Asperger's syndrome: What to consider?

Asperger's syndrome is a neurodevelopmental disorder which is part of the large family of autism spectrum disorders. People with Asperger's syndrome have difficulties in social interactions, verbal and non-verbal communication, and may display behavioural oddities, with stereotypies and limited interests. They show no language delay and their cognitive development is not marked by an overall delay but by specific impairments in certain areas such as the executive functions. The clinical presentations are very heterogeneous, varying according to age and psychiatric comorbidities. Screening, diagnosis and specialized treatment are not made any easier by the diversity of the clinical manifestations. Asperger's syndrome is often diagnosed belatedly, at 11years of age on average and even in adulthood in some cases. This late diagnosis has a significant impact on the risks of depression and a poor quality of life. However, in adulthood or in adolescence, certain situations, personality traits and cognitive profiles or certain comorbidities should suggest the hypothesis of an Asperger-type autism spectrum disorder. We propose here a review of the clinical situations at different ages of life that could help with the screening and the referral of patients to specialized clinicians for diagnosis and appropriate treatment.

The Impact of Hearing Aids on Listening Effort and Listening-Related Fatigue - Investigations in a Virtual Realistic Listening Environment.

Participation in complex listening situations such as group conversations in noisy environments sets high demands on the auditory system and on cognitive processing. Reports of hearing-impaired people indicate that strenuous listening situations occurring throughout the day lead to feelings of fatigue at the end of the day. The aim of the present study was to develop a suitable test sequence to evoke and measure listening effort (LE) and listening-related fatigue (LRF), and, to evaluate the influence of hearing aid use on both dimensions in mild to moderately hearing-impaired participants. The chosen approach aims to reconstruct a representative acoustic day (Time Compressed Acoustic Day [TCAD]) by means of an eight-part hearing-test sequence with a total duration of approximately 2½ h. For this purpose, the hearing test sequence combined four different listening tasks with five different acoustic scenarios and was presented to the 20 test subjects using virtual acoustics in an open field measurement in aided and unaided conditions. Besides subjective ratings of LE and LRF, behavioral measures (response accuracy, reaction times), and an attention test (d2-R) were performed prior to and after the TCAD. Furthermore, stress hormones were evaluated by taking salivary samples. Subjective ratings of LRF increased throughout the test sequence. This effect was observed to be higher when testing unaided. In three of the eight listening tests, the aided condition led to significantly faster reaction times/response accuracies than in the unaided condition. In the d2-R test, an interaction in processing speed between time (pre- vs. post-TCAD) and provision (unaided vs. aided) was found suggesting an influence of hearing aid provision on LRF. A comparison of the averaged subjective ratings at the beginning and end of the TCAD shows a significant increase in LRF for both conditions. At the end of the TCAD, subjective fatigue was significantly lower when wearing hearing aids. The analysis of stress hormones did not reveal significant effects.

Neural tracking to go: auditory attention decoding and saliency detection with mobile EEG.

Objective.Neuro-steered assistive technologies have been suggested to offer a major advancement in future devices like neuro-steered hearing aids. Auditory attention decoding (AAD) methods would in that case allow for identification of an attended speaker within complex auditory environments, exclusively from neural data. Decoding the attended speaker using neural information has so far only been done in controlled laboratory settings. Yet, it is known that ever-present factors like distraction and movement are reflected in the neural signal parameters related to attention.Approach.Thus, in the current study we applied a two-competing speaker paradigm to investigate performance of a commonly applied electroencephalography-based AAD model outside of the laboratory during leisure walking and distraction. Unique environmental sounds were added to the auditory scene and served as distractor events.Main results. The current study shows, for the first time, that the attended speaker can be accurately decoded during natural movement. At a temporal resolution of as short as 5 s and without artifact attenuation, decoding was found to be significantly above chance level. Further, as hypothesized, we found a decrease in attention to the to-be-attended and the to-be-ignored speech stream after the occurrence of a salient event. Additionally, we demonstrate that it is possible to predict neural correlates of distraction with a computational model of auditory saliency based on acoustic features.Significance.Taken together, our study shows that auditory attention tracking outside of the laboratory in ecologically valid conditions is feasible and a step towards the development of future neural-steered hearing aids.