Are ‘‘Dichotic’’ Deficits Uniquely Dichotic? Investigating Dichotic Performance with the Dichotic Digits Difference Test (DDdT) in a Large Clinical Population of Children Referred for an Auditory Processing Assessment

2020 ◽  
Author(s):  
Sharon Cameron ◽  
Harvey Dillon
Keyword(s):  
Auditory Processing ◽  
Large Population ◽  
Clinical Population ◽  
Clinical Group ◽  
Central Auditory Processing ◽  
Typically Developing ◽  
Central Auditory Processing Disorder ◽  
Significant Difference ◽  
Z Scores ◽  
Listening Task

Background: Previous studies in a large population of typically developing (TD) children and a smallclinical group showed high correlations between the dichotic and diotic conditions of the Dichotic Digitsdifference Test (DDdT), as well as between DDdT performance and measures of memory and attention.Purpose: The purpose of the study was to investigate the performance on the DDdT in a large clinical sample.Research Design: Correlational analysis between the DDdT diotic condition and the dichotic free recall (FR)right-ear, left-ear, and total (ear-averaged) conditions, as well as between DDdT and memory performance.Study Sample: One hundred one children (6 years, 3 months to 15 years, 0 months, mean 9 years, 6 months)were referred for assessment to the Australian Hearing Central Auditory Processing Disorder (CAPD) service.Results were compared with data from 112 TD children collected from previously published studies.Data Collection and Analysis: Z-scores were used to account for the effect of age on performance.Mean differences between clinical and TD children were investigated using analysis of variance(ANOVA). Pearson product-moment correlations determined the strength of relationships between DDdTconditions and the number memory forward (NMF) and reversed (NMR) subtests of the Test of AuditoryProcessing Skills—Third Edition.Results: Performance by the clinical group on the DDdT dichotic FR (RE, LE, and total) conditions wassignificantly correlated with the diotic condition (r = 0.7; 0.7, 0.8; p < 0.001). Significant correlations werefound between the DDdT diotic and dichotic FR conditions and the NMF (r = 0.5–0.6, p < 0.001) andNMR (r = 0.2–0.5, p < 0.025–0.001). ANOVA revealed no significant difference between the TD andclinical groups (p = 1.0000) in respect to the advantage they got from dichotic listening (calculated asdichotic FR total minus diotic score). Multiple regression revealed that diotic performance and short-termmemory accounted for 68% of the variation in dichotic performance. Random measurement erroraccounted for a further 16%.Conclusions: Factors other than dichotic performance strongly impact a child’s ability to perform a dichoticdigit listening task. This result has widespread implications in respect to the interpretation of CAPDtest results.

scholarly journals Are “Dichotic” Deficits Uniquely Dichotic? Investigating Dichotic Performance with the Dichotic Digits Difference Test (DDdT) in a Large Clinical Population of Children Referred for an Auditory Processing Assessment

2020 ◽  
Vol 31 (03) ◽  
pp. 233-242 ◽  
Author(s):  
Sharon Cameron ◽  
Harvey Dillon
Keyword(s):  
Auditory Processing ◽  
Short Term Memory ◽  
Clinical Sample ◽  
Large Population ◽  
Clinical Population ◽  
Clinical Group ◽  
Central Auditory Processing ◽  
Random Measurement Error ◽  
Significant Difference ◽  
Difference Test

