Cristina Ferraz Borges Murphy

Correlações entre leitura, consciência fonológica e processamento temporal auditivo

BACKGROUND: auditory temporal processing and reading. AIM: to analyse the potential correlations between reading acquisition, phonological awareness, and auditory temporal processing in Brazilian children with dyslexia. METHOD: this study evaluated sixty children, nine to twelve years of age, divided into two groups: a control group of twenty seven children without dyslexia and a study group of thirty three children with dyslexia. The children in both groups were submitted to tests designed to assess reading skills, phonological awareness, and auditory temporal processing. RESULTS: in the results of all three tests, significant differences were found between the dyslexic children and those in the control group, with poorer results for the dyslexic group. However, for both groups, correlations were found only between the performance on the reading test and the performance on the phonological awareness test. CONCLUSION: dyslexic children demonstrated poorer results in all tests when compared to their controls. However, there was no definitive evidence that their poor performance on the auditory temporal processing tests was directly related to their phonological awareness skills, or even to their reading skills.

Habilidades auditivas em crianças com dislexia e transtorno do déficit de atenção e hiperatividade

BACKGROUND: auditory processing and co-occurrence of pathologies. AIM: to investigate the performance of children with Dyslexia and attention deficit hyperactivity disorder (ADHD) in behavioral and auditory processing tests, comparing the results to a control group. METHOD: participants of the study were 30 children, with ages between 7 and 12 years, divided into three groups: a control group of 10 children, a study group of 10 children with dyslexia and a study group of 10 children with ADHD. All participants were submitted to the following auditory processing tests: Speech in Noise, Dichotic of Digits and Frequency Pattern. RESULTS: concerning the Speech in Noise Test, there was an interactive effect between the control group and the ADHD group (p < 0.001), with the ADHD group presenting a significantly lower performance; for the Dichotic of Digits test, there was an interactive effect between the three groups (p < 0.001), with the ADHD group presenting a lower performance, followed by the dyslexic and control groups; for the Frequency Pattern, there was a marginal effect (p = 0.056) with the ADHA group presenting a lower performance, followed by the dyslexic and control groups. CONCLUSION: the ADHD group presented a poorer performance in all tests when compared to the dyslexic and control groups. This result suggests a relationship between attention and hearing abilities.

How auditory temporal processing deficits relate to dyslexia

Studies have shown that dyslexic children present a deficiency in the temporal processing of auditory stimuli applied in rapid succession. However, discussion continues concerning the way this deficiency can be influenced by temporal variables of auditory processing tests. Therefore, the purpose of the present study was to analyze by auditory temporal processing tests the effect of temporal variables such as interstimulus intervals, stimulus duration and type of task on dyslexic children compared to a control group. Of the 60 children evaluated, 33 were dyslexic (mean age = 10.5 years) and 27 were normal controls (mean age = 10.8 years). Auditory processing tests assess the abilities of discrimination and ordering of stimuli in relation to their duration and frequency. Results showed a significant difference in the average accuracy of control and dyslexic groups considering each variable (interstimulus intervals: 47.9 +/- 5.5 vs 37.18 +/- 6.0; stimulus duration: 61.4 +/- 7.6 vs 50.9 +/- 9.0; type of task: 59.9 +/- 7.9 vs 46.5 +/- 9.0) and the dyslexic group demonstrated significantly lower performance in all situations. Moreover, there was an interactive effect between the group and the duration of stimulus variables for the frequency-pattern tests, with the dyslexic group demonstrating significantly lower results for short durations (53.4 +/- 8.2 vs 48.4 +/- 11.1), as opposed to no difference in performance for the control group (62.2 +/- 7.1 vs 60.6 +/- 7.9). These results support the hypothesis that associates dyslexia with auditory temporal processing, identifying the stimulus-duration variable as the only one that unequally influenced the performance of the two groups.

Processamento auditivo (central) em crianças com dislexia: avaliação comportamental e eletrofisiológica

PURPOSE: To compare the performances of children with dyslexia and a control group in behavioral tests of (Central) Auditory Processing and Long Latency Auditory Evoked Potentials (P300). METHODS: Participants were 22 individuals with dyslexia (study group) and 16 individuals with typical development (control group). All individuals underwent behavioral and electrophysiological assessment of (Central) Auditory Processing (Frequency Pattern Test, Dichotic Digit Test, Speech-in-Noise Test, and P300). RESULTS: Concerning the behavioral tests, there was difference between groups for the Frequency Pattern Test and for the left ear in the Dichotic Digit Test, with worse performance observed in the study group. Considering the P300, there was difference between groups regarding amplitude and latency absolute values, but this finding was not statistically significant. CONCLUSION: The findings suggest that individuals with dyslexia present temporal auditory processing and figure-ground alterations, which was evidenced by behavioral auditory processing tests. There was no difference between the performance of both groups for the P300 test.

