Developmental Language Disorder: Wake and Sleep Epileptiform Discharges and Co-morbid Neurodevelopmental Disorders.

Developmental language disorder (DLD) is frequently associated with other developmental diseases and may lead to a handicap through adolescence or adulthood. The aim of our retrospective study was to characterize DLD subgroups, their etiological factors and clinical comorbidities, and the role of epileptiform discharges in wake and sleep recordings. Fifty-five children (42 male, mean age 6.2 ± 1.4 years, range 4-9 years) were included in the present study and underwent phoniatric, psychologic, neurologic, as well as wake and nocturnal electroencephalography (EEG) or polysomnography (PSG) examinations. A receptive form of DLD was determined in 34 children (63.0%), and an expressive form was found in 20 children (37.0%). Poor cooperation in one child did not permit exact classification. DLD children with the receptive form had significantly lower mean phonemic hearing (79.1% ± 10.9) in comparison with those with the expressive form (89.7% ± 6.2, p < 0.001). A high amount of perinatal risk factors was found in both groups (50.9%) as well as comorbid developmental diseases. Developmental motor coordination disorder was diagnosed in 33 children (61.1%), and attention deficit or hyperactivity disorder was diagnosed in 39 children (70.9%). Almost one half of DLD children (49.1%) showed abnormalities on the wake EEG; epileptiform discharges were found in 20 children (36.4%). Nocturnal EEG and PSG recordings showed enhanced epileptiform discharges, and they were found in 30 children (55.6%, p = 0.01). The wake EEG showed focal discharges predominantly in the temporal or temporo-parieto-occipital regions bilaterally, while in the sleep recordings, focal activity was shifted to the fronto-temporo-central areas (p < 0.001). Almost all epileptiform discharges appeared in non-rapid eye movement (NREM) sleep. A close connection was found between DLD and perinatal risk factors, as well as neurodevelopmental disorders. Epileptiform discharges showed an enhancement in nocturnal sleep, and the distribution of focal discharges changed.

Influence of age on speech intelligibility in babble noise.

Problems with hearing aids, particularly with regard to speech intelligibility in the presence of noise, are commonly reported by older individuals in everyday practice. The main goal of this study was to measure differences in speech intelligibility between older and younger people and to establish how speech intelligibility in competitive noise differs between younger and older populations with similar hearing status. More than 400 persons were tested using the Czech Test of Sentence Intelligibility in Babble Noise and divided into younger (40-65 years) and older (66-85 years) age groups. Test performance was compared between age groups based on subgroups stratified by SRT values (speech reception threshold in word audiometry in silence). Results showed a significant correlation between older age and diminished sentence intelligibility in competitive noise. Evaluation using a nonparametric U­test showed a statistical difference between the younger and older groups in sentence intelligibility, with a speech signal presented at 65 dB sound pressure level (SPL) and competitive babble noise also presented at 65 dB SPL. Increased difficulty in the use of hearing aids in older users is related, among other things, to a reduced ability to discriminate speech not only in silence but particularly in competitive variable noise due both to their aging auditory functions and to a diminished capacity to differentiate the time factors of sounds. It is probably connected with the diminished function of inhibitory neurons.

[Speech intelligibility in noise at presbycusis]. / Rozumení reci v sumu u presbyakuze.

Evaluation of speech recognition is possible by presenting testing material in sentence form with presence of competitive noise. We developed new test of sentence intelligibility in noise in the Czech language. This article demonstrates results of the influence of the babble noise on sentence intelligibility in hearing impaired listeners with presbycusis. The time characteristics of babble noise are similar to human voice. That is the reason why this noise masking is more enhanced at the central hearing level than any other noise masking. A group of 423 persons was divided into younger group (age from 40 to 65 years, N = 191, mean age 55.8 years.) and older group (age from 66 to 85 years, N = 232, mean age 75.4 years). For these two age groups, we compared the test performance in the subgroups stratified by the speech audiometry in silence. We demonstrate a statistically significant worse understanding of sentences in the older group against the younger group listening to sentences at level 65 dB SPL in competitive noise at level 65 dB SPL (p = 0.05). The development of the sentence intelligibility in noise test increased the possibilities of audiological examination by another test, which was up to now missing in the Czech language.

Central auditory processing disorder (CAPD) in children with specific language impairment (SLI). Central auditory tests.

The aim of this project is to use central auditory tests for diagnosis of central auditory processing disorder (CAPD) in children with specific language impairment (SLI), in order to confirm relationship between speech-language impairment and central auditory processing. We attempted to establish special dichotic binaural tests in Czech language modified for younger children. Tests are based on behavioral audiometry using dichotic listening (different auditory stimuli that presented to each ear simultaneously). The experimental tasks consisted of three auditory measures (test 1-3)-dichotic listening of two-syllable words presented like binaural interaction tests. Children with SLI are unable to create simple sentences from two words that are heard separately but simultaneously. Results in our group of 90 pre-school children (6-7 years old) confirmed integration deficit and problems with quality of short-term memory. Average rate of success of children with specific language impairment was 56% in test 1, 64% in test 2 and 63% in test 3. Results of control group: 92% in test 1, 93% in test 2 and 92% in test 3 (p<0.001). Our results indicate the relationship between disorders of speech-language perception and central auditory processing disorders.