AbstractPrevious studies in a large population of typically developing (TD) children and a small clinical group showed high correlations between the dichotic and diotic conditions of the Dichotic Digits difference Test (DDdT), as well as between DDdT performance and measures of memory and attention.The purpose of the study was to investigate the performance on the DDdT in a large clinical sample.Correlational analysis between the DDdT diotic condition and the dichotic free recall (FR) right-ear, left-ear, and total (ear-averaged) conditions, as well as between DDdT and memory performance.One hundred one children (6 years 3 months to 15 years 0 month, mean 9 years 6 months) were referred for assessment to the Australian Hearing Central Auditory Processing Disorder (CAPD) service. Results were compared with data from 112 TD children collected from previously published studies.Z-scores were used to account for the effect of age on performance. Mean differences between clinical and TD children were investigated using analysis of variance (ANOVA). Pearson product-moment correlations determined the strength of relationships between DDdT conditions and the number memory forward (NMF) and reversed (NMR) subtests of the Test of Auditory Processing Skills—Third Edition.Performance by the clinical group on the DDdT dichotic FR (RE, LE, and total) conditions was significantly correlated with the diotic condition (r = 0.7; 0.7, 0.8; p < 0.001). Significant correlations were found between the DDdT diotic and dichotic FR conditions and the NMF (r = 0.5–0.6, p < 0.001) and NMR (r = 0.2–0.5, p < 0.025–0.001). ANOVA revealed no significant difference between the TD and clinical groups (p = 1.0000) in respect to the advantage they got from dichotic listening (calculated as dichotic FR total minus diotic score). Multiple regression revealed that diotic performance and short-term memory accounted for 68% of the variation in dichotic performance. Random measurement error accounted for a further 16%.Factors other than dichotic performance strongly impact a child’s ability to perform a dichotic digit listening task. This result has widespread implications in respect to the interpretation of CAPD test results.

The Utility of Visual Analogs of Central Auditory Tests in the Differential Diagnosis of (Central) Auditory Processing Disorder and Attention Deficit Hyperactivity Disorder

2011 ◽  
Vol 22 (08) ◽  
pp. 501-514 ◽  
Author(s):  
Teri James Bellis ◽  
Cassie Billiet ◽  
Jody Ross
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Differential Diagnosis ◽  
Auditory Processing ◽  
Auditory Processing Disorder ◽  
Central Auditory Processing ◽  
Typically Developing ◽  
Typically Developing Children ◽  
Central Auditory Processing Disorder ◽  
Hyperactivity Disorder ◽  
Comparison Measures

Background: Cacace and McFarland (2005) have suggested that the addition of cross-modal analogs will improve the diagnostic specificity of (C)APD (central auditory processing disorder) by ensuring that deficits observed are due to the auditory nature of the stimulus and not to supra-modal or other confounds. Others (e.g., Musiek et al, 2005) have expressed concern about the use of such analogs in diagnosing (C)APD given the uncertainty as to the degree to which cross-modal measures truly are analogous and emphasize the nonmodularity of the CANs (central auditory nervous system) and its function, which precludes modality specificity of (C)APD. To date, no studies have examined the clinical utility of cross-modal (e.g., visual) analogs of central auditory tests in the differential diagnosis of (C)APD. Purpose: This study investigated performance of children diagnosed with (C)APD, children diagnosed with ADHD (attention deficit hyperactivity disorder), and typically developing children on three diagnostic tests of central auditory function and their corresponding visual analogs. The study sought to determine whether deficits observed in the (C)APD group were restricted to the auditory modality and the degree to which the addition of visual analogs aids in the ability to differentiate among groups. Research Design: An experimental repeated measures design was employed. Study Sample: Participants consisted of three groups of right-handed children (normal control, n = 10; ADHD, n = 10; (C)APD, n = 7) with normal and symmetrical hearing sensitivity, normal or corrected-to-normal visual acuity, and no family or personal history of disorders unrelated to their primary diagnosis. Participants in Groups 2 and 3 met current diagnostic criteria for ADHD and (C)APD. Data Collection and Analysis: Visual analogs of three tests in common clinical use for the diagnosis of (C)APD were used (Dichotic Digits [Musiek, 1983]; Frequency Patterns [Pinheiro and Ptacek, 1971]; and Duration Patterns [Pinheiro and Musiek, 1985]). Participants underwent two 1 hr test sessions separated by at least 1 wk. Order of sessions (auditory, visual) and tests within each session were counterbalanced across participants. ANCOVAs (analyses of covariance) were used to examine effects of group, modality, and laterality (Dichotic/Dichoptic Digits) or response condition (auditory and visual patterning). In addition, planned univariate ANCOVAs were used to examine effects of group on intratest comparison measures (REA, HLD [Humming-Labeling Differential]). Results: Children with both ADHD and (C)APD performed more poorly overall than typically developing children on all tasks, with the (C)APD group exhibiting the poorest performance on the auditory and visual patterns tests but the ADHD and (C)APD group performing similarly on the Dichotic/Dichoptic Digits task. However, each of the auditory and visual intratest comparison measures, when taken individually, was able to distinguish the (C)APD group from both the normal control and ADHD groups, whose performance did not differ from one another. Conclusions: Results underscore the importance of intratest comparison measures in the interpretation of central auditory tests (American Speech-Language-Hearing Association [ASHA], 2005; American Academy of Audiology [AAA], 2010). Results also support the “non-modular” view of (C)APD in which cross-modal deficits would be predicted based on shared neuroanatomical substrates. Finally, this study demonstrates that auditory tests alone are sufficient to distinguish (C)APD from supra-modal disorders, with cross-modal analogs adding little if anything to the differential diagnostic process.