Auditory processing in children and adolescents in situations of risk and vulnerability

CONTEXT AND OBJECTIVE Children and adolescents who live in situations of social vulnerability present a series of health problems. Nonetheless, affirmations that sensory and cognitive abnormalities are present are a matter of controversy. The aim of this study was to investigate aspects to auditory processing, through applying the brainstem auditory evoked potential (BAEP) and behavioral auditory processing tests to children living on the streets, and comparison with a control group. DESIGN AND SETTING Cross-sectional study in the Laboratory of Auditory Processing, School of Medicine, Universidade de São Paulo. METHODS The auditory processing tests were applied to a group of 27 individuals, subdivided into 11 children (7 to 10 years old) and 16 adolescents (11 to 16 years old), of both sexes, in situations of social vulnerability, compared with an age-matched control group of 10 children and 11 adolescents without complaints. The BAEP test was also applied to investigate the integrity of the auditory pathway. RESULTS For both children and adolescents, there were significant differences between the study and control groups in most of the tests applied, with significantly worse performance in the study group, except in the pediatric speech intelligibility test. Only one child had an abnormal result in the BAEP test. CONCLUSIONS The results showed that the study group (children and adolescents) presented poor performance in the behavioral auditory processing tests, despite their unaltered auditory brainstem pathways, as shown by their normal results in the BAEP test.

Effect of Nonlinguistic Auditory Training on Phonological and Reading Skills

Objective: To analyze the effect of nonverbal auditory training on reading and phonological awareness tasks in children with dyslexia and the effect of age in relation to post-training learning considering the ages from 7 to 14. Methods: In experiment 1, one group with dyslexia (total = 12) was trained and compared with a group of untrained dyslexic subjects (total = 28). In experiment 2, the performance of the trained dyslexic group (total = 18) was compared at three different moments: 2 months before, at the beginning, and at the end of training. Training was carried out for 2 months using a computer program responsible for training discrimination skills. Results: The group receiving nonverbal auditory training demonstrated significant improvements (mainly for the group from 7 to 10 years old), not only in the nonverbal auditory skills trained (p < 0.001), but also in phonological awareness syllable tasks (synthesis, segmentation, manipulation and syllable transposition) in experiment 1 (p < 0.003), and phonemic tasks (p < 0.001) and text reading (p < 0.001) in experiment 2. Conclusion: The results suggest a link between verbal and nonverbal skills, in addition to corroborating studies regarding the existence of a critical learning period.

Auditory and Visual Sustained Attention in Children with Speech Sound Disorder

Although research has demonstrated that children with specific language impairment (SLI) and reading disorder (RD) exhibit sustained attention deficits, no study has investigated sustained attention in children with speech sound disorder (SSD). Given the overlap of symptoms, such as phonological memory deficits, between these different language disorders (i.e., SLI, SSD and RD) and the relationships between working memory, attention and language processing, it is worthwhile to investigate whether deficits in sustained attention also occur in children with SSD. A total of 55 children (18 diagnosed with SSD (8.11±1.231) and 37 typically developing children (8.76±1.461)) were invited to participate in this study. Auditory and visual sustained-attention tasks were applied. Children with SSD performed worse on these tasks; they committed a greater number of auditory false alarms and exhibited a significant decline in performance over the course of the auditory detection task. The extent to which performance is related to auditory perceptual difficulties and probable working memory deficits is discussed. Further studies are needed to better understand the specific nature of these deficits and their clinical implications.

