervous system (CANS) that affects those mechanisms that underlie fundamental auditory perception, including localization and lateralization; discrimination of speech and non-speech sounds; auditory pattern recognition; temporal aspects of audition, including integration, resolution, ordering, and masking; and auditory performance with competing and/or degraded acoustic signals (American Speech-Language-Hearing Association, 2005a, b). Although it is recognized that central auditory dysfunction may coexist with other disorders, CAPD is conceptualized as a sensory-based auditory disorder. Administration of behavioral and/or electrophysiologic audiologic tests that have been shown to be sensitive and specific to dysfunction of the CANS is critical for a proper diagnosis of CAPD, in addition to assessments and collaboration with a multidisciplinary team. Intervention recommendations for CAPD diagnosis are based on the demonstrated auditory processing deficits and related listening and related complaints. This chapter provides an overview of current definitions and conceptualizations, methods of diagnosis of, and intervention for, CAPD. The chapter culminates with a case study illustrating pre- and posttreatment behavioral and electrophysiologic diagnostic findings.

Strategy choice mediates the link between auditory processing and spelling

Relations among linguistic auditory processing, nonlinguistic auditory processing, spelling ability, and spelling strategy choice were examined. Sixty-three undergraduate students completed measures of auditory processing (one involving distinguishing similar tones, one involving distinguishing similar phonemes, and one involving selecting appropriate spellings for individual phonemes). Participants also completed a modified version of a standardized spelling test, and a secondary spelling test with retrospective strategy reports. Once testing was completed, participants were divided into phonological versus nonphonological spellers on the basis of the number of words they spelled using phonological strategies only. Results indicated a) moderate to strong positive correlations among the different auditory processing tasks in terms of reaction time, but not accuracy levels, and b) weak to moderate positive correlations between measures of linguistic auditory processing (phoneme distinction and phoneme spelling choice in the presence of foils) and spelling ability for phonological spellers, but not for nonphonological spellers. These results suggest a possible explanation for past contradictory research on auditory processing and spelling, which has been divided in terms of whether or not disabled spellers seemed to have poorer auditory processing than did typically developing spellers, and suggest implications for teaching spelling to children with good versus poor auditory processing abilities.

Auditory processing disorders: relationship to cognitive processes and underlying auditory neural integrity

BACKGROUND

Auditory processing disorder (APD) in children has been reported and discussed in the clinical and research literature for many years yet there remains poor agreement on diagnostic criteria, the relationship between APD and cognitive skills, and the importance of assessing underlying neural integrity.

PURPOSE

The present study used a repeated measures design to examine the relationship between a clinical APD diagnosis achieved with behavioral tests used in many clinics, cognitive abilities measured with standardized tests of intelligence, academic achievement, language, phonology, memory and attention and measures of auditory neural integrity as measured with acoustic reflex thresholds and auditory brainstem responses.

METHOD

Participants were 63 children, 7-17 years of age, who reported listening difficulties in spite of normal hearing thresholds. Parents/guardians completed surveys about the child's auditory and attention behavior while children completed an audiologic examination that included 5 behavioral tests of auditory processing ability. Standardized tests that examined intelligence, academic achievement, language, phonology, memory and attention, and objective tests auditory function included crossed and uncrossed acoustic reflex thresholds and auditory brainstem responses (ABR) were also administered to each child.

RESULTS

Forty of the children received an APD diagnosis based on the 5 behavioral tests and 23 did not. The groups of children performed similarly on intelligence measures but the children with an APD diagnosis tended to perform more poorly on other cognitive measures. Auditory brainstem responses and acoustic reflex thresholds were often abnormal in both groups of children.

SUMMARY

Results of this study suggest that a purely behavioral test battery may be insufficient to accurately identify all children with auditory processing disorders. Physiologic test measures, including acoustic reflex and auditory brainstem response tests, are important indicators of auditory function and may be the only indication of a problem. The results also suggest that performance on behavioral APD tests may be strongly influenced by the child's language levels.

