Differential Diagnosis of Speech Sound Disorder (Phonological Disorder): Audiological Assessment beyond the Pure-tone Audiogram

2015 ◽  
Vol 26 (04) ◽  
pp. 423-435 ◽  
Author(s):  
Vasiliki Vivian Iliadou ◽  
Gail D. Chermak ◽  
Doris-Eva Bamiou
Keyword(s):  
Auditory Processing ◽  
Pure Tone ◽  
Case Reports ◽  
Full Range ◽  
Speech Sound ◽  
Pure Tone Audiometry ◽  
Central Auditory Processing ◽  
Auditory Function ◽  
Speech Sound Disorder ◽  
Auditory Nervous System

Background: According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosis of speech sound disorder (SSD) requires a determination that it is not the result of other congenital or acquired conditions, including hearing loss or neurological conditions that may present with similar symptomatology. Purpose: To examine peripheral and central auditory function for the purpose of determining whether a peripheral or central auditory disorder was an underlying factor or contributed to the child’s SSD. Research Design: Central auditory processing disorder clinic pediatric case reports. Study Sample: Three clinical cases are reviewed of children with diagnosed SSD who were referred for audiological evaluation by their speech–language pathologists as a result of slower than expected progress in therapy. Results: Audiological testing revealed auditory deficits involving peripheral auditory function or the central auditory nervous system. These cases demonstrate the importance of increasing awareness among professionals of the need to fully evaluate the auditory system to identify auditory deficits that could contribute to a patient’s speech sound (phonological) disorder. Conclusions: Audiological assessment in cases of suspected SSD should not be limited to pure-tone audiometry given its limitations in revealing the full range of peripheral and central auditory deficits, deficits which can compromise treatment of SSD.

AUDIOLOGICAL CORRELATES OF AGE-RELATED MANIFESTATIONS OF AUDITORY DISORDERS

2020 ◽  
pp. 549-554
Author(s):  
Л. Е. Голованова ◽  
Е. А. Огородникова ◽  
Н. С. Белокурова ◽  
Е. С. Лаптева ◽  
М. Ю. Бобошко
Keyword(s):  
Hearing Aids ◽  
Auditory Processing ◽  
Pure Tone ◽  
Young Patients ◽  
Pure Tone Audiometry ◽  
Sound Field ◽  
Speech Audiometry ◽  
Central Auditory Processing ◽  
Central Auditory Processing Disorder ◽  
Age Related

Целью исследования был сравнительный анализ жалоб и аудиологических показателей у пациентов сурдологического центра в зависимости от возраста. Представлены результаты обследования 300 первичных пациентов (случайная выборка), обратившихся к сурдологу-оториноларингологу в течение 1 мес. В группу молодых пациентов (19-44 года) вошли 40 человек; в группу среднего возраста (45- 59 лет) - 62 человека; в группу пожилых (60-74 года) - 100 человек; в группу старческого возраста (75-90 лет) - 98 человек. Обследование включало сбор жалоб и анамнеза, ЛОР-осмотр, тональную пороговую аудиометрию, импедансометрию, речевую аудиометрию в наушниках для выявления признаков центральных слуховых расстройств или в свободном звуковом поле для оценки эффективности слухопротезирования. Установлено, что для ранней диагностики тугоухости и профилактики возрастных сенсорнокогнитивных дисфункций целесообразно использовать не только результаты тональной пороговой аудиометрии, но и данные речевой аудиометрии, а также анализ субъективных жалоб. Результаты работы свидетельствуют о необходимости организации скрининга состояния слуха в рамках диспансеризации населения старше 60 лет. The aim of the study was a comparative analysis of complaints and audiological findings in patients of the audiological center depending on their age. The results of the examination of 300 fi rstly consulted patients (random sample) are presented. The group of young patients (19-44 years) included 40 people; middle age (45-59 years) - 62 people; elderly (60-74 years) - 100 people; senile age (75-90 years) - 98 people. The survey included the collection of complaints and anamnesis, ENT checkup, pure tone audiometry, impedancemetry, speech audiometry in headphones to detect the signs of Central Auditory Processing Disorder or in the free sound field to assess the effectiveness of hearing aids. It was found that for early diagnosis of hearing loss and prevention of age-related sensory-cognitive dysfunction, it is advisable to use not only the results of pure tone audiometry, but also the data of speech audiometry, as well as the analysis of subjective complaints. The results of the work indicate the need for hearing screening in the population over 60 years old.

scholarly journals Hearing Characteristics of Stroke Patients: Prevalence and Characteristics of Hearing Impairment and Auditory Processing Disorders in Stroke Patients

