The significance of right ear auditory processing to balance.

Although the association between balance and hearing thresholds at different frequencies in the right/left ear is crucial, it has received scant empirical attention. Balance is widely ignored when evaluating hearing in adults. This study examined the relative contribution of left versus right ear hearing at different frequencies to balance, and the mediating role of suprathreshold speech perception on age-balance associations. Pure tone hearing thresholds (500-4000 Hz), suprathreshold speech perception, balance, and risk of falling were evaluated in 295 adults. The results indicate that the right ear contributes more to balance than the left ear. This might imply dominance of the left hemisphere in processing hearing cues for balance. Frequencies within the speech range (500/1000/2000 Hz) were correlated with balance and mediated the interaction between age and balance. These results should be considered when tailoring hearing and balance rehabilitation programs.

Students' Evaluation of Simulation-Based Training in a Communication Sciences and Disorders Program.

The current study aimed to evaluate simulation-based medical education (SBME) training and its contribution to the learning process of students in a communication sciences and disorders (CSD) program. The training was integrated in different stages of the program, over 4 years, with different students. The content and complexity of each of the simulation activities targeted specific skills, tailored to the students' learning phase. Students completed a nine-item survey at the end of the first and second semesters of the second year, evaluating the simulation training program structure and students' self-efficacy relating to the building of relationships between care givers and patients. A total of 246 questionnaires were analyzed. Students reported significantly increased self-efficacy in a range of clinical skills and perceived the inclusion of simulated patients (SPs) into a clinical skills program as valuable. Our data suggest that scenarios that reflect real-life situations (environment, atmosphere, equipment, etc.) have the strongest impact on the students' ability to implement professional and communication skills. A strong positive correlation was found between the video-based debriefing and students' perception of the improvement in their professional and communication skills. These findings suggest that this is a feasible and powerful training approach that can be applied in the CSD curriculum.

Exposure to music and noise-induced hearing loss (NIHL) among professional pop/rock/jazz musicians.

Noise-induced hearing loss (NIHL) has been extensively studied in industrial work environments. With the advent of new technologies, loud music has been increasingly affecting listeners outside of the industrial setting. Most research on the effects of music and hearing loss has focused on classical musicians. The purpose of the current study was to examine the relationship between the amount of experience a professional pop/rock/jazz musician has and objective and subjective variables of the musician's hearing loss. This study also examined professional pop/rock/jazz musicians' use of hearing protection devices in relation to the extent of their exposure to amplified music. Forty-four pop/rock/jazz musicians were interviewed using the Pop/Rock/Jazz Musician's Questionnaire (PRJMQ) in order to obtain self-reported symptoms of tinnitus and hyperacusis. Forty-two of the subjects were also tested for air-conduction hearing thresholds in the frequency range of 1-8 kHz. Results show that the extent of professional pop/rock/jazz musicians' exposure to amplified music was related to both objective and subjective variables of hearing loss: Greater musical experience was positively linked to higher hearing thresholds in the frequency range of 3-6 kHz and to the subjective symptom of tinnitus. Weekly hours playing were found to have a greater effect on hearing loss in comparison to years playing. Use of hearing protection was not linked to the extent of exposure to amplified music. It is recommended that further research be conducted with a larger sample, in order to gain a greater understanding of the detrimental effects of hours playing versus years playing.

Binaural masking level difference in skilled reading children and children with dyslexia.

BACKGROUND: Combining stimuli arriving at both ears makes it possible to locate sounds in the environment and to better detect signals or understand speech in noise when the sound sources are separated spatially. The sensitivity of the binaural system to interaural differences in time and amplitude can be investigated by means of the binaural masking level difference (BMLD). The age at which the BMLD reaches adult levels appears to depend partly upon masker bandwidth. Less is known about the effect of masker's level on the development of BMLD in children. In the present study we assessed the effect of masker level on the BMLD of 3rd and 5th grade skilled reading children. In view of possible binaural hearing effects in dyslexia, the BMLD of a group of 5th grade children with reading difficulties was measured. METHODS: Detection thresholds of 500 Hz pure tone were measured at noise levels of 40 dBHL, 50 dBHL and 60 dBHL. RESULTS: All subjects presented increased MLD values with the rise of noise intensity between 40 dBHL and 60 dBHL. Among the skilled readers the results showed that younger children had smaller BMLDs than older children at all masker levels. However, a significant group-by-intensity interaction indicated that although the reading disabled group had reduced BMLD values than older skilled readers at noise levels of 50 dBHL and 60 dBHL, no difference was found between their BMLD values and those of the young skilled readers at noise levels of 50 dBHL and 60 dBHL. Moreover, their BMLD values at noise level of 40 dBHL were higher than those of the 3rd grade typically reading students while no difference was found between them and 5th grade efficient readers. CONCLUSIONS: These results support the existence of both quantitative and qualitative differences in binaural hearing of children with developmental dyslexia.

Effects of speech in noise and dichotic listening intervention programs on central auditory processing disorders.

