Assessment of cochlear electrophysiology in typically developing children and children with auditory processing disorder.

OBJECTIVE: Children with auditory processing disorder (APD) are reported to have abnormal auditory brainstem responses (ABR) but little is understood about their cochlear integrity. Poor cochlear integrity can affect neural responses. In this study, cochlear and auditory brainstem integrity was investigated in children with APD. METHOD: Twenty children with APD, sixteen typically developing children and twenty adults participated in this study. Click evoked electrocochleography (ECochG) and ABRs were recorded from all the participants. Cochlear responses were analyzed using a) latency and amplitude of summating potential; action potential, b) transmission time between summating potential and action potential, c) summating potential/action potential amplitude ratio and d) action potential latency difference to condensation and rarefaction polarity. Amplitude in the ABR components was examined. RESULTS: Children with APD showed similar cochlear function to the typically developing children. There were no significant differences in wave I amplitude between children with APD and typically developing children. However, wave V amplitude was significantly reduced in children with APD compared to typically developing children. CONCLUSION: In the absence of any functional differences in the cochlea, children with APD can show poor amplitude in the later components of the ABR. The ABR anomalies observed in children with APD arise due to poor neural processing, possibly after the first auditory synapse.

Perceptual and Objective Assessment of Envelope Enhancement for Children With Auditory Processing Disorder.

This paper evaluated the performance of an envelope enhancement (EE) algorithm subjectively by children with auditory processing disorder (APD), and objectively through computational models. Speech intelligibility data was collected from children with APD, for unprocessed and envelope-enhanced speech in the presence of stationary and non-stationary background noise at different signal to noise ratios (SNRs), both with and without noise reduction (NR) algorithms as a front-end to the EE algorithm. Furthermore, intrusive and non-intrusive objective speech intelligibility metrics were derived to predict the perceptual impact of this EE algorithm. Subjective data for stationary noise conditions revealed that the combination of NR and EE algorithms significantly improved the speech intelligibility scores at poor SNRs. In contrast, the same combination was ineffective in improving speech intelligibility in non-stationary noise conditions. Taken together, subjective results suggest that exaggerating the envelope cues improves speech identification scores for children with APD. However, the benefit obtained varies depending upon the type and level of the background noise. Both intrusive and non-intrusive objective speech intelligibility estimators exhibited good correlation with the subjective data, with the intrusive metric demonstrating better generalization capabilities. Implications of these results for hearing aid applications for children with APD is discussed.