2017 ◽  
Vol 28 (06) ◽  
pp. 491-505 ◽  
Author(s):  
Nehzat Koohi ◽  
Deborah A. Vickers ◽  
Rahul Lakshmanan ◽  
Hoskote Chandrashekar ◽  
David J. Werring ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Auditory Processing ◽  
Otoacoustic Emissions ◽  
Pure Tone Audiometry ◽  
Stroke Survivors ◽  
Central Auditory Processing ◽  
Hearing Impairments ◽  
Stroke Patients ◽  
Brainstem Response

Background: Stroke survivors may suffer from a range of hearing impairments that may restrict their participation in postacute rehabilitation programs. Hearing impairment may have a significant impact on listening, linguistic skills, and overall communication of the affected stroke patient. However, no studies sought to systematically characterize auditory function of stroke patients in detail, to establish the different types of hearing impairments in this cohort of patients. Such information would be clinically useful in understanding and addressing the hearing needs of stroke survivors. Purpose: The present study aimed to characterize and classify the hearing impairments, using a detailed audiological assessment test battery, in order to determine the level of clinical need and inform appropriate rehabilitation for this patient population. Research Design: A case–control study. Study Sample: Forty-two recruited stroke patients who were discharged from a stroke unit and 40 control participants matched for age. Data Collection and Analysis: All participants underwent pure-tone audiometry and immittance measurements including acoustic reflex threshold, transient-evoked otoacoustic emissions, auditory-evoked brainstem response, and a central auditory processing assessment battery, performed in a single session. Hearing impairments were classified as peripheral hearing loss (cochlear and neural type), central auditory processing disorder (CAPD), and as a combination of CAPD and peripheral hearing loss. Results: Overall mean hearing thresholds were not significantly different between the control and stroke groups. The most common type of hearing impairment in stroke patients was the combination type, “peripheral and CAPD,” in the 61- to 80-yr-old subgroup (in 55%), and auditory processing deficits in 18- to 60-yr-olds (in 40%), which were both significantly higher than in controls. Conclusions: This is the first study to examine hearing function in detail in stroke patients. Given the importance of hearing for the efficiency of communication, it is essential to identify hearing impairments and differentiate peripheral and central deficits to define an appropriate intervention plan.

Auditory function in early syphilis A follow up study

1984 ◽  
Vol 98 (6) ◽  
pp. 567-572 ◽  
Author(s):  
Ulf Rosenhall Gun-Briti Löwhagen ◽  
Gösta Roupe
Keyword(s):  
Hearing Loss ◽  
Auditory System ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Auditory Brainstem ◽  
Vascular Involvement ◽  
Auditory Function ◽  
Follow Up Study ◽  
Before And After

Abstract Twenty-six patients with secondary or early latent sypilis were examined by auditory brainstem reponse (ABR) audiometry and by pure tone audiometry before and after treatment. Normalization was registered in four of seven patients with pathological ABR before treatment, while in three patients the ABR abnormalities remained after treatment. Thirteen patients exhibited a sensorineural hearing-loss before treatment. In two patients this hearing-loss improved after treatment and a syphilitic etiology seems plausible. The reversible lesions in the auditory system may be related to asymptomatic syphilitic meningitis. Permanent ABR abnormalities might reflect syphilitic vascular involvement in the brainstem.

The Effect of Aging and the High-Frequency Auditory Threshold on Speech-Evoked Mismatch Negativity in a Noisy Background

2015 ◽  
Vol 21 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Junming Chen ◽  
Suijun Chen ◽  
Yiqing Zheng ◽  
Yongkang Ou
Keyword(s):  
Auditory Processing ◽  
High Frequency ◽  
Mismatch Negativity ◽  
Pure Tone ◽  
The Elderly ◽  
Elderly Subjects ◽  
Control Group ◽  
Central Auditory Processing ◽  
Hearing Thresholds ◽  
Noisy Background

