Efficacy of acoustic stimulation techniques on cognitive functions in individuals with Alzheimer's disease-a scoping review.

BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder that severely affects cognitive functions and social behaviors, leading to a significant decline in an individual's quality of life. Auditory processing deficits often precede the clinical symptoms of AD, prompting interest in auditory-based interventions as potential treatments. This scoping review aimed to compile the existing evidence on active and passive auditory-based interventions for individuals with AD and its prodromal stages. METHOD AND RESULTS: This scoping review followed Arksey and O'Malley's five-step framework to identify the existing evidence on auditory-based interventions for AD. Four databases (PubMed, Web of Science, CINAHL, and Embase) were used to search for studies on auditory stimulation techniques to treat cognitive decline in AD patients. In total, 14 studies were included in the analysis. Seven studies explored active auditory stimulation techniques, such as the Brain Fitness Program (BrainHQ), aiming to improve cognitive function in individuals with Mild Cognitive Impairment (MCI). The other seven studies focused on passive auditory stimulation, often combined with other sensory stimuli such as light or tactile inputs. Passive stimulation studies have focused mainly on Gamma Entrainment Using Sensory Stimulation (GENUS). The intervention frequency and duration varied across studies, ranging from one session lasting 8 h to a year. Both active and passive auditory stimulation showed potential for enhancing cognitive function in individuals with AD. CONCLUSION: The literature suggests that auditory stimulation may positively influence cortical wiring and enhance cognitive abilities. Multimodal interventions that combine auditory stimulation with other sensory or behavioural approaches could yield more substantial effects on global cognition. However, the study design, intervention characteristics and outcome measures varied across studies, underscoring the necessity for standardised reporting. Well-designed studies using standard cognitive assessment protocols are recommended.

Children's speech, language and communication skills and parental knowledge in the growing up in New Zealand cohort.

INTRODUCTION: There is a substantial discrepancy between international and local prevalence rates for speech, language and communication needs (SLCN) amongst children in New Zealand. Reports of communication impairment are likely to be underestimates. Prevalence data can describe population characteristics and inform the scope and nature of services to adequately meet demand. Parents and other caregivers are central to the early identification of children with communication needs but they may not recognise their child's needs or act on their concerns. METHOD: Cross-sectional data were available for the Growing Up in New Zealand (GUiNZ) longitudinal study cohort at 24, 54 and 72 months of age, with 76% of whanau (families; n = 5241) completing three data waves. Descriptive and chi-square analyses were used to address: (1) What are the communication abilities of children in the first 5 years of life? (2) What do New Zealand parents understand of their children's communication? (3) Do New Zealand parents have concerns? (4) What are the trajectories of parental concern for children's communication in the first 6 years of life? RESULTS: At 24 months old, 16% of children had communication skills that were of concern to their parents. At 54 months, there were concerns for 12.6% of children. Although most parents were able to describe their child's expressive abilities, many parents remained unconcerned when their child demonstrated communication skills that did not met developmental expectations. CONCLUSION: Parents can offer valuable insights about their children, but in many cases their level of concern about SLCN did not align with a professional view which reflects a more nuanced understanding of children's speech and language and the impact on future communication skills and needs. Increased awareness through public health messaging specifically regarding lifelong influences of communication challenges will aid in prevention, early detection and intervention. WHAT THIS PAPER ADDS: What is already known on this subject Parent's expectations of child speech and language development will inform how responsive they are to difficulties in their child. Appropriate parental concern is key to recognition of children with speech, language and communication needs that warrant referral to a professional. What this paper adds to existing knowledge Parents are aware of expressive language skills that children acquire and can accurately identify their children's skills but have less knowledge of the ages of acquisition. Some parents are not concerned, do not seek support despite recognisable difficulties, and demonstrate limited understanding of the future consequences for children with communication needs that are unmet. What are the potential or actual clinical implications of this work? Public health messaging should include both skills and age ranges for speech and language acquisition. Additionally, educating the public of the impact of speech, language and communication skills on children's futures is needed.

Longitudinal assessment of listening skills in UK infants with hearing aids using the LittlEARS® auditory questionnaire.

OBJECTIVE: To investigate listening skills in infant hearing aid users using the LittlEARS® Auditory Questionnaire (LEAQ). DESIGN: Caregivers completed the LEAQ, and hearing aid data logging was recorded, at infant age 3-7 months and 7-21 months. STUDY SAMPLE: Seventy infant hearing aid users with permanent bilateral hearing loss, no developmental comorbidities, aged 3-7 months at first visit. RESULTS: Infants with mild and moderate losses tended to have scores within the normative range at the early time point (88%), but 29% were below the normative range when older. Thirty percent of infants with severe hearing loss were outside the normative range at the early time point and 60% outside the normative range when older. Infants with profound loss were almost always (95%) outside the normative range. At the later time point, and for infants with severe-to-profound loss, low LEAQ scores were associated with fewer daily hours hearing aid use. Scores were poorer than previous reports in the literature for infant hearing aid users. CONCLUSIONS: This study provides further knowledge on infant listening performance and hearing aid use over time that can be used to guide management of individual cases and to develop and audit service quality improvements.

Longitudinal Changes in Hearing Aid Use and Hearing Aid Management Challenges in Infants.

