1 / 47

Unlocking the Potential: Assessing Children's Auditory Processing Skills

This resource explores central auditory processing skills, disorders, and assessment methodologies to aid in understanding and addressing auditory issues in children. It delves into the continuum of auditory processing, differentiating disorders, and providing insights on differential diagnosis and intervention planning. The text emphasizes the importance of identifying and treating auditory processing disorders in a comprehensive manner, involving professionals like audiologists and speech-language pathologists, to enhance children's communication and learning abilities.

bradleyh
Download Presentation

Unlocking the Potential: Assessing Children's Auditory Processing Skills

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Yes, you CANS! Assessing children’s central auditory processing skills Jeanane M. Ferre, PhD, CCC-A Oak Park, IL 60301 708.848.4363 Fax: 708.848.7233 jmfphd@comcast.net www.dr-ferre.com

  2. disclosures • Financial • Invited speaker – honorarium • Pro-Ed author • Consultant – school districts in IL, GA, WI, HI • Adjunct Faculty- Northwestern University Rush University • Nonfinancial • ASHA member • ISHA member

  3. The “wh” questions about CAPDs • What is central auditory processing ? • Better Q- what ARE the central auditory processes? • What is a central auditory processing disorder? • Why should be assess these skills and/or treat these issues? • Who should be tested, and when?

  4. Auditory processing is “what we do with what we hear” • Accurate definition? Yes • Diagnostically useful? Not so much • Why? Here’s the system with which we are dealing.

  5. OUTPUT SYNTHESIS DISCRIMINATION

  6. Continuum of Processing

  7. Central auditory processing • neural processing of auditory stimuli • Auditory discrimination • Binaural processing • Temporal processing • A Central Auditory Processing Disorder (CAPD) is any deficiency in skills subserved by CENTRAL auditory mechanism in brainstem/brain

  8. Outer, Middle, Inner, 8th nerve Peripheral Auditory System

  9. Cortical system Right hemisphere Parietal lobe Frontal lobe Temporal lobe Occipital lobe Left hemisphere

  10. Subcortical/cortical auditory functions • Auditory discrimination – ability to analyze fine acoustic differences in signal spectra • Occurs through the thalamic level AND primary auditory cortex (Heschl’s gyrus) • Perception of ACOUSTIC signal

  11. Binaural processing - interaction between the two sides • Binaural fusion – interaction between ears • Reflects brainstem integrity • Assists listening in noise, localization, perception • Also referred to by some as binaural synthesis • Dichotic listening – interaction between hemispheres • Integration – process multiple targets • Separation – process one and ignore another • Reflects cortical integrity

  12. Temporal processing – ability to use timing aspects of signal • Temporal resolution- a left hemisphere skill involving ability to perceive perceptual boundaries (“1” versus “2” targets) • Temporal patterning – a right hemisphere skill involving ability to perceive order/sequence • BOTH skills important for perception of running speech

  13. Beyond CENTRAL auditory processing • Phonologic-phonemic processing • Relates to literacy/pre-literacy skills • Includes speech-to-print, spelling, writing • Linguistic Processing • Ability to interpret/attach meaning to signal • Foundation for metalinguistics/conceptual language • Executive Functions • Under control of frontal/pre-motor cortex • Planning, execution, regulation of a response

  14. Another way to “look” at process

  15. So, why test for CAPDs? • Auditory discrimination – analysis of fine differences in acoustic spectra • Binaural processing – recognition and manipulation of multiple acoustic targets • Temporal processing - using timing aspects of signals • Underlie ability to recognize/use speech • Necessary for active listening/ learning/ communication • Educationally relevant to ALL Common Core standards, including standard for Speaking and Listening

  16. Processing disorders can co-exist with other disorders

  17. Attention Deficit Disorder • distractible, inattentive, disorganization • Executive Function Difficulties • poor working memory, strategy development • Behavior Disorders • opposition, perseveration, noncompliance • Asperger’s Syndrome • poor social language, impaired affect • Nonverbal Learning Disability • impaired prosody, use of nonverbal cues • Speech-Language Impairment • poor phonological awareness, pragmatic language

  18. Differential diagnosis • Differentiates among disorders having similar symptoms/ manifestations • SLPs, psychologists, neuropsychologists & others provide insights re: listener’s auditory performance in various contexts • Audiologists use well-controlled, norm-referenced tests that minimize influence of language, cognition & other sensory skills & maximize auditory system function • Tests designed to tax CAP skills • Patterns diagnose specific CAPD • Test results help customize deficit-specific differential intervention

  19. Differential Intervention • Balance of treatment and management based upon neuroscientific principles & derived from assessment results • Customizes treatment and management plans to treat impaired skills & to minimize impact on listener’s life treatment management Neuroscience foundations

  20. Assessing processing skills

  21. Continuum of Processing Aud & SLP Speech-language pathologist Audiologist

  22. Diagnostic CAPD Testing Battery • What? • Battery of tests to determine how efficiently CANS operates • How? • Overloading or overworking it • Who? • Children as young as 6 years • Results compared to age-matched peers Performance profiles yield insights into nature of CAPD