Auditory Temporal-Organization Abilities in School-Age Children With Peripheral Hearing Loss

2013 ◽  
Vol 56 (4) ◽  
pp. 1065-1074 ◽  
Author(s):  
Amineh Koravand ◽  
Benoît Jutras
Keyword(s):  
Hearing Loss ◽  
Auditory Processing ◽  
Normal Hearing ◽  
Temporal Organization ◽  
School Age Children ◽  
Central Auditory Processing ◽  
Central Auditory Processing Disorder ◽  
Verbal Stimuli ◽  
Sequential Organization ◽  
Significant Difference

Purpose The objective was to assess auditory sequential organization (ASO) ability in children with and without hearing loss. Method Forty children 9 to 12 years old participated in the study: 12 with sensory hearing loss (HL), 12 with central auditory processing disorder (CAPD), and 16 with normal hearing. They performed an ASO task in which they were asked to recall 2, 3, and 5 verbal and nonverbal stimuli with an interstimulus interval (ISI) of 425 ms as well as sequences of 2 elements with an ISI of 20 or 1,000 ms. Results No significant difference was found between the group of children with HL and the 2 other groups on nonverbal stimuli in all testing conditions. Regardless of ISI duration or number of elements in the sequence, children with HL had significantly fewer correct responses than children with normal hearing and children with CAPD for the verbal stimuli /ba/–/da/. Children with HL had significantly better performance than children with CAPD for the verbal a/–/da/ when the number of elements in the sequence varied. Conclusions Children with sensory HL showed impaired ASO ability when recalling verbal /ba/–/da/. Results suggest that hearing loss can induce a specific signature when processing these verbal stimuli.

Assessment of Functional Hearing in Greek-Speaking Children Diagnosed with Central Auditory Processing Disorder

2016 ◽  
Vol 27 (05) ◽  
pp. 395-405 ◽  
Author(s):  
Chris Sidiras ◽  
Vasiliki Vivian Iliadou ◽  
Gail D. Chermak ◽  
Ioannis Nimatoudis
Keyword(s):  
Auditory Processing ◽  
Auditory Processing Disorder ◽  
Control Group ◽  
Clinical Group ◽  
Central Auditory Processing ◽  
Comorbid Conditions ◽  
Academic Problems ◽  
Control Groups ◽  
Central Auditory Processing Disorder ◽  
And Control