Developmental disorders: what can be learned from cognitive neuropsychology?

The discipline of cognitive neuropsychology has been important for informing theories of cognition and describing the nature of acquired cognitive disorders, but its applicability in a developmental context has been questioned. Here, we revisit this issue, asking whether the cognitive neuropsychological approach can be helpful for exploring the nature and causes of developmental disorders and, if so, how. We outline the key features of the cognitive neuropsychological approach, and then consider how some of the major challenges to this approach from a developmental perspective might be met. In doing so, we distinguish between challenges to the methods of cognitive neuropsychology and those facing its deeper conceptual underpinnings. We conclude that the detailed investigation of patterns of both associations and dissociations, and across both developmental and acquired cases, can assist in describing the cognitive deficits within developmental disorders and in delineating possible causal pathways to their acquisition.

Electrophysiological measures of attention during speech perception predict metalinguistic skills in children

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5-Year-old children attend to the initial portions of words in continuous speech.

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The attention effect's magnitude is correlated with linguistic as opposed to nonlinguistic skills.

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Specifically, attention in speech predicts performance on a complex metalinguistic task.

Event-related potential (ERP) evidence demonstrates that preschool-aged children selectively attend to informative moments such as word onsets during speech perception. Although this observation indicates a role for attention in language processing, it is unclear whether this type of attention is part of basic speech perception mechanisms, higher-level language skills, or general cognitive abilities. The current study examined these possibilities by measuring ERPs from 5-year-old children listening to a narrative containing attention probes presented before, during, and after word onsets as well as at random control times. Children also completed behavioral tests assessing verbal and nonverbal skills. Probes presented after word onsets elicited a more negative ERP response beginning around 100 ms after probe onset than control probes, indicating increased attention to word-initial segments. Crucially, the magnitude of this difference was correlated with performance on verbal tasks, but showed no relationship to nonverbal measures. More specifically, ERP attention effects were most strongly correlated with performance on a complex metalinguistic task involving grammaticality judgments. These results demonstrate that effective allocation of attention during speech perception supports higher-level, controlled language processing in children by allowing them to focus on relevant information at individual word and complex sentence levels.

Musical experience, auditory perception and reading-related skills in children

BACKGROUND

The relationships between auditory processing and reading-related skills remain poorly understood despite intensive research. Here we focus on the potential role of musical experience as a confounding factor. Specifically we ask whether the pattern of correlations between auditory and reading related skills differ between children with different amounts of musical experience.

METHODOLOGY/PRINCIPAL FINDINGS

Third grade children with various degrees of musical experience were tested on a battery of auditory processing and reading related tasks. Very poor auditory thresholds and poor memory skills were abundant only among children with no musical education. In this population, indices of auditory processing (frequency and interval discrimination thresholds) were significantly correlated with and accounted for up to 13% of the variance in reading related skills. Among children with more than one year of musical training, auditory processing indices were better, yet reading related skills were not correlated with them. A potential interpretation for the reduction in the correlations might be that auditory and reading-related skills improve at different rates as a function of musical training.

CONCLUSIONS/SIGNIFICANCE

Participants' previous musical training, which is typically ignored in studies assessing the relations between auditory and reading related skills, should be considered. Very poor auditory and memory skills are rare among children with even a short period of musical training, suggesting musical training could have an impact on both. The lack of correlation in the musically trained population suggests that a short period of musical training does not enhance reading related skills of individuals with within-normal auditory processing skills. Further studies are required to determine whether the associations between musical training, auditory processing and memory are indeed causal or whether children with poor auditory and memory skills are less likely to study music and if so, why this is the case.

Basic auditory processing deficits in dyslexia: systematic review of the behavioral and event-related potential/ field evidence

A review of research that uses behavioral, electroencephalographic, and/or magnetoencephalographic methods to investigate auditory processing deficits in individuals with dyslexia is presented. Findings show that measures of frequency, rise time, and duration discrimination as well as amplitude modulation and frequency modulation detection were most often impaired in individuals with dyslexia. Less consistent findings were found for intensity and gap perception. Additional factors that mediate auditory processing deficits in individuals with dyslexia and their implications are discussed.