  23. CAPD Test Battery • Minimize influence of language, cognition & other sensory skills on performance • Maximize function of CANS • Results examined re: • central auditory processes being taxed • anatomical sites subserving those skills

  24. Considerations for testing • Hearing sensitivity • Sufficient expressive speech skills • Sufficient receptive language skills • Intelligence test results

  25. Differential Screening Test of Processing Screen continuum 8 subtests delivered via CD 3 auditory processing 2 phonemic/phonic 3 language Identifies where to refer and/or spend more time in assessment Available from LinguiSystems

  26. Informal assessment of CAP skills • Spelling • Memory for words vs. sentences • Music • Alphabet • Wepman, ITPA • Multisyllabic words • Checklists and record review

  27. Assessing skills beyond the CAPs • Phonologic Processing • Sound blending, auditory closure, spelling • Language Processing • Receptive/expressive vocabulary • Hierarchy of language processing • Multisensory and memory skills • Executive Functions • Flexibility, impulsivity, self-monitoring • Planning, problem-solving, attention/vigilance • Fluid thinking and divergent reasoning

  28. Interpreting CAP test results • Absolute analysis • Norm-referenced • Compare to age-matched peers • Per test pass-fail criterion: >2SDs below mean for age • No “below average” CAP skills – skill set is normal or disordered • Relative analysis • Examination of patterns across tests • Ear differences • “Ties that bind” We DON’T “diagnose” per test – we look at battery!

  29. Interpreting CAP test results • NOT CAPD • Performance below normal on single test • Performance below normal on all tests • Definition of a CAPD • Poor scores on sets of tests tapping similar function • Bellis/Ferre model describes 5 test profiles

  30. Auditory decoding deficit • Poor discrimination of fine acoustic differences in signal • Probable site: primary auditory cortex • Signal distortion – poor neural representation • Exhibit impaired discrimination, closure, & temporal resolution • Poor scores on low redundancy tests, gap detection, and (possibly) binaural integration • Behaviorally: they can’t “hear”

  31. Decoding deficit - manifestations • Needs repetition – lots of “what?” • Mishears information • Fatigues easily • Difficulty in noise esp. as noise gets louder • Slow/inaccurate • Reading decoding/comprehension • Spelling • Receptive language issues including vocabulary, syntax, semantics, second language acquisition

  32. Integration Deficit • Deficit in performing tasks requiring interhemispheric communication • Probable site: corpus callosum • Insufficient development of corpus callosum • Poor integration skills • Excessive LE suppression on dichotic tasks AND poor labelling with good mimicking of patterns • “it’s too much” – not synthesizing inputs

  33. Integration deficit manifestations • Trouble multitasking • Poor transitions • Needs more time • Slow but accurate • Variable difficulty in noise • “how to & how much” • Reading decoding and/or comprehension • Spelling, Written language • Other sensory skills • Syntactic and related language arts skills

  34. Prosodic deficit • Deficiency in use of prosodic features of target • Probable site: right hemisphere • Inefficient RH pattern recognition • Trouble with acoustic contours • Exhibits poor temporal patterning • Poor scores both labelled AND mimicked on patterning tasks AND excessive LE suppression on dichotic tasks • Behaviorally: it’s all “blah, blah, blah”

  35. Prosodic deficit manifestations • Poor direction following • Loses focus after first few sentences • May have flat affect • Poor figure-ground skills • Misunderstands intent of message • Social & pragmatic lang. • Phonological processing • Music perception/ appreciation • Nonverbal communication • Academic impact can be variable

  36. Secondary CAP test profiles • The “auditory” manifestations of more supramodal or neurocognitive disorder and NOT true CAPD • Associative deficit • Output-Organization deficit

  37. Associative deficit profile • NOT applying rules of language to acoustic signal • Likely due to poor communication between primary and secondary (association) cortices (intra-hemispheric integration) • Poor scores for both ears on dichotic tests, good labelling/mimicking, adequate discrimination • Poor “translators”, “I don’t get it”

  38. Associative deficit manifestations • Misunderstands meaning • Linguistically inappropriate responses • Poor peer relations • May appear noncompliant • Noise not a major issue • May “daydream” while working • Receptive, expressive, social, pragmatic, functional comm. • Memory issues, math • Reading/language arts • “Auditory” manifestations of LPD

  39. Output-organization deficit • Deficient ability to organize, sequence, plan appropriate response • May be due to deficient efferent, motor planning, or executive function • Exhibit difficulty with expression/execution • Poor scores multiple target tasks, in noise, sequencing errors • Can’t get it back out

  40. Output-organization manifestations • In the classroom • May be disorganized • May be impulsive • May be poor planner • Poor task completion • Poor direction following • At risk for deficits in • Speech production • Sequential memory • Recall, word finding • Executive function skills

  41. Test results help professionals develop deficit-specific intervention strategiesEffective intervention includes management remediation Neuroscientific principles & test results

  42. Assessment Summary Auditory processing Language Processing Is “on top of” basic language Develops in hierarchy from concrete to abstract Develops and refines throughout lifespan • Occurs before you “know” the target • Can adversely affect language • Is “adult-like” by early teens Any processing impairment can adversely affect learning & social-emotional health Differential diagnosis MUST be used to find the level of breakdown

More Related