Assessment and Scoring - Part 2 Flashcards
What is the gaps in noise (GIN) test?
Developed by Musiek in 2005
Test of temporal processing
Measures temporal resolution
Monaural presentation (each ear tested individually)
7 years old to adults
Four test lists and one practice list (not linguistically loaded)
Four test lists contain between 29 and 36 trials
Each segment is a 6 s burst of white noise with 0 to 3 silent periods (a few trials contain no gaps)
2, 3, 4, 5, 6, 8, 10, 12, 15, or 20 ms gaps with 6 repetitions of each gap duration
Total number of gaps/test = 60
20 minutes to administer
Sensitivity for CANS lesions = 67%
Specificity for CANS lesions = 94%
How do you set-up for the GIN test?
Two-channels required
Left (test) channel (Ext A) = SIN stimuli (noise and gaps)
Right channel (Ext B) = gap indication signal (route to bone, “beep” presented to the right channel to alert examiner each time a gap occurs in the left channel)
Test administered at 35 to 50 dB SL re: SRT for each ear
Administer practice first
If > two false responses occur within first 5 segments, stop the test and reinstruct
What are the instructions for the GIN test?
In this test you are going to hear noise and within the noise there will be gaps of silence that will vary in length. Some may be very short and occasionally there will be no gaps. As soon as you hear the gap, press the response button. The noise levels may vary
What does early mean in the GIN test?
Gaps occurring early in the early third of the steady noise
What does middle mean in the GIN test?
Gaps occurring in the middle third of the steady noise
What does late mean in the GIN test?
Gaps occurring in the late third of the steady noise
What do the numbers in each trial mean in the GIN test?
Represents the length of the gap in msec
How do you score the GIN test?
O = correct; X = false positive; NR = No response
False positive = Listener responds when no gap is present
Allow two false positives (do not include in the scoring)
Additional false positives are tallied as errors when scoring
The authors of the test suggests that everyone develop their own normative data
What are the two ways in which the GIN test score is computed?
Total GIN score %:
Total correct number minus false positives ÷ (60 X 100) (one ear)
Total correct number minus false positives ÷ (120 X 100) (two ears)
> 52% is normal (8 to 11yrs)
> 54% is normal (12 to adults)
No norms for 7 years
Gap threshold:
Shortest gap duration that is perceived (at least 4 of the 6 gaps are correctly identified; performance for longer gap durations are not worse)
Approximate gap threshold (Ath)
Normal = < 4 to 6 ms
Concern = > 8 ms
A more sensitive measure than percent correct
What is the pitch pattern sequency test (PPST)?
Developed by Musiek and Pinheiro
7 years old to adults (use Bellis norms because they are age specific)
Linguistic loading
Assesses cerebral hemispheric disorders, corpus callosum dysfunction, and neuromaturation issues
Results can be hummed (for up to 12 year olds) to reduce linguistic loading in listeners with disruption in interhemispheric transfer of information
Sensitivity is moderate to high for verbal tasks (83%)
Monaurally presented
10 minutes to administer
Are abnormal results demonstrated in the PPST for children with learning and language disabilities?
Yes
But with normal intelligence because of neuromaturation
What is the PPST comprised of?
Three tone sequences of low and high frequency tones
The low frequency tone is 880 Hz and the high frequency tone is 1122 Hz (1430 Hz for younger children 6-9yrs to make it easier)
One tone is always different from the other two (6 possible patterns of tones)
120 patterns presented during the test; 60 for each ear
Generally acceptable to use half-lists (30 patterns per ear)
Listener can either whistle or hum the patterns or say the patterns out loud (high-low-high)
Humming is permitted till 12 years
Is there a practice test for the PPST?
No
What is the presentation for the PPST?
Presentation level: 50 dB SL re: 1000 Hz tonal threshold
Start with linguistic labeling
If a child cannot perform or cannot perform reliably, run another trial and ask the child to hum
Compare performance between responses
If humming improves scores it may indicate language learning problems or disruptions of interhemispheric transfer of auditory information
Will children with musical training do well on the PPST?
Yes
Children that are musically trained will ace this test even if they have auditory processing issues
What are PPST pattern reversals?
Certain pattern reversals are allows de to short-term memory storage problems
H-L-H reversed to L-H-L
H-H-L reversed to L-L-H
H-L-L reversed to L-H-H
L-H-L reversed to H-L-H
L-L-H reversed to H-H-L
L-H-H reversed to H-L-L
We will not count the reversals as correct, it needs to be exactly the same
Other places may count the reversals as correct
How do you score the PPST?
Final total score = % correct response + % correct reversals
Mean for % correct: 91% (9 to 10 yrs) and 90% (adults)
Mean for final total scores (with reversals): 96% (9 to 10 yrs) and 96% (adults)
Ranges: 88 to 100% (9 to 10 yrs) and 85 to 100% (adults)
* we will not use these norms in class because they have reversals
What norms should we use if we are not using reversals?
The Bellis norms
What is the duration pattern sequence test (DPT)?