Word stress processing in specific language impairment: auditory or representational deficits?

Word stress processing has repeatedly been reported to be affected in specific language impairment (SLI) with potential consequences for various aspects of language development. However, it still remains unresolved whether word stress impairments in SLI are due to deficits in basic auditory processing or to a degraded phonological representation or both. We addressed this question examining an unselected sample of 10 children with SLI and 11 typically developing (TD) children, aged about 8 years, with respect to their basic auditory processing (duration and skewness discrimination) and phonological representation of prosodic (word stress) and segmental (consonant) contrasts. Our results show lower performance of the SLI group compared to the TD group in all tasks. Crucially, two subgroups of children with SLI emerged from our analyses: While one group was impaired in basic auditory perception, particularly affecting duration discrimination, the other showed no significant auditory processing deficits but a representational impairment.

Psychophysical estimates of frequency discrimination: more than just limitations of auditory processing

Efficient auditory processing is hypothesized to support language and literacy development. However, behavioral tasks used to assess this hypothesis need to be robust to non-auditory specific individual differences. This study compared frequency discrimination abilities in a heterogeneous sample of adults using two different psychoacoustic task designs, referred to here as: 2I_6A_X and 3I_2AFC designs. The role of individual differences in nonverbal IQ (NVIQ), socioeconomic status (SES) and musical experience in predicting frequency discrimination thresholds on each task were assessed using multiple regression analyses. The 2I_6A_X task was more cognitively demanding and hence more susceptible to differences specifically in SES and musical training. Performance on this task did not, however, relate to nonword repetition ability (a measure of language learning capacity). The 3I_2AFC task, by contrast, was only susceptible to musical training. Moreover, thresholds measured using it predicted some variance in nonword repetition performance. This design thus seems suitable for use in studies addressing questions regarding the role of auditory processing in supporting language and literacy development.

Phonologische Verarbeitung bei Grundschulkindern mit schwacher Lesefähigkeit

Defizite in der phonologischen Informationsverarbeitung werden heute als Kernsymptom der Lese-Rechtschreibstörung betrachtet. In Trainingsstudien mit betroffenen Kindern erwiesen sich Phonemwahrnehmungsfähigkeiten als trainierbar, und Programme, in denen Aufgaben zur phonologischen Bewusstheit mit der systematischen Vermittlung von Phonem-Graphem-Zuordnungen kombiniert wurden, zeigten Transfereffekte auf Lese- und Rechtschreibleistungen. Ausgehend von diesen Erkenntnissen wurde ein computerbasiertes Trainingsprogramm zur Förderung der Phonemwahrnehmung, der phonologischen Bewusstheit und der Graphem-Phonem-Zuordnungen für deutschsprachige Grundschulkinder mit Lese-Rechtschreibstörung entwickelt. Aufgrund der besonderen Relevanz der Vokallänge für die deutsche Orthographie enthält das Programm neben Aufgaben, die auf Konsonanten fokussieren, auch Vokallängenaufgaben. Bei der Konzipierung des Programms wurden etablierte, ursprünglich für andere Sprachen entwickelte Aufgaben an die deutsche Phonologie angepasst und in ein computerbasiertes Format übersetzt. Im Rahmen der vorliegenden Studie sollte überprüft werden, ob die konstruierten Trainingsaufgaben die spezifischen Defizite von Kindern mit Lese-Rechtschreibstörung wie intendiert abbilden. Hierzu wurden leseschwache Dritt- und Viertklässler (n = 35) mit mindestens durchschnittlichen Lesern derselben Klassenstufen (n = 75; Kontrollgruppe) hinsichtlich ihrer Leistungen in den Aufgaben verglichen. Die leseschwachen Kinder zeigten in allen Aufgaben schlechtere Leistungen als die Kontrollgruppe. Die Effektstärken der Gruppenunterschiede (Cohen's d) lagen im mittleren bis hohen Bereich (0.50 – 2.19). Die Ergebnisse bestätigen, dass die Aufgaben des Trainingsprogramms die spezifischen Defizite leseschwacher Kinder abbilden. Ein Training mit diesen Aufgaben erscheint daher grundsätzlich sinnvoll. Die Wirkungen eines solchen Trainings auf die schriftsprachlichen Leistungen von Kindern mit Lese-Rechtschreibstörung werden in zukünftigen Studien überprüft.