Mismatch negativity (MMN) has been widely used to study the function of central auditory processing in the elderly. However, current research has not yet considered the effect of noise and high-frequency hearing threshold on MMN in the elderly. The aim of this study was to evaluate the effect of aging and high-frequency hearing loss on speech-related MMN in noisy backgrounds. Additionally, the possible mechanisms of central auditory processing dysfunction in the elderly were investigated. Fifty people aged 61-80 (70 ± 5.8) years were recruited for this study. They were divided into a 61- to 70-year-old group and a 71- to 80-year-old group. Fifty younger adults aged 21-40 (31 ± 5.3) years were recruited as healthy controls. Pure-tone hearing thresholds were recorded. A speech discrimination score (SDS) and a speech-evoked MMN under white noise with a bandwidth from 125 to 8,000 Hz background condition were recorded. The relationships between SDS and MMN latency and amplitude were analyzed. The effects of age and binaural 2,000-, 4,000- and 8,000-Hz pure-tone hearing thresholds on MMN latency and amplitude were analyzed. We found that the hearing thresholds of 2,000, 4,000 and 8,000 Hz in the 61- to 70-year-old and 71- to 80-year-old groups were higher than those in the control group. The SDS in a noisy background in the 61- to 70-year-old and 71- to 80-year-old groups were lower than those in the control group. Speech-evoked MMN latency was longer in the 61- to 70-year-old and in the 71- to 80-year-old groups than in the control group (215.8 ± 14.2 ms). SDS and speech-evoked MMN latency were negatively correlated. Age and speech-evoked MMN latency were positively correlated, as were the binaural 4,000- to 8,000-Hz pure-tone hearing thresholds and speech-evoked MMN. This study suggests that in elderly subjects, the function of preattentive central auditory processing changes. Additionally, increasing age and high-frequency hearing thresholds create a synergy in neurons that is weakened in the MMN time window, which may be a cause of central auditory processing disorders in elderly subjects in noisy background conditions.

Prognostic Value of a Test of Central Auditory Function in Conversion from Mild Cognitive Impairment to Dementia

2020 ◽  
Vol 25 (5) ◽  
pp. 276-282 ◽  
Author(s):  
Jenny Häggström ◽  
Christina Hederstierna ◽  
Ulf Rosenhall ◽  
Per Östberg ◽  
Esma Idrizbegovic
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Pure Tone Audiometry ◽  
Cognitive Outcome ◽  
Central Auditory Processing ◽  
Auditory Function ◽  
Predictive Capacity ◽  
Significant Difference ◽  
Central Auditory Function

Background/Objective: It has been suggested that central auditory processing dysfunction might precede the development of cognitive decline and Alzheimer’s disease (AD). The Dichotic Digits Test (DDT) has been proposed as a test of central auditory function. Our objective was to evaluate the predictive capacity of the DDT in conversion from mild cognitive impairment (MCI) to dementia. Methods: A total of 57 participants (26 females) with MCI were tested at baseline with pure tone audiometry, speech in quiet and in noise, and the DDT. The cognitive outcome was retrieved from medical files after 5 years. Groupwise comparisons of the baseline DDT scores were performed and the relative risk was calculated. Results: Altogether 22 subjects developed any kind of dementia. Of the original 57 individuals within the MCI group, 15 developed AD and 7 developed other types of dementia. There was no significant difference in baseline DDT scores between the participants who converted to AD and those who did not. However, the group who developed other types of dementia (especially frontotemporal dementia) had lower DDT scores in the left ear than those participants who did not develop dementia. With a baseline DDT score below 50% correct responses, the participants diagnosed with MCI had a 2.49-times-higher risk of developing dementia than those with scores of 50% or better. Conclusion: The DDT as a central auditory test may be suitable when evaluating cognitive decline.

“He'll Grow out of it Soon—Won't He?”—The Characteristics of Older Children's Speech When They Do—and Don't—Grow out of it

2015 ◽  
Vol 16 (2) ◽  
pp. 25-36 ◽  
Author(s):  
Yvonne Wren
Keyword(s):  
Risk Factors ◽  
Full Range ◽  
Speech Sound ◽  
Early Years ◽  
Language Therapy ◽  
Speech Sound Disorder ◽  
Sound System ◽  
Speech And Language Therapy ◽  
Therapy Services ◽  
Children's Speech

Speech sound disorder is a common reason for referral to speech and language therapy services in the early years. While for some children, their difficulties are transitory and they either respond to intervention or their difficulties resolve, for others, their speech sound difficulties evolve into persistent speech disorder (PSD). The purpose of this article is to provide information on the features of PSD and how to assess children with PSD in order to identify the full range and limits of their speech sound system. Reference is made to ALSPAC, a large longitudinal population study, regarding prevalence, possible subtypes, and risk factors for PSD.

Central Auditory Function in Young Stutterers

1984 ◽  
Vol 59 (3) ◽  
pp. 699-705 ◽  
Author(s):  
Gordon W. Blood ◽  
Ingrid M. Blood
Keyword(s):  
Auditory Processing ◽  
Central Auditory Processing ◽  
Auditory Function ◽  
Central Auditory Function ◽  
Auditory Functions

16 stutterers and 16 nonstutterers between the ages of 8 and 11 yr. were administered a battery of central auditory processing tests. The six audiological tests evaluated a range of auditory functions. Analysis indicated no significant differences between the two groups; however, inspection of the data showed 6 of the stuttering subjects performed consistently more poorly on four of the tests than the nonstuttering subjects. Results are discussed in relationship to subgroups of stutterers with auditory problems.