Developed by Musiek, Baran, and Pinheiro
Test of duration discrimination, temporal ordering, and linguistic labeling
Sensitive to cortical lesions and disruption of interhemispheric transfer of auditory information
> 9 or 10 yrs to adults
Difficult to test for younger children
Duration pattern and pitch pattern should both be assessed (assessing two different temporal processes)
Don’t have clear information on what it means when someone fails this test
How is the DPT conducted?
Presentation at 50 dB SL re: 1000 Hz tone threshold
The level can be increased if a hearing loss is present
Monaural test
What are the test items for the DPT?
Three consecutive 1000 Hz tones one of which is either of a longer or shorter duration than the other two
Tonal duration either 500 or 250 ms
Six different combinations of long and short tones (LLS, LSL, SLL, SSL, SLS, LSS)
Each pattern is presented 10 times in random order
10 practice and 60 test items, 30 items per ear
Say: long-short-short (LSS)
What are the norms for the DPT?
Right ear -
Mean: 96%
SD: 4.36
Range: 87 to 100%
Left ear -
Mean: 96%
SD: 7.2
Range: 70 to 100%
*Lower level is a pass for the left ear because there is an inherently built in REA (at least until 12)
*Bellis has different age-specific norms
What are time compressed speech tests?
Low redundancy speech test
Utilizes time-compressed speech from various word lists to assess cortical auditory processing abilities
Elderly have significant difficulty with these tests (independent of peripheral HL)
By stressing the aging auditory system, these tests provide a good tool to assess speech processing deficits at the cortical level
Most of these tests are not standardized (affected by test stimuli and phonemic and acoustic distortions from the compression)
Any test designed to assess cortical function can be affected by dysfucntion of lower brain centers (as well as periphery)
What is NU-6 with 45% compression?
Monaural low redundancy test
Temporal characteristics of the signal are altered electronically without affecting frequency characteristics
Should be administered only when hearing is normal
Sensitive to diffuse pathology in the primary auditory cortex
7 yrs to adult
Administered with and without reverberation
Presented at a comfortable level (50 dB HL)
Listener repeats back the words
Calculate percent correct per ear
What is the time compressed sentence test?
Developed by Keith
Monaural low redundancy speech test
Performed monaurally for each ear separately
Time compression at 40% and 60%
Ten practice sentences are recorded with zero time compression
During presentation, do not pause the CD to allow more response time
You can pause between lists
How is the time compressed sentence test scored?
Each sentence is divided into three parts giving the possibility of three errors per sentence (max 3 errors)
Draw a line through errors
Errors in articles of speech such as “the” and “a” are not considered an error
% Correct = 100 – (# of errors x 3.3)
Add the total number of errors
Multiply that number by 3.3
Subtract total from 100 for percent correct
% Correct = 100 - (3 x 3.3) = 100 - 9.9 = 91.1%
Compare to norms
What is the low pass filtered NU-6 at 750 Hz test?
Monaural low redundancy speech test
Perform for each ear at 50 dB HL (Bellis, 2003)
Norms are reported for 1000 Hz cut-off male speaker lists and may not be equivalent for 750 Hz cut-off
*Problem with norms
What is the synthetic sentence identification-ipsilateral competing message test (SSI-ICM)?
Low redundancy monaural speech test (putting noise in environment - taking away extra redundant speech cues)
8 yrs to adult
Linguistic loading
Assesses auditory recognition, memory, and figure-ground
Assesses lower brainstem lesions
Sensitivity is moderate to high
Synthetic sentences presented to the target ear
Competing message (Davy Crockett story) presented to same ear at different message-to-competition ratios (MCRs)
How is the SSI-ICM scored?
The test is scored as a percentage score for each ear
Administered only if normal hearing at .5, 1, and 2 kHz
What is the synthetic sentence identification-contralateral competing message (SSI-CCM)?
Low-redundancy binaural speech test
Dichotic presentation assesses binaural separation
8 yrs to adult
Linguistically loaded
Moderate to high sensitivity
Assessing a central lesion
Sensitive to temporal lobe deficits
How is SSI-CCM scored?
Each ear is tested individually
The test is scored as a percentage for each ear
Administered only if normal hearing at .5, 1, and 2 kHz
For the SSI-ICM/CCM, are the initial sentences presented where 100% performance is expected?
Yes
At about 30 dB SL re: SRT; +10 MCR (signal is better)
What is the presentation for the testing of SSI-ICM/CCM?
We will present at 30 dB SL re: SRT
For the SSI-CCM the MCR is varied at 0 and -40 MCR (easier bc of spatial separation)
For SSI-ICM, the MCR is varied in 10 dB steps from 0, to +10, to -20 because it is a more difficult listening situation
Does the SSI depend on visual cues?
Yes
Which may be a limitation for adults with visual problems or for children with reading or developmental delays
Does the SSI show a maturation effect?
Yes
Test scores improve in successive age groups from 8 years to 25 years deteriorating sharply from 60 to 90 years
Can comparing PB-max and SSI-ICM?
Yes
Can provide a peripheral-central ratio that may be useful in judging prognosis of hearing aids or other rehabilitative measures
Which one is better determines what area has the deficit