Sensitivity to lexical stress in dyslexia: a case of cognitive not perceptual stress

Sensitivity to lexical stress in adult German-speaking students with reading difficulty was investigated using minimal pair prepositional verbs whose meaning and syntax depend on the location of the stressed syllable. Two tests of stress perception were used: (i) a stress location task, where listeners indicated the location of the perceptually most prominent syllable, and (ii) a stress pattern identification task, where listeners indicated if the stress pattern was appropriate for its semantic frame. The students with reading difficulties performed worse than the normally reading students on both tasks. Their poorer performance did not reflect the lack of a percept for lexical stress rather patterns of performance across the two tasks suggested that each loaded onto different underlying cognitive abilities. Deficits in these, rather than perceptual difficulties, explained observed group differences. Students with reading difficulties have a normal implicit knowledge of lexical stress usage but lack the necessary cognitive resources for developing an explicit metalinguistic awareness of it. Deficits in these skills not deficiencies in lexical stress perception are implicated in their reading difficulties.

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.

Investigating speech perception in children with dyslexia: is there evidence of a consistent deficit in individuals?

PURPOSE

The claim that speech perception abilities are impaired in dyslexia was investigated in a group of 62 children with dyslexia and 51 average readers matched in age.

METHOD

To test whether there was robust evidence of speech perception deficits in children with dyslexia, speech perception in noise and quiet was measured using 8 different tasks involving the identification and discrimination of a complex and highly natural synthetic "bee"-"pea" contrast (copy synthesized from natural models) and the perception of naturally produced words.

RESULTS

Children with dyslexia, on average, performed more poorly than did average readers in the synthetic syllables identification task in quiet and in across-category discrimination (but not when tested using an adaptive procedure). They did not differ from average readers on 2 tasks of word recognition in noise or identification of synthetic syllables in noise. For all tasks, a majority of individual children with dyslexia performed within norms. Finally, speech perception generally did not correlate with pseudoword reading or phonological processing--the core skills related to dyslexia.

CONCLUSIONS

On the tasks and speech stimuli that the authors used, most children with dyslexia did not appear to show a consistent deficit in speech perception.

Speech perception in noise deficits in Japanese children with reading difficulties: effects of presentation rate

We examined the effects of presentation rate on speech perception in noise and its relation to reading in 117 typically developing (TD) children and 10 children with reading difficulties (RD) in Japan. Responses in a speech perception task were measured for speed, accuracy, and stability in two conditions that varied stimulus presentation rate: high rate and same rate conditions. TD children exhibited significantly more stable responses in the high rate condition than they did in the same rate condition. Multiple regression analyses indicated that response stability in the high rate condition accounted for a unique amount of variance in reading and mora deletion. As a group, children with RD performed less accurately than did TD children in the high rate condition, but not in the same rate condition. Findings suggest that the dependence of speech perception on stimulus context relates to reading proficiency or difficulty in Japanese children. The influences of phonology and orthography of language on the relationships between speech perception and reading are discussed.

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.

The Role of the Speech-Language Pathologist in Identifying and Treating Children With Auditory Processing Disorder

Purpose

A summary of issues regarding auditory processing disorder (APD) is presented, including some of the remaining questions and challenges raised by the articles included in the clinical forum.

Method

Evolution of APD as a diagnostic entity within audiology and speech-language pathology is reviewed. A summary of treatment efficacy results and issues is provided, as well as the continuing dilemma for speech-language pathologists (SLPs) charged with providing treatment for referred APD clients.