Associations between Diet and Both High and Low Pure Tone Averages and Transient Evoked Otoacoustic Emissions in an Older Adult Population-Based Study

2011 ◽  
Vol 22 (01) ◽  
pp. 049-058 ◽  
Author(s):  
Christopher Spankovich ◽  
Linda J. Hood ◽  
Heidi J. Silver ◽  
Warren Lambert ◽  
Victoria M. Flood ◽  
...  
Keyword(s):  
Otoacoustic Emissions ◽  
Human Population ◽  
Pure Tone ◽  
Adult Population ◽  
Redox Homeostasis ◽  
Pure Tone Audiometry ◽  
Population Based ◽  
Vascular Health ◽  
Auditory Function ◽  
Cross Sectional

Background: Evidence from animal models suggests that redox homeostasis (the balance between oxidative stressors and antioxidants) and vascular health are important in the pathogenesis of sensorineural hearing loss (SNHL) and that dietary nutrients that have roles in these processes could influence the susceptibility to SNHL. Purpose: To examine associations between total nutrient intakes and auditory function outcomes in an older human population. Research Design: Descriptive characteristics and dietary data from food frequency questionnaires were collected in a cross-sectional study design and analyzed for associations with auditory function outcomes (i.e., otoacoustic emissions and pure tone audiometry measured in a sound-treated room by an audiologist). Study Sample: 2111 adults, 49–99 yr of age Results: Higher carbohydrate, vitamin C, vitamin E, riboflavin, magnesium, and lycopene intakes were all significantly associated with larger TEOAE amplitude and better pure tone thresholds. Higher cholesterol, fat, and retinol intakes were significantly associated with lower TEOAE amplitude and worse pure tone thresholds. Conclusions: These data suggest that nutrients with known roles in redox homeostasis and vascular health are associated with auditory function measures in a human population. Further investigation is warranted to determine direct and indirect influences of dietary intake on measures of auditory function and to explore which nutrients/nutrient combinations are predictive of SNHL.

Nonmodularity of the Central Auditory Nervous System

2005 ◽  
Vol 14 (2) ◽  
pp. 128-138 ◽  
Author(s):  
Frank E. Musiek ◽  
Teri James Bellis ◽  
Gail D. Chermak
Keyword(s):  
Nervous System ◽  
Differential Diagnosis ◽  
Sensitivity And Specificity ◽  
Diagnostic Tests ◽  
Diagnostic Tools ◽  
Central Auditory Processing ◽  
Auditory Function ◽  
Auditory Nervous System ◽  
Central Auditory Function ◽  
Central Auditory Nervous System

This response to A. T. Cacace and D. J. McFarland (2005) identifies points of agreement and disagreement regarding the concept of modularity in the diagnosis of (central) auditory processing disorder [(C)APD]. We concur that the evaluation of (C)APD must take into consideration the influence of higher order global or pansensory issues on performance on tests of central auditory function. To accomplish this goal, multidisciplinary (e.g., multimodal) testing is an integral part of differential diagnosis of (C)APD. We also agree that the efficiency of diagnostic tests of (C)APD should not be evaluated by imprecise criteria [e.g., "presumed" or "suspected" (C)APD], which do not provide accurate measures of the true sensitivity and specificity of these tests. Our conceptualization and recommendations for clinical practice in this area diverge, however, from that of Cacace and McFarland in a number of pivotal ways. Based on the current limitations of multimodal assessment relative to issues related to scope of practice and test efficiency, as well as the accumulated basic science and clinical literature that demonstrates the nonmodularity and interactive organization of the brain, we recommend use of the sensitized test battery of the central auditory nervous system (CANS) in combination with multidisciplinary testing to differentially diagnose (C)APD and to guide treatment of the disorder. We assert that sensitivity and specificity measures derived from individuals with well-circumscribed lesions of the CANS provide an important guide to establishing the validity of central auditory diagnostic tests. We note that researchers in the area of auditory science and (C)APD must acknowledge the challenges of the clinical arena, and we encourage their continued help to develop diagnostic tools that are both efficient and practical for the differential diagnosis of (C)APD. We conclude that our approach, which combines multidisciplinary evaluation and specific tests of central auditory function that have demonstrated sensitivity and specificity for disorders of the CANS, allows us to identify (and thus rehabilitate) the auditory deficits present in individuals with (C)APD in its "purest" form. It also permits the identification and rehabilitation of auditory deficits in individuals who exhibit auditory perceptual problems that coexist with other processing problems, while ruling out those who perform poorly on auditory tests because of a global, supramodal problem involving cognition, attention, language, memory, or related skills.

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