Impact of Educational Level on Performance on Auditory Processing Tests

Research has demonstrated that a higher level of education is associated with better performance on cognitive tests among middle-aged and elderly people. However, the effects of education on auditory processing skills have not yet been evaluated. Previous demonstrations of sensory-cognitive interactions in the aging process indicate the potential importance of this topic. Therefore, the primary purpose of this study was to investigate the performance of middle-aged and elderly people with different levels of formal education on auditory processing tests. A total of 177 adults with no evidence of cognitive, psychological or neurological conditions took part in the research. The participants completed a series of auditory assessments, including dichotic digit, frequency pattern and speech-in-noise tests. A working memory test was also performed to investigate the extent to which auditory processing and cognitive performance were associated. The results demonstrated positive but weak correlations between years of schooling and performance on all of the tests applied. The factor “years of schooling” was also one of the best predictors of frequency pattern and speech-in-noise test performance. Additionally, performance on the working memory, frequency pattern and dichotic digit tests was also correlated, suggesting that the influence of educational level on auditory processing performance might be associated with the cognitive demand of the auditory processing tests rather than auditory sensory aspects itself. Longitudinal research is required to investigate the causal relationship between educational level and auditory processing skills.

Children with speech sound disorder: comparing a non-linguistic auditory approach with a phonological intervention approach to improve phonological skills

This study aimed to compare the effects of a non-linguistic auditory intervention approach with a phonological intervention approach on the phonological skills of children with speech sound disorder (SSD). A total of 17 children, aged 7–12 years, with SSD were randomly allocated to either the non-linguistic auditory temporal intervention group (n = 10, average age 7.7 ± 1.2) or phonological intervention group (n = 7, average age 8.6 ± 1.2). The intervention outcomes included auditory-sensory measures (auditory temporal processing skills) and cognitive measures (attention, short-term memory, speech production, and phonological awareness skills). The auditory approach focused on non-linguistic auditory training (e.g., backward masking and frequency discrimination), whereas the phonological approach focused on speech sound training (e.g., phonological organization and awareness). Both interventions consisted of 12 45-min sessions delivered twice per week, for a total of 9 h. Intra-group analysis demonstrated that the auditory intervention group showed significant gains in both auditory and cognitive measures, whereas no significant gain was observed in the phonological intervention group. No significant improvement on phonological skills was observed in any of the groups. Inter-group analysis demonstrated significant differences between the improvement following training for both groups, with a more pronounced gain for the non-linguistic auditory temporal intervention in one of the visual attention measures and both auditory measures. Therefore, both analyses suggest that although the non-linguistic auditory intervention approach appeared to be the most effective intervention approach, it was not sufficient to promote the enhancement of phonological skills.

O Potencial Evocado Auditivo com estímulo de fala pode ser uma ferramenta útil na prática clínica

Purpose : To discuss the clinical applicability of the speech-evoked Auditory Brainstem Response (speech-evoked ABR) to help identifying auditory processing disorders. Methods : We analyzed the records of 27 children and adolescents, aged between seven and 15, who presented abnormal speech-evoked ABR. Then, the data from the behavioral auditory processing evaluation of these individuals were surveyed. Results : It was observed that, among the 27 children with abnormal speech-evoked ABR, 23 also had auditory processing disorders. Therefore, from this sample, an 85.15% probability of observing abnormal behavioral assessment of auditory processing in a child who presented abnormal speech-evoked ABR was obtained. Conclusion : It is argued that the speech-evoked ABR can be used in clinical practice as an important aid tool in the diagnosis of auditory processing disorder, because, in this study, an abnormal speech-evoked ABR usually represented a deficit in the results of behavioral assessment of auditory processing. Thus, it can be used to obtain information about the perception of speech sounds in children under seven years or with challenging behavioral assessment.PURPOSE To discuss the clinical applicability of the speech-evoked Auditory Brainstem Response (speech-evoked ABR) to help identifying auditory processing disorders. METHODS We analyzed the records of 27 children and adolescents, aged between seven and 15, who presented abnormal speech-evoked ABR. Then, the data from the behavioral auditory processing evaluation of these individuals were surveyed. RESULTS It was observed that, among the 27 children with abnormal speech-evoked ABR, 23 also had auditory processing disorders. Therefore, from this sample, an 85.15% probability of observing abnormal behavioral assessment of auditory processing in a child who presented abnormal speech-evoked ABR was obtained. CONCLUSION It is argued that the speech-evoked ABR can be used in clinical practice as an important aid tool in the diagnosis of auditory processing disorder, because, in this study, an abnormal speech-evoked ABR usually represented a deficit in the results of behavioral assessment of auditory processing. Thus, it can be used to obtain information about the perception of speech sounds in children under seven years or with challenging behavioral assessment.