Conclusion

The role of the SLP in diagnosing and treating APD remains under discussion, despite lack of efficacy data supporting auditory intervention and questions regarding the clinical relevance and validity of APD.

Effects of bottom-up and top-down intervention principles in emergent literacy in children at risk of developmental dyslexia: a longitudinal study

This longitudinal study focused on the effects of two different principles of intervention in children at risk of developing dyslexia from 5 to 8 years old. The children were selected on the basis of a background questionnaire given to parents and preschool teachers, with cognitive and functional magnetic resonance imaging results substantiating group differences in neuropsychological processes associated with phonology, orthography, and phoneme-grapheme correspondence (i.e., alphabetic principle). The two principles of intervention were bottom-up (BU), "from sound to meaning", and top-down (TD), "from meaning to sound." Thus, four subgroups were established: risk/BU, risk/TD, control/BU, and control/TD. Computer-based training took place for 2 months every spring, and cognitive assessments were performed each fall of the project period. Measures of preliteracy skills for reading and spelling were phonological awareness, working memory, verbal learning, and letter knowledge. Literacy skills were assessed by word reading and spelling. At project end the control group scored significantly above age norm, whereas the risk group scored within the norm. In the at-risk group, training based on the BU principle had the strongest effects on phonological awareness and working memory scores, whereas training based on the TD principle had the strongest effects on verbal learning, letter knowledge, and literacy scores. It was concluded that appropriate, specific, data-based intervention starting in preschool can mitigate literacy impairment and that interventions should contain BU training for preliteracy skills and TD training for literacy training.

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.

Impairments in speech and nonspeech sound categorization in children with dyslexia are driven by temporal processing difficulties

Auditory processing problems in persons with dyslexia are still subject to debate, and one central issue concerns the specific nature of the deficit. In particular, it is questioned whether the deficit is specific to speech and/or specific to temporal processing. To resolve this issue, a categorical perception identification task was administered in thirteen 11-year old dyslexic readers and 25 matched normal readers using 4 sound continua: (1) a speech contrast exploiting temporal cues (/bA/-/dA/), (2) a speech contrast defined by nontemporal spectral cues (/u/-/y/), (3) a nonspeech temporal contrast (spectrally rotated/bA/-/da/), and (4) a nonspeech nontemporal contrast (spectrally rotated/u/-/y/). Results indicate that children with dyslexia are less consistent in classifying speech and nonspeech sounds on the basis of rapidly changing (i.e., temporal) information whereas they are unimpaired in steady-state speech and nonspeech sounds. The deficit is thus restricted to categorizing sounds on the basis of temporal cues and is independent of the speech status of the stimuli. The finding of a temporal-specific but not speech-specific deficit in children with dyslexia is in line with findings obtained in adults using the same paradigm (Vandermosten et al., 2010, Proceedings of the National Academy of Sciences of the United States of America, 107: 10389-10394). Comparison of the child and adult data indicates that the consistency of categorization considerably improves between late childhood and adulthood, particularly for the continua with temporal cues. Dyslexic and normal readers show a similar developmental progress with the dyslexic readers lagging behind both in late childhood and in adulthood.

Auditive Verarbeitungs- und Wahrnehmungsstörungen (AVWS) im Kindesalter

Auditive Verarbeitungs- und Wahrnehmungsstörungen (AVWS) sind umschriebene Funktionsdefizite in der auditiven Informationsverarbeitung und Wahrnehmung bei intaktem peripherem Gehör und mindestens durchschnittlicher Intelligenz. Häufig sind Lernstörungen, primäre bzw. sekundäre Spracherwerbsstörungen, supramodale Aufmerksamkeitsprobleme oder tiefgreifende Entwicklungsstörungen mit AVWS im Sinn von Komorbidität assoziiert. Deswegen erscheint Eltern, Lehrern oder Untersuchern das AVWS-Konzept zur Erklärung solcher Entwicklungs- und Lernauffälligkeiten plausibel. Da Sprachsignale zerebral anders als nicht sprachliche Signale ausgewertet werden, kann Sprachwahrnehmung allenfalls als ein Spezialfall der auditiven Verarbeitung und Wahrnehmung betrachtet werden. Kausale Beziehungen zwischen gestörten auditiven Funktionen und klinischen Störungsbildern wurden bislang nicht zuverlässig belegt. Es besteht ein Mangel an kontrollierten bzw. randomisierten Therapiestudien.

Decreased sensitivity to phonemic mismatch in spoken word processing in adult developmental dyslexia

Initial lexical activation in typical populations is a direct reflection of the goodness of fit between the presented stimulus and the intended target. In this study, lexical activation was investigated upon presentation of polysyllabic pseudowords (such as procodile for crocodile) for the atypical population of dyslexic adults to see to what extent mismatching phonemic information affects lexical activation in the face of overwhelming support for one specific lexical candidate. Results of an auditory lexical decision task showed that sensitivity to phonemic mismatch was less in the dyslexic population, compared to the respective control group. However, the dyslexic participants were outperformed by their controls only for word-initial mismatches. It is argued that a subtle speech decoding deficit affects lexical activation levels and makes spoken word processing less robust against distortion.

Computer-based auditory training (CBAT): benefits for children with language- and reading-related learning difficulties

This article reviews the evidence for computer-based auditory training (CBAT) in children with language, reading, and related learning difficulties, and evaluates the extent it can benefit children with auditory processing disorder (APD). Searches were confined to studies published between 2000 and 2008, and they are rated according to the level of evidence hierarchy proposed by the American Speech-Language Hearing Association (ASHA) in 2004. We identified 16 studies of two commercially available CBAT programs (13 studies of Fast ForWord (FFW) and three studies of Earobics) and five further outcome studies of other non-speech and simple speech sounds training, available for children with language, learning, and reading difficulties. The results suggest that, apart from the phonological awareness skills, the FFW and Earobics programs seem to have little effect on the language, spelling, and reading skills of children. Non-speech and simple speech sounds training may be effective in improving children's reading skills, but only if it is delivered by an audio-visual method. There is some initial evidence to suggest that CBAT may be of benefit for children with APD. Further research is necessary, however, to substantiate these preliminary findings.

Auditory and cognitive abilities of children suspected of auditory processing disorder (APD)

OBJECTIVE

Auditory processing disorder (APD) is typically characterised by difficulties in 'listening', particularly to speech in a noisy environment, despite normal peripheral function. In school-age children, APD has attracted considerable interest because of suspicions that it may lead to learning difficulties, especially affecting language and literacy. Here, we evaluated auditory and cognitive abilities in a group of children referred for an auditory evaluation on the grounds of a suspected auditory processing disorder (susAPD), and in age-matched children who were typically developing, in order to determine the extent to which any deficits in cognitive abilities could be related to auditory deficits.

METHODS

A battery of auditory and cognitive tests was applied to 20 susAPD school-age children, all reported as having listening/hearing problems but performing within normal limits for standard audiometric assessments. Also tested was a group of 28 age-matched controls. The auditory tasks consisted of two simple same/different discrimination tasks, one using speech, and one nonspeech. The cognitive evaluation comprised a vocabulary test, a test of grammar and four non-verbal IQ measures. Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) were assessed in the susAPD group through a standardised questionnaire.

RESULTS

A significant proportion of susAPD children appeared to display genuine auditory deficits evidenced by poor performance on at least one of the auditory tasks, although about 1/3 had no detectable deficit. Children in the susAPD group scored consistently lower than the controls on cognitive measures that were both verbal (vocabulary and grammar) and non-verbal. Strikingly, susAPD children with relatively good auditory performance did not differ in cognitive ability from susAPD children with poor auditory performance. Similarly, within-group correlations between auditory and cognitive measures were weak or non-existent. Measures of ADHD did not correlate with any aspect of auditory or cognitive performance.

CONCLUSIONS

Although children suspected of having APD do show, on average, poorer performance on a number of auditory tasks, the presence or absence of an auditory deficit appears to have little impact on the development of the verbal and non-verbal skills tested here.