Twenty children with central auditory processing disorders [(C)APD] were subjected to a structured intervention program of listening skills in quiet and in noise. Their performance was compared to that of a control group of 10 children with (C)APD with no special treatment. Pretests were conducted in quiet and in degraded listening conditions (speech noise and competing speech). The (C)APD management approach was integrative and included top-down and bottom-up strategies. It focused on environmental modifications, remediation techniques, and compensatory strategies. Training was conducted with monosyllabic and polysyllabic words, sentences and phrases in quiet and in noise. Comparisons of pre- and post-management measures indicated increase in speech recognition performance in background noise and competing speech for the treatment group. This improvement was exhibited for both ears. A significant difference between ears was found with the left ear showing improvement in both the short and the long versions of competing sentence tests and the right ear performing better in the long competing sentences only following intervention. No changes were documented for the control group. These findings add to a growing body of literature suggesting that interactive auditory training can improve listening skills.

Dyslexia and the failure to form a perceptual anchor.

In a large subgroup of dyslexic individuals (D-LDs), reading difficulties are part of a broader learning and language disability. Recent studies indicate that D-LDs perform poorly in many psychoacoustic tasks compared with individuals with normal reading ability. We found that D-LDs perform as well as normal readers in speech perception in noise and in a difficult tone comparison task. However, their performance did not improve when these same tasks were performed with a smaller stimulus set. In contrast to normal readers, they did not benefit from stimulus-specific repetitions, suggesting that they have difficulties forming perceptual anchors. These findings are inconsistent with previously suggested static models of dyslexia. Instead, we propose that D-LDs' core deficit is a general difficulty in dynamically constructing stimulus-specific predictions, deriving from deficient stimulus-specific adaptation mechanisms. This hypothesis provides a direct link between D-LDs' high-level difficulties and mechanisms at the level of specific neuronal circuits.

Cortical activity of children with dyslexia during natural speech processing: evidence of auditory processing deficiency.

Children with dyslexia have difficulties with phonological processing. It is assumed that deficits in auditory temporal processing underlie the phonological difficulties of dyslectic subjects (i.e. the processing of rapid acoustic changes that occur in speech). In this study we assessed behavioral and electrophysiological evoked brain responses of dyslectic and skilled reading children while performing a set of hierarchically structured auditory tasks. Stimuli consisted of auditory natural unmodified speech that was controlled for the parameter of changing rate of main acoustic cues: vowels (slowly changing speech cues: /i/ versus /u/) and consonant-vowel (CV) syllables (rapidly changing speech cues: /da/ versus /ga/). Brain auditory processing differed significantly between groups: reaction time of dyslectic readers was prolonged in identifying speech stimuli and increased with increased phonological demand. Latencies of auditory evoked responses (auditory event related potentials [AERPs]) recorded during syllable identification of the dyslectic group were prolonged relative to those of skilled readers. Moreover, N1 amplitudes during vowel processing were larger for the dyslectic children and P3 amplitudes during CV processing were smaller for the dyslectic children. From the results of this study it is evident that the latency and amplitude of AERPs are sensitive measures of the complexity of phonological processing in skilled and dyslectic readers. These results may be signs of deficient auditory processing of natural speech under normal listening conditions as a contributing factor to reading difficulties in dyslexia. Detecting a dysfunction in the central auditory processing pathway might lead to early detection of children who may benefit from phonetic-acoustic training methods.

Reduced medial olivocochlear bundle system function in children with auditory processing disorders.

A common complaint of children with auditory processing disorders (APD) is difficulty in understanding speech in the presence of background noise. Evidence from animal and human studies has suggested that the medial olivocochlear bundle (MOCB) may play a role in hearing in noise. The MOCB function can be evaluated by the suppression effect of the transient evoked otoacoustic emissions (TEOAE) in response to contralateral acoustic stimulation (CAS). The present study was conducted to investigate the suppression effect of TEOAE in APD children. The study groups comprised 15 APD children aged 8-13 years associated with learning disabilities and 15 controls matched for gender and age. The suppression effect of TEOAE was evaluated by comparing the TEOAE levels with and without CAS. A significantly reduced suppression effect of TEOAE was demonstrated in the APD group, when compared to the controls. In addition, higher TEOAE levels were found in the APD group, suggesting inherent reduced MOCB activity on the outer hair cells in APD children. These results imply that some APD children present low activity of the MOCB system, which may indicate a reduced auditory inhibitory function and affect their ability to hear in the presence of background noise.

A comparison between vocal reaction time and word recognition measures of children with APD and age-matched peers using auditory word discrimination test.

The purpose of this study was to investigate the possibility of improving speech recognition testing sensitivity in children with auditory processing disorders (APD) by incorporating response time measures. A group of children identified in a clinical setting as having APD was compared to an age-matched peer group using a vocal reaction time (VRT) format. The participants were between the ages of 5.5 and 15 years. All children were presented spoken monosyllabic words of the clinical Hebrew speech discrimination test. Statistically significant differences were found, with means in the APD children reflecting slower performance than that of their peers. The two groups did not differ in their performance accuracy. These data show that combining response time measures with percent correct scores improved test sensitivity. Such an approach may hold promise for future clinical applications in the assessment of APD.