OBJECTIVE: If the benefits of newborn hearing screening and early intervention are to be fully realized, there is a need to understand the challenges of hearing aid management in infants. The aim was to investigate longitudinal changes in hearing aid use and hearing aid management challenges in very young infants. DESIGN: Eighty-one primarily female (99%) caregivers of infant hearing aid users completed a questionnaire about hearing aid management experiences, first when their infants were 3 to 7 months old (1 to 6 months after hearing aid fitting) and again at 7 to 21 months of age. Hearing aid data logging was compared with caregiver reports of daily use for 66 infants. RESULTS: The main hearing aid management challenges reported by caregivers were performing listening checks and troubleshooting. These challenges reduced over the approximately 5-month time period but remained a problem with around a quarter of respondents still not confident or unsure about troubleshooting, and around a third not performing a daily listening check. Mean daily hearing aid use, obtained from data logging, declined significantly over time from 6.6 to 5.3 hours. Further analysis revealed reduced hearing aid use was primarily among infants with profound losses (n = 11). Caregivers overestimated daily hours of use at both time points. Caregivers reported difficulty with the infants pulling out their hearing aids, especially at the later time point. CONCLUSIONS: The findings from this relatively large sample of caregivers of young infants, assessed at two time points, revealed significant challenges in hearing aid management, including highly variable daily hearing aid use. Interventions that use behavior change techniques may be needed to ensure intentions are consistently turned into successful actions, if the benefits of newborn hearing screening and early intervention are to be fully realized.

Professional expertise amongst speech-language therapists: "willing to share".

Purpose The current healthcare environment provides several challenges to the existing roles of healthcare professionals. The value of the professional expert is also under scrutiny. The purpose of this paper is to generate a construction of professional expertise amongst practitioners in the current healthcare environment. It used the speech-language therapy community in New Zealand (NZ) as an example. Design/methodology/approach Speech-language therapists currently practicing in NZ completed an online survey including qualitative and quantitative components. The range of experience and work settings of participants ( n=119) was representative of the workforce. Findings Participants clearly identified being "highly experienced" and "having in-depth knowledge" as essential elements of professional expertise. Thematic analysis generated two interconnected themes of a professional expert being a personal leader and teacher, and a highly experienced, knowledgeable and skilful practitioner. Additionally, practitioners needed to be seen to contribute to the community in order to be known as experts. Clinical practice was valued differently from research generation. Originality/value This study is novel in exploring a construction of professional expertise amongst practitioners in a current healthcare community. Within that community, experts could be viewed as highly effective practitioners that visibly contribute to the professional community. The study draws attention to the role of reputation and the impacts of being a clinical teacher or leader compared with pursuing a research role. This could be particularly relevant in the promotion of evidence-based practice.

Impact of cognition and noise reduction on speech perception in adults with unilateral cochlear implants.

OBJECTIVES: The purpose of this study was to investigate the impact of cognition and noise reduction (NR) technology in cochlear implants (CIs) on speech perception and listening effort. METHODS: Thirteen adults fitted with unilateral CIs (Nucleus® 6, CP900) participated in this study. Participants performed: (I) cognitive tests of working memory and processing speed, (II) speech perception in noise tests, and (III) an auditory-visual dual-task paradigm to quantify listening effort, as a part of the three-phase experimental study. Both the participant and the tester, performing the outcome measures, were blinded to the NR settings (ON/OFF) of the CI for phases II and III. RESULTS: Speech intelligibility significantly improved with the NR activated, but was independent of individual differences in cognitive abilities. Listening effort did not significantly change with NR setting; however, there was a trend for participants with good working memory to have better speech perception scores with NR activated during the effortful listening task (dual-task paradigm). CONCLUSION: Future studies are warranted to explore the interaction between cognition and CI NR algorithms during an effortful listening task.

Predictors of the time to attain full oral feeding in late preterm infants.

AIM: The aim of this study was to determine the factors that predict the timing and age at which preterm infants (born 32-36 weeks gestation) commenced and attained full oral feeding. METHODS: We conducted a retrospective review of medical records of 647 preterm infants born 2005-2011. Infants were from six neonatal intensive care units in New Zealand, all World Health Organisation Baby-friendly Hospital Initiative accredited. RESULTS: Median time to the first oral feed offered was one day, and median time to the time of full oral feeding was 12 days. No infants attained full oral feeding before 33(+3) weeks postmenstrual age. Gestational age, birthweight, medical conditions and location of the neonatal unit were significantly associated with the time taken to commence and attain full oral feeding. CONCLUSION: This study highlights the factors that are associated with the rate at which late preterm infants commence oral feeding and progress to full oral feeding. These findings offer important considerations not only for clinical practice but also discharge planning given the preference for preterm infants reaching full oral feeds before discharge from hospital. Prospective experimental research is required to confirm infant, maternal and environmental factors that influence feeding milestones in late preterm infants.

The audiological journey and early outcomes of twelve infants with auditory neuropathy spectrum disorder from birth to two years of age.

OBJECTIVE: To describe the audiological journey of a group of infants with auditory neuropathy spectrum disorder (ANSD) following the fitting of hearing aids, and to investigate the potential benefits of including cortical auditory-evoked potentials (CAEPs) and a measure of functional auditory behaviour during early audiological management. DESIGN: Results from chart revision of estimated hearing threshold, early behavioural testing, parental observation, and functional auditory behaviour assessments were described, and compared to visual reinforcement audiometry (VRA) thresholds obtained at a mean corrected age of 10 months (SD 3). The relationship with CAEPs and functional performance was examined. STUDY SAMPLE: The study included 12 infants diagnosed with ANSD and fitted with amplification. RESULTS: The estimated 4FA at a mean corrected age of four months (SD5) was within ± 10 dB of VRA results in 75% of infants when unaided and aided behavioural observation audiometry (BOA), together with unaided and aided parental observations was combined. Infants with a greater proportion of CAEPs present had higher PEACH scores. CONCLUSIONS: Delaying amplification until VRA results were available would have led to a significant period of auditory deprivation for infants in this study group. None of the assessments could accurately determine hearing thresholds when used in isolation, however when used in combination clinicians were able to obtain sufficient information to fit hearing aids early, and identify infants requiring closer monitoring.