Background: Including speech recognition in noise testing in audiological evaluations may reveal functional hearing deficits that may otherwise remain undetected. Purpose: The current study explored the potential utility of the Speech-in-Babble (SinB) test in the assessment of central auditory processing disorder (CAPD) in young children for whom diagnosis is challenging. Research Design: A cross-sectional analysis. Study Sample: Forty-one Greek children 4–13 yr of age diagnosed with CAPD and exhibiting listening and academic problems (clinical group) and 20 age-matched controls with no listening or academic problems participated in the study. Data Collection and Analysis: All participants’ auditory processing was assessed using the same tests and instrumentation in a sound-treated room. Two equivalent lists of the SinB test, developed at the Psychoacoustic Laboratory of the Aristotle University of Thessaloniki, were administered monaurally in a counterbalanced order. SinB consists of lists of 50 phonetically balanced disyllabic words presented in background multitalker babble. Five signal-to-noise ratios (SNRs) were used in a fixed order. The children were instructed to repeat the word after each presentation. The SNR at which the child achieved 50% correct word identification served as the dependent variable or outcome measure, with higher SinB scores (measured in SNR dB) corresponding to poorer performance. Results: SinB performance was better (lower SNR) for the normal control group versus the clinical group [F (1,35) = 43.03, p < 0.0001]. SinB inversely correlated with age for both CAPD and control groups (r = −0.648, p << 0.001 and r = −0.658, p < 0.005, respectively). Regression analysis revealed that linear models better explained the variance in the data than a quadratic model for both the control and CAPD groups. The slope (beta value of the linear model) was steeper for the clinical group compared to the control group (beta = −0.306 versus beta = −0.130, respectively). An analysis of covariance run with age as the covariate to assess the potential effect of comorbidity on SinB performance in children with CAPD with and without comorbid conditions revealed no significant difference<strike>s</strike> between groups [F (1,38) = 0.149, p > 0.05]. Conclusions: This study offers the first detailed presentation of the performance of Greek children on a Greek language SinB test. The main finding is that SinB scores improved as a function of age in a constant manner as represented by the slope of the linear regression line for both CAPD and control groups. Results suggest that this speech recognition in competition test holds promise for differentiating typically developing Greek children from those children with CAPD across the age range studied here (4–13 yr). The SinB seemed rather immune to the presence of comorbid conditions presented by some of the children in this study, suggesting its potential utility as a valid measure of central auditory processing. While there are many speech-in-noise or competition tests in English, there are fewer in other languages. Tests like the SinB should be developed in other languages to ensure that children demonstrating “listening” problems can be properly evaluated.

Investigating the Interaction between Dichotic Deficits and Cognitive Abilities Using the Dichotic Digits difference Test (DDdT) Part 2

2016 ◽  
Vol 27 (06) ◽  
pp. 470-479 ◽  
Author(s):  
Sharon Cameron ◽  
Helen Glyde ◽  
Harvey Dillon ◽  
Jessica Whitfield
Keyword(s):  
Test Performance ◽  
Auditory Processing ◽  
Cognitive Abilities ◽  
Performance Test ◽  
Assessment Tools ◽  
Clinical Population ◽  
Attention And Memory ◽  
Central Auditory Processing ◽  
Typically Developing ◽  
Difference Test

Background: The Dichotic Digits difference Test (DDdT) was developed to investigate the relationship between dichotic processing and cognitive abilities and, through the use of differential test scores, to provide professionals with a clinical tool that could aid in differentiation of clients with genuine dichotic deficits from those where cognitive disorders affect test performance. The DDdT consists of four subtests: dichotic free recall (FR), dichotic directed left ear, dichotic directed right ear, and diotic. Scores are calculated for six conditions: FR left ear (LE), right ear (RE), and total, as well as the directed left ear, directed right ear, and diotic, and four difference measures: dichotic advantage, RE advantage FR, RE advantage directed, and attention advantage. Purpose: To investigate the role of cognitive abilities on DDdT test performance. Research Design: Correlational analysis between the various DDdT conditions and difference measures, as well as between dichotic, diotic, and cognitive factors (memory, intelligence, and attention). Study Sample: Fifty typically developing children (aged 7 yr 0 mo to 12 yr 1 mo, mean = 9 yr 2 mo) and ten children recruited from the Australian Hearing CAPD Service who were diagnosed with a memory or dichotic deficit (aged 7 yr 0 mo to 15 yr 0 mo, mean = 9 yr 5 mo) took part in the study. Data Collection and Analysis: The Pearson product moment correlations were used to determine the strength of relationships between DDdT conditions as well as relationships between scores on these conditions and performance on the various cognitive assessment tools, which included the number memory forward and reversed subtests of the Test of Auditory Processing Skills – Third Edition, IVA + Plus Continuous Performance Test, and the Test of Non-Verbal Intelligence-4 (TONI-4). A parent questionnaire (Fisher’s Auditory Checklist) and a participant questionnaire (Listening Inventory for Education) were also administered. Results: Diotic performance was significantly correlated with performance on all the DDdT dichotic FR conditions (r = 0.6–0.8; p < 0.00001). Further, significant correlations were found between the FR LE, total, and diotic conditions, and the cognitive measures of attention and memory, with r ranging from 0.4 to 0.5 (p < 0.01–0.001). Right-ear performance was not significantly correlated to any cognitive measure, except for FR RE and number memory forward (r = 0.35; p = 0.006). The DDdT dichotic advantage measure was investigated in a subset of clinical children and found to aid in differentiating true dichotic from spurious results. Conclusions: As found in the DDdT normative data study that precedes in the companion paper (DDdT Study Part 1; Cameron et al, 2016), the high correlation between dichotic and diotic performances by the clinical and typically developing participants suggests that factors other than dichotic performance play a substantial role in a child’s ability to perform a dichotic listening task. Indeed, 61% of the variance in FR total scores for the children in this study was accounted for by factors that do not involve the perception of dichotic stimuli. This view is supported by the correlations between measures of attention and memory and dichotic scores. This result has wide-spread implications in respect to interpretation of central auditory processing disorder test results and further investigation of the use of the DDdT in a clinical population is warranted.

The Importance of Modality Specificity in Diagnosing Central Auditory Processing Disorder

2005 ◽  
Vol 14 (2) ◽  
pp. 112-123 ◽  
Author(s):  
Anthony T. Cacace ◽  
Dennis J. McFarland
Keyword(s):  
Auditory Processing ◽  
Discriminant Validity ◽  
Explanatory Power ◽  
Large Body ◽  
Critical Discussion ◽  
Auditory Processing Disorder ◽  
Central Auditory Processing ◽  
Central Auditory Processing Disorder ◽  
Scientific Disciplines ◽  
Modality Specificity

Purpose: This article argues for the use of modality specificity as a unifying framework by which to conceptualize and diagnose central auditory processing disorder (CAPD). The intent is to generate dialogue and critical discussion in this area of study. Method: Research in the cognitive, behavioral, and neural sciences that relates to the concept of modality specificity was reviewed and synthesized. Results: Modality specificity has a long history as an organizing construct within a diverse collection of mainstream scientific disciplines. The principle of modality specificity was contrasted with the unimodal inclusive framework, which holds that auditory tests alone are sufficient to make the CAPD diagnosis. Evidence from a large body of data demonstrated that the unimodal framework was unable to delineate modality-specific processes from more generalized dysfunction; it lacked discriminant validity and resulted in an incomplete assessment. Consequently, any hypothetical model resulting from incomplete assessments or potential therapies that are based on indeterminate diagnoses are themselves questionable, and caution should be used in their application. Conclusions: Improving specificity of diagnosis is an imperative core issue to the area of CAPD. Without specificity, the concept has little explanatory power. Because of serious flaws in concept and design, the unimodal inclusive framework should be abandoned in favor of a more valid approach that uses modality specificity.

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.

Sign in / Sign up

Export Citation